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Senate File 104 - IntroducedA Bill ForAn Act 1relating to the compassionate use of medical
2cannabis Act, reclassifying marijuana, including
3tetrahydrocannabinols, from a schedule I controlled
4substance to a schedule II controlled substance, providing
5for civil and criminal penalties and fees, and including
6effective date provisions.
7BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 124.204, subsection 4, paragraphs m and
2u, Code 2019, are amended by striking the paragraphs.
3 Sec. 2. Section 124.204, subsection 7, Code 2019, is amended
4by striking the subsection.
5 Sec. 3. Section 124.206, subsection 7, Code 2019, is amended
6to read as follows:
77. Hallucinogenic substances. Unless specifically excepted
8or unless listed in another schedule, any material, compound,
9mixture, or preparation which contains any quantity of the
10following substances, or, for purposes of paragraphs “a” and
11“b”, which contains any of its salts, isomers, or salts of
12isomers whenever the existence of such salts, isomers, or salts
13of isomers is possible within the specific chemical designation
14(for purposes of this paragraph only, the term “isomer”
15includes the optical, positional, and geometric isomers):
16a. Marijuana when used for medicinal purposes pursuant to
17rules of the board.
18b. Tetrahydrocannabinols, meaning tetrahydrocannabinols
19naturally contained in a plant of the genus cannabis (cannabis
20plant) as well as synthetic equivalents of the substances
21contained in the cannabis plant, or in the resinous extractives
22of such plant, and synthetic substances, derivatives, and their
23isomers with similar chemical structure and pharmacological
24activity to those substances contained in the plant, such as
25the following:
26(1) 1 cis or trans tetrahydrocannabinol, and their optical
27isomers.
28(2) 6 cis or trans tetrahydrocannabinol, and their optical
29isomers.
30(3) 3,4 cis or trans tetrahydrocannabinol, and their
31optical isomers. (Since nomenclature of these substances
32is not internationally standardized, compounds of these
33structures, regardless of numerical designation of atomic
34positions covered.)
35b. c. Nabilone [another name for nabilone: (+-) -
-1-1trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1-
2hydroxy-6,6-dimethyl-9H-dibenzo[b,d]pyran-9-one].
3c. d. Dronabinol [(-)-delta-9-trans-tetrahydrocannabinol]
4in an oral solution in a drug product approved for marketing by
5the United States food and drug administration.
6 Sec. 4. Section 124.401, subsection 5, unnumbered paragraph
73, Code 2019, is amended to read as follows:
8A person may knowingly or intentionally recommend, possess,
9use, dispense, deliver, transport, or administer cannabidiol
10 medical cannabis if the recommendation, possession, use,
11dispensing, delivery, transporting, or administering is in
12accordance with the provisions of chapter 124E 124F. For
13purposes 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.
16This 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.
19As used in this chapter:
201. “Debilitating medical condition” means any of the
21following:
22a. Cancer, if the underlying condition or treatment produces
23one or more of the following:
24(1) Intractable pain.
25(2) Nausea or severe vomiting.
26(3) Cachexia or severe wasting.
27b. Multiple sclerosis.
28c. Epilepsy or seizure disorders.
29d. AIDS or HIV as defined in section 141A.1.
30e. Glaucoma.
31f. Hepatitis C.
32g. Crohn’s disease or ulcerative colitis.
33h. Amyotrophic lateral sclerosis.
34i. Ehlers-Danlos syndrome.
35j. Post-traumatic stress disorder.
-2- 1k. Tourette’s syndrome.
2l. Any terminal illness, with a probable life expectancy of
3under one year, if the illness or its treatment produces one or
4more of the following:
5(1) Intractable pain.
6(2) Nausea or severe vomiting.
7(3) Cachexia or severe wasting.
8m. Intractable pain.
9n. Parkinson’s disease.
10o. Muscular dystrophy.
11p. Huntington’s disease.
12q. Alzheimer’s disease.
13r. Complex regional pain syndrome, type I and II.
14s. Rheumatoid arthritis.
15t. Polyarteritis nodosa.
16u. Any other chronic or debilitating disease or medical
17condition or its medical treatment approved by the department
18pursuant to rule.
192. “Department” means the department of public health.
203. “Disqualifying felony offense” means a violation under
21federal or state law of a felony offense, which has as an
22element the possession, use, or distribution of a controlled
23substance, as defined in 21 U.S.C. §802(6).
244. “Enclosed, locked facility” means a closet, room,
25greenhouse, or other enclosed area equipped with locks or
26other security devices that permit access only by authorized
27personnel.
285. “Health care practitioner” means an individual licensed
29under chapter 148 to practice medicine and surgery or
30osteopathic medicine and surgery or an individual licensed to
31practice medicine in any other state who provides specialty
32care for an Iowa resident for one or more of the debilitating
33medical conditions provided in this chapter.
346. “Intractable pain” means a pain in which the cause of the
35pain cannot be removed or otherwise treated with the consent
-3-1of the patient and which, in the generally accepted course of
2medical practice, no relief or cure of the cause of the pain
3is possible, or none has been found after reasonable efforts.
4Reasonable efforts for relieving or curing the cause of the
5pain may be determined on the basis of but are not limited to
6any of the following:
7a. When treating a nonterminally ill patient for intractable
8pain, evaluation by the attending physician and one or more
9physicians specializing in pain medicine or the treatment of
10the area, system, or organ of the body perceived as the source
11of the pain.
12b. When treating a terminally ill patient, evaluation by
13the attending physician who does so in accordance with the
14level of care, skill, and treatment that would be recognized
15by a reasonably prudent physician under similar conditions and
16circumstances.
177. “Medical cannabis” means any species of the genus
18cannabis plant, or any mixture or preparation of them,
19including whole plant extracts and resins.
208. “Medical cannabis dispensary” means an entity licensed
21under section 124F.8 that acquires medical cannabis from a
22medical cannabis manufacturer in this state for the purpose
23of dispensing medical cannabis in this state pursuant to this
24chapter.
259. “Medical cannabis manufacturer” means an entity licensed
26under section 124F.6 to manufacture and to possess, cultivate,
27transport, or supply medical cannabis pursuant to the
28provisions of this chapter.
2910. “Primary caregiver” means a person, at least eighteen
30years of age, who has been designated by a patient’s health
31care practitioner or a person having custody of a patient, as
32a necessary caretaker taking responsibility for managing the
33well-being of the patient with respect to the use of medical
34cannabis pursuant to the provisions of this chapter.
3511. “Written certification” means a document signed by a
-4-1health care practitioner, with whom the patient has established
2a patient-provider relationship, which states that the patient
3has a debilitating medical condition and identifies that
4condition and provides any other relevant information.
5 Sec. 7. NEW SECTION. 124F.3 Health care practitioner
6certification — duties.
71. Prior to a patient’s submission of an application for a
8medical cannabis registration card pursuant to section 124F.4,
9a health care practitioner shall do all of the following:
10a. Determine, in the health care practitioner’s medical
11judgment, whether the patient whom the health care practitioner
12has examined and treated suffers from a debilitating medical
13condition that qualifies for the use of medical cannabis under
14this chapter, and if so determined, provide the patient with a
15written certification of that diagnosis.
16b. Provide explanatory information as provided by the
17department to the patient about the therapeutic use of medical
18cannabis.
19c. Determine, on an annual basis, if the patient continues
20to suffer from a debilitating medical condition and, if so,
21issue the patient a new certification of that diagnosis. This
22paragraph shall not apply if the patient is suffering from an
23incurable debilitating medical condition.
24d. Otherwise comply with all requirements established by the
25department pursuant to rule.
262. A health care practitioner may provide, but has no duty
27to provide, a written certification pursuant to this section.
28 Sec. 8. NEW SECTION. 124F.4 Medical cannabis registration
29card.
301. Issuance to patient. The department may approve the
31issuance of a medical cannabis registration card by the
32department of transportation to a patient who:
33a. Is at least eighteen years of age.
34b. Is a permanent resident of this state.
35c. Submits a written certification to the department signed
-5-1by the patient’s health care practitioner that the patient is
2suffering from a debilitating medical condition.
3d. Submits an application to the department, on a form
4created by the department, in consultation with the department
5of transportation, that contains all of the following:
6(1) The patient’s full name, Iowa residence address, date
7of birth, and telephone number.
8(2) A copy of the patient’s valid photograph
9identification.
10(3) Full name, address, and telephone number of the
11patient’s health care practitioner.
12(4) Full name, residence address, date of birth, and
13telephone number of each primary caregiver of the patient, if
14any.
15(5) Any other information required by rule.
16e. Submits a medical cannabis registration card fee of one
17hundred dollars to the department. If the patient attests to
18receiving social security disability benefits, supplemental
19security insurance payments, or being enrolled in the medical
20assistance program, the fee shall be twenty-five dollars.
212. Patient card contents. A medical cannabis registration
22card issued to a patient by the department of transportation
23pursuant to subsection 1 shall contain, at a minimum, all of
24the following:
25a. The patient’s full name, Iowa residence address, and date
26of birth.
27b. The patient’s photograph.
28c. The date of issuance and expiration of the registration
29card.
30d. Any other information required by rule.
313. Issuance to primary caregiver. For a patient in a
32primary caregiver’s care, the department may approve the
33issuance of a medical cannabis registration card by the
34department of transportation to the primary caregiver who:
35a. Submits a written certification to the department signed
-6-1by the patient’s health care practitioner that the patient in
2the primary caregiver’s care is suffering from a debilitating
3medical condition.
4b. Submits an application to the department, on a form
5created by the department, in consultation with the department
6of transportation, that contains all of the following:
7(1) The primary caregiver’s full name, residence address,
8date of birth, and telephone number.
9(2) The patient’s full name.
10(3) A copy of the primary caregiver’s valid photograph
11identification.
12(4) Full name, address, and telephone number of the
13patient’s health care practitioner.
14(5) Any other information required by rule.
15c. Submits a medical cannabis registration card fee of
16twenty-five dollars to the department.
174. Primary caregiver card contents. A medical cannabis
18registration card issued by the department of transportation to
19a primary caregiver pursuant to subsection 3 shall contain, at
20a minimum, all of the following:
21a. The primary caregiver’s full name, residence address, and
22date of birth.
23b. The primary caregiver’s photograph.
24c. The date of issuance and expiration of the registration
25card.
26d. The registration card number of each patient in the
27primary caregiver’s care. If the patient in the primary
28caregiver’s care is under the age of eighteen, the full name of
29the patient’s parent or legal guardian.
30e. Any other information required by rule.
315. Expiration date of card. A medical cannabis registration
32card issued pursuant to this section shall expire one year
33after the date of issuance and may be renewed.
346. Card issuance — department of transportation.
35a. The department may enter into a chapter 28E agreement
-7-1with the department of transportation to facilitate the
2issuance of medical cannabis registration cards pursuant to
3subsections 1 and 3.
4b. The department of transportation may issue renewal
5medical cannabis registration cards through an online or
6in-person process.
7 Sec. 9. NEW SECTION. 124F.5 Medical advisory board —
8duties.
91. No later than August 15, 2019, the director of public
10health shall establish a medical advisory board consisting of
11nine practitioners representing the fields of neurology, pain
12management, gastroenterology, oncology, psychiatry, pediatrics,
13infectious disease, family medicine, and pharmacy, and three
14patients or primary caregivers with valid medical cannabis
15registration cards. The practitioners shall be nationally
16board-certified in their area of specialty and knowledgeable
17about the use of medical cannabis.
182. A quorum of the advisory board shall consist of seven
19members.
203. The duties of the advisory board shall include but not be
21limited to the following:
22a. Reviewing and recommending to the department for
23approval additional chronic or debilitating diseases or
24medical conditions or their treatments as debilitating medical
25conditions that qualify for the use of medical cannabis under
26this chapter.
27b. Accepting and reviewing petitions to add chronic or
28debilitating diseases or medical conditions or their medical
29treatments to the list of debilitating medical conditions that
30qualify for the use of medical cannabis under this chapter.
31c. Working with the department regarding the requirements
32for the licensure of medical cannabis manufacturers and medical
33cannabis dispensaries, including licensure procedures.
34d. Advising the department regarding the location of
35medical cannabis dispensaries throughout the state, the form
-8-1and quantity of allowable medical cannabis to be dispensed
2to a patient or primary caregiver, and the general oversight
3of medical cannabis manufacturers and medical cannabis
4dispensaries in this state.
5e. Convening at least twice per year to conduct public
6hearings and to review and recommend for approval petitions,
7which shall be maintained as confidential personal health
8information, to add chronic or debilitating diseases or
9medical conditions or their medical treatments to the list of
10debilitating medical conditions that qualify for the use of
11medical cannabis under this chapter.
12f. Recommending improvements relating to the effectiveness
13of the provisions of this chapter.
14g. In making recommendations pursuant to this section,
15consideration of the economic and financial impacts on patients
16and the medical cannabis industry, and making recommendations
17that minimize the extent of such impacts to the greatest extent
18practicable.
19 Sec. 10. NEW SECTION. 124F.6 Medical cannabis manufacturer
20licensure.
211. a. The department shall license up to four medical
22cannabis manufacturers to manufacture medical cannabis within
23this state consistent with the provisions of this chapter by
24December 1, 2019. The department shall license new medical
25cannabis manufacturers or relicense the existing medical
26cannabis manufacturers by December 1 of each year.
27b. Information submitted during the application process
28shall be confidential until the medical cannabis manufacturer
29is licensed by the department unless otherwise protected from
30disclosure under state or federal law.
312. As a condition for licensure, a medical cannabis
32manufacturer must agree to begin supplying medical cannabis to
33medical cannabis dispensaries in this state by July 2, 2020.
343. The department shall consider the following factors in
35determining whether to license a medical cannabis manufacturer:
-9- 1a. The technical expertise of the medical cannabis
2manufacturer regarding medical cannabis.
3b. The qualifications of the medical cannabis manufacturer’s
4ownership and management team.
5c. The long-term financial stability of the medical cannabis
6manufacturer.
7d. The ability to provide appropriate security measures on
8the premises of the medical cannabis manufacturer.
9e. Whether the medical cannabis manufacturer has
10demonstrated an ability to meet certain medical cannabis
11production needs for medical use regarding the range of
12recommended dosages for each debilitating medical condition,
13the range of chemical compositions of any plant of the genus
14cannabis that will likely be medically beneficial for each
15of the debilitating medical conditions, and the form of the
16medical cannabis in the manner determined by the department
17pursuant to rule.
18f. The medical cannabis manufacturer’s projection of and
19ongoing assessment of fees on patients with debilitating
20medical conditions.
21g. The medical cannabis manufacturer’s experience in medical
22cannabis production, plant extraction, and pharmaceutical
23formulations.
244. The department shall require each medical cannabis
25manufacturer to contract with a laboratory approved by the
26department to test the medical cannabis produced by the
27manufacturer. The department shall require that the laboratory
28report testing results to the manufacturer in a manner
29determined by the department pursuant to rule.
305. Each entity submitting an application for licensure
31as a medical cannabis manufacturer shall pay a nonrefundable
32application fee of fifteen thousand dollars to the department.
33 Sec. 11. NEW SECTION. 124F.7 Medical cannabis
34manufacturers.
351. A medical cannabis manufacturer shall contract with a
-10-1laboratory approved by the department for purposes of testing
2the medical cannabis manufactured by the medical cannabis
3manufacturer as to content, contamination, and consistency.
4The cost of all laboratory testing shall be paid by the medical
5cannabis manufacturer.
62. The operating documents of a medical cannabis
7manufacturer shall include all of the following:
8a. Procedures for the oversight of the medical cannabis
9manufacturer and procedures to ensure accurate recordkeeping.
10b. Procedures for the implementation of appropriate security
11measures to deter and prevent the theft of medical cannabis and
12unauthorized entrance into areas containing medical cannabis.
133. A medical cannabis manufacturer shall implement security
14requirements, including requirements for protection of each
15location by a fully operational security alarm system, facility
16access controls, perimeter intrusion detection systems, and a
17personnel identification system.
184. A medical cannabis manufacturer shall not share
19office space with, refer patients to, or have any financial
20relationship with a health care practitioner.
215. A medical cannabis manufacturer shall not permit any
22person to consume medical cannabis on the property of the
23medical cannabis manufacturer.
246. A medical cannabis manufacturer is subject to reasonable
25inspection by the department.
267. A medical cannabis manufacturer shall not employ a
27person who is under eighteen years of age or who has been
28convicted of a disqualifying felony offense. An employee
29of a medical cannabis manufacturer shall be subject to a
30background investigation conducted by the division of criminal
31investigation of the department of public safety and a national
32criminal history background check.
338. A medical cannabis manufacturer shall not operate in any
34location, whether for manufacturing, cultivating, harvesting,
35packaging, or processing, within one thousand feet of a public
-11-1or private school existing before the date of the medical
2cannabis manufacturer’s licensure by the department.
39. A medical cannabis manufacturer shall comply with
4reasonable restrictions set by the department relating to
5signage, marketing, display, and advertising of medical
6cannabis.
710. a. A medical cannabis manufacturer shall provide a
8reliable and ongoing supply of medical cannabis to medical
9cannabis dispensaries pursuant to this chapter.
10b. All manufacturing, cultivating, harvesting, packaging,
11and processing of medical cannabis shall take place in an
12enclosed, locked facility at a physical address provided to the
13department during the licensure process.
14c. A medical cannabis manufacturer shall not manufacture
15edible medical cannabis products utilizing food coloring.
16d. A medical cannabis manufacturer shall manufacture a
17reliable and ongoing supply of medical cannabis to treat every
18debilitating medical condition listed in this chapter.
1911. The department shall establish and collect an annual
20fee from a medical cannabis manufacturer not to exceed the cost
21of regulating and inspecting the manufacturer in the calendar
22year.
23 Sec. 12. NEW SECTION. 124F.8 Medical cannabis dispensary
24licensure.
251. a. The department shall license by April 2, 2020, twelve
26medical cannabis dispensaries to dispense medical cannabis
27within this state consistent with the provisions of this
28chapter. The department shall license new medical cannabis
29dispensaries or relicense the existing medical cannabis
30dispensaries by December 1 of each year.
31b. Information submitted during the application process
32shall be confidential until the medical cannabis dispensary
33is licensed by the department unless otherwise protected from
34disclosure under state or federal law.
352. As a condition for licensure, a medical cannabis
-12-1dispensary must agree to begin supplying medical cannabis to
2patients by July 16, 2020.
33. The department shall consider the following factors in
4determining whether to license a medical cannabis dispensary:
5a. The technical expertise of the medical cannabis
6dispensary regarding medical cannabis.
7b. The qualifications of the medical cannabis dispensary’s
8owners and management team.
9c. The long-term financial stability of the medical cannabis
10dispensary.
11d. The ability to provide appropriate security measures on
12the premises of the medical cannabis dispensary.
13e. The medical cannabis dispensary’s projection and ongoing
14assessment of fees for the purchase of medical cannabis on
15patients with debilitating medical conditions.
164. Each entity submitting an application for licensure
17as a medical cannabis dispensary shall pay a nonrefundable
18application fee of fifteen thousand dollars to the department.
19 Sec. 13. NEW SECTION. 124F.9 Medical cannabis dispensaries.
201. a. Medical cannabis dispensaries shall be located based
21on geographical need throughout the state to improve patient
22access.
23b. A medical cannabis dispensary may dispense medical
24cannabis pursuant to the provisions of this chapter but shall
25not dispense any medical cannabis in a form or quantity other
26than the form or quantity allowed by the department pursuant
27to rule.
282. The operating documents of a medical cannabis dispensary
29shall include all of the following:
30a. Procedures for the oversight of the medical cannabis
31dispensary and procedures to ensure accurate recordkeeping.
32b. Procedures for the implementation of appropriate security
33measures to deter and prevent the theft of medical cannabis and
34unauthorized entrance into areas containing medical cannabis.
353. A medical cannabis dispensary shall implement security
-13-1requirements, including requirements for protection by a fully
2operational security alarm system, facility access controls,
3perimeter intrusion detection systems, and a personnel
4identification system.
54. A medical cannabis dispensary shall not share office
6space with, refer patients to, or have any financial
7relationship with a health care practitioner.
85. A medical cannabis dispensary shall not permit any person
9to consume medical cannabis on the property of the medical
10cannabis dispensary.
116. A medical cannabis dispensary is subject to reasonable
12inspection by the department.
137. A medical cannabis dispensary shall not employ a
14person who is under eighteen years of age or who has been
15convicted of a disqualifying felony offense. An employee
16of a medical cannabis dispensary shall be subject to a
17background investigation conducted by the division of criminal
18investigation of the department of public safety and a national
19criminal history background check.
208. A medical cannabis dispensary shall not operate in any
21location within one thousand feet of a public or private school
22existing before the date of the medical cannabis dispensary’s
23licensure by the department.
249. A medical cannabis dispensary shall comply with
25reasonable restrictions set by the department relating to
26signage, marketing, display, and advertising of medical
27cannabis.
2810. Prior to dispensing of any medical cannabis, a medical
29cannabis dispensary shall do all of the following:
30a. Verify that the medical cannabis dispensary has received
31a valid medical cannabis registration card from a patient or a
32patient’s primary caregiver, if applicable.
33b. Assign a tracking number to any medical cannabis
34dispensed from the medical cannabis dispensary.
35c. (1) Properly package medical cannabis in compliance with
-14-1federal law regarding child resistant packaging and exemptions
2for packaging for elderly patients, and label medical cannabis
3with a list of all active ingredients and individually
4identifying information, including all of the following:
5(a) The name and date of birth of the patient and the
6patient’s primary caregiver, if appropriate.
7(b) The medical cannabis registration card numbers of the
8patient 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
11not be limited to all of the following:
12(a) Warning labels regarding the use of medical cannabis by
13a woman during pregnancy and while breastfeeding.
14(b) Clearly labeled packaging indicating that an edible
15medical cannabis product contains medical cannabis and which
16packaging shall not imitate candy products or in any way make
17the product marketable to children.
18 Sec. 14. NEW SECTION. 124F.10 Fees.
19Medical cannabis registration card fees and medical cannabis
20manufacturer and medical cannabis dispensary application
21and annual fees collected by the department pursuant to
22this chapter shall be retained by the department, shall be
23considered repayment receipts as defined in section 8.2, and
24shall be used for the purpose of regulating medical cannabis
25manufacturers and medical cannabis dispensaries and for other
26expenses necessary for the administration of this chapter.
27 Sec. 15. NEW SECTION. 124F.11 Department duties — rules.
281. a. The department shall maintain a confidential file of
29the names of each patient to or for whom the department issues
30a medical cannabis registration card, the name of each primary
31caregiver to whom the department issues a medical cannabis
32registration card under section 124F.4, and the names of each
33health care practitioner who provides a written certification
34for medical cannabis pursuant to this chapter.
35b. Individual names contained in the file shall be
-15-1confidential and shall not be subject to disclosure, except as
2provided in subparagraph (1).
3(1) Information in the confidential file maintained
4pursuant to paragraph “a” may be released on an individual basis
5to the following persons under the following circumstances:
6(a) To authorized employees or agents of the department and
7the department of transportation as necessary to perform the
8duties of the department and the department of transportation
9pursuant to this chapter.
10(b) To authorized employees of state or local law
11enforcement agencies, but only for the purpose of verifying
12that a person is lawfully in possession of a medical cannabis
13registration card issued pursuant to this chapter.
14(c) To authorized employees of a medical cannabis
15dispensary, but only for the purpose of verifying that a person
16is lawfully in possession of a medical cannabis registration
17card issued pursuant to this chapter.
18(d) To any other authorized persons recognized by the
19department by rule, but only for the purpose of verifying
20that a person is lawfully in possession of a medical cannabis
21registration card issued pursuant to this chapter.
22(2) Release of information pursuant to subparagraph
23(1) shall be consistent with the federal Health Insurance
24Portability and Accountability Act of 1996, Pub.L. No.
25104-191.
262. The department shall adopt rules pursuant to chapter
2717A to administer this chapter which shall include but not be
28limited to rules to do all of the following:
29a. Govern the manner in which the department shall consider
30applications for new and renewal medical cannabis registration
31cards.
32b. Identify criteria and set forth procedures for
33including additional chronic or debilitating diseases or
34medical conditions or their medical treatments on the list of
35debilitating medical conditions that qualify for the use of
-16-1medical cannabis. Procedures shall include a petition process
2and shall allow for public comment and public hearings before
3the medical advisory board.
4c. Set forth additional chronic or debilitating diseases
5or medical conditions or associated medical treatments for
6inclusion on the list of debilitating medical conditions that
7qualify for the use of medical cannabis as recommended by the
8medical advisory board.
9d. Establish, in consultation with medical cannabis
10manufacturers and medical cannabis dispensaries, the form and
11quantity of medical cannabis allowed to be dispensed to a
12patient or primary caregiver pursuant to this chapter. The
13form and quantity of medical cannabis shall be appropriate to
14serve the medical needs of patients with debilitating medical
15conditions.
16e. Establish, in conjunction with the medical advisory
17board, requirements for the licensure of medical cannabis
18manufacturers and medical cannabis dispensaries and set forth
19procedures for medical cannabis manufacturers and medical
20cannabis dispensaries to obtain licenses.
21f. Develop a dispensing system for medical cannabis within
22this state that provides for all of the following:
23(1) Medical cannabis dispensaries within this state housed
24on secured grounds and operated by licensed medical cannabis
25dispensaries.
26(2) The dispensing of medical cannabis to patients and
27their primary caregivers to occur at locations designated by
28the department.
29g. Establish and collect annual fees from medical cannabis
30manufacturers and medical cannabis dispensaries to cover
31the costs associated with regulating and inspecting medical
32cannabis manufacturers and medical cannabis dispensaries.
33h. Specify and implement procedures that address public
34safety including security procedures and product quality
35including measures to ensure contaminant-free cultivation of
-17-1medical cannabis, safety, and labeling.
2i. Establish and implement a medical cannabis inventory
3and delivery tracking system to track medical cannabis
4from production by a medical cannabis manufacturer through
5dispensing at a medical cannabis dispensary.
6 Sec. 16. NEW SECTION. 124F.12 Reciprocity.
7A valid medical cannabis registration card, or its
8equivalent, issued under the laws of another state that allows
9an out-of-state patient to possess or use medical cannabis in
10the jurisdiction of issuance shall have the same force and
11effect as a valid medical cannabis registration card issued
12pursuant to this chapter, except that an out-of-state patient
13in this state shall not obtain medical cannabis from a medical
14cannabis dispensary in this state and an out-of-state patient
15shall not smoke medical cannabis.
16 Sec. 17. NEW SECTION. 124F.13 Use of medical cannabis —
17affirmative defenses.
181. A health care practitioner, including any authorized
19agent or employee thereof, shall not be subject to
20prosecution for the unlawful certification, possession, or
21administration of marijuana under the laws of this state for
22activities arising directly out of or directly related to the
23certification or use of medical cannabis in the treatment of
24a patient diagnosed with a debilitating medical condition as
25authorized by this chapter.
262. A medical cannabis manufacturer, including any
27authorized agent or employee thereof, shall not be subject
28to prosecution for manufacturing, possessing, cultivating,
29harvesting, packaging, processing, transporting, or supplying
30medical cannabis pursuant to this chapter.
313. A medical cannabis dispensary, including any authorized
32agent or employee thereof, shall not be subject to prosecution
33for transporting, supplying, or dispensing medical cannabis
34pursuant to this chapter.
35a. In a prosecution for the unlawful possession of marijuana
-18-1under the laws of this state, including but not limited to
2chapters 124 and 453B, it is an affirmative and complete
3defense to the prosecution that the patient has been diagnosed
4with a debilitating medical condition, used or possessed
5medical cannabis pursuant to a certification by a health care
6practitioner as authorized under this chapter, and, for a
7patient eighteen years of age or older, is in possession of a
8valid medical cannabis registration card.
9b. In a prosecution for the unlawful possession of marijuana
10under the laws of this state, including but not limited to
11chapters 124 and 453B, it is an affirmative and complete
12defense to the prosecution that the person possessed medical
13cannabis because the person is a primary caregiver of a patient
14who has been diagnosed with a debilitating medical condition
15and is in possession of a valid medical cannabis registration
16card, and where the primary caregiver’s possession of the
17medical cannabis is on behalf of the patient and for the
18patient’s use only as authorized under this chapter.
19c. If a patient or primary caregiver is charged with the
20commission of a crime and is not in possession of the person’s
21medical cannabis registration card, any charge or charges filed
22against the person shall be dismissed by the court if the
23person produces to the court prior to or at the person’s trial
24a medical cannabis registration card issued to that person and
25valid at the time the person was charged.
264. An agency of this state or a political subdivision
27thereof, including any law enforcement agency, shall not remove
28or initiate proceedings to remove a patient under the age
29of eighteen from the home of a parent based solely upon the
30parent’s or patient’s possession or use of medical cannabis as
31authorized under this chapter.
32 Sec. 18. NEW SECTION. 124F.14 Penalties.
331. A person who knowingly or intentionally possesses or
34uses medical cannabis in violation of the requirements of this
35chapter is subject to the penalties provided under chapters 124
-19-1and 453B.
22. A medical cannabis manufacturer or a medical cannabis
3dispensary shall be assessed a civil penalty of up to one
4thousand dollars per violation for any violation of this
5chapter in addition to any other applicable penalties.
6 Sec. 19. NEW SECTION. 124F.15 Use of medical cannabis —
7smoking prohibited.
8A patient shall not consume medical cannabis possessed
9or used as authorized under this chapter by smoking medical
10cannabis.
11 Sec. 20. NEW SECTION. 124F.16 Employment.
121. An employer in this state may retain, create, reinstate,
13or enforce a written zero tolerance policy prohibiting the
14possession or use of medical cannabis or any derivative
15thereof including cannabidiol by an employee in the employer’s
16workplace, including but not limited to a policy prohibiting
17an employee from having any detectable amount of medical
18cannabis or any derivative thereof including cannabidiol in the
19employee’s body while at work.
202. An employer’s prohibition of the possession or use
21of medical cannabis or any derivative thereof including
22cannabidiol under this section shall not be considered to be
23an unfair or discriminatory employment practice under section
24216.6.
25 Sec. 21. Section 730.5, subsection 11, paragraph f, Code
262019, is amended to read as follows:
27f. Testing or taking action against an employee or
28prospective employee with a confirmed positive test result due
29to the employee’s or prospective employee’s use of medical
30cannabidiol 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
33emergency rules under section 17A.4, subsection 3, and section
3417A.5, subsection 2, paragraph “b”, to implement the provisions
35of this division of this Act and the rules shall be effective
-20-1immediately upon filing unless a later date is specified in the
2rules. Any rules adopted in accordance with this section shall
3also be published as a notice of intended action as provided
4in section 17A.4.
5 Sec. 24. TRANSITION PROVISIONS.
61. A medical cannabidiol registration card issued
7under chapter 124E prior to the effective date of this Act
8remains effective and continues in effect as issued for the
9twelve-month period following its issuance. This Act does not
10preclude a medical cannabidiol registration card holder from
11seeking to renew the registration card prior to the expiration
12of the twelve-month period.
132. Members of the medical cannabidiol board created in
14section 124E.5 shall continue to serve until the appointment of
15the medical advisory board created in section 124F.5.
163. Any rule, form, order, license, or directive promulgated
17by the medical cannabidiol board created in section 124E.5, or
18by the department, in force and effect immediately prior to the
19appointment of the medical advisory board, shall continue in
20full force and effect until the earlier of the following:
21a. It is amended, rescinded, or supplemented by the
22affirmative actions of the medical advisory board or the
23department, as applicable.
24b. It expires by its own terms.
254. A medical cannabidiol manufacturer licensed pursuant
26to section 124E.6 and operating immediately prior to the
27effective date of this Act shall operate as a medical cannabis
28manufacturer pursuant to section 124F.6 until the earlier of
29the following:
30a. The license is revoked by the affirmative action of the
31department.
32b. The license expires by its own terms.
33c. The medical cannabidiol manufacturer becomes licensed as
34a medical cannabis manufacturer.
355. A medical cannabidiol dispensary licensed pursuant to
-21-1section 124E.8 and operating immediately prior to the effective
2date of this Act shall operate as a medical cannabis dispensary
3pursuant to section 124F.8 until the earlier of the following:
4a. The license is revoked by the affirmative action of the
5department.
6b. The license expires by its own terms.
7c. The medical cannabidiol dispensary becomes licensed as
8a medical cannabis dispensary.
9 Sec. 25. EFFECTIVE UPON ENACTMENT. This Act, being deemed
10of immediate importance, takes effect upon enactment.
11EXPLANATION
12The inclusion of this explanation does not constitute agreement with
13the explanation’s substance by the members of the general assembly.
14This bill creates the compassionate use of medical cannabis
15Act, reclassifies marijuana, including tetrahydrocannabinols,
16from a schedule I controlled substance to a schedule II
17controlled substance, and provides for civil and criminal
18penalties and fees.
19OVERVIEW. The bill allows a patient with a debilitating
20medical condition who receives a written certification from
21the patient’s health care practitioner that the patient has
22a debilitating medical condition and who submits the written
23certification along with an application to the department of
24public health (department) for a medical cannabis registration
25card to allow for the lawful use of medical cannabis to treat
26the patient’s debilitating medical condition. A patient who
27is issued a medical cannabis registration card will be able
28to receive medical cannabis directly from a medical cannabis
29dispensary operated and licensed in this state.
30RECLASSIFICATION. The bill reclassifies marijuana,
31including tetrahydrocannabinols as a schedule II controlled
32substance instead of a schedule I controlled substance and
33strikes references to the authority of the board of pharmacy to
34adopt rules for the use of marijuana or tetrahydrocannabinols
35for medicinal purposes.
-22- 1A schedule I controlled substance is a highly addictive
2substance that has no accepted medical use in the United States
3and a schedule II controlled substance is a highly addictive
4substance that has an accepted medical use in the United
5States. The reclassification of marijuana from a schedule I
6controlled substance to a schedule II controlled substance
7would allow a physician to issue a prescription for marijuana
8under state law. However, federal regulations may prohibit
9such prescriptions.
10The penalties remain unchanged for violations involving
11marijuana under the bill. The penalties under Code section
12124.401 range from a class “B” felony punishable by up to 50
13years of confinement to a serious misdemeanor punishable by
14up to six months of confinement depending on the amount of
15marijuana involved in the offense.
16The bill amends Code section 124.401, relating to prohibited
17acts involving controlled substances, to provide that it is
18lawful for a person to knowingly or intentionally recommend,
19possess, use, dispense, deliver, transport, or administer
20medical cannabis if the recommendation, possession, use,
21dispensing, delivery, transporting, or administering is in
22accordance with the provisions of the bill.
23DEFINITIONS. The bill provides the following definitions:
24“Debilitating medical condition” means cancer, multiple
25sclerosis, epilepsy or seizure disorders, AIDS or HIV,
26Hepatitis C, Crohn’s disease or ulcerative colitis, amyotrophic
27lateral sclerosis, intractable pain, glaucoma, any terminal
28illness with a probable life expectancy of under one year,
29Ehlers-Danlos syndrome, post-traumatic stress disorder,
30Tourette’s syndrome, and any other chronic or debilitating
31disease or medical condition or its medical treatment approved
32by the department by rule.
33“Health care practitioner” means an individual licensed
34under Code chapter 148 to practice medicine and surgery or
35osteopathic medicine and surgery or an individual licensed to
-23-1prescribe medicine in any other state who provides specialty
2care to an Iowa resident for one or more debilitating medical
3conditions specified in the bill.
4“Medical cannabis” means any species of the genus cannabis
5plant, or any mixture or preparation of them, including whole
6plant extracts and resins.
7“Medical cannabis manufacturer” means an entity licensed
8by the department to manufacture and to possess, cultivate,
9transport, or supply, medical cannabis pursuant to the bill.
10“Medical cannabis dispensary” means an entity licensed under
11the bill that acquires medical cannabis from a medical cannabis
12manufacturer in this state for the purpose of dispensing
13medical cannabis in this state pursuant to the bill.
14“Primary caregiver” means a person, at least 18 years of age,
15who has been designated by a patient’s health care practitioner
16or a person having custody of a patient, as a necessary
17caretaker taking responsibility for managing the well-being
18of the patient with respect to the use of medical cannabis
19pursuant to the bill.
20“Written certification” means a document signed by a health
21care practitioner, with whom the patient has established a
22patient-provider relationship, which states that the patient
23has a debilitating medical condition and which identifies that
24condition, and provides any other relevant information.
25HEALTH CARE PRACTITIONER CERTIFICATION. The bill provides
26that prior to a patient’s submission of an application
27for a medical cannabis registration card, if a health care
28practitioner determines that the patient whom the health
29care practitioner has examined and treated suffers from a
30debilitating medical condition, the health care practitioner
31may provide the patient with a written certification of that
32diagnosis. The health care practitioner must also provide
33explanatory information to the patient about the therapeutic
34use of medical cannabis, and if the patient continues to
35suffer from a debilitating medical condition, the health care
-24-1practitioner may issue the patient a new certification of
2that diagnosis on an annual basis. The bill specifies that
3a health care practitioner has no duty to provide a written
4certification.
5MEDICAL CANNABIS REGISTRATION CARD — PATIENT AND PRIMARY
6CAREGIVER. The department may approve the issuance of a
7medical cannabis registration card to a patient who is at least
818 years of age and is a permanent resident of this state, who
9submits a written certification by the patient’s health care
10practitioner to the department, and who submits an application
11to the department with certain information along with a medical
12registration card fee. The department may also approve the
13issuance of a medical cannabis registration card to a primary
14caregiver who is at least 18 years of age, who submits a
15written certification by the patient’s health care practitioner
16to the department on behalf of the patient, and who submits an
17application to the department with certain information along
18with a medical cannabis registration card fee. A medical
19cannabis registration card expires one year after the date of
20issuance and may be renewed.
21MEDICAL ADVISORY BOARD. The director of public health is
22directed to establish a medical advisory board, no later than
23August 15, 2019, to consist of nine practitioners representing
24the fields of neurology, pain management, gastroenterology,
25oncology, psychiatry, pediatrics, infectious disease,
26family medicine, and pharmacy, and three patients or primary
27caregivers with valid medical cannabis registration cards. The
28duties of the board include but are not limited to reviewing
29and recommending to the department for approval additional
30chronic or debilitating diseases or medical conditions or their
31treatments as debilitating medical conditions that qualify for
32the use of medical cannabis under the bill.
33MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS
34DISPENSARIES — LICENSURE. The bill requires the department
35to license up to four medical cannabis manufacturers for
-25-1the manufacture of medical cannabis within this state by
2December 1, 2019, and to license twelve medical cannabis
3dispensaries by April 2, 2020. Information submitted during
4the application process is confidential until the medical
5cannabis manufacturer or the medical cannabis dispensary is
6licensed by the department unless otherwise protected from
7disclosure under state or federal law. As a condition for
8licensure, a medical cannabis manufacturer must agree to begin
9supplying medical cannabis to medical cannabis dispensaries in
10this state by July 2, 2020, and a medical cannabis dispensary
11must agree to begin supplying medical cannabis to patients by
12July 16, 2020. The department is directed to consider several
13factors in determining whether to license a medical cannabis
14manufacturer and a medical cannabis dispensary including
15technical expertise, employee qualifications, financial
16stability, security measures, and production needs and
17capacity. Each medical cannabis manufacturer is required to
18contract with a laboratory approved by the department to test
19the medical cannabis produced by the manufacturer and to report
20testing results to the medical cannabis manufacturer. Each
21entity submitting an application for licensure as a medical
22cannabis manufacturer shall pay a nonrefundable application
23fee of $15,000 to the department and each entity submitting
24an application for licensure as a medical cannabis dispensary
25shall pay a nonrefundable application fee of $15,000 to the
26department.
27MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS
28DISPENSARIES — ADDITIONAL PROVISIONS. The operating
29documents of a medical cannabis manufacturer and a medical
30cannabis dispensary shall include procedures for oversight and
31recordkeeping activities of the medical cannabis manufacturer
32and the medical cannabis dispensary and certain security
33measures undertaken by the medical cannabis manufacturer
34and the medical cannabis dispensary. A medical cannabis
35manufacturer and a medical cannabis dispensary are prohibited
-26-1from sharing office space with, referring patients to,
2or having a financial relationship with a health care
3practitioner, permitting any person to consume medical cannabis
4on the property of the medical cannabis manufacturer or the
5medical cannabis dispensary, employing a person who is under
618 years of age or who has been convicted of a disqualifying
7felony offense, and from operating in any location within 1,000
8feet of a public or private school existing before the date
9of the licensure of the medical cannabis manufacturer or the
10medical cannabis dispensary. In addition, a medical cannabis
11manufacturer and a medical cannabis dispensary are subject to
12reasonable inspection and certain reasonable restrictions.
13A medical cannabis manufacturer is required to provide a
14reliable and ongoing supply of medical cannabis to medical
15cannabis dispensaries and shall not manufacture edible medical
16cannabis products utilizing food coloring. All manufacturing,
17cultivating, harvesting, packaging, and processing of medical
18cannabis is required to take place in an enclosed, locked
19facility.
20Prior to dispensing any medical cannabis, a medical cannabis
21dispensary is required to verify that the medical cannabis
22dispensary has received a valid medical cannabis registration
23card from a patient or a patient’s primary caregiver, if
24applicable, assign a tracking number to any medical cannabis
25dispensed from the medical cannabis dispensary, and properly
26package and label medical cannabis in compliance with the
27provisions of the bill and certain federal laws.
28DEPARTMENT DUTIES — CONFIDENTIALITY. The department
29is required to maintain a confidential file of the names
30of each patient and primary caregiver issued a medical
31cannabis registration card, and the names of each health
32care practitioner who provides a written certification for
33medical cannabis under the bill. Individual names contained
34in the file shall be confidential and shall not be subject to
35disclosure, except that information in the confidential file
-27-1may be released on an individual basis to authorized employees
2or agents of the department, the department of transportation,
3and a medical cannabis dispensary as necessary to perform
4their duties, to authorized employees of state or local law
5enforcement agencies for the purpose of verifying that a person
6is lawfully in possession of a medical cannabis registration
7card, and to any other authorized employees for the purpose of
8verifying that a person is lawfully in possession of a medical
9cannabis registration card. Release of information must also
10be consistent with federal Health Insurance Portability and
11Accountability Act regulations.
12ADDITIONAL DEPARTMENT DUTIES — RULES. The bill requires
13the department to adopt rules relating to the manner in which
14the department shall consider applications for new and renewal
15medical cannabis registration cards, identify criteria and
16set forth procedures for including additional chronic or
17debilitating diseases or medical conditions or their medical
18treatments on the list of debilitating medical conditions,
19establish the form and quantity of medical cannabis allowed to
20be dispensed to a patient or primary caregiver in the form and
21quantity appropriate to serve the medical needs of the patient
22with the debilitating medical condition, establish requirements
23for the licensure of medical cannabis manufacturers and medical
24cannabis dispensaries, develop a dispensing system for medical
25cannabis within this state that follows certain requirements,
26establish and implement a medical cannabis inventory and
27delivery tracking system, and specify and implement procedures
28that address public safety including security procedures and
29product quality, safety, and labeling.
30RECIPROCITY. The bill provides that a valid medical
31cannabis registration card, or its equivalent, issued under
32the laws of another state that allows an out-of-state patient
33to possess or use medical cannabis in the jurisdiction of
34issuance shall have the same force and effect as a valid
35medical cannabis card issued under the bill, except that an
-28-1out-of-state patient in this state shall not obtain medical
2cannabis from a medical cannabis dispensary and an out-of-state
3patient shall not smoke medical cannabis in this state.
4USE OF MEDICAL CANNABIS — SMOKING PROHIBITED. The bill
5provides that a patient shall not consume the medical cannabis
6by smoking the medical cannabis.
7USE OF MEDICAL CANNABIS — AFFIRMATIVE DEFENSES. The bill
8provides prosecution immunity for a health care practitioner,
9a medical cannabis manufacturer, and a medical cannabis
10dispensary, including any authorized agents or employees of the
11health care practitioner, medical cannabis manufacturer, and
12medical cannabis dispensary, for activities undertaken by the
13health care practitioner, medical cannabis manufacturer, and
14medical cannabis dispensary pursuant to the provisions of the
15bill.
16The bill provides that in a prosecution for the unlawful
17possession of marijuana under the laws of this state,
18including but not limited to Code chapters 124 (controlled
19substances) and 453B (excise tax on unlawful dealing in
20certain substances), it is an affirmative and complete
21defense to the prosecution that the patient has been diagnosed
22with a debilitating medical condition, used or possessed
23medical cannabis pursuant to a certification by a health
24care practitioner, and, for a patient age 18 or older, is
25in possession of a valid medical cannabis registration
26card. The bill provides a similar affirmative defense for a
27primary caretaker of a patient who has been diagnosed with a
28debilitating medical condition who is in possession of a valid
29medical cannabis registration card.
30The bill provides that an agency of this state or a political
31subdivision thereof, including any law enforcement agency,
32shall not remove or initiate proceedings to remove a patient
33under the age of 18 from the home of a parent based solely upon
34the parent’s or patient’s possession or use of medical cannabis
35as authorized under the bill.
-29- 1PENALTIES. The bill provides that a person who knowingly or
2intentionally possesses or uses medical cannabis in violation
3of the requirements of the bill is subject to the penalties
4provided under Code chapters 124 and 453B. In addition, a
5medical cannabis manufacturer or a medical cannabis dispensary
6shall be assessed a civil penalty of up to $1,000 per violation
7for any violation of the bill in addition to any other
8applicable penalties.
9REPEAL. The bill repeals Code chapter 124E, the medical
10cannabidiol Act.
11EMERGENCY RULES. The bill provides that the department
12may adopt emergency rules and the rules shall be effective
13immediately upon filing unless a later date is specified in the
14rules.
15EFFECTIVE DATE. The bill takes effect upon enactment.
16TRANSITION PROVISIONS. The bill provides that a medical
17cannabis registration card issued under Code chapter 124E
18(medical cannabidiol Act) prior to the effective date of the
19bill, shall remain effective and continues in effect as issued
20for the 12-month period following its issuance. The bill also
21provides that members of the medical cannabidiol board shall
22continue to serve until the appointment of the medical advisory
23board and that rules, forms, orders, licenses, and directives
24promulgated by the medical cannabidiol board that are in force
25and effect immediately prior to the appointment of the medical
26advisory board shall remain in full force and effect until
27amended, rescinded, or supplemented by affirmative actions of
28the medical advisory board or they expire by their own terms.
-30-ss/rh
2cannabis Act, reclassifying marijuana, including
3tetrahydrocannabinols, from a schedule I controlled
4substance to a schedule II controlled substance, providing
5for civil and criminal penalties and fees, and including
6effective date provisions.
7BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 124.204, subsection 4, paragraphs m and
2u, Code 2019, are amended by striking the paragraphs.
3 Sec. 2. Section 124.204, subsection 7, Code 2019, is amended
4by striking the subsection.
5 Sec. 3. Section 124.206, subsection 7, Code 2019, is amended
6to read as follows:
77. Hallucinogenic substances. Unless specifically excepted
8or unless listed in another schedule, any material, compound,
9mixture, or preparation which contains any quantity of the
10following substances, or, for purposes of paragraphs “a” and
11“b”, which contains any of its salts, isomers, or salts of
12isomers whenever the existence of such salts, isomers, or salts
13of isomers is possible within the specific chemical designation
14(for purposes of this paragraph only, the term “isomer”
15includes the optical, positional, and geometric isomers):
16a. Marijuana when used for medicinal purposes pursuant to
17rules of the board.
18b. Tetrahydrocannabinols, meaning tetrahydrocannabinols
19naturally contained in a plant of the genus cannabis (cannabis
20plant) as well as synthetic equivalents of the substances
21contained in the cannabis plant, or in the resinous extractives
22of such plant, and synthetic substances, derivatives, and their
23isomers with similar chemical structure and pharmacological
24activity to those substances contained in the plant, such as
25the following:
26(1) 1 cis or trans tetrahydrocannabinol, and their optical
27isomers.
28(2) 6 cis or trans tetrahydrocannabinol, and their optical
29isomers.
30(3) 3,4 cis or trans tetrahydrocannabinol, and their
31optical isomers. (Since nomenclature of these substances
32is not internationally standardized, compounds of these
33structures, regardless of numerical designation of atomic
34positions covered.)
35b. c. Nabilone [another name for nabilone: (+-) -
-1-1trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1-
2hydroxy-6,6-dimethyl-9H-dibenzo[b,d]pyran-9-one].
3c. d. Dronabinol [(-)-delta-9-trans-tetrahydrocannabinol]
4in an oral solution in a drug product approved for marketing by
5the United States food and drug administration.
6 Sec. 4. Section 124.401, subsection 5, unnumbered paragraph
73, Code 2019, is amended to read as follows:
8A person may knowingly or intentionally recommend, possess,
9use, dispense, deliver, transport, or administer cannabidiol
10 medical cannabis if the recommendation, possession, use,
11dispensing, delivery, transporting, or administering is in
12accordance with the provisions of chapter 124E 124F. For
13purposes 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.
16This 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.
19As used in this chapter:
201. “Debilitating medical condition” means any of the
21following:
22a. Cancer, if the underlying condition or treatment produces
23one or more of the following:
24(1) Intractable pain.
25(2) Nausea or severe vomiting.
26(3) Cachexia or severe wasting.
27b. Multiple sclerosis.
28c. Epilepsy or seizure disorders.
29d. AIDS or HIV as defined in section 141A.1.
30e. Glaucoma.
31f. Hepatitis C.
32g. Crohn’s disease or ulcerative colitis.
33h. Amyotrophic lateral sclerosis.
34i. Ehlers-Danlos syndrome.
35j. Post-traumatic stress disorder.
-2- 1k. Tourette’s syndrome.
2l. Any terminal illness, with a probable life expectancy of
3under one year, if the illness or its treatment produces one or
4more of the following:
5(1) Intractable pain.
6(2) Nausea or severe vomiting.
7(3) Cachexia or severe wasting.
8m. Intractable pain.
9n. Parkinson’s disease.
10o. Muscular dystrophy.
11p. Huntington’s disease.
12q. Alzheimer’s disease.
13r. Complex regional pain syndrome, type I and II.
14s. Rheumatoid arthritis.
15t. Polyarteritis nodosa.
16u. Any other chronic or debilitating disease or medical
17condition or its medical treatment approved by the department
18pursuant to rule.
192. “Department” means the department of public health.
203. “Disqualifying felony offense” means a violation under
21federal or state law of a felony offense, which has as an
22element the possession, use, or distribution of a controlled
23substance, as defined in 21 U.S.C. §802(6).
244. “Enclosed, locked facility” means a closet, room,
25greenhouse, or other enclosed area equipped with locks or
26other security devices that permit access only by authorized
27personnel.
285. “Health care practitioner” means an individual licensed
29under chapter 148 to practice medicine and surgery or
30osteopathic medicine and surgery or an individual licensed to
31practice medicine in any other state who provides specialty
32care for an Iowa resident for one or more of the debilitating
33medical conditions provided in this chapter.
346. “Intractable pain” means a pain in which the cause of the
35pain cannot be removed or otherwise treated with the consent
-3-1of the patient and which, in the generally accepted course of
2medical practice, no relief or cure of the cause of the pain
3is possible, or none has been found after reasonable efforts.
4Reasonable efforts for relieving or curing the cause of the
5pain may be determined on the basis of but are not limited to
6any of the following:
7a. When treating a nonterminally ill patient for intractable
8pain, evaluation by the attending physician and one or more
9physicians specializing in pain medicine or the treatment of
10the area, system, or organ of the body perceived as the source
11of the pain.
12b. When treating a terminally ill patient, evaluation by
13the attending physician who does so in accordance with the
14level of care, skill, and treatment that would be recognized
15by a reasonably prudent physician under similar conditions and
16circumstances.
177. “Medical cannabis” means any species of the genus
18cannabis plant, or any mixture or preparation of them,
19including whole plant extracts and resins.
208. “Medical cannabis dispensary” means an entity licensed
21under section 124F.8 that acquires medical cannabis from a
22medical cannabis manufacturer in this state for the purpose
23of dispensing medical cannabis in this state pursuant to this
24chapter.
259. “Medical cannabis manufacturer” means an entity licensed
26under section 124F.6 to manufacture and to possess, cultivate,
27transport, or supply medical cannabis pursuant to the
28provisions of this chapter.
2910. “Primary caregiver” means a person, at least eighteen
30years of age, who has been designated by a patient’s health
31care practitioner or a person having custody of a patient, as
32a necessary caretaker taking responsibility for managing the
33well-being of the patient with respect to the use of medical
34cannabis pursuant to the provisions of this chapter.
3511. “Written certification” means a document signed by a
-4-1health care practitioner, with whom the patient has established
2a patient-provider relationship, which states that the patient
3has a debilitating medical condition and identifies that
4condition and provides any other relevant information.
5 Sec. 7. NEW SECTION. 124F.3 Health care practitioner
6certification — duties.
71. Prior to a patient’s submission of an application for a
8medical cannabis registration card pursuant to section 124F.4,
9a health care practitioner shall do all of the following:
10a. Determine, in the health care practitioner’s medical
11judgment, whether the patient whom the health care practitioner
12has examined and treated suffers from a debilitating medical
13condition that qualifies for the use of medical cannabis under
14this chapter, and if so determined, provide the patient with a
15written certification of that diagnosis.
16b. Provide explanatory information as provided by the
17department to the patient about the therapeutic use of medical
18cannabis.
19c. Determine, on an annual basis, if the patient continues
20to suffer from a debilitating medical condition and, if so,
21issue the patient a new certification of that diagnosis. This
22paragraph shall not apply if the patient is suffering from an
23incurable debilitating medical condition.
24d. Otherwise comply with all requirements established by the
25department pursuant to rule.
262. A health care practitioner may provide, but has no duty
27to provide, a written certification pursuant to this section.
28 Sec. 8. NEW SECTION. 124F.4 Medical cannabis registration
29card.
301. Issuance to patient. The department may approve the
31issuance of a medical cannabis registration card by the
32department of transportation to a patient who:
33a. Is at least eighteen years of age.
34b. Is a permanent resident of this state.
35c. Submits a written certification to the department signed
-5-1by the patient’s health care practitioner that the patient is
2suffering from a debilitating medical condition.
3d. Submits an application to the department, on a form
4created by the department, in consultation with the department
5of transportation, that contains all of the following:
6(1) The patient’s full name, Iowa residence address, date
7of birth, and telephone number.
8(2) A copy of the patient’s valid photograph
9identification.
10(3) Full name, address, and telephone number of the
11patient’s health care practitioner.
12(4) Full name, residence address, date of birth, and
13telephone number of each primary caregiver of the patient, if
14any.
15(5) Any other information required by rule.
16e. Submits a medical cannabis registration card fee of one
17hundred dollars to the department. If the patient attests to
18receiving social security disability benefits, supplemental
19security insurance payments, or being enrolled in the medical
20assistance program, the fee shall be twenty-five dollars.
212. Patient card contents. A medical cannabis registration
22card issued to a patient by the department of transportation
23pursuant to subsection 1 shall contain, at a minimum, all of
24the following:
25a. The patient’s full name, Iowa residence address, and date
26of birth.
27b. The patient’s photograph.
28c. The date of issuance and expiration of the registration
29card.
30d. Any other information required by rule.
313. Issuance to primary caregiver. For a patient in a
32primary caregiver’s care, the department may approve the
33issuance of a medical cannabis registration card by the
34department of transportation to the primary caregiver who:
35a. Submits a written certification to the department signed
-6-1by the patient’s health care practitioner that the patient in
2the primary caregiver’s care is suffering from a debilitating
3medical condition.
4b. Submits an application to the department, on a form
5created by the department, in consultation with the department
6of transportation, that contains all of the following:
7(1) The primary caregiver’s full name, residence address,
8date of birth, and telephone number.
9(2) The patient’s full name.
10(3) A copy of the primary caregiver’s valid photograph
11identification.
12(4) Full name, address, and telephone number of the
13patient’s health care practitioner.
14(5) Any other information required by rule.
15c. Submits a medical cannabis registration card fee of
16twenty-five dollars to the department.
174. Primary caregiver card contents. A medical cannabis
18registration card issued by the department of transportation to
19a primary caregiver pursuant to subsection 3 shall contain, at
20a minimum, all of the following:
21a. The primary caregiver’s full name, residence address, and
22date of birth.
23b. The primary caregiver’s photograph.
24c. The date of issuance and expiration of the registration
25card.
26d. The registration card number of each patient in the
27primary caregiver’s care. If the patient in the primary
28caregiver’s care is under the age of eighteen, the full name of
29the patient’s parent or legal guardian.
30e. Any other information required by rule.
315. Expiration date of card. A medical cannabis registration
32card issued pursuant to this section shall expire one year
33after the date of issuance and may be renewed.
346. Card issuance — department of transportation.
35a. The department may enter into a chapter 28E agreement
-7-1with the department of transportation to facilitate the
2issuance of medical cannabis registration cards pursuant to
3subsections 1 and 3.
4b. The department of transportation may issue renewal
5medical cannabis registration cards through an online or
6in-person process.
7 Sec. 9. NEW SECTION. 124F.5 Medical advisory board —
8duties.
91. No later than August 15, 2019, the director of public
10health shall establish a medical advisory board consisting of
11nine practitioners representing the fields of neurology, pain
12management, gastroenterology, oncology, psychiatry, pediatrics,
13infectious disease, family medicine, and pharmacy, and three
14patients or primary caregivers with valid medical cannabis
15registration cards. The practitioners shall be nationally
16board-certified in their area of specialty and knowledgeable
17about the use of medical cannabis.
182. A quorum of the advisory board shall consist of seven
19members.
203. The duties of the advisory board shall include but not be
21limited to the following:
22a. Reviewing and recommending to the department for
23approval additional chronic or debilitating diseases or
24medical conditions or their treatments as debilitating medical
25conditions that qualify for the use of medical cannabis under
26this chapter.
27b. Accepting and reviewing petitions to add chronic or
28debilitating diseases or medical conditions or their medical
29treatments to the list of debilitating medical conditions that
30qualify for the use of medical cannabis under this chapter.
31c. Working with the department regarding the requirements
32for the licensure of medical cannabis manufacturers and medical
33cannabis dispensaries, including licensure procedures.
34d. Advising the department regarding the location of
35medical cannabis dispensaries throughout the state, the form
-8-1and quantity of allowable medical cannabis to be dispensed
2to a patient or primary caregiver, and the general oversight
3of medical cannabis manufacturers and medical cannabis
4dispensaries in this state.
5e. Convening at least twice per year to conduct public
6hearings and to review and recommend for approval petitions,
7which shall be maintained as confidential personal health
8information, to add chronic or debilitating diseases or
9medical conditions or their medical treatments to the list of
10debilitating medical conditions that qualify for the use of
11medical cannabis under this chapter.
12f. Recommending improvements relating to the effectiveness
13of the provisions of this chapter.
14g. In making recommendations pursuant to this section,
15consideration of the economic and financial impacts on patients
16and the medical cannabis industry, and making recommendations
17that minimize the extent of such impacts to the greatest extent
18practicable.
19 Sec. 10. NEW SECTION. 124F.6 Medical cannabis manufacturer
20licensure.
211. a. The department shall license up to four medical
22cannabis manufacturers to manufacture medical cannabis within
23this state consistent with the provisions of this chapter by
24December 1, 2019. The department shall license new medical
25cannabis manufacturers or relicense the existing medical
26cannabis manufacturers by December 1 of each year.
27b. Information submitted during the application process
28shall be confidential until the medical cannabis manufacturer
29is licensed by the department unless otherwise protected from
30disclosure under state or federal law.
312. As a condition for licensure, a medical cannabis
32manufacturer must agree to begin supplying medical cannabis to
33medical cannabis dispensaries in this state by July 2, 2020.
343. The department shall consider the following factors in
35determining whether to license a medical cannabis manufacturer:
-9- 1a. The technical expertise of the medical cannabis
2manufacturer regarding medical cannabis.
3b. The qualifications of the medical cannabis manufacturer’s
4ownership and management team.
5c. The long-term financial stability of the medical cannabis
6manufacturer.
7d. The ability to provide appropriate security measures on
8the premises of the medical cannabis manufacturer.
9e. Whether the medical cannabis manufacturer has
10demonstrated an ability to meet certain medical cannabis
11production needs for medical use regarding the range of
12recommended dosages for each debilitating medical condition,
13the range of chemical compositions of any plant of the genus
14cannabis that will likely be medically beneficial for each
15of the debilitating medical conditions, and the form of the
16medical cannabis in the manner determined by the department
17pursuant to rule.
18f. The medical cannabis manufacturer’s projection of and
19ongoing assessment of fees on patients with debilitating
20medical conditions.
21g. The medical cannabis manufacturer’s experience in medical
22cannabis production, plant extraction, and pharmaceutical
23formulations.
244. The department shall require each medical cannabis
25manufacturer to contract with a laboratory approved by the
26department to test the medical cannabis produced by the
27manufacturer. The department shall require that the laboratory
28report testing results to the manufacturer in a manner
29determined by the department pursuant to rule.
305. Each entity submitting an application for licensure
31as a medical cannabis manufacturer shall pay a nonrefundable
32application fee of fifteen thousand dollars to the department.
33 Sec. 11. NEW SECTION. 124F.7 Medical cannabis
34manufacturers.
351. A medical cannabis manufacturer shall contract with a
-10-1laboratory approved by the department for purposes of testing
2the medical cannabis manufactured by the medical cannabis
3manufacturer as to content, contamination, and consistency.
4The cost of all laboratory testing shall be paid by the medical
5cannabis manufacturer.
62. The operating documents of a medical cannabis
7manufacturer shall include all of the following:
8a. Procedures for the oversight of the medical cannabis
9manufacturer and procedures to ensure accurate recordkeeping.
10b. Procedures for the implementation of appropriate security
11measures to deter and prevent the theft of medical cannabis and
12unauthorized entrance into areas containing medical cannabis.
133. A medical cannabis manufacturer shall implement security
14requirements, including requirements for protection of each
15location by a fully operational security alarm system, facility
16access controls, perimeter intrusion detection systems, and a
17personnel identification system.
184. A medical cannabis manufacturer shall not share
19office space with, refer patients to, or have any financial
20relationship with a health care practitioner.
215. A medical cannabis manufacturer shall not permit any
22person to consume medical cannabis on the property of the
23medical cannabis manufacturer.
246. A medical cannabis manufacturer is subject to reasonable
25inspection by the department.
267. A medical cannabis manufacturer shall not employ a
27person who is under eighteen years of age or who has been
28convicted of a disqualifying felony offense. An employee
29of a medical cannabis manufacturer shall be subject to a
30background investigation conducted by the division of criminal
31investigation of the department of public safety and a national
32criminal history background check.
338. A medical cannabis manufacturer shall not operate in any
34location, whether for manufacturing, cultivating, harvesting,
35packaging, or processing, within one thousand feet of a public
-11-1or private school existing before the date of the medical
2cannabis manufacturer’s licensure by the department.
39. A medical cannabis manufacturer shall comply with
4reasonable restrictions set by the department relating to
5signage, marketing, display, and advertising of medical
6cannabis.
710. a. A medical cannabis manufacturer shall provide a
8reliable and ongoing supply of medical cannabis to medical
9cannabis dispensaries pursuant to this chapter.
10b. All manufacturing, cultivating, harvesting, packaging,
11and processing of medical cannabis shall take place in an
12enclosed, locked facility at a physical address provided to the
13department during the licensure process.
14c. A medical cannabis manufacturer shall not manufacture
15edible medical cannabis products utilizing food coloring.
16d. A medical cannabis manufacturer shall manufacture a
17reliable and ongoing supply of medical cannabis to treat every
18debilitating medical condition listed in this chapter.
1911. The department shall establish and collect an annual
20fee from a medical cannabis manufacturer not to exceed the cost
21of regulating and inspecting the manufacturer in the calendar
22year.
23 Sec. 12. NEW SECTION. 124F.8 Medical cannabis dispensary
24licensure.
251. a. The department shall license by April 2, 2020, twelve
26medical cannabis dispensaries to dispense medical cannabis
27within this state consistent with the provisions of this
28chapter. The department shall license new medical cannabis
29dispensaries or relicense the existing medical cannabis
30dispensaries by December 1 of each year.
31b. Information submitted during the application process
32shall be confidential until the medical cannabis dispensary
33is licensed by the department unless otherwise protected from
34disclosure under state or federal law.
352. As a condition for licensure, a medical cannabis
-12-1dispensary must agree to begin supplying medical cannabis to
2patients by July 16, 2020.
33. The department shall consider the following factors in
4determining whether to license a medical cannabis dispensary:
5a. The technical expertise of the medical cannabis
6dispensary regarding medical cannabis.
7b. The qualifications of the medical cannabis dispensary’s
8owners and management team.
9c. The long-term financial stability of the medical cannabis
10dispensary.
11d. The ability to provide appropriate security measures on
12the premises of the medical cannabis dispensary.
13e. The medical cannabis dispensary’s projection and ongoing
14assessment of fees for the purchase of medical cannabis on
15patients with debilitating medical conditions.
164. Each entity submitting an application for licensure
17as a medical cannabis dispensary shall pay a nonrefundable
18application fee of fifteen thousand dollars to the department.
19 Sec. 13. NEW SECTION. 124F.9 Medical cannabis dispensaries.
201. a. Medical cannabis dispensaries shall be located based
21on geographical need throughout the state to improve patient
22access.
23b. A medical cannabis dispensary may dispense medical
24cannabis pursuant to the provisions of this chapter but shall
25not dispense any medical cannabis in a form or quantity other
26than the form or quantity allowed by the department pursuant
27to rule.
282. The operating documents of a medical cannabis dispensary
29shall include all of the following:
30a. Procedures for the oversight of the medical cannabis
31dispensary and procedures to ensure accurate recordkeeping.
32b. Procedures for the implementation of appropriate security
33measures to deter and prevent the theft of medical cannabis and
34unauthorized entrance into areas containing medical cannabis.
353. A medical cannabis dispensary shall implement security
-13-1requirements, including requirements for protection by a fully
2operational security alarm system, facility access controls,
3perimeter intrusion detection systems, and a personnel
4identification system.
54. A medical cannabis dispensary shall not share office
6space with, refer patients to, or have any financial
7relationship with a health care practitioner.
85. A medical cannabis dispensary shall not permit any person
9to consume medical cannabis on the property of the medical
10cannabis dispensary.
116. A medical cannabis dispensary is subject to reasonable
12inspection by the department.
137. A medical cannabis dispensary shall not employ a
14person who is under eighteen years of age or who has been
15convicted of a disqualifying felony offense. An employee
16of a medical cannabis dispensary shall be subject to a
17background investigation conducted by the division of criminal
18investigation of the department of public safety and a national
19criminal history background check.
208. A medical cannabis dispensary shall not operate in any
21location within one thousand feet of a public or private school
22existing before the date of the medical cannabis dispensary’s
23licensure by the department.
249. A medical cannabis dispensary shall comply with
25reasonable restrictions set by the department relating to
26signage, marketing, display, and advertising of medical
27cannabis.
2810. Prior to dispensing of any medical cannabis, a medical
29cannabis dispensary shall do all of the following:
30a. Verify that the medical cannabis dispensary has received
31a valid medical cannabis registration card from a patient or a
32patient’s primary caregiver, if applicable.
33b. Assign a tracking number to any medical cannabis
34dispensed from the medical cannabis dispensary.
35c. (1) Properly package medical cannabis in compliance with
-14-1federal law regarding child resistant packaging and exemptions
2for packaging for elderly patients, and label medical cannabis
3with a list of all active ingredients and individually
4identifying information, including all of the following:
5(a) The name and date of birth of the patient and the
6patient’s primary caregiver, if appropriate.
7(b) The medical cannabis registration card numbers of the
8patient 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
11not be limited to all of the following:
12(a) Warning labels regarding the use of medical cannabis by
13a woman during pregnancy and while breastfeeding.
14(b) Clearly labeled packaging indicating that an edible
15medical cannabis product contains medical cannabis and which
16packaging shall not imitate candy products or in any way make
17the product marketable to children.
18 Sec. 14. NEW SECTION. 124F.10 Fees.
19Medical cannabis registration card fees and medical cannabis
20manufacturer and medical cannabis dispensary application
21and annual fees collected by the department pursuant to
22this chapter shall be retained by the department, shall be
23considered repayment receipts as defined in section 8.2, and
24shall be used for the purpose of regulating medical cannabis
25manufacturers and medical cannabis dispensaries and for other
26expenses necessary for the administration of this chapter.
27 Sec. 15. NEW SECTION. 124F.11 Department duties — rules.
281. a. The department shall maintain a confidential file of
29the names of each patient to or for whom the department issues
30a medical cannabis registration card, the name of each primary
31caregiver to whom the department issues a medical cannabis
32registration card under section 124F.4, and the names of each
33health care practitioner who provides a written certification
34for medical cannabis pursuant to this chapter.
35b. Individual names contained in the file shall be
-15-1confidential and shall not be subject to disclosure, except as
2provided in subparagraph (1).
3(1) Information in the confidential file maintained
4pursuant to paragraph “a” may be released on an individual basis
5to the following persons under the following circumstances:
6(a) To authorized employees or agents of the department and
7the department of transportation as necessary to perform the
8duties of the department and the department of transportation
9pursuant to this chapter.
10(b) To authorized employees of state or local law
11enforcement agencies, but only for the purpose of verifying
12that a person is lawfully in possession of a medical cannabis
13registration card issued pursuant to this chapter.
14(c) To authorized employees of a medical cannabis
15dispensary, but only for the purpose of verifying that a person
16is lawfully in possession of a medical cannabis registration
17card issued pursuant to this chapter.
18(d) To any other authorized persons recognized by the
19department by rule, but only for the purpose of verifying
20that a person is lawfully in possession of a medical cannabis
21registration card issued pursuant to this chapter.
22(2) Release of information pursuant to subparagraph
23(1) shall be consistent with the federal Health Insurance
24Portability and Accountability Act of 1996, Pub.L. No.
25104-191.
262. The department shall adopt rules pursuant to chapter
2717A to administer this chapter which shall include but not be
28limited to rules to do all of the following:
29a. Govern the manner in which the department shall consider
30applications for new and renewal medical cannabis registration
31cards.
32b. Identify criteria and set forth procedures for
33including additional chronic or debilitating diseases or
34medical conditions or their medical treatments on the list of
35debilitating medical conditions that qualify for the use of
-16-1medical cannabis. Procedures shall include a petition process
2and shall allow for public comment and public hearings before
3the medical advisory board.
4c. Set forth additional chronic or debilitating diseases
5or medical conditions or associated medical treatments for
6inclusion on the list of debilitating medical conditions that
7qualify for the use of medical cannabis as recommended by the
8medical advisory board.
9d. Establish, in consultation with medical cannabis
10manufacturers and medical cannabis dispensaries, the form and
11quantity of medical cannabis allowed to be dispensed to a
12patient or primary caregiver pursuant to this chapter. The
13form and quantity of medical cannabis shall be appropriate to
14serve the medical needs of patients with debilitating medical
15conditions.
16e. Establish, in conjunction with the medical advisory
17board, requirements for the licensure of medical cannabis
18manufacturers and medical cannabis dispensaries and set forth
19procedures for medical cannabis manufacturers and medical
20cannabis dispensaries to obtain licenses.
21f. Develop a dispensing system for medical cannabis within
22this state that provides for all of the following:
23(1) Medical cannabis dispensaries within this state housed
24on secured grounds and operated by licensed medical cannabis
25dispensaries.
26(2) The dispensing of medical cannabis to patients and
27their primary caregivers to occur at locations designated by
28the department.
29g. Establish and collect annual fees from medical cannabis
30manufacturers and medical cannabis dispensaries to cover
31the costs associated with regulating and inspecting medical
32cannabis manufacturers and medical cannabis dispensaries.
33h. Specify and implement procedures that address public
34safety including security procedures and product quality
35including measures to ensure contaminant-free cultivation of
-17-1medical cannabis, safety, and labeling.
2i. Establish and implement a medical cannabis inventory
3and delivery tracking system to track medical cannabis
4from production by a medical cannabis manufacturer through
5dispensing at a medical cannabis dispensary.
6 Sec. 16. NEW SECTION. 124F.12 Reciprocity.
7A valid medical cannabis registration card, or its
8equivalent, issued under the laws of another state that allows
9an out-of-state patient to possess or use medical cannabis in
10the jurisdiction of issuance shall have the same force and
11effect as a valid medical cannabis registration card issued
12pursuant to this chapter, except that an out-of-state patient
13in this state shall not obtain medical cannabis from a medical
14cannabis dispensary in this state and an out-of-state patient
15shall not smoke medical cannabis.
16 Sec. 17. NEW SECTION. 124F.13 Use of medical cannabis —
17affirmative defenses.
181. A health care practitioner, including any authorized
19agent or employee thereof, shall not be subject to
20prosecution for the unlawful certification, possession, or
21administration of marijuana under the laws of this state for
22activities arising directly out of or directly related to the
23certification or use of medical cannabis in the treatment of
24a patient diagnosed with a debilitating medical condition as
25authorized by this chapter.
262. A medical cannabis manufacturer, including any
27authorized agent or employee thereof, shall not be subject
28to prosecution for manufacturing, possessing, cultivating,
29harvesting, packaging, processing, transporting, or supplying
30medical cannabis pursuant to this chapter.
313. A medical cannabis dispensary, including any authorized
32agent or employee thereof, shall not be subject to prosecution
33for transporting, supplying, or dispensing medical cannabis
34pursuant to this chapter.
35a. In a prosecution for the unlawful possession of marijuana
-18-1under the laws of this state, including but not limited to
2chapters 124 and 453B, it is an affirmative and complete
3defense to the prosecution that the patient has been diagnosed
4with a debilitating medical condition, used or possessed
5medical cannabis pursuant to a certification by a health care
6practitioner as authorized under this chapter, and, for a
7patient eighteen years of age or older, is in possession of a
8valid medical cannabis registration card.
9b. In a prosecution for the unlawful possession of marijuana
10under the laws of this state, including but not limited to
11chapters 124 and 453B, it is an affirmative and complete
12defense to the prosecution that the person possessed medical
13cannabis because the person is a primary caregiver of a patient
14who has been diagnosed with a debilitating medical condition
15and is in possession of a valid medical cannabis registration
16card, and where the primary caregiver’s possession of the
17medical cannabis is on behalf of the patient and for the
18patient’s use only as authorized under this chapter.
19c. If a patient or primary caregiver is charged with the
20commission of a crime and is not in possession of the person’s
21medical cannabis registration card, any charge or charges filed
22against the person shall be dismissed by the court if the
23person produces to the court prior to or at the person’s trial
24a medical cannabis registration card issued to that person and
25valid at the time the person was charged.
264. An agency of this state or a political subdivision
27thereof, including any law enforcement agency, shall not remove
28or initiate proceedings to remove a patient under the age
29of eighteen from the home of a parent based solely upon the
30parent’s or patient’s possession or use of medical cannabis as
31authorized under this chapter.
32 Sec. 18. NEW SECTION. 124F.14 Penalties.
331. A person who knowingly or intentionally possesses or
34uses medical cannabis in violation of the requirements of this
35chapter is subject to the penalties provided under chapters 124
-19-1and 453B.
22. A medical cannabis manufacturer or a medical cannabis
3dispensary shall be assessed a civil penalty of up to one
4thousand dollars per violation for any violation of this
5chapter in addition to any other applicable penalties.
6 Sec. 19. NEW SECTION. 124F.15 Use of medical cannabis —
7smoking prohibited.
8A patient shall not consume medical cannabis possessed
9or used as authorized under this chapter by smoking medical
10cannabis.
11 Sec. 20. NEW SECTION. 124F.16 Employment.
121. An employer in this state may retain, create, reinstate,
13or enforce a written zero tolerance policy prohibiting the
14possession or use of medical cannabis or any derivative
15thereof including cannabidiol by an employee in the employer’s
16workplace, including but not limited to a policy prohibiting
17an employee from having any detectable amount of medical
18cannabis or any derivative thereof including cannabidiol in the
19employee’s body while at work.
202. An employer’s prohibition of the possession or use
21of medical cannabis or any derivative thereof including
22cannabidiol under this section shall not be considered to be
23an unfair or discriminatory employment practice under section
24216.6.
25 Sec. 21. Section 730.5, subsection 11, paragraph f, Code
262019, is amended to read as follows:
27f. Testing or taking action against an employee or
28prospective employee with a confirmed positive test result due
29to the employee’s or prospective employee’s use of medical
30cannabidiol 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
33emergency rules under section 17A.4, subsection 3, and section
3417A.5, subsection 2, paragraph “b”, to implement the provisions
35of this division of this Act and the rules shall be effective
-20-1immediately upon filing unless a later date is specified in the
2rules. Any rules adopted in accordance with this section shall
3also be published as a notice of intended action as provided
4in section 17A.4.
5 Sec. 24. TRANSITION PROVISIONS.
61. A medical cannabidiol registration card issued
7under chapter 124E prior to the effective date of this Act
8remains effective and continues in effect as issued for the
9twelve-month period following its issuance. This Act does not
10preclude a medical cannabidiol registration card holder from
11seeking to renew the registration card prior to the expiration
12of the twelve-month period.
132. Members of the medical cannabidiol board created in
14section 124E.5 shall continue to serve until the appointment of
15the medical advisory board created in section 124F.5.
163. Any rule, form, order, license, or directive promulgated
17by the medical cannabidiol board created in section 124E.5, or
18by the department, in force and effect immediately prior to the
19appointment of the medical advisory board, shall continue in
20full force and effect until the earlier of the following:
21a. It is amended, rescinded, or supplemented by the
22affirmative actions of the medical advisory board or the
23department, as applicable.
24b. It expires by its own terms.
254. A medical cannabidiol manufacturer licensed pursuant
26to section 124E.6 and operating immediately prior to the
27effective date of this Act shall operate as a medical cannabis
28manufacturer pursuant to section 124F.6 until the earlier of
29the following:
30a. The license is revoked by the affirmative action of the
31department.
32b. The license expires by its own terms.
33c. The medical cannabidiol manufacturer becomes licensed as
34a medical cannabis manufacturer.
355. A medical cannabidiol dispensary licensed pursuant to
-21-1section 124E.8 and operating immediately prior to the effective
2date of this Act shall operate as a medical cannabis dispensary
3pursuant to section 124F.8 until the earlier of the following:
4a. The license is revoked by the affirmative action of the
5department.
6b. The license expires by its own terms.
7c. The medical cannabidiol dispensary becomes licensed as
8a medical cannabis dispensary.
9 Sec. 25. EFFECTIVE UPON ENACTMENT. This Act, being deemed
10of immediate importance, takes effect upon enactment.
11EXPLANATION
12The inclusion of this explanation does not constitute agreement with
13the explanation’s substance by the members of the general assembly.
14This bill creates the compassionate use of medical cannabis
15Act, reclassifies marijuana, including tetrahydrocannabinols,
16from a schedule I controlled substance to a schedule II
17controlled substance, and provides for civil and criminal
18penalties and fees.
19OVERVIEW. The bill allows a patient with a debilitating
20medical condition who receives a written certification from
21the patient’s health care practitioner that the patient has
22a debilitating medical condition and who submits the written
23certification along with an application to the department of
24public health (department) for a medical cannabis registration
25card to allow for the lawful use of medical cannabis to treat
26the patient’s debilitating medical condition. A patient who
27is issued a medical cannabis registration card will be able
28to receive medical cannabis directly from a medical cannabis
29dispensary operated and licensed in this state.
30RECLASSIFICATION. The bill reclassifies marijuana,
31including tetrahydrocannabinols as a schedule II controlled
32substance instead of a schedule I controlled substance and
33strikes references to the authority of the board of pharmacy to
34adopt rules for the use of marijuana or tetrahydrocannabinols
35for medicinal purposes.
-22- 1A schedule I controlled substance is a highly addictive
2substance that has no accepted medical use in the United States
3and a schedule II controlled substance is a highly addictive
4substance that has an accepted medical use in the United
5States. The reclassification of marijuana from a schedule I
6controlled substance to a schedule II controlled substance
7would allow a physician to issue a prescription for marijuana
8under state law. However, federal regulations may prohibit
9such prescriptions.
10The penalties remain unchanged for violations involving
11marijuana under the bill. The penalties under Code section
12124.401 range from a class “B” felony punishable by up to 50
13years of confinement to a serious misdemeanor punishable by
14up to six months of confinement depending on the amount of
15marijuana involved in the offense.
16The bill amends Code section 124.401, relating to prohibited
17acts involving controlled substances, to provide that it is
18lawful for a person to knowingly or intentionally recommend,
19possess, use, dispense, deliver, transport, or administer
20medical cannabis if the recommendation, possession, use,
21dispensing, delivery, transporting, or administering is in
22accordance with the provisions of the bill.
23DEFINITIONS. The bill provides the following definitions:
24“Debilitating medical condition” means cancer, multiple
25sclerosis, epilepsy or seizure disorders, AIDS or HIV,
26Hepatitis C, Crohn’s disease or ulcerative colitis, amyotrophic
27lateral sclerosis, intractable pain, glaucoma, any terminal
28illness with a probable life expectancy of under one year,
29Ehlers-Danlos syndrome, post-traumatic stress disorder,
30Tourette’s syndrome, and any other chronic or debilitating
31disease or medical condition or its medical treatment approved
32by the department by rule.
33“Health care practitioner” means an individual licensed
34under Code chapter 148 to practice medicine and surgery or
35osteopathic medicine and surgery or an individual licensed to
-23-1prescribe medicine in any other state who provides specialty
2care to an Iowa resident for one or more debilitating medical
3conditions specified in the bill.
4“Medical cannabis” means any species of the genus cannabis
5plant, or any mixture or preparation of them, including whole
6plant extracts and resins.
7“Medical cannabis manufacturer” means an entity licensed
8by the department to manufacture and to possess, cultivate,
9transport, or supply, medical cannabis pursuant to the bill.
10“Medical cannabis dispensary” means an entity licensed under
11the bill that acquires medical cannabis from a medical cannabis
12manufacturer in this state for the purpose of dispensing
13medical cannabis in this state pursuant to the bill.
14“Primary caregiver” means a person, at least 18 years of age,
15who has been designated by a patient’s health care practitioner
16or a person having custody of a patient, as a necessary
17caretaker taking responsibility for managing the well-being
18of the patient with respect to the use of medical cannabis
19pursuant to the bill.
20“Written certification” means a document signed by a health
21care practitioner, with whom the patient has established a
22patient-provider relationship, which states that the patient
23has a debilitating medical condition and which identifies that
24condition, and provides any other relevant information.
25HEALTH CARE PRACTITIONER CERTIFICATION. The bill provides
26that prior to a patient’s submission of an application
27for a medical cannabis registration card, if a health care
28practitioner determines that the patient whom the health
29care practitioner has examined and treated suffers from a
30debilitating medical condition, the health care practitioner
31may provide the patient with a written certification of that
32diagnosis. The health care practitioner must also provide
33explanatory information to the patient about the therapeutic
34use of medical cannabis, and if the patient continues to
35suffer from a debilitating medical condition, the health care
-24-1practitioner may issue the patient a new certification of
2that diagnosis on an annual basis. The bill specifies that
3a health care practitioner has no duty to provide a written
4certification.
5MEDICAL CANNABIS REGISTRATION CARD — PATIENT AND PRIMARY
6CAREGIVER. The department may approve the issuance of a
7medical cannabis registration card to a patient who is at least
818 years of age and is a permanent resident of this state, who
9submits a written certification by the patient’s health care
10practitioner to the department, and who submits an application
11to the department with certain information along with a medical
12registration card fee. The department may also approve the
13issuance of a medical cannabis registration card to a primary
14caregiver who is at least 18 years of age, who submits a
15written certification by the patient’s health care practitioner
16to the department on behalf of the patient, and who submits an
17application to the department with certain information along
18with a medical cannabis registration card fee. A medical
19cannabis registration card expires one year after the date of
20issuance and may be renewed.
21MEDICAL ADVISORY BOARD. The director of public health is
22directed to establish a medical advisory board, no later than
23August 15, 2019, to consist of nine practitioners representing
24the fields of neurology, pain management, gastroenterology,
25oncology, psychiatry, pediatrics, infectious disease,
26family medicine, and pharmacy, and three patients or primary
27caregivers with valid medical cannabis registration cards. The
28duties of the board include but are not limited to reviewing
29and recommending to the department for approval additional
30chronic or debilitating diseases or medical conditions or their
31treatments as debilitating medical conditions that qualify for
32the use of medical cannabis under the bill.
33MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS
34DISPENSARIES — LICENSURE. The bill requires the department
35to license up to four medical cannabis manufacturers for
-25-1the manufacture of medical cannabis within this state by
2December 1, 2019, and to license twelve medical cannabis
3dispensaries by April 2, 2020. Information submitted during
4the application process is confidential until the medical
5cannabis manufacturer or the medical cannabis dispensary is
6licensed by the department unless otherwise protected from
7disclosure under state or federal law. As a condition for
8licensure, a medical cannabis manufacturer must agree to begin
9supplying medical cannabis to medical cannabis dispensaries in
10this state by July 2, 2020, and a medical cannabis dispensary
11must agree to begin supplying medical cannabis to patients by
12July 16, 2020. The department is directed to consider several
13factors in determining whether to license a medical cannabis
14manufacturer and a medical cannabis dispensary including
15technical expertise, employee qualifications, financial
16stability, security measures, and production needs and
17capacity. Each medical cannabis manufacturer is required to
18contract with a laboratory approved by the department to test
19the medical cannabis produced by the manufacturer and to report
20testing results to the medical cannabis manufacturer. Each
21entity submitting an application for licensure as a medical
22cannabis manufacturer shall pay a nonrefundable application
23fee of $15,000 to the department and each entity submitting
24an application for licensure as a medical cannabis dispensary
25shall pay a nonrefundable application fee of $15,000 to the
26department.
27MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS
28DISPENSARIES — ADDITIONAL PROVISIONS. The operating
29documents of a medical cannabis manufacturer and a medical
30cannabis dispensary shall include procedures for oversight and
31recordkeeping activities of the medical cannabis manufacturer
32and the medical cannabis dispensary and certain security
33measures undertaken by the medical cannabis manufacturer
34and the medical cannabis dispensary. A medical cannabis
35manufacturer and a medical cannabis dispensary are prohibited
-26-1from sharing office space with, referring patients to,
2or having a financial relationship with a health care
3practitioner, permitting any person to consume medical cannabis
4on the property of the medical cannabis manufacturer or the
5medical cannabis dispensary, employing a person who is under
618 years of age or who has been convicted of a disqualifying
7felony offense, and from operating in any location within 1,000
8feet of a public or private school existing before the date
9of the licensure of the medical cannabis manufacturer or the
10medical cannabis dispensary. In addition, a medical cannabis
11manufacturer and a medical cannabis dispensary are subject to
12reasonable inspection and certain reasonable restrictions.
13A medical cannabis manufacturer is required to provide a
14reliable and ongoing supply of medical cannabis to medical
15cannabis dispensaries and shall not manufacture edible medical
16cannabis products utilizing food coloring. All manufacturing,
17cultivating, harvesting, packaging, and processing of medical
18cannabis is required to take place in an enclosed, locked
19facility.
20Prior to dispensing any medical cannabis, a medical cannabis
21dispensary is required to verify that the medical cannabis
22dispensary has received a valid medical cannabis registration
23card from a patient or a patient’s primary caregiver, if
24applicable, assign a tracking number to any medical cannabis
25dispensed from the medical cannabis dispensary, and properly
26package and label medical cannabis in compliance with the
27provisions of the bill and certain federal laws.
28DEPARTMENT DUTIES — CONFIDENTIALITY. The department
29is required to maintain a confidential file of the names
30of each patient and primary caregiver issued a medical
31cannabis registration card, and the names of each health
32care practitioner who provides a written certification for
33medical cannabis under the bill. Individual names contained
34in the file shall be confidential and shall not be subject to
35disclosure, except that information in the confidential file
-27-1may be released on an individual basis to authorized employees
2or agents of the department, the department of transportation,
3and a medical cannabis dispensary as necessary to perform
4their duties, to authorized employees of state or local law
5enforcement agencies for the purpose of verifying that a person
6is lawfully in possession of a medical cannabis registration
7card, and to any other authorized employees for the purpose of
8verifying that a person is lawfully in possession of a medical
9cannabis registration card. Release of information must also
10be consistent with federal Health Insurance Portability and
11Accountability Act regulations.
12ADDITIONAL DEPARTMENT DUTIES — RULES. The bill requires
13the department to adopt rules relating to the manner in which
14the department shall consider applications for new and renewal
15medical cannabis registration cards, identify criteria and
16set forth procedures for including additional chronic or
17debilitating diseases or medical conditions or their medical
18treatments on the list of debilitating medical conditions,
19establish the form and quantity of medical cannabis allowed to
20be dispensed to a patient or primary caregiver in the form and
21quantity appropriate to serve the medical needs of the patient
22with the debilitating medical condition, establish requirements
23for the licensure of medical cannabis manufacturers and medical
24cannabis dispensaries, develop a dispensing system for medical
25cannabis within this state that follows certain requirements,
26establish and implement a medical cannabis inventory and
27delivery tracking system, and specify and implement procedures
28that address public safety including security procedures and
29product quality, safety, and labeling.
30RECIPROCITY. The bill provides that a valid medical
31cannabis registration card, or its equivalent, issued under
32the laws of another state that allows an out-of-state patient
33to possess or use medical cannabis in the jurisdiction of
34issuance shall have the same force and effect as a valid
35medical cannabis card issued under the bill, except that an
-28-1out-of-state patient in this state shall not obtain medical
2cannabis from a medical cannabis dispensary and an out-of-state
3patient shall not smoke medical cannabis in this state.
4USE OF MEDICAL CANNABIS — SMOKING PROHIBITED. The bill
5provides that a patient shall not consume the medical cannabis
6by smoking the medical cannabis.
7USE OF MEDICAL CANNABIS — AFFIRMATIVE DEFENSES. The bill
8provides prosecution immunity for a health care practitioner,
9a medical cannabis manufacturer, and a medical cannabis
10dispensary, including any authorized agents or employees of the
11health care practitioner, medical cannabis manufacturer, and
12medical cannabis dispensary, for activities undertaken by the
13health care practitioner, medical cannabis manufacturer, and
14medical cannabis dispensary pursuant to the provisions of the
15bill.
16The bill provides that in a prosecution for the unlawful
17possession of marijuana under the laws of this state,
18including but not limited to Code chapters 124 (controlled
19substances) and 453B (excise tax on unlawful dealing in
20certain substances), it is an affirmative and complete
21defense to the prosecution that the patient has been diagnosed
22with a debilitating medical condition, used or possessed
23medical cannabis pursuant to a certification by a health
24care practitioner, and, for a patient age 18 or older, is
25in possession of a valid medical cannabis registration
26card. The bill provides a similar affirmative defense for a
27primary caretaker of a patient who has been diagnosed with a
28debilitating medical condition who is in possession of a valid
29medical cannabis registration card.
30The bill provides that an agency of this state or a political
31subdivision thereof, including any law enforcement agency,
32shall not remove or initiate proceedings to remove a patient
33under the age of 18 from the home of a parent based solely upon
34the parent’s or patient’s possession or use of medical cannabis
35as authorized under the bill.
-29- 1PENALTIES. The bill provides that a person who knowingly or
2intentionally possesses or uses medical cannabis in violation
3of the requirements of the bill is subject to the penalties
4provided under Code chapters 124 and 453B. In addition, a
5medical cannabis manufacturer or a medical cannabis dispensary
6shall be assessed a civil penalty of up to $1,000 per violation
7for any violation of the bill in addition to any other
8applicable penalties.
9REPEAL. The bill repeals Code chapter 124E, the medical
10cannabidiol Act.
11EMERGENCY RULES. The bill provides that the department
12may adopt emergency rules and the rules shall be effective
13immediately upon filing unless a later date is specified in the
14rules.
15EFFECTIVE DATE. The bill takes effect upon enactment.
16TRANSITION PROVISIONS. The bill provides that a medical
17cannabis registration card issued under Code chapter 124E
18(medical cannabidiol Act) prior to the effective date of the
19bill, shall remain effective and continues in effect as issued
20for the 12-month period following its issuance. The bill also
21provides that members of the medical cannabidiol board shall
22continue to serve until the appointment of the medical advisory
23board and that rules, forms, orders, licenses, and directives
24promulgated by the medical cannabidiol board that are in force
25and effect immediately prior to the appointment of the medical
26advisory board shall remain in full force and effect until
27amended, rescinded, or supplemented by affirmative actions of
28the medical advisory board or they expire by their own terms.
-30-ss/rh