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House File 221 - 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
-1-1nabilone: (+-) -
2trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1-hydroxy-6,6-
3dimethyl-9H-dibenzo[b,d]pyran-9-one].
4c. d. Dronabinol [(-)-delta-9-trans-tetrahydrocannabinol]
5in an oral solution in a drug product approved for marketing by
6the United States food and drug administration.
7 Sec. 4. Section 124.401, subsection 5, unnumbered paragraph
83, Code 2019, is amended to read as follows:
9A person may knowingly or intentionally recommend, possess,
10use, dispense, deliver, transport, or administer cannabidiol
11 medical cannabis if the recommendation, possession, use,
12dispensing, delivery, transporting, or administering is in
13accordance with the provisions of chapter 124E 124F. For
14purposes of this paragraph, “cannabidiol” “medical cannabis”
15 means the same as defined in section 124E.2 124F.2.
16 Sec. 5. NEW SECTION. 124F.1 Short title.
17This chapter shall be known and may be cited as the
18“Compassionate Use of Medical Cannabis Act”.
19 Sec. 6. NEW SECTION. 124F.2 Definitions.
20As used in this chapter:
211. “Debilitating medical condition” means any of the
22following:
23a. Cancer, if the underlying condition or treatment produces
24one or more of the following:
25(1) Intractable pain.
26(2) Nausea or severe vomiting.
27(3) Cachexia or severe wasting.
28b. Multiple sclerosis.
29c. Epilepsy or seizure disorders.
30d. AIDS or HIV as defined in section 141A.1.
31e. Glaucoma.
32f. Hepatitis C.
33g. Crohn’s disease or ulcerative colitis.
34h. Amyotrophic lateral sclerosis.
35i. Ehlers-Danlos syndrome.
-2- 1j. Post-traumatic stress disorder.
2k. Tourette’s syndrome.
3l. Any terminal illness, with a probable life expectancy of
4under one year, if the illness or its treatment produces one or
5more of the following:
6(1) Intractable pain.
7(2) Nausea or severe vomiting.
8(3) Cachexia or severe wasting.
9m. Intractable pain.
10n. Parkinson’s disease.
11o. Muscular dystrophy.
12p. Huntington’s disease.
13q. Alzheimer’s disease.
14r. Complex regional pain syndrome, type I and II.
15s. Rheumatoid arthritis.
16t. Polyarteritis nodosa.
17u. Any other chronic or debilitating disease or medical
18condition or its medical treatment approved by the department
19pursuant to rule.
202. “Department” means the department of public health.
213. “Disqualifying felony offense” means a violation under
22federal or state law of a felony offense, which has as an
23element the possession, use, or distribution of a controlled
24substance, as defined in 21 U.S.C. §802(6).
254. “Enclosed, locked facility” means a closet, room,
26greenhouse, or other enclosed area equipped with locks or
27other security devices that permit access only by authorized
28personnel.
295. “Health care practitioner” means an individual licensed
30under chapter 148 to practice medicine and surgery or
31osteopathic medicine and surgery or an individual licensed to
32practice medicine in any other state who provides specialty
33care for an Iowa resident for one or more of the debilitating
34medical conditions provided in this chapter.
356. “Intractable pain” means a pain in which the cause of the
-3-1pain cannot be removed or otherwise treated with the consent
2of the patient and which, in the generally accepted course of
3medical practice, no relief or cure of the cause of the pain
4is possible, or none has been found after reasonable efforts.
5Reasonable efforts for relieving or curing the cause of the
6pain may be determined on the basis of but are not limited to
7any of the following:
8a. When treating a nonterminally ill patient for intractable
9pain, evaluation by the attending physician and one or more
10physicians specializing in pain medicine or the treatment of
11the area, system, or organ of the body perceived as the source
12of the pain.
13b. When treating a terminally ill patient, evaluation by
14the attending physician who does so in accordance with the
15level of care, skill, and treatment that would be recognized
16by a reasonably prudent physician under similar conditions and
17circumstances.
187. “Medical cannabis” means any species of the genus
19cannabis plant, or any mixture or preparation of them,
20including whole plant extracts and resins.
218. “Medical cannabis dispensary” means an entity licensed
22under section 124F.8 that acquires medical cannabis from a
23medical cannabis manufacturer in this state for the purpose
24of dispensing medical cannabis in this state pursuant to this
25chapter.
269. “Medical cannabis manufacturer” means an entity licensed
27under section 124F.6 to manufacture and to possess, cultivate,
28transport, or supply medical cannabis pursuant to the
29provisions of this chapter.
3010. “Primary caregiver” means a person, at least eighteen
31years of age, who has been designated by a patient’s health
32care practitioner or a person having custody of a patient, as
33a necessary caretaker taking responsibility for managing the
34well-being of the patient with respect to the use of medical
35cannabis pursuant to the provisions of this chapter.
-4- 111. “Written certification” means a document signed by a
2health care practitioner, with whom the patient has established
3a patient-provider relationship, which states that the patient
4has a debilitating medical condition and identifies that
5condition and provides any other relevant information.
6 Sec. 7. NEW SECTION. 124F.3 Health care practitioner
7certification — duties.
81. Prior to a patient’s submission of an application for a
9medical cannabis registration card pursuant to section 124F.4,
10a health care practitioner shall do all of the following:
11a. Determine, in the health care practitioner’s medical
12judgment, whether the patient whom the health care practitioner
13has examined and treated suffers from a debilitating medical
14condition that qualifies for the use of medical cannabis under
15this chapter, and if so determined, provide the patient with a
16written certification of that diagnosis.
17b. Provide explanatory information as provided by the
18department to the patient about the therapeutic use of medical
19cannabis.
20c. Determine, on an annual basis, if the patient continues
21to suffer from a debilitating medical condition and, if so,
22issue the patient a new certification of that diagnosis. This
23paragraph shall not apply if the patient is suffering from an
24incurable debilitating medical condition.
25d. Otherwise comply with all requirements established by the
26department pursuant to rule.
272. A health care practitioner may provide, but has no duty
28to provide, a written certification pursuant to this section.
29 Sec. 8. NEW SECTION. 124F.4 Medical cannabis registration
30card.
311. Issuance to patient. The department may approve the
32issuance of a medical cannabis registration card by the
33department of transportation to a patient who:
34a. Is at least eighteen years of age.
35b. Is a permanent resident of this state.
-5- 1c. Submits a written certification to the department signed
2by the patient’s health care practitioner that the patient is
3suffering from a debilitating medical condition.
4d. 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 patient’s full name, Iowa residence address, date
8of birth, and telephone number.
9(2) A copy of the patient’s valid photograph
10identification.
11(3) Full name, address, and telephone number of the
12patient’s health care practitioner.
13(4) Full name, residence address, date of birth, and
14telephone number of each primary caregiver of the patient, if
15any.
16(5) Any other information required by rule.
17e. Submits a medical cannabis registration card fee of one
18hundred dollars to the department. If the patient attests to
19receiving social security disability benefits, supplemental
20security insurance payments, or being enrolled in the medical
21assistance program, the fee shall be twenty-five dollars.
222. Patient card contents. A medical cannabis registration
23card issued to a patient by the department of transportation
24pursuant to subsection 1 shall contain, at a minimum, all of
25the following:
26a. The patient’s full name, Iowa residence address, and date
27of birth.
28b. The patient’s photograph.
29c. The date of issuance and expiration of the registration
30card.
31d. Any other information required by rule.
323. Issuance to primary caregiver. For a patient in a
33primary caregiver’s care, the department may approve the
34issuance of a medical cannabis registration card by the
35department of transportation to the primary caregiver who:
-6- 1a. Submits a written certification to the department signed
2by the patient’s health care practitioner that the patient in
3the primary caregiver’s care is suffering from a debilitating
4medical condition.
5b. Submits an application to the department, on a form
6created by the department, in consultation with the department
7of transportation, that contains all of the following:
8(1) The primary caregiver’s full name, residence address,
9date of birth, and telephone number.
10(2) The patient’s full name.
11(3) A copy of the primary caregiver’s valid photograph
12identification.
13(4) Full name, address, and telephone number of the
14patient’s health care practitioner.
15(5) Any other information required by rule.
16c. Submits a medical cannabis registration card fee of
17twenty-five dollars to the department.
184. Primary caregiver card contents. A medical cannabis
19registration card issued by the department of transportation to
20a primary caregiver pursuant to subsection 3 shall contain, at
21a minimum, all of the following:
22a. The primary caregiver’s full name, residence address, and
23date of birth.
24b. The primary caregiver’s photograph.
25c. The date of issuance and expiration of the registration
26card.
27d. The registration card number of each patient in the
28primary caregiver’s care. If the patient in the primary
29caregiver’s care is under the age of eighteen, the full name of
30the patient’s parent or legal guardian.
31e. Any other information required by rule.
325. Expiration date of card. A medical cannabis registration
33card issued pursuant to this section shall expire one year
34after the date of issuance and may be renewed.
356. Card issuance — department of transportation.
-7- 1a. The department may enter into a chapter 28E agreement
2with the department of transportation to facilitate the
3issuance of medical cannabis registration cards pursuant to
4subsections 1 and 3.
5b. The department of transportation may issue renewal
6medical cannabis registration cards through an online or
7in-person process.
8 Sec. 9. NEW SECTION. 124F.5 Medical advisory board —
9duties.
101. No later than August 15, 2019, the director of public
11health shall establish a medical advisory board consisting of
12nine practitioners representing the fields of neurology, pain
13management, gastroenterology, oncology, psychiatry, pediatrics,
14infectious disease, family medicine, and pharmacy, and three
15patients or primary caregivers with valid medical cannabis
16registration cards. The practitioners shall be nationally
17board-certified in their area of specialty and knowledgeable
18about the use of medical cannabis.
192. A quorum of the advisory board shall consist of seven
20members.
213. The duties of the advisory board shall include but not be
22limited to the following:
23a. Reviewing and recommending to the department for
24approval additional chronic or debilitating diseases or
25medical conditions or their treatments as debilitating medical
26conditions that qualify for the use of medical cannabis under
27this chapter.
28b. Accepting and reviewing petitions to add chronic or
29debilitating diseases or medical conditions or their medical
30treatments to the list of debilitating medical conditions that
31qualify for the use of medical cannabis under this chapter.
32c. Working with the department regarding the requirements
33for the licensure of medical cannabis manufacturers and medical
34cannabis dispensaries, including licensure procedures.
35d. Advising the department regarding the location of
-8-1medical cannabis dispensaries throughout the state, the form
2and quantity of allowable medical cannabis to be dispensed
3to a patient or primary caregiver, and the general oversight
4of medical cannabis manufacturers and medical cannabis
5dispensaries in this state.
6e. Convening at least twice per year to conduct public
7hearings and to review and recommend for approval petitions,
8which shall be maintained as confidential personal health
9information, to add chronic or debilitating diseases or
10medical conditions or their medical treatments to the list of
11debilitating medical conditions that qualify for the use of
12medical cannabis under this chapter.
13f. Recommending improvements relating to the effectiveness
14of the provisions of this chapter.
15g. In making recommendations pursuant to this section,
16consideration of the economic and financial impacts on patients
17and the medical cannabis industry, and making recommendations
18that minimize the extent of such impacts to the greatest extent
19practicable.
20 Sec. 10. NEW SECTION. 124F.6 Medical cannabis manufacturer
21licensure.
221. a. The department shall license up to four medical
23cannabis manufacturers to manufacture medical cannabis within
24this state consistent with the provisions of this chapter by
25December 1, 2019. The department shall license new medical
26cannabis manufacturers or relicense the existing medical
27cannabis manufacturers by December 1 of each year.
28b. Information submitted during the application process
29shall be confidential until the medical cannabis manufacturer
30is licensed by the department unless otherwise protected from
31disclosure under state or federal law.
322. As a condition for licensure, a medical cannabis
33manufacturer must agree to begin supplying medical cannabis to
34medical cannabis dispensaries in this state by July 2, 2020.
353. The department shall consider the following factors in
-9-1determining whether to license a medical cannabis manufacturer:
2a. The technical expertise of the medical cannabis
3manufacturer regarding medical cannabis.
4b. The qualifications of the medical cannabis manufacturer’s
5ownership and management team.
6c. The long-term financial stability of the medical cannabis
7manufacturer.
8d. The ability to provide appropriate security measures on
9the premises of the medical cannabis manufacturer.
10e. Whether the medical cannabis manufacturer has
11demonstrated an ability to meet certain medical cannabis
12production needs for medical use regarding the range of
13recommended dosages for each debilitating medical condition,
14the range of chemical compositions of any plant of the genus
15cannabis that will likely be medically beneficial for each
16of the debilitating medical conditions, and the form of the
17medical cannabis in the manner determined by the department
18pursuant to rule.
19f. The medical cannabis manufacturer’s projection of and
20ongoing assessment of fees on patients with debilitating
21medical conditions.
22g. The medical cannabis manufacturer’s experience in medical
23cannabis production, plant extraction, and pharmaceutical
24formulations.
254. The department shall require each medical cannabis
26manufacturer to contract with a laboratory approved by the
27department to test the medical cannabis produced by the
28manufacturer. The department shall require that the laboratory
29report testing results to the manufacturer in a manner
30determined by the department pursuant to rule.
315. Each entity submitting an application for licensure
32as a medical cannabis manufacturer shall pay a nonrefundable
33application fee of fifteen thousand dollars to the department.
34 Sec. 11. NEW SECTION. 124F.7 Medical cannabis
35manufacturers.
-10- 11. A medical cannabis manufacturer shall contract with a
2laboratory approved by the department for purposes of testing
3the medical cannabis manufactured by the medical cannabis
4manufacturer as to content, contamination, and consistency.
5The cost of all laboratory testing shall be paid by the medical
6cannabis manufacturer.
72. The operating documents of a medical cannabis
8manufacturer shall include all of the following:
9a. Procedures for the oversight of the medical cannabis
10manufacturer and procedures to ensure accurate recordkeeping.
11b. Procedures for the implementation of appropriate security
12measures to deter and prevent the theft of medical cannabis and
13unauthorized entrance into areas containing medical cannabis.
143. A medical cannabis manufacturer shall implement security
15requirements, including requirements for protection of each
16location by a fully operational security alarm system, facility
17access controls, perimeter intrusion detection systems, and a
18personnel identification system.
194. A medical cannabis manufacturer shall not share
20office space with, refer patients to, or have any financial
21relationship with a health care practitioner.
225. A medical cannabis manufacturer shall not permit any
23person to consume medical cannabis on the property of the
24medical cannabis manufacturer.
256. A medical cannabis manufacturer is subject to reasonable
26inspection by the department.
277. A medical cannabis manufacturer shall not employ a
28person who is under eighteen years of age or who has been
29convicted of a disqualifying felony offense. An employee
30of a medical cannabis manufacturer shall be subject to a
31background investigation conducted by the division of criminal
32investigation of the department of public safety and a national
33criminal history background check.
348. A medical cannabis manufacturer shall not operate in any
35location, whether for manufacturing, cultivating, harvesting,
-11-1packaging, or processing, within one thousand feet of a public
2or private school existing before the date of the medical
3cannabis manufacturer’s licensure by the department.
49. A medical cannabis manufacturer shall comply with
5reasonable restrictions set by the department relating to
6signage, marketing, display, and advertising of medical
7cannabis.
810. a. A medical cannabis manufacturer shall provide a
9reliable and ongoing supply of medical cannabis to medical
10cannabis dispensaries pursuant to this chapter.
11b. All manufacturing, cultivating, harvesting, packaging,
12and processing of medical cannabis shall take place in an
13enclosed, locked facility at a physical address provided to the
14department during the licensure process.
15c. A medical cannabis manufacturer shall not manufacture
16edible medical cannabis products utilizing food coloring.
17d. A medical cannabis manufacturer shall manufacture a
18reliable and ongoing supply of medical cannabis to treat every
19debilitating medical condition listed in this chapter.
2011. The department shall establish and collect an annual
21fee from a medical cannabis manufacturer not to exceed the cost
22of regulating and inspecting the manufacturer in the calendar
23year.
24 Sec. 12. NEW SECTION. 124F.8 Medical cannabis dispensary
25licensure.
261. a. The department shall license by April 2, 2020, twelve
27medical cannabis dispensaries to dispense medical cannabis
28within this state consistent with the provisions of this
29chapter. The department shall license new medical cannabis
30dispensaries or relicense the existing medical cannabis
31dispensaries by December 1 of each year.
32b. Information submitted during the application process
33shall be confidential until the medical cannabis dispensary
34is licensed by the department unless otherwise protected from
35disclosure under state or federal law.
-12- 12. As a condition for licensure, a medical cannabis
2dispensary must agree to begin supplying medical cannabis to
3patients by July 16, 2020.
43. The department shall consider the following factors in
5determining whether to license a medical cannabis dispensary:
6a. The technical expertise of the medical cannabis
7dispensary regarding medical cannabis.
8b. The qualifications of the medical cannabis dispensary’s
9owners and management team.
10c. The long-term financial stability of the medical cannabis
11dispensary.
12d. The ability to provide appropriate security measures on
13the premises of the medical cannabis dispensary.
14e. The medical cannabis dispensary’s projection and ongoing
15assessment of fees for the purchase of medical cannabis on
16patients with debilitating medical conditions.
174. Each entity submitting an application for licensure
18as a medical cannabis dispensary shall pay a nonrefundable
19application fee of fifteen thousand dollars to the department.
20 Sec. 13. NEW SECTION. 124F.9 Medical cannabis dispensaries.
211. a. Medical cannabis dispensaries shall be located based
22on geographical need throughout the state to improve patient
23access.
24b. A medical cannabis dispensary may dispense medical
25cannabis pursuant to the provisions of this chapter but shall
26not dispense any medical cannabis in a form or quantity other
27than the form or quantity allowed by the department pursuant
28to rule.
292. The operating documents of a medical cannabis dispensary
30shall include all of the following:
31a. Procedures for the oversight of the medical cannabis
32dispensary and procedures to ensure accurate recordkeeping.
33b. Procedures for the implementation of appropriate security
34measures to deter and prevent the theft of medical cannabis and
35unauthorized entrance into areas containing medical cannabis.
-13- 13. A medical cannabis dispensary shall implement security
2requirements, including requirements for protection by a fully
3operational security alarm system, facility access controls,
4perimeter intrusion detection systems, and a personnel
5identification system.
64. A medical cannabis dispensary shall not share office
7space with, refer patients to, or have any financial
8relationship with a health care practitioner.
95. A medical cannabis dispensary shall not permit any person
10to consume medical cannabis on the property of the medical
11cannabis dispensary.
126. A medical cannabis dispensary is subject to reasonable
13inspection by the department.
147. A medical cannabis dispensary shall not employ a
15person who is under eighteen years of age or who has been
16convicted of a disqualifying felony offense. An employee
17of a medical cannabis dispensary shall be subject to a
18background investigation conducted by the division of criminal
19investigation of the department of public safety and a national
20criminal history background check.
218. A medical cannabis dispensary shall not operate in any
22location within one thousand feet of a public or private school
23existing before the date of the medical cannabis dispensary’s
24licensure by the department.
259. A medical cannabis dispensary shall comply with
26reasonable restrictions set by the department relating to
27signage, marketing, display, and advertising of medical
28cannabis.
2910. Prior to dispensing of any medical cannabis, a medical
30cannabis dispensary shall do all of the following:
31a. Verify that the medical cannabis dispensary has received
32a valid medical cannabis registration card from a patient or a
33patient’s primary caregiver, if applicable.
34b. Assign a tracking number to any medical cannabis
35dispensed from the medical cannabis dispensary.
-14- 1c. (1) Properly package medical cannabis in compliance with
2federal law regarding child resistant packaging and exemptions
3for packaging for elderly patients, and label medical cannabis
4with a list of all active ingredients and individually
5identifying information, including all of the following:
6(a) The name and date of birth of the patient and the
7patient’s primary caregiver, if appropriate.
8(b) The medical cannabis registration card numbers of the
9patient and the patient’s primary caregiver, if applicable.
10(c) The chemical composition of the medical cannabis.
11(2) Proper packaging of medical cannabis shall include but
12not be limited to all of the following:
13(a) Warning labels regarding the use of medical cannabis by
14a woman during pregnancy and while breastfeeding.
15(b) Clearly labeled packaging indicating that an edible
16medical cannabis product contains medical cannabis and which
17packaging shall not imitate candy products or in any way make
18the product marketable to children.
19 Sec. 14. NEW SECTION. 124F.10 Fees.
20Medical cannabis registration card fees and medical cannabis
21manufacturer and medical cannabis dispensary application
22and annual fees collected by the department pursuant to
23this chapter shall be retained by the department, shall be
24considered repayment receipts as defined in section 8.2, and
25shall be used for the purpose of regulating medical cannabis
26manufacturers and medical cannabis dispensaries and for other
27expenses necessary for the administration of this chapter.
28 Sec. 15. NEW SECTION. 124F.11 Department duties — rules.
291. a. The department shall maintain a confidential file of
30the names of each patient to or for whom the department issues
31a medical cannabis registration card, the name of each primary
32caregiver to whom the department issues a medical cannabis
33registration card under section 124F.4, and the names of each
34health care practitioner who provides a written certification
35for medical cannabis pursuant to this chapter.
-15- 1b. Individual names contained in the file shall be
2confidential and shall not be subject to disclosure, except as
3provided in subparagraph (1).
4(1) Information in the confidential file maintained
5pursuant to paragraph “a” may be released on an individual basis
6to the following persons under the following circumstances:
7(a) To authorized employees or agents of the department and
8the department of transportation as necessary to perform the
9duties of the department and the department of transportation
10pursuant to this chapter.
11(b) To authorized employees of state or local law
12enforcement agencies, but only for the purpose of verifying
13that a person is lawfully in possession of a medical cannabis
14registration card issued pursuant to this chapter.
15(c) To authorized employees of a medical cannabis
16dispensary, but only for the purpose of verifying that a person
17is lawfully in possession of a medical cannabis registration
18card issued pursuant to this chapter.
19(d) To any other authorized persons recognized by the
20department by rule, but only for the purpose of verifying
21that a person is lawfully in possession of a medical cannabis
22registration card issued pursuant to this chapter.
23(2) Release of information pursuant to subparagraph
24(1) shall be consistent with the federal Health Insurance
25Portability and Accountability Act of 1996, Pub.L. No.
26104-191.
272. The department shall adopt rules pursuant to chapter
2817A to administer this chapter which shall include but not be
29limited to rules to do all of the following:
30a. Govern the manner in which the department shall consider
31applications for new and renewal medical cannabis registration
32cards.
33b. Identify criteria and set forth procedures for
34including additional chronic or debilitating diseases or
35medical conditions or their medical treatments on the list of
-16-1debilitating medical conditions that qualify for the use of
2medical cannabis. Procedures shall include a petition process
3and shall allow for public comment and public hearings before
4the medical advisory board.
5c. Set forth additional chronic or debilitating diseases
6or medical conditions or associated medical treatments for
7inclusion on the list of debilitating medical conditions that
8qualify for the use of medical cannabis as recommended by the
9medical advisory board.
10d. Establish, in consultation with medical cannabis
11manufacturers and medical cannabis dispensaries, the form and
12quantity of medical cannabis allowed to be dispensed to a
13patient or primary caregiver pursuant to this chapter. The
14form and quantity of medical cannabis shall be appropriate to
15serve the medical needs of patients with debilitating medical
16conditions.
17e. Establish, in conjunction with the medical advisory
18board, requirements for the licensure of medical cannabis
19manufacturers and medical cannabis dispensaries and set forth
20procedures for medical cannabis manufacturers and medical
21cannabis dispensaries to obtain licenses.
22f. Develop a dispensing system for medical cannabis within
23this state that provides for all of the following:
24(1) Medical cannabis dispensaries within this state housed
25on secured grounds and operated by licensed medical cannabis
26dispensaries.
27(2) The dispensing of medical cannabis to patients and
28their primary caregivers to occur at locations designated by
29the department.
30g. Establish and collect annual fees from medical cannabis
31manufacturers and medical cannabis dispensaries to cover
32the costs associated with regulating and inspecting medical
33cannabis manufacturers and medical cannabis dispensaries.
34h. Specify and implement procedures that address public
35safety including security procedures and product quality
-17-1including measures to ensure contaminant-free cultivation of
2medical cannabis, safety, and labeling.
3i. Establish and implement a medical cannabis inventory
4and delivery tracking system to track medical cannabis
5from production by a medical cannabis manufacturer through
6dispensing at a medical cannabis dispensary.
7 Sec. 16. NEW SECTION. 124F.12 Reciprocity.
8A valid medical cannabis registration card, or its
9equivalent, issued under the laws of another state that allows
10an out-of-state patient to possess or use medical cannabis in
11the jurisdiction of issuance shall have the same force and
12effect as a valid medical cannabis registration card issued
13pursuant to this chapter, except that an out-of-state patient
14in this state shall not obtain medical cannabis from a medical
15cannabis dispensary in this state and an out-of-state patient
16shall not smoke medical cannabis.
17 Sec. 17. NEW SECTION. 124F.13 Use of medical cannabis —
18affirmative defenses.
191. A health care practitioner, including any authorized
20agent or employee thereof, shall not be subject to
21prosecution for the unlawful certification, possession, or
22administration of marijuana under the laws of this state for
23activities arising directly out of or directly related to the
24certification or use of medical cannabis in the treatment of
25a patient diagnosed with a debilitating medical condition as
26authorized by this chapter.
272. A medical cannabis manufacturer, including any
28authorized agent or employee thereof, shall not be subject
29to prosecution for manufacturing, possessing, cultivating,
30harvesting, packaging, processing, transporting, or supplying
31medical cannabis pursuant to this chapter.
323. A medical cannabis dispensary, including any authorized
33agent or employee thereof, shall not be subject to prosecution
34for transporting, supplying, or dispensing medical cannabis
35pursuant to this chapter.
-18- 1a. In a prosecution for the unlawful possession of marijuana
2under the laws of this state, including but not limited to
3chapters 124 and 453B, it is an affirmative and complete
4defense to the prosecution that the patient has been diagnosed
5with a debilitating medical condition, used or possessed
6medical cannabis pursuant to a certification by a health care
7practitioner as authorized under this chapter, and, for a
8patient eighteen years of age or older, is in possession of a
9valid medical cannabis registration card.
10b. In a prosecution for the unlawful possession of marijuana
11under the laws of this state, including but not limited to
12chapters 124 and 453B, it is an affirmative and complete
13defense to the prosecution that the person possessed medical
14cannabis because the person is a primary caregiver of a patient
15who has been diagnosed with a debilitating medical condition
16and is in possession of a valid medical cannabis registration
17card, and where the primary caregiver’s possession of the
18medical cannabis is on behalf of the patient and for the
19patient’s use only as authorized under this chapter.
20c. If a patient or primary caregiver is charged with the
21commission of a crime and is not in possession of the person’s
22medical cannabis registration card, any charge or charges filed
23against the person shall be dismissed by the court if the
24person produces to the court prior to or at the person’s trial
25a medical cannabis registration card issued to that person and
26valid at the time the person was charged.
274. An agency of this state or a political subdivision
28thereof, including any law enforcement agency, shall not remove
29or initiate proceedings to remove a patient under the age
30of eighteen from the home of a parent based solely upon the
31parent’s or patient’s possession or use of medical cannabis as
32authorized under this chapter.
33 Sec. 18. NEW SECTION. 124F.14 Penalties.
341. A person who knowingly or intentionally possesses or
35uses medical cannabis in violation of the requirements of this
-19-1chapter is subject to the penalties provided under chapters 124
2and 453B.
32. A medical cannabis manufacturer or a medical cannabis
4dispensary shall be assessed a civil penalty of up to one
5thousand dollars per violation for any violation of this
6chapter in addition to any other applicable penalties.
7 Sec. 19. NEW SECTION. 124F.15 Use of medical cannabis —
8smoking prohibited.
9A patient shall not consume medical cannabis possessed
10or used as authorized under this chapter by smoking medical
11cannabis.
12 Sec. 20. NEW SECTION. 124F.16 Employment.
131. An employer in this state may retain, create, reinstate,
14or enforce a written zero tolerance policy prohibiting the
15possession or use of medical cannabis or any derivative
16thereof including cannabidiol by an employee in the employer’s
17workplace, including but not limited to a policy prohibiting
18an employee from having any detectable amount of medical
19cannabis or any derivative thereof including cannabidiol in the
20employee’s body while at work.
212. An employer’s prohibition of the possession or use
22of medical cannabis or any derivative thereof including
23cannabidiol under this section shall not be considered to be
24an unfair or discriminatory employment practice under section
25216.6.
26 Sec. 21. Section 730.5, subsection 11, paragraph f, Code
272019, is amended to read as follows:
28f. Testing or taking action against an employee or
29prospective employee with a confirmed positive test result due
30to the employee’s or prospective employee’s use of medical
31cannabidiol cannabis as authorized under chapter 124E 124F.
32 Sec. 22. REPEAL. Chapter 124E, Code 2019, is repealed.
33 Sec. 23. EMERGENCY RULES. The department may adopt
34emergency rules under section 17A.4, subsection 3, and section
3517A.5, subsection 2, paragraph “b”, to implement the provisions
-20-1of this division of this Act and the rules shall be effective
2immediately upon filing unless a later date is specified in the
3rules. Any rules adopted in accordance with this section shall
4also be published as a notice of intended action as provided
5in section 17A.4.
6 Sec. 24. TRANSITION PROVISIONS.
71. A medical cannabidiol registration card issued
8under chapter 124E prior to the effective date of this Act
9remains effective and continues in effect as issued for the
10twelve-month period following its issuance. This Act does not
11preclude a medical cannabidiol registration card holder from
12seeking to renew the registration card prior to the expiration
13of the twelve-month period.
142. Members of the medical cannabidiol board created in
15section 124E.5 shall continue to serve until the appointment of
16the medical advisory board created in section 124F.5.
173. Any rule, form, order, license, or directive promulgated
18by the medical cannabidiol board created in section 124E.5, or
19by the department, in force and effect immediately prior to the
20appointment of the medical advisory board, shall continue in
21full force and effect until the earlier of the following:
22a. It is amended, rescinded, or supplemented by the
23affirmative actions of the medical advisory board or the
24department, as applicable.
25b. It expires by its own terms.
264. A medical cannabidiol manufacturer licensed pursuant
27to section 124E.6 and operating immediately prior to the
28effective date of this Act shall operate as a medical cannabis
29manufacturer pursuant to section 124F.6 until the earlier of
30the following:
31a. The license is revoked by the affirmative action of the
32department.
33b. The license expires by its own terms.
34c. The medical cannabidiol manufacturer becomes licensed as
35a medical cannabis manufacturer.
-21- 15. A medical cannabidiol dispensary licensed pursuant to
2section 124E.8 and operating immediately prior to the effective
3date of this Act shall operate as a medical cannabis dispensary
4pursuant to section 124F.8 until the earlier of the following:
5a. The license is revoked by the affirmative action of the
6department.
7b. The license expires by its own terms.
8c. The medical cannabidiol dispensary becomes licensed as
9a medical cannabis dispensary.
10 Sec. 25. EFFECTIVE UPON ENACTMENT. This Act, being deemed
11of immediate importance, takes effect upon enactment.
12EXPLANATION
13The inclusion of this explanation does not constitute agreement with
14the explanation’s substance by the members of the general assembly.
15This bill creates the compassionate use of medical cannabis
16Act, reclassifies marijuana, including tetrahydrocannabinols,
17from a schedule I controlled substance to a schedule II
18controlled substance, and provides for civil and criminal
19penalties and fees.
20OVERVIEW. The bill allows a patient with a debilitating
21medical condition who receives a written certification from
22the patient’s health care practitioner that the patient has
23a debilitating medical condition and who submits the written
24certification along with an application to the department of
25public health (department) for a medical cannabis registration
26card to allow for the lawful use of medical cannabis to treat
27the patient’s debilitating medical condition. A patient who
28is issued a medical cannabis registration card will be able
29to receive medical cannabis directly from a medical cannabis
30dispensary operated and licensed in this state.
31RECLASSIFICATION. The bill reclassifies marijuana,
32including tetrahydrocannabinols as a schedule II controlled
33substance instead of a schedule I controlled substance and
34strikes references to the authority of the board of pharmacy to
35adopt rules for the use of marijuana or tetrahydrocannabinols
-22-1for medicinal purposes.
2A schedule I controlled substance is a highly addictive
3substance that has no accepted medical use in the United States
4and a schedule II controlled substance is a highly addictive
5substance that has an accepted medical use in the United
6States. The reclassification of marijuana from a schedule I
7controlled substance to a schedule II controlled substance
8would allow a physician to issue a prescription for marijuana
9under state law. However, federal regulations may prohibit
10such prescriptions.
11The penalties remain unchanged for violations involving
12marijuana under the bill. The penalties under Code section
13124.401 range from a class “B” felony punishable by up to 50
14years of confinement to a serious misdemeanor punishable by
15up to six months of confinement depending on the amount of
16marijuana involved in the offense.
17The bill amends Code section 124.401, relating to prohibited
18acts involving controlled substances, to provide that it is
19lawful for a person to knowingly or intentionally recommend,
20possess, use, dispense, deliver, transport, or administer
21medical cannabis if the recommendation, possession, use,
22dispensing, delivery, transporting, or administering is in
23accordance with the provisions of the bill.
24DEFINITIONS. The bill provides the following definitions:
25“Debilitating medical condition” means cancer, multiple
26sclerosis, epilepsy or seizure disorders, AIDS or HIV,
27Hepatitis C, Crohn’s disease or ulcerative colitis, amyotrophic
28lateral sclerosis, intractable pain, glaucoma, any terminal
29illness with a probable life expectancy of under one year,
30Ehlers-Danlos syndrome, post-traumatic stress disorder,
31Tourette’s syndrome, and any other chronic or debilitating
32disease or medical condition or its medical treatment approved
33by the department by rule.
34“Health care practitioner” means an individual licensed
35under Code chapter 148 to practice medicine and surgery or
-23-1osteopathic medicine and surgery or an individual licensed to
2prescribe medicine in any other state who provides specialty
3care to an Iowa resident for one or more debilitating medical
4conditions specified in the bill.
5“Medical cannabis” means any species of the genus cannabis
6plant, or any mixture or preparation of them, including whole
7plant extracts and resins.
8“Medical cannabis manufacturer” means an entity licensed
9by the department to manufacture and to possess, cultivate,
10transport, or supply, medical cannabis pursuant to the bill.
11“Medical cannabis dispensary” means an entity licensed under
12the bill that acquires medical cannabis from a medical cannabis
13manufacturer in this state for the purpose of dispensing
14medical cannabis in this state pursuant to the bill.
15“Primary caregiver” means a person, at least 18 years of age,
16who has been designated by a patient’s health care practitioner
17or a person having custody of a patient, as a necessary
18caretaker taking responsibility for managing the well-being
19of the patient with respect to the use of medical cannabis
20pursuant to the bill.
21“Written certification” means a document signed by a health
22care practitioner, with whom the patient has established a
23patient-provider relationship, which states that the patient
24has a debilitating medical condition and which identifies that
25condition, and provides any other relevant information.
26HEALTH CARE PRACTITIONER CERTIFICATION. The bill provides
27that prior to a patient’s submission of an application
28for a medical cannabis registration card, if a health care
29practitioner determines that the patient whom the health
30care practitioner has examined and treated suffers from a
31debilitating medical condition, the health care practitioner
32may provide the patient with a written certification of that
33diagnosis. The health care practitioner must also provide
34explanatory information to the patient about the therapeutic
35use of medical cannabis, and if the patient continues to
-24-1suffer from a debilitating medical condition, the health care
2practitioner may issue the patient a new certification of
3that diagnosis on an annual basis. The bill specifies that
4a health care practitioner has no duty to provide a written
5certification.
6MEDICAL CANNABIS REGISTRATION CARD — PATIENT AND PRIMARY
7CAREGIVER. The department may approve the issuance of a
8medical cannabis registration card to a patient who is at least
918 years of age and is a permanent resident of this state, who
10submits a written certification by the patient’s health care
11practitioner to the department, and who submits an application
12to the department with certain information along with a medical
13registration card fee. The department may also approve the
14issuance of a medical cannabis registration card to a primary
15caregiver who is at least 18 years of age, who submits a
16written certification by the patient’s health care practitioner
17to the department on behalf of the patient, and who submits an
18application to the department with certain information along
19with a medical cannabis registration card fee. A medical
20cannabis registration card expires one year after the date of
21issuance and may be renewed.
22MEDICAL ADVISORY BOARD. The director of public health is
23directed to establish a medical advisory board, no later than
24August 15, 2019, to consist of nine practitioners representing
25the fields of neurology, pain management, gastroenterology,
26oncology, psychiatry, pediatrics, infectious disease,
27family medicine, and pharmacy, and three patients or primary
28caregivers with valid medical cannabis registration cards. The
29duties of the board include but are not limited to reviewing
30and recommending to the department for approval additional
31chronic or debilitating diseases or medical conditions or their
32treatments as debilitating medical conditions that qualify for
33the use of medical cannabis under the bill.
34MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS
35DISPENSARIES — LICENSURE. The bill requires the department
-25-1to license up to four medical cannabis manufacturers for
2the manufacture of medical cannabis within this state by
3December 1, 2019, and to license twelve medical cannabis
4dispensaries by April 2, 2020. Information submitted during
5the application process is confidential until the medical
6cannabis manufacturer or the medical cannabis dispensary is
7licensed by the department unless otherwise protected from
8disclosure under state or federal law. As a condition for
9licensure, a medical cannabis manufacturer must agree to begin
10supplying medical cannabis to medical cannabis dispensaries in
11this state by July 2, 2020, and a medical cannabis dispensary
12must agree to begin supplying medical cannabis to patients by
13July 16, 2020. The department is directed to consider several
14factors in determining whether to license a medical cannabis
15manufacturer and a medical cannabis dispensary including
16technical expertise, employee qualifications, financial
17stability, security measures, and production needs and
18capacity. Each medical cannabis manufacturer is required to
19contract with a laboratory approved by the department to test
20the medical cannabis produced by the manufacturer and to report
21testing results to the medical cannabis manufacturer. Each
22entity submitting an application for licensure as a medical
23cannabis manufacturer shall pay a nonrefundable application
24fee of $15,000 to the department and each entity submitting
25an application for licensure as a medical cannabis dispensary
26shall pay a nonrefundable application fee of $15,000 to the
27department.
28MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS
29DISPENSARIES — ADDITIONAL PROVISIONS. The operating
30documents of a medical cannabis manufacturer and a medical
31cannabis dispensary shall include procedures for oversight and
32recordkeeping activities of the medical cannabis manufacturer
33and the medical cannabis dispensary and certain security
34measures undertaken by the medical cannabis manufacturer
35and the medical cannabis dispensary. A medical cannabis
-26-1manufacturer and a medical cannabis dispensary are prohibited
2from sharing office space with, referring patients to,
3or having a financial relationship with a health care
4practitioner, permitting any person to consume medical cannabis
5on the property of the medical cannabis manufacturer or the
6medical cannabis dispensary, employing a person who is under
718 years of age or who has been convicted of a disqualifying
8felony offense, and from operating in any location within 1,000
9feet of a public or private school existing before the date
10of the licensure of the medical cannabis manufacturer or the
11medical cannabis dispensary. In addition, a medical cannabis
12manufacturer and a medical cannabis dispensary are subject to
13reasonable inspection and certain reasonable restrictions.
14A medical cannabis manufacturer is required to provide a
15reliable and ongoing supply of medical cannabis to medical
16cannabis dispensaries and shall not manufacture edible medical
17cannabis products utilizing food coloring. All manufacturing,
18cultivating, harvesting, packaging, and processing of medical
19cannabis is required to take place in an enclosed, locked
20facility.
21Prior to dispensing any medical cannabis, a medical cannabis
22dispensary is required to verify that the medical cannabis
23dispensary has received a valid medical cannabis registration
24card from a patient or a patient’s primary caregiver, if
25applicable, assign a tracking number to any medical cannabis
26dispensed from the medical cannabis dispensary, and properly
27package and label medical cannabis in compliance with the
28provisions of the bill and certain federal laws.
29DEPARTMENT DUTIES — CONFIDENTIALITY. The department
30is required to maintain a confidential file of the names
31of each patient and primary caregiver issued a medical
32cannabis registration card, and the names of each health
33care practitioner who provides a written certification for
34medical cannabis under the bill. Individual names contained
35in the file shall be confidential and shall not be subject to
-27-1disclosure, except that information in the confidential file
2may be released on an individual basis to authorized employees
3or agents of the department, the department of transportation,
4and a medical cannabis dispensary as necessary to perform
5their duties, to authorized employees of state or local law
6enforcement agencies for the purpose of verifying that a person
7is lawfully in possession of a medical cannabis registration
8card, and to any other authorized employees for the purpose of
9verifying that a person is lawfully in possession of a medical
10cannabis registration card. Release of information must also
11be consistent with federal Health Insurance Portability and
12Accountability Act regulations.
13ADDITIONAL DEPARTMENT DUTIES — RULES. The bill requires
14the department to adopt rules relating to the manner in which
15the department shall consider applications for new and renewal
16medical cannabis registration cards, identify criteria and
17set forth procedures for including additional chronic or
18debilitating diseases or medical conditions or their medical
19treatments on the list of debilitating medical conditions,
20establish the form and quantity of medical cannabis allowed to
21be dispensed to a patient or primary caregiver in the form and
22quantity appropriate to serve the medical needs of the patient
23with the debilitating medical condition, establish requirements
24for the licensure of medical cannabis manufacturers and medical
25cannabis dispensaries, develop a dispensing system for medical
26cannabis within this state that follows certain requirements,
27establish and implement a medical cannabis inventory and
28delivery tracking system, and specify and implement procedures
29that address public safety including security procedures and
30product quality, safety, and labeling.
31RECIPROCITY. The bill provides that a valid medical
32cannabis registration card, or its equivalent, issued under
33the laws of another state that allows an out-of-state patient
34to possess or use medical cannabis in the jurisdiction of
35issuance shall have the same force and effect as a valid
-28-1medical cannabis card issued under the bill, except that an
2out-of-state patient in this state shall not obtain medical
3cannabis from a medical cannabis dispensary and an out-of-state
4patient shall not smoke medical cannabis in this state.
5USE OF MEDICAL CANNABIS — SMOKING PROHIBITED. The bill
6provides that a patient shall not consume the medical cannabis
7by smoking the medical cannabis.
8USE OF MEDICAL CANNABIS — AFFIRMATIVE DEFENSES. The bill
9provides prosecution immunity for a health care practitioner,
10a medical cannabis manufacturer, and a medical cannabis
11dispensary, including any authorized agents or employees of the
12health care practitioner, medical cannabis manufacturer, and
13medical cannabis dispensary, for activities undertaken by the
14health care practitioner, medical cannabis manufacturer, and
15medical cannabis dispensary pursuant to the provisions of the
16bill.
17The bill provides that in a prosecution for the unlawful
18possession of marijuana under the laws of this state,
19including but not limited to Code chapters 124 (controlled
20substances) and 453B (excise tax on unlawful dealing in
21certain substances), it is an affirmative and complete
22defense to the prosecution that the patient has been diagnosed
23with a debilitating medical condition, used or possessed
24medical cannabis pursuant to a certification by a health
25care practitioner, and, for a patient age 18 or older, is
26in possession of a valid medical cannabis registration
27card. The bill provides a similar affirmative defense for a
28primary caretaker of a patient who has been diagnosed with a
29debilitating medical condition who is in possession of a valid
30medical cannabis registration card.
31The bill provides that an agency of this state or a political
32subdivision thereof, including any law enforcement agency,
33shall not remove or initiate proceedings to remove a patient
34under the age of 18 from the home of a parent based solely upon
35the parent’s or patient’s possession or use of medical cannabis
-29-1as authorized under the bill.
2PENALTIES. The bill provides that a person who knowingly or
3intentionally possesses or uses medical cannabis in violation
4of the requirements of the bill is subject to the penalties
5provided under Code chapters 124 and 453B. In addition, a
6medical cannabis manufacturer or a medical cannabis dispensary
7shall be assessed a civil penalty of up to $1,000 per violation
8for any violation of the bill in addition to any other
9applicable penalties.
10REPEAL. The bill repeals Code chapter 124E, the medical
11cannabidiol Act.
12EMERGENCY RULES. The bill provides that the department
13may adopt emergency rules and the rules shall be effective
14immediately upon filing unless a later date is specified in the
15rules.
16EFFECTIVE DATE. The bill takes effect upon enactment.
17TRANSITION PROVISIONS. The bill provides that a medical
18cannabis registration card issued under Code chapter 124E
19(medical cannabidiol Act) prior to the effective date of the
20bill, shall remain effective and continues in effect as issued
21for the 12-month period following its issuance. The bill also
22provides that members of the medical cannabidiol board shall
23continue to serve until the appointment of the medical advisory
24board and that rules, forms, orders, licenses, and directives
25promulgated by the medical cannabidiol board that are in force
26and effect immediately prior to the appointment of the medical
27advisory board shall remain in full force and effect until
28amended, rescinded, or supplemented by affirmative actions of
29the 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
-1-1nabilone: (+-) -
2trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1-hydroxy-6,6-
3dimethyl-9H-dibenzo[b,d]pyran-9-one].
4c. d. Dronabinol [(-)-delta-9-trans-tetrahydrocannabinol]
5in an oral solution in a drug product approved for marketing by
6the United States food and drug administration.
7 Sec. 4. Section 124.401, subsection 5, unnumbered paragraph
83, Code 2019, is amended to read as follows:
9A person may knowingly or intentionally recommend, possess,
10use, dispense, deliver, transport, or administer cannabidiol
11 medical cannabis if the recommendation, possession, use,
12dispensing, delivery, transporting, or administering is in
13accordance with the provisions of chapter 124E 124F. For
14purposes of this paragraph, “cannabidiol” “medical cannabis”
15 means the same as defined in section 124E.2 124F.2.
16 Sec. 5. NEW SECTION. 124F.1 Short title.
17This chapter shall be known and may be cited as the
18“Compassionate Use of Medical Cannabis Act”.
19 Sec. 6. NEW SECTION. 124F.2 Definitions.
20As used in this chapter:
211. “Debilitating medical condition” means any of the
22following:
23a. Cancer, if the underlying condition or treatment produces
24one or more of the following:
25(1) Intractable pain.
26(2) Nausea or severe vomiting.
27(3) Cachexia or severe wasting.
28b. Multiple sclerosis.
29c. Epilepsy or seizure disorders.
30d. AIDS or HIV as defined in section 141A.1.
31e. Glaucoma.
32f. Hepatitis C.
33g. Crohn’s disease or ulcerative colitis.
34h. Amyotrophic lateral sclerosis.
35i. Ehlers-Danlos syndrome.
-2- 1j. Post-traumatic stress disorder.
2k. Tourette’s syndrome.
3l. Any terminal illness, with a probable life expectancy of
4under one year, if the illness or its treatment produces one or
5more of the following:
6(1) Intractable pain.
7(2) Nausea or severe vomiting.
8(3) Cachexia or severe wasting.
9m. Intractable pain.
10n. Parkinson’s disease.
11o. Muscular dystrophy.
12p. Huntington’s disease.
13q. Alzheimer’s disease.
14r. Complex regional pain syndrome, type I and II.
15s. Rheumatoid arthritis.
16t. Polyarteritis nodosa.
17u. Any other chronic or debilitating disease or medical
18condition or its medical treatment approved by the department
19pursuant to rule.
202. “Department” means the department of public health.
213. “Disqualifying felony offense” means a violation under
22federal or state law of a felony offense, which has as an
23element the possession, use, or distribution of a controlled
24substance, as defined in 21 U.S.C. §802(6).
254. “Enclosed, locked facility” means a closet, room,
26greenhouse, or other enclosed area equipped with locks or
27other security devices that permit access only by authorized
28personnel.
295. “Health care practitioner” means an individual licensed
30under chapter 148 to practice medicine and surgery or
31osteopathic medicine and surgery or an individual licensed to
32practice medicine in any other state who provides specialty
33care for an Iowa resident for one or more of the debilitating
34medical conditions provided in this chapter.
356. “Intractable pain” means a pain in which the cause of the
-3-1pain cannot be removed or otherwise treated with the consent
2of the patient and which, in the generally accepted course of
3medical practice, no relief or cure of the cause of the pain
4is possible, or none has been found after reasonable efforts.
5Reasonable efforts for relieving or curing the cause of the
6pain may be determined on the basis of but are not limited to
7any of the following:
8a. When treating a nonterminally ill patient for intractable
9pain, evaluation by the attending physician and one or more
10physicians specializing in pain medicine or the treatment of
11the area, system, or organ of the body perceived as the source
12of the pain.
13b. When treating a terminally ill patient, evaluation by
14the attending physician who does so in accordance with the
15level of care, skill, and treatment that would be recognized
16by a reasonably prudent physician under similar conditions and
17circumstances.
187. “Medical cannabis” means any species of the genus
19cannabis plant, or any mixture or preparation of them,
20including whole plant extracts and resins.
218. “Medical cannabis dispensary” means an entity licensed
22under section 124F.8 that acquires medical cannabis from a
23medical cannabis manufacturer in this state for the purpose
24of dispensing medical cannabis in this state pursuant to this
25chapter.
269. “Medical cannabis manufacturer” means an entity licensed
27under section 124F.6 to manufacture and to possess, cultivate,
28transport, or supply medical cannabis pursuant to the
29provisions of this chapter.
3010. “Primary caregiver” means a person, at least eighteen
31years of age, who has been designated by a patient’s health
32care practitioner or a person having custody of a patient, as
33a necessary caretaker taking responsibility for managing the
34well-being of the patient with respect to the use of medical
35cannabis pursuant to the provisions of this chapter.
-4- 111. “Written certification” means a document signed by a
2health care practitioner, with whom the patient has established
3a patient-provider relationship, which states that the patient
4has a debilitating medical condition and identifies that
5condition and provides any other relevant information.
6 Sec. 7. NEW SECTION. 124F.3 Health care practitioner
7certification — duties.
81. Prior to a patient’s submission of an application for a
9medical cannabis registration card pursuant to section 124F.4,
10a health care practitioner shall do all of the following:
11a. Determine, in the health care practitioner’s medical
12judgment, whether the patient whom the health care practitioner
13has examined and treated suffers from a debilitating medical
14condition that qualifies for the use of medical cannabis under
15this chapter, and if so determined, provide the patient with a
16written certification of that diagnosis.
17b. Provide explanatory information as provided by the
18department to the patient about the therapeutic use of medical
19cannabis.
20c. Determine, on an annual basis, if the patient continues
21to suffer from a debilitating medical condition and, if so,
22issue the patient a new certification of that diagnosis. This
23paragraph shall not apply if the patient is suffering from an
24incurable debilitating medical condition.
25d. Otherwise comply with all requirements established by the
26department pursuant to rule.
272. A health care practitioner may provide, but has no duty
28to provide, a written certification pursuant to this section.
29 Sec. 8. NEW SECTION. 124F.4 Medical cannabis registration
30card.
311. Issuance to patient. The department may approve the
32issuance of a medical cannabis registration card by the
33department of transportation to a patient who:
34a. Is at least eighteen years of age.
35b. Is a permanent resident of this state.
-5- 1c. Submits a written certification to the department signed
2by the patient’s health care practitioner that the patient is
3suffering from a debilitating medical condition.
4d. 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 patient’s full name, Iowa residence address, date
8of birth, and telephone number.
9(2) A copy of the patient’s valid photograph
10identification.
11(3) Full name, address, and telephone number of the
12patient’s health care practitioner.
13(4) Full name, residence address, date of birth, and
14telephone number of each primary caregiver of the patient, if
15any.
16(5) Any other information required by rule.
17e. Submits a medical cannabis registration card fee of one
18hundred dollars to the department. If the patient attests to
19receiving social security disability benefits, supplemental
20security insurance payments, or being enrolled in the medical
21assistance program, the fee shall be twenty-five dollars.
222. Patient card contents. A medical cannabis registration
23card issued to a patient by the department of transportation
24pursuant to subsection 1 shall contain, at a minimum, all of
25the following:
26a. The patient’s full name, Iowa residence address, and date
27of birth.
28b. The patient’s photograph.
29c. The date of issuance and expiration of the registration
30card.
31d. Any other information required by rule.
323. Issuance to primary caregiver. For a patient in a
33primary caregiver’s care, the department may approve the
34issuance of a medical cannabis registration card by the
35department of transportation to the primary caregiver who:
-6- 1a. Submits a written certification to the department signed
2by the patient’s health care practitioner that the patient in
3the primary caregiver’s care is suffering from a debilitating
4medical condition.
5b. Submits an application to the department, on a form
6created by the department, in consultation with the department
7of transportation, that contains all of the following:
8(1) The primary caregiver’s full name, residence address,
9date of birth, and telephone number.
10(2) The patient’s full name.
11(3) A copy of the primary caregiver’s valid photograph
12identification.
13(4) Full name, address, and telephone number of the
14patient’s health care practitioner.
15(5) Any other information required by rule.
16c. Submits a medical cannabis registration card fee of
17twenty-five dollars to the department.
184. Primary caregiver card contents. A medical cannabis
19registration card issued by the department of transportation to
20a primary caregiver pursuant to subsection 3 shall contain, at
21a minimum, all of the following:
22a. The primary caregiver’s full name, residence address, and
23date of birth.
24b. The primary caregiver’s photograph.
25c. The date of issuance and expiration of the registration
26card.
27d. The registration card number of each patient in the
28primary caregiver’s care. If the patient in the primary
29caregiver’s care is under the age of eighteen, the full name of
30the patient’s parent or legal guardian.
31e. Any other information required by rule.
325. Expiration date of card. A medical cannabis registration
33card issued pursuant to this section shall expire one year
34after the date of issuance and may be renewed.
356. Card issuance — department of transportation.
-7- 1a. The department may enter into a chapter 28E agreement
2with the department of transportation to facilitate the
3issuance of medical cannabis registration cards pursuant to
4subsections 1 and 3.
5b. The department of transportation may issue renewal
6medical cannabis registration cards through an online or
7in-person process.
8 Sec. 9. NEW SECTION. 124F.5 Medical advisory board —
9duties.
101. No later than August 15, 2019, the director of public
11health shall establish a medical advisory board consisting of
12nine practitioners representing the fields of neurology, pain
13management, gastroenterology, oncology, psychiatry, pediatrics,
14infectious disease, family medicine, and pharmacy, and three
15patients or primary caregivers with valid medical cannabis
16registration cards. The practitioners shall be nationally
17board-certified in their area of specialty and knowledgeable
18about the use of medical cannabis.
192. A quorum of the advisory board shall consist of seven
20members.
213. The duties of the advisory board shall include but not be
22limited to the following:
23a. Reviewing and recommending to the department for
24approval additional chronic or debilitating diseases or
25medical conditions or their treatments as debilitating medical
26conditions that qualify for the use of medical cannabis under
27this chapter.
28b. Accepting and reviewing petitions to add chronic or
29debilitating diseases or medical conditions or their medical
30treatments to the list of debilitating medical conditions that
31qualify for the use of medical cannabis under this chapter.
32c. Working with the department regarding the requirements
33for the licensure of medical cannabis manufacturers and medical
34cannabis dispensaries, including licensure procedures.
35d. Advising the department regarding the location of
-8-1medical cannabis dispensaries throughout the state, the form
2and quantity of allowable medical cannabis to be dispensed
3to a patient or primary caregiver, and the general oversight
4of medical cannabis manufacturers and medical cannabis
5dispensaries in this state.
6e. Convening at least twice per year to conduct public
7hearings and to review and recommend for approval petitions,
8which shall be maintained as confidential personal health
9information, to add chronic or debilitating diseases or
10medical conditions or their medical treatments to the list of
11debilitating medical conditions that qualify for the use of
12medical cannabis under this chapter.
13f. Recommending improvements relating to the effectiveness
14of the provisions of this chapter.
15g. In making recommendations pursuant to this section,
16consideration of the economic and financial impacts on patients
17and the medical cannabis industry, and making recommendations
18that minimize the extent of such impacts to the greatest extent
19practicable.
20 Sec. 10. NEW SECTION. 124F.6 Medical cannabis manufacturer
21licensure.
221. a. The department shall license up to four medical
23cannabis manufacturers to manufacture medical cannabis within
24this state consistent with the provisions of this chapter by
25December 1, 2019. The department shall license new medical
26cannabis manufacturers or relicense the existing medical
27cannabis manufacturers by December 1 of each year.
28b. Information submitted during the application process
29shall be confidential until the medical cannabis manufacturer
30is licensed by the department unless otherwise protected from
31disclosure under state or federal law.
322. As a condition for licensure, a medical cannabis
33manufacturer must agree to begin supplying medical cannabis to
34medical cannabis dispensaries in this state by July 2, 2020.
353. The department shall consider the following factors in
-9-1determining whether to license a medical cannabis manufacturer:
2a. The technical expertise of the medical cannabis
3manufacturer regarding medical cannabis.
4b. The qualifications of the medical cannabis manufacturer’s
5ownership and management team.
6c. The long-term financial stability of the medical cannabis
7manufacturer.
8d. The ability to provide appropriate security measures on
9the premises of the medical cannabis manufacturer.
10e. Whether the medical cannabis manufacturer has
11demonstrated an ability to meet certain medical cannabis
12production needs for medical use regarding the range of
13recommended dosages for each debilitating medical condition,
14the range of chemical compositions of any plant of the genus
15cannabis that will likely be medically beneficial for each
16of the debilitating medical conditions, and the form of the
17medical cannabis in the manner determined by the department
18pursuant to rule.
19f. The medical cannabis manufacturer’s projection of and
20ongoing assessment of fees on patients with debilitating
21medical conditions.
22g. The medical cannabis manufacturer’s experience in medical
23cannabis production, plant extraction, and pharmaceutical
24formulations.
254. The department shall require each medical cannabis
26manufacturer to contract with a laboratory approved by the
27department to test the medical cannabis produced by the
28manufacturer. The department shall require that the laboratory
29report testing results to the manufacturer in a manner
30determined by the department pursuant to rule.
315. Each entity submitting an application for licensure
32as a medical cannabis manufacturer shall pay a nonrefundable
33application fee of fifteen thousand dollars to the department.
34 Sec. 11. NEW SECTION. 124F.7 Medical cannabis
35manufacturers.
-10- 11. A medical cannabis manufacturer shall contract with a
2laboratory approved by the department for purposes of testing
3the medical cannabis manufactured by the medical cannabis
4manufacturer as to content, contamination, and consistency.
5The cost of all laboratory testing shall be paid by the medical
6cannabis manufacturer.
72. The operating documents of a medical cannabis
8manufacturer shall include all of the following:
9a. Procedures for the oversight of the medical cannabis
10manufacturer and procedures to ensure accurate recordkeeping.
11b. Procedures for the implementation of appropriate security
12measures to deter and prevent the theft of medical cannabis and
13unauthorized entrance into areas containing medical cannabis.
143. A medical cannabis manufacturer shall implement security
15requirements, including requirements for protection of each
16location by a fully operational security alarm system, facility
17access controls, perimeter intrusion detection systems, and a
18personnel identification system.
194. A medical cannabis manufacturer shall not share
20office space with, refer patients to, or have any financial
21relationship with a health care practitioner.
225. A medical cannabis manufacturer shall not permit any
23person to consume medical cannabis on the property of the
24medical cannabis manufacturer.
256. A medical cannabis manufacturer is subject to reasonable
26inspection by the department.
277. A medical cannabis manufacturer shall not employ a
28person who is under eighteen years of age or who has been
29convicted of a disqualifying felony offense. An employee
30of a medical cannabis manufacturer shall be subject to a
31background investigation conducted by the division of criminal
32investigation of the department of public safety and a national
33criminal history background check.
348. A medical cannabis manufacturer shall not operate in any
35location, whether for manufacturing, cultivating, harvesting,
-11-1packaging, or processing, within one thousand feet of a public
2or private school existing before the date of the medical
3cannabis manufacturer’s licensure by the department.
49. A medical cannabis manufacturer shall comply with
5reasonable restrictions set by the department relating to
6signage, marketing, display, and advertising of medical
7cannabis.
810. a. A medical cannabis manufacturer shall provide a
9reliable and ongoing supply of medical cannabis to medical
10cannabis dispensaries pursuant to this chapter.
11b. All manufacturing, cultivating, harvesting, packaging,
12and processing of medical cannabis shall take place in an
13enclosed, locked facility at a physical address provided to the
14department during the licensure process.
15c. A medical cannabis manufacturer shall not manufacture
16edible medical cannabis products utilizing food coloring.
17d. A medical cannabis manufacturer shall manufacture a
18reliable and ongoing supply of medical cannabis to treat every
19debilitating medical condition listed in this chapter.
2011. The department shall establish and collect an annual
21fee from a medical cannabis manufacturer not to exceed the cost
22of regulating and inspecting the manufacturer in the calendar
23year.
24 Sec. 12. NEW SECTION. 124F.8 Medical cannabis dispensary
25licensure.
261. a. The department shall license by April 2, 2020, twelve
27medical cannabis dispensaries to dispense medical cannabis
28within this state consistent with the provisions of this
29chapter. The department shall license new medical cannabis
30dispensaries or relicense the existing medical cannabis
31dispensaries by December 1 of each year.
32b. Information submitted during the application process
33shall be confidential until the medical cannabis dispensary
34is licensed by the department unless otherwise protected from
35disclosure under state or federal law.
-12- 12. As a condition for licensure, a medical cannabis
2dispensary must agree to begin supplying medical cannabis to
3patients by July 16, 2020.
43. The department shall consider the following factors in
5determining whether to license a medical cannabis dispensary:
6a. The technical expertise of the medical cannabis
7dispensary regarding medical cannabis.
8b. The qualifications of the medical cannabis dispensary’s
9owners and management team.
10c. The long-term financial stability of the medical cannabis
11dispensary.
12d. The ability to provide appropriate security measures on
13the premises of the medical cannabis dispensary.
14e. The medical cannabis dispensary’s projection and ongoing
15assessment of fees for the purchase of medical cannabis on
16patients with debilitating medical conditions.
174. Each entity submitting an application for licensure
18as a medical cannabis dispensary shall pay a nonrefundable
19application fee of fifteen thousand dollars to the department.
20 Sec. 13. NEW SECTION. 124F.9 Medical cannabis dispensaries.
211. a. Medical cannabis dispensaries shall be located based
22on geographical need throughout the state to improve patient
23access.
24b. A medical cannabis dispensary may dispense medical
25cannabis pursuant to the provisions of this chapter but shall
26not dispense any medical cannabis in a form or quantity other
27than the form or quantity allowed by the department pursuant
28to rule.
292. The operating documents of a medical cannabis dispensary
30shall include all of the following:
31a. Procedures for the oversight of the medical cannabis
32dispensary and procedures to ensure accurate recordkeeping.
33b. Procedures for the implementation of appropriate security
34measures to deter and prevent the theft of medical cannabis and
35unauthorized entrance into areas containing medical cannabis.
-13- 13. A medical cannabis dispensary shall implement security
2requirements, including requirements for protection by a fully
3operational security alarm system, facility access controls,
4perimeter intrusion detection systems, and a personnel
5identification system.
64. A medical cannabis dispensary shall not share office
7space with, refer patients to, or have any financial
8relationship with a health care practitioner.
95. A medical cannabis dispensary shall not permit any person
10to consume medical cannabis on the property of the medical
11cannabis dispensary.
126. A medical cannabis dispensary is subject to reasonable
13inspection by the department.
147. A medical cannabis dispensary shall not employ a
15person who is under eighteen years of age or who has been
16convicted of a disqualifying felony offense. An employee
17of a medical cannabis dispensary shall be subject to a
18background investigation conducted by the division of criminal
19investigation of the department of public safety and a national
20criminal history background check.
218. A medical cannabis dispensary shall not operate in any
22location within one thousand feet of a public or private school
23existing before the date of the medical cannabis dispensary’s
24licensure by the department.
259. A medical cannabis dispensary shall comply with
26reasonable restrictions set by the department relating to
27signage, marketing, display, and advertising of medical
28cannabis.
2910. Prior to dispensing of any medical cannabis, a medical
30cannabis dispensary shall do all of the following:
31a. Verify that the medical cannabis dispensary has received
32a valid medical cannabis registration card from a patient or a
33patient’s primary caregiver, if applicable.
34b. Assign a tracking number to any medical cannabis
35dispensed from the medical cannabis dispensary.
-14- 1c. (1) Properly package medical cannabis in compliance with
2federal law regarding child resistant packaging and exemptions
3for packaging for elderly patients, and label medical cannabis
4with a list of all active ingredients and individually
5identifying information, including all of the following:
6(a) The name and date of birth of the patient and the
7patient’s primary caregiver, if appropriate.
8(b) The medical cannabis registration card numbers of the
9patient and the patient’s primary caregiver, if applicable.
10(c) The chemical composition of the medical cannabis.
11(2) Proper packaging of medical cannabis shall include but
12not be limited to all of the following:
13(a) Warning labels regarding the use of medical cannabis by
14a woman during pregnancy and while breastfeeding.
15(b) Clearly labeled packaging indicating that an edible
16medical cannabis product contains medical cannabis and which
17packaging shall not imitate candy products or in any way make
18the product marketable to children.
19 Sec. 14. NEW SECTION. 124F.10 Fees.
20Medical cannabis registration card fees and medical cannabis
21manufacturer and medical cannabis dispensary application
22and annual fees collected by the department pursuant to
23this chapter shall be retained by the department, shall be
24considered repayment receipts as defined in section 8.2, and
25shall be used for the purpose of regulating medical cannabis
26manufacturers and medical cannabis dispensaries and for other
27expenses necessary for the administration of this chapter.
28 Sec. 15. NEW SECTION. 124F.11 Department duties — rules.
291. a. The department shall maintain a confidential file of
30the names of each patient to or for whom the department issues
31a medical cannabis registration card, the name of each primary
32caregiver to whom the department issues a medical cannabis
33registration card under section 124F.4, and the names of each
34health care practitioner who provides a written certification
35for medical cannabis pursuant to this chapter.
-15- 1b. Individual names contained in the file shall be
2confidential and shall not be subject to disclosure, except as
3provided in subparagraph (1).
4(1) Information in the confidential file maintained
5pursuant to paragraph “a” may be released on an individual basis
6to the following persons under the following circumstances:
7(a) To authorized employees or agents of the department and
8the department of transportation as necessary to perform the
9duties of the department and the department of transportation
10pursuant to this chapter.
11(b) To authorized employees of state or local law
12enforcement agencies, but only for the purpose of verifying
13that a person is lawfully in possession of a medical cannabis
14registration card issued pursuant to this chapter.
15(c) To authorized employees of a medical cannabis
16dispensary, but only for the purpose of verifying that a person
17is lawfully in possession of a medical cannabis registration
18card issued pursuant to this chapter.
19(d) To any other authorized persons recognized by the
20department by rule, but only for the purpose of verifying
21that a person is lawfully in possession of a medical cannabis
22registration card issued pursuant to this chapter.
23(2) Release of information pursuant to subparagraph
24(1) shall be consistent with the federal Health Insurance
25Portability and Accountability Act of 1996, Pub.L. No.
26104-191.
272. The department shall adopt rules pursuant to chapter
2817A to administer this chapter which shall include but not be
29limited to rules to do all of the following:
30a. Govern the manner in which the department shall consider
31applications for new and renewal medical cannabis registration
32cards.
33b. Identify criteria and set forth procedures for
34including additional chronic or debilitating diseases or
35medical conditions or their medical treatments on the list of
-16-1debilitating medical conditions that qualify for the use of
2medical cannabis. Procedures shall include a petition process
3and shall allow for public comment and public hearings before
4the medical advisory board.
5c. Set forth additional chronic or debilitating diseases
6or medical conditions or associated medical treatments for
7inclusion on the list of debilitating medical conditions that
8qualify for the use of medical cannabis as recommended by the
9medical advisory board.
10d. Establish, in consultation with medical cannabis
11manufacturers and medical cannabis dispensaries, the form and
12quantity of medical cannabis allowed to be dispensed to a
13patient or primary caregiver pursuant to this chapter. The
14form and quantity of medical cannabis shall be appropriate to
15serve the medical needs of patients with debilitating medical
16conditions.
17e. Establish, in conjunction with the medical advisory
18board, requirements for the licensure of medical cannabis
19manufacturers and medical cannabis dispensaries and set forth
20procedures for medical cannabis manufacturers and medical
21cannabis dispensaries to obtain licenses.
22f. Develop a dispensing system for medical cannabis within
23this state that provides for all of the following:
24(1) Medical cannabis dispensaries within this state housed
25on secured grounds and operated by licensed medical cannabis
26dispensaries.
27(2) The dispensing of medical cannabis to patients and
28their primary caregivers to occur at locations designated by
29the department.
30g. Establish and collect annual fees from medical cannabis
31manufacturers and medical cannabis dispensaries to cover
32the costs associated with regulating and inspecting medical
33cannabis manufacturers and medical cannabis dispensaries.
34h. Specify and implement procedures that address public
35safety including security procedures and product quality
-17-1including measures to ensure contaminant-free cultivation of
2medical cannabis, safety, and labeling.
3i. Establish and implement a medical cannabis inventory
4and delivery tracking system to track medical cannabis
5from production by a medical cannabis manufacturer through
6dispensing at a medical cannabis dispensary.
7 Sec. 16. NEW SECTION. 124F.12 Reciprocity.
8A valid medical cannabis registration card, or its
9equivalent, issued under the laws of another state that allows
10an out-of-state patient to possess or use medical cannabis in
11the jurisdiction of issuance shall have the same force and
12effect as a valid medical cannabis registration card issued
13pursuant to this chapter, except that an out-of-state patient
14in this state shall not obtain medical cannabis from a medical
15cannabis dispensary in this state and an out-of-state patient
16shall not smoke medical cannabis.
17 Sec. 17. NEW SECTION. 124F.13 Use of medical cannabis —
18affirmative defenses.
191. A health care practitioner, including any authorized
20agent or employee thereof, shall not be subject to
21prosecution for the unlawful certification, possession, or
22administration of marijuana under the laws of this state for
23activities arising directly out of or directly related to the
24certification or use of medical cannabis in the treatment of
25a patient diagnosed with a debilitating medical condition as
26authorized by this chapter.
272. A medical cannabis manufacturer, including any
28authorized agent or employee thereof, shall not be subject
29to prosecution for manufacturing, possessing, cultivating,
30harvesting, packaging, processing, transporting, or supplying
31medical cannabis pursuant to this chapter.
323. A medical cannabis dispensary, including any authorized
33agent or employee thereof, shall not be subject to prosecution
34for transporting, supplying, or dispensing medical cannabis
35pursuant to this chapter.
-18- 1a. In a prosecution for the unlawful possession of marijuana
2under the laws of this state, including but not limited to
3chapters 124 and 453B, it is an affirmative and complete
4defense to the prosecution that the patient has been diagnosed
5with a debilitating medical condition, used or possessed
6medical cannabis pursuant to a certification by a health care
7practitioner as authorized under this chapter, and, for a
8patient eighteen years of age or older, is in possession of a
9valid medical cannabis registration card.
10b. In a prosecution for the unlawful possession of marijuana
11under the laws of this state, including but not limited to
12chapters 124 and 453B, it is an affirmative and complete
13defense to the prosecution that the person possessed medical
14cannabis because the person is a primary caregiver of a patient
15who has been diagnosed with a debilitating medical condition
16and is in possession of a valid medical cannabis registration
17card, and where the primary caregiver’s possession of the
18medical cannabis is on behalf of the patient and for the
19patient’s use only as authorized under this chapter.
20c. If a patient or primary caregiver is charged with the
21commission of a crime and is not in possession of the person’s
22medical cannabis registration card, any charge or charges filed
23against the person shall be dismissed by the court if the
24person produces to the court prior to or at the person’s trial
25a medical cannabis registration card issued to that person and
26valid at the time the person was charged.
274. An agency of this state or a political subdivision
28thereof, including any law enforcement agency, shall not remove
29or initiate proceedings to remove a patient under the age
30of eighteen from the home of a parent based solely upon the
31parent’s or patient’s possession or use of medical cannabis as
32authorized under this chapter.
33 Sec. 18. NEW SECTION. 124F.14 Penalties.
341. A person who knowingly or intentionally possesses or
35uses medical cannabis in violation of the requirements of this
-19-1chapter is subject to the penalties provided under chapters 124
2and 453B.
32. A medical cannabis manufacturer or a medical cannabis
4dispensary shall be assessed a civil penalty of up to one
5thousand dollars per violation for any violation of this
6chapter in addition to any other applicable penalties.
7 Sec. 19. NEW SECTION. 124F.15 Use of medical cannabis —
8smoking prohibited.
9A patient shall not consume medical cannabis possessed
10or used as authorized under this chapter by smoking medical
11cannabis.
12 Sec. 20. NEW SECTION. 124F.16 Employment.
131. An employer in this state may retain, create, reinstate,
14or enforce a written zero tolerance policy prohibiting the
15possession or use of medical cannabis or any derivative
16thereof including cannabidiol by an employee in the employer’s
17workplace, including but not limited to a policy prohibiting
18an employee from having any detectable amount of medical
19cannabis or any derivative thereof including cannabidiol in the
20employee’s body while at work.
212. An employer’s prohibition of the possession or use
22of medical cannabis or any derivative thereof including
23cannabidiol under this section shall not be considered to be
24an unfair or discriminatory employment practice under section
25216.6.
26 Sec. 21. Section 730.5, subsection 11, paragraph f, Code
272019, is amended to read as follows:
28f. Testing or taking action against an employee or
29prospective employee with a confirmed positive test result due
30to the employee’s or prospective employee’s use of medical
31cannabidiol cannabis as authorized under chapter 124E 124F.
32 Sec. 22. REPEAL. Chapter 124E, Code 2019, is repealed.
33 Sec. 23. EMERGENCY RULES. The department may adopt
34emergency rules under section 17A.4, subsection 3, and section
3517A.5, subsection 2, paragraph “b”, to implement the provisions
-20-1of this division of this Act and the rules shall be effective
2immediately upon filing unless a later date is specified in the
3rules. Any rules adopted in accordance with this section shall
4also be published as a notice of intended action as provided
5in section 17A.4.
6 Sec. 24. TRANSITION PROVISIONS.
71. A medical cannabidiol registration card issued
8under chapter 124E prior to the effective date of this Act
9remains effective and continues in effect as issued for the
10twelve-month period following its issuance. This Act does not
11preclude a medical cannabidiol registration card holder from
12seeking to renew the registration card prior to the expiration
13of the twelve-month period.
142. Members of the medical cannabidiol board created in
15section 124E.5 shall continue to serve until the appointment of
16the medical advisory board created in section 124F.5.
173. Any rule, form, order, license, or directive promulgated
18by the medical cannabidiol board created in section 124E.5, or
19by the department, in force and effect immediately prior to the
20appointment of the medical advisory board, shall continue in
21full force and effect until the earlier of the following:
22a. It is amended, rescinded, or supplemented by the
23affirmative actions of the medical advisory board or the
24department, as applicable.
25b. It expires by its own terms.
264. A medical cannabidiol manufacturer licensed pursuant
27to section 124E.6 and operating immediately prior to the
28effective date of this Act shall operate as a medical cannabis
29manufacturer pursuant to section 124F.6 until the earlier of
30the following:
31a. The license is revoked by the affirmative action of the
32department.
33b. The license expires by its own terms.
34c. The medical cannabidiol manufacturer becomes licensed as
35a medical cannabis manufacturer.
-21- 15. A medical cannabidiol dispensary licensed pursuant to
2section 124E.8 and operating immediately prior to the effective
3date of this Act shall operate as a medical cannabis dispensary
4pursuant to section 124F.8 until the earlier of the following:
5a. The license is revoked by the affirmative action of the
6department.
7b. The license expires by its own terms.
8c. The medical cannabidiol dispensary becomes licensed as
9a medical cannabis dispensary.
10 Sec. 25. EFFECTIVE UPON ENACTMENT. This Act, being deemed
11of immediate importance, takes effect upon enactment.
12EXPLANATION
13The inclusion of this explanation does not constitute agreement with
14the explanation’s substance by the members of the general assembly.
15This bill creates the compassionate use of medical cannabis
16Act, reclassifies marijuana, including tetrahydrocannabinols,
17from a schedule I controlled substance to a schedule II
18controlled substance, and provides for civil and criminal
19penalties and fees.
20OVERVIEW. The bill allows a patient with a debilitating
21medical condition who receives a written certification from
22the patient’s health care practitioner that the patient has
23a debilitating medical condition and who submits the written
24certification along with an application to the department of
25public health (department) for a medical cannabis registration
26card to allow for the lawful use of medical cannabis to treat
27the patient’s debilitating medical condition. A patient who
28is issued a medical cannabis registration card will be able
29to receive medical cannabis directly from a medical cannabis
30dispensary operated and licensed in this state.
31RECLASSIFICATION. The bill reclassifies marijuana,
32including tetrahydrocannabinols as a schedule II controlled
33substance instead of a schedule I controlled substance and
34strikes references to the authority of the board of pharmacy to
35adopt rules for the use of marijuana or tetrahydrocannabinols
-22-1for medicinal purposes.
2A schedule I controlled substance is a highly addictive
3substance that has no accepted medical use in the United States
4and a schedule II controlled substance is a highly addictive
5substance that has an accepted medical use in the United
6States. The reclassification of marijuana from a schedule I
7controlled substance to a schedule II controlled substance
8would allow a physician to issue a prescription for marijuana
9under state law. However, federal regulations may prohibit
10such prescriptions.
11The penalties remain unchanged for violations involving
12marijuana under the bill. The penalties under Code section
13124.401 range from a class “B” felony punishable by up to 50
14years of confinement to a serious misdemeanor punishable by
15up to six months of confinement depending on the amount of
16marijuana involved in the offense.
17The bill amends Code section 124.401, relating to prohibited
18acts involving controlled substances, to provide that it is
19lawful for a person to knowingly or intentionally recommend,
20possess, use, dispense, deliver, transport, or administer
21medical cannabis if the recommendation, possession, use,
22dispensing, delivery, transporting, or administering is in
23accordance with the provisions of the bill.
24DEFINITIONS. The bill provides the following definitions:
25“Debilitating medical condition” means cancer, multiple
26sclerosis, epilepsy or seizure disorders, AIDS or HIV,
27Hepatitis C, Crohn’s disease or ulcerative colitis, amyotrophic
28lateral sclerosis, intractable pain, glaucoma, any terminal
29illness with a probable life expectancy of under one year,
30Ehlers-Danlos syndrome, post-traumatic stress disorder,
31Tourette’s syndrome, and any other chronic or debilitating
32disease or medical condition or its medical treatment approved
33by the department by rule.
34“Health care practitioner” means an individual licensed
35under Code chapter 148 to practice medicine and surgery or
-23-1osteopathic medicine and surgery or an individual licensed to
2prescribe medicine in any other state who provides specialty
3care to an Iowa resident for one or more debilitating medical
4conditions specified in the bill.
5“Medical cannabis” means any species of the genus cannabis
6plant, or any mixture or preparation of them, including whole
7plant extracts and resins.
8“Medical cannabis manufacturer” means an entity licensed
9by the department to manufacture and to possess, cultivate,
10transport, or supply, medical cannabis pursuant to the bill.
11“Medical cannabis dispensary” means an entity licensed under
12the bill that acquires medical cannabis from a medical cannabis
13manufacturer in this state for the purpose of dispensing
14medical cannabis in this state pursuant to the bill.
15“Primary caregiver” means a person, at least 18 years of age,
16who has been designated by a patient’s health care practitioner
17or a person having custody of a patient, as a necessary
18caretaker taking responsibility for managing the well-being
19of the patient with respect to the use of medical cannabis
20pursuant to the bill.
21“Written certification” means a document signed by a health
22care practitioner, with whom the patient has established a
23patient-provider relationship, which states that the patient
24has a debilitating medical condition and which identifies that
25condition, and provides any other relevant information.
26HEALTH CARE PRACTITIONER CERTIFICATION. The bill provides
27that prior to a patient’s submission of an application
28for a medical cannabis registration card, if a health care
29practitioner determines that the patient whom the health
30care practitioner has examined and treated suffers from a
31debilitating medical condition, the health care practitioner
32may provide the patient with a written certification of that
33diagnosis. The health care practitioner must also provide
34explanatory information to the patient about the therapeutic
35use of medical cannabis, and if the patient continues to
-24-1suffer from a debilitating medical condition, the health care
2practitioner may issue the patient a new certification of
3that diagnosis on an annual basis. The bill specifies that
4a health care practitioner has no duty to provide a written
5certification.
6MEDICAL CANNABIS REGISTRATION CARD — PATIENT AND PRIMARY
7CAREGIVER. The department may approve the issuance of a
8medical cannabis registration card to a patient who is at least
918 years of age and is a permanent resident of this state, who
10submits a written certification by the patient’s health care
11practitioner to the department, and who submits an application
12to the department with certain information along with a medical
13registration card fee. The department may also approve the
14issuance of a medical cannabis registration card to a primary
15caregiver who is at least 18 years of age, who submits a
16written certification by the patient’s health care practitioner
17to the department on behalf of the patient, and who submits an
18application to the department with certain information along
19with a medical cannabis registration card fee. A medical
20cannabis registration card expires one year after the date of
21issuance and may be renewed.
22MEDICAL ADVISORY BOARD. The director of public health is
23directed to establish a medical advisory board, no later than
24August 15, 2019, to consist of nine practitioners representing
25the fields of neurology, pain management, gastroenterology,
26oncology, psychiatry, pediatrics, infectious disease,
27family medicine, and pharmacy, and three patients or primary
28caregivers with valid medical cannabis registration cards. The
29duties of the board include but are not limited to reviewing
30and recommending to the department for approval additional
31chronic or debilitating diseases or medical conditions or their
32treatments as debilitating medical conditions that qualify for
33the use of medical cannabis under the bill.
34MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS
35DISPENSARIES — LICENSURE. The bill requires the department
-25-1to license up to four medical cannabis manufacturers for
2the manufacture of medical cannabis within this state by
3December 1, 2019, and to license twelve medical cannabis
4dispensaries by April 2, 2020. Information submitted during
5the application process is confidential until the medical
6cannabis manufacturer or the medical cannabis dispensary is
7licensed by the department unless otherwise protected from
8disclosure under state or federal law. As a condition for
9licensure, a medical cannabis manufacturer must agree to begin
10supplying medical cannabis to medical cannabis dispensaries in
11this state by July 2, 2020, and a medical cannabis dispensary
12must agree to begin supplying medical cannabis to patients by
13July 16, 2020. The department is directed to consider several
14factors in determining whether to license a medical cannabis
15manufacturer and a medical cannabis dispensary including
16technical expertise, employee qualifications, financial
17stability, security measures, and production needs and
18capacity. Each medical cannabis manufacturer is required to
19contract with a laboratory approved by the department to test
20the medical cannabis produced by the manufacturer and to report
21testing results to the medical cannabis manufacturer. Each
22entity submitting an application for licensure as a medical
23cannabis manufacturer shall pay a nonrefundable application
24fee of $15,000 to the department and each entity submitting
25an application for licensure as a medical cannabis dispensary
26shall pay a nonrefundable application fee of $15,000 to the
27department.
28MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS
29DISPENSARIES — ADDITIONAL PROVISIONS. The operating
30documents of a medical cannabis manufacturer and a medical
31cannabis dispensary shall include procedures for oversight and
32recordkeeping activities of the medical cannabis manufacturer
33and the medical cannabis dispensary and certain security
34measures undertaken by the medical cannabis manufacturer
35and the medical cannabis dispensary. A medical cannabis
-26-1manufacturer and a medical cannabis dispensary are prohibited
2from sharing office space with, referring patients to,
3or having a financial relationship with a health care
4practitioner, permitting any person to consume medical cannabis
5on the property of the medical cannabis manufacturer or the
6medical cannabis dispensary, employing a person who is under
718 years of age or who has been convicted of a disqualifying
8felony offense, and from operating in any location within 1,000
9feet of a public or private school existing before the date
10of the licensure of the medical cannabis manufacturer or the
11medical cannabis dispensary. In addition, a medical cannabis
12manufacturer and a medical cannabis dispensary are subject to
13reasonable inspection and certain reasonable restrictions.
14A medical cannabis manufacturer is required to provide a
15reliable and ongoing supply of medical cannabis to medical
16cannabis dispensaries and shall not manufacture edible medical
17cannabis products utilizing food coloring. All manufacturing,
18cultivating, harvesting, packaging, and processing of medical
19cannabis is required to take place in an enclosed, locked
20facility.
21Prior to dispensing any medical cannabis, a medical cannabis
22dispensary is required to verify that the medical cannabis
23dispensary has received a valid medical cannabis registration
24card from a patient or a patient’s primary caregiver, if
25applicable, assign a tracking number to any medical cannabis
26dispensed from the medical cannabis dispensary, and properly
27package and label medical cannabis in compliance with the
28provisions of the bill and certain federal laws.
29DEPARTMENT DUTIES — CONFIDENTIALITY. The department
30is required to maintain a confidential file of the names
31of each patient and primary caregiver issued a medical
32cannabis registration card, and the names of each health
33care practitioner who provides a written certification for
34medical cannabis under the bill. Individual names contained
35in the file shall be confidential and shall not be subject to
-27-1disclosure, except that information in the confidential file
2may be released on an individual basis to authorized employees
3or agents of the department, the department of transportation,
4and a medical cannabis dispensary as necessary to perform
5their duties, to authorized employees of state or local law
6enforcement agencies for the purpose of verifying that a person
7is lawfully in possession of a medical cannabis registration
8card, and to any other authorized employees for the purpose of
9verifying that a person is lawfully in possession of a medical
10cannabis registration card. Release of information must also
11be consistent with federal Health Insurance Portability and
12Accountability Act regulations.
13ADDITIONAL DEPARTMENT DUTIES — RULES. The bill requires
14the department to adopt rules relating to the manner in which
15the department shall consider applications for new and renewal
16medical cannabis registration cards, identify criteria and
17set forth procedures for including additional chronic or
18debilitating diseases or medical conditions or their medical
19treatments on the list of debilitating medical conditions,
20establish the form and quantity of medical cannabis allowed to
21be dispensed to a patient or primary caregiver in the form and
22quantity appropriate to serve the medical needs of the patient
23with the debilitating medical condition, establish requirements
24for the licensure of medical cannabis manufacturers and medical
25cannabis dispensaries, develop a dispensing system for medical
26cannabis within this state that follows certain requirements,
27establish and implement a medical cannabis inventory and
28delivery tracking system, and specify and implement procedures
29that address public safety including security procedures and
30product quality, safety, and labeling.
31RECIPROCITY. The bill provides that a valid medical
32cannabis registration card, or its equivalent, issued under
33the laws of another state that allows an out-of-state patient
34to possess or use medical cannabis in the jurisdiction of
35issuance shall have the same force and effect as a valid
-28-1medical cannabis card issued under the bill, except that an
2out-of-state patient in this state shall not obtain medical
3cannabis from a medical cannabis dispensary and an out-of-state
4patient shall not smoke medical cannabis in this state.
5USE OF MEDICAL CANNABIS — SMOKING PROHIBITED. The bill
6provides that a patient shall not consume the medical cannabis
7by smoking the medical cannabis.
8USE OF MEDICAL CANNABIS — AFFIRMATIVE DEFENSES. The bill
9provides prosecution immunity for a health care practitioner,
10a medical cannabis manufacturer, and a medical cannabis
11dispensary, including any authorized agents or employees of the
12health care practitioner, medical cannabis manufacturer, and
13medical cannabis dispensary, for activities undertaken by the
14health care practitioner, medical cannabis manufacturer, and
15medical cannabis dispensary pursuant to the provisions of the
16bill.
17The bill provides that in a prosecution for the unlawful
18possession of marijuana under the laws of this state,
19including but not limited to Code chapters 124 (controlled
20substances) and 453B (excise tax on unlawful dealing in
21certain substances), it is an affirmative and complete
22defense to the prosecution that the patient has been diagnosed
23with a debilitating medical condition, used or possessed
24medical cannabis pursuant to a certification by a health
25care practitioner, and, for a patient age 18 or older, is
26in possession of a valid medical cannabis registration
27card. The bill provides a similar affirmative defense for a
28primary caretaker of a patient who has been diagnosed with a
29debilitating medical condition who is in possession of a valid
30medical cannabis registration card.
31The bill provides that an agency of this state or a political
32subdivision thereof, including any law enforcement agency,
33shall not remove or initiate proceedings to remove a patient
34under the age of 18 from the home of a parent based solely upon
35the parent’s or patient’s possession or use of medical cannabis
-29-1as authorized under the bill.
2PENALTIES. The bill provides that a person who knowingly or
3intentionally possesses or uses medical cannabis in violation
4of the requirements of the bill is subject to the penalties
5provided under Code chapters 124 and 453B. In addition, a
6medical cannabis manufacturer or a medical cannabis dispensary
7shall be assessed a civil penalty of up to $1,000 per violation
8for any violation of the bill in addition to any other
9applicable penalties.
10REPEAL. The bill repeals Code chapter 124E, the medical
11cannabidiol Act.
12EMERGENCY RULES. The bill provides that the department
13may adopt emergency rules and the rules shall be effective
14immediately upon filing unless a later date is specified in the
15rules.
16EFFECTIVE DATE. The bill takes effect upon enactment.
17TRANSITION PROVISIONS. The bill provides that a medical
18cannabis registration card issued under Code chapter 124E
19(medical cannabidiol Act) prior to the effective date of the
20bill, shall remain effective and continues in effect as issued
21for the 12-month period following its issuance. The bill also
22provides that members of the medical cannabidiol board shall
23continue to serve until the appointment of the medical advisory
24board and that rules, forms, orders, licenses, and directives
25promulgated by the medical cannabidiol board that are in force
26and effect immediately prior to the appointment of the medical
27advisory board shall remain in full force and effect until
28amended, rescinded, or supplemented by affirmative actions of
29the medical advisory board or they expire by their own terms.
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