Relating to the compassionate use of medical cannabis Act, reclassifying marijuana, including tetrahydrocannabinols, from a schedule I controlled substance to a schedule II controlled substance, providing for civil and criminal penalties and fees, and including effective date provisions

A patient who is issued a medical cannabis registration card will be able to receive medical cannabis directly from a medical cannabis dispensary operated and licensed in this state. RECLASSIFICATION. The bill reclassifies marijuana, including tetrahydrocannabinols as a schedule II controlled substance instead of a schedule I controlled substance and strikes references to the authority of the board of pharmacy to adopt rules for the use of marijuana or tetrahydrocannabinols for medicinal purposes. A schedule I controlled substance is a highly addictive substance that has no accepted medical use in the United States and a schedule II controlled substance is a highly addictive substance that has an accepted medical use in the United States. The reclassification of marijuana from a schedule I controlled substance to a schedule II controlled substance would allow a physician to issue a prescription for marijuana under state law. However, federal regulations may prohibit such prescriptions. The penalties remain unchanged for violations involving marijuana under the bill.401 range from a class “B” felony punishable by up to 50 years of confinement to a serious misdemeanor punishable by up to six months of confinement depending on the amount of marijuana involved in the offense.401, relating to prohibited acts involving controlled substances, to provide that it is lawful for a person to knowingly or intentionally recommend, possess, use, dispense, deliver, transport, or administer medical cannabis if the recommendation, possession, use, dispensing, delivery, transporting, or administering is in accordance with the provisions of the bill. DEFINITIONS. The bill provides the following definitions: “Debilitating medical condition” means cancer, multiple sclerosis, epilepsy or seizure disorders, AIDS or HIV, Hepatitis C, Crohn’s disease or ulcerative colitis, amyotrophic lateral sclerosis, intractable pain, glaucoma, any terminal illness with a probable life expectancy of under one year, Ehlers-Danlos syndrome, post-traumatic stress disorder, Tourette’s syndrome, and any other chronic or debilitating disease or medical condition or its medical treatment approved by the department by rule. “Health care practitioner” means an individual licensed under Code chapter 148 to practice medicine and surgery or osteopathic medicine and surgery or an individual licensed to prescribe medicine in any other state who provides specialty care to an Iowa resident for one or more debilitating medical conditions specified in the bill. “Medical cannabis” means any species of the genus cannabis plant, or any mixture or preparation of them, including whole plant extracts and resins. “Medical cannabis manufacturer” means an entity licensed by the department to manufacture and to possess, cultivate, transport, or supply, medical cannabis pursuant to the bill. “Medical cannabis dispensary” means an entity licensed under the bill that acquires medical cannabis from a medical cannabis manufacturer in this state for the purpose of dispensing medical cannabis in this state pursuant to the bill. “Primary caregiver” means a person, at least 18 years of age, who has been designated by a patient’s health care practitioner or a person having custody of a patient, as a necessary caretaker taking responsibility for managing the well-being of the patient with respect to the use of medical cannabis pursuant to the bill. “Written certification” means a document signed by a health care practitioner, with whom the patient has established a patient-provider relationship, which states that the patient has a debilitating medical condition and which identifies that condition, and provides any other relevant information. HEALTH CARE PRACTITIONER CERTIFICATION. The bill provides that prior to a patient’s submission of an application for a medical cannabis registration card, if a health care practitioner determines that the patient whom the health care practitioner has examined and treated suffers from a debilitating medical condition, the health care practitioner may provide the patient with a written certification of that diagnosis. The health care practitioner must also provide explanatory information to the patient about the therapeutic use of medical cannabis, and if the patient continues to suffer from a debilitating medical condition, the health care practitioner may issue the patient a new certification of that diagnosis on an annual basis. The bill specifies that a health care practitioner has no duty to provide a written certification. MEDICAL CANNABIS REGISTRATION CARD —— PATIENT AND PRIMARY CAREGIVER. The department may approve the issuance of a medical cannabis registration card to a patient who is at least 18 years of age and is a permanent resident of this state, who submits a written certification by the patient’s health care practitioner to the department, and who submits an application to the department with certain information along with a medical registration card fee. The department may also approve the issuance of a medical cannabis registration card to a primary caregiver who is at least 18 years of age, who submits a written certification by the patient’s health care practitioner to the department on behalf of the patient, and who submits an application to the department with certain information along with a medical cannabis registration card fee. A medical cannabis registration card expires one year after the date of issuance and may be renewed. MEDICAL ADVISORY BOARD. The director of public health is directed to establish a medical advisory board, no later than August 15, 2019, to consist of nine practitioners representing the fields of neurology, pain management, gastroenterology, oncology, psychiatry, pediatrics, infectious disease, family medicine, and pharmacy, and three patients or primary caregivers with valid medical cannabis registration cards. The duties of the board include but are not limited to reviewing and recommending to the department for approval additional chronic or debilitating diseases or medical conditions or their treatments as debilitating medical conditions that qualify for the use of medical cannabis under the bill. MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS DISPENSARIES —— LICENSURE. The bill requires the department to license up to four medical cannabis manufacturers for the manufacture of medical cannabis within this state by December 1, 2019, and to license twelve medical cannabis dispensaries by April 2, 2020. Information submitted during the application process is confidential until the medical cannabis manufacturer or the medical cannabis dispensary is licensed by the department unless otherwise protected from disclosure under state or federal law. As a condition for licensure, a medical cannabis manufacturer must agree to begin supplying medical cannabis to medical cannabis dispensaries in this state by July 2, 2020, and a medical cannabis dispensary must agree to begin supplying medical cannabis to patients by July 16, 2020. The department is directed to consider several factors in determining whether to license a medical cannabis manufacturer and a medical cannabis dispensary including technical expertise, employee qualifications, financial stability, security measures, and production needs and capacity. Each medical cannabis manufacturer is required to contract with a laboratory approved by the department to test the medical cannabis produced by the manufacturer and to report testing results to the medical cannabis manufacturer. Each entity submitting an application for licensure as a medical cannabis manufacturer shall pay a nonrefundable application fee of $15,000 to the department and each entity submitting an application for licensure as a medical cannabis dispensary shall pay a nonrefundable application fee of $15,000 to the department. MEDICAL CANNABIS MANUFACTURERS AND MEDICAL CANNABIS DISPENSARIES —— ADDITIONAL PROVISIONS. The operating documents of a medical cannabis manufacturer and a medical cannabis dispensary shall include procedures for oversight and recordkeeping activities of the medical cannabis manufacturer and the medical cannabis dispensary and certain security measures undertaken by the medical cannabis manufacturer and the medical cannabis dispensary. A medical cannabis manufacturer and a medical cannabis dispensary are prohibited from sharing office space with, referring patients to, or having a financial relationship with a health care practitioner, permitting any person to consume medical cannabis on the property of the medical cannabis manufacturer or the medical cannabis dispensary, employing a person who is under 18 years of age or who has been convicted of a disqualifying felony offense, and from operating in any location within 1,000 feet of a public or private school existing before the date of the licensure of the medical cannabis manufacturer or the medical cannabis dispensary. In addition, a medical cannabis manufacturer and a medical cannabis dispensary are subject to reasonable inspection and certain reasonable restrictions. A medical cannabis manufacturer is required to provide a reliable and ongoing supply of medical cannabis to medical cannabis dispensaries and shall not manufacture edible medical cannabis products utilizing food coloring. All manufacturing, cultivating, harvesting, packaging, and processing of medical cannabis is required to take place in an enclosed, locked facility. Prior to dispensing any medical cannabis, a medical cannabis dispensary is required to verify that the medical cannabis dispensary has received a valid medical cannabis registration card from a patient or a patient’s primary caregiver, if applicable, assign a tracking number to any medical cannabis dispensed from the medical cannabis dispensary, and properly package and label medical cannabis in compliance with the provisions of the bill and certain federal laws. DEPARTMENT DUTIES —— CONFIDENTIALITY. The department is required to maintain a confidential file of the names of each patient and primary caregiver issued a medical cannabis registration card, and the names of each health care practitioner who provides a written certification for medical cannabis under the bill. Individual names contained in the file shall be confidential and shall not be subject to disclosure, except that information in the confidential file may be released on an individual basis to authorized employees or agents of the department, the department of transportation, and a medical cannabis dispensary as necessary to perform their duties, to authorized employees of state or local law enforcement agencies for the purpose of verifying that a person is lawfully in possession of a medical cannabis registration card, and to any other authorized employees for the purpose of verifying that a person is lawfully in possession of a medical cannabis registration card. Release of information must also be consistent with federal Health Insurance Portability and Accountability Act regulations. ADDITIONAL DEPARTMENT DUTIES —— RULES. The bill requires the department to adopt rules relating to the manner in which the department shall consider applications for new and renewal medical cannabis registration cards, identify criteria and set forth procedures for including additional chronic or debilitating diseases or medical conditions or their medical treatments on the list of debilitating medical conditions, establish the form and quantity of medical cannabis allowed to be dispensed to a patient or primary caregiver in the form and quantity appropriate to serve the medical needs of the patient with the debilitating medical condition, establish requirements for the licensure of medical cannabis manufacturers and medical cannabis dispensaries, develop a dispensing system for medical cannabis within this state that follows certain requirements, establish and implement a medical cannabis inventory and delivery tracking system, and specify and implement procedures that address public safety including security procedures and product quality, safety, and labeling. RECIPROCITY. The bill provides that a valid medical cannabis registration card, or its equivalent, issued under the laws of another state that allows an out-of-state patient to possess or use medical cannabis in the jurisdiction of issuance shall have the same force and effect as a valid medical cannabis card issued under the bill, except that an out-of-state patient in this state shall not obtain medical cannabis from a medical cannabis dispensary and an out-of-state patient shall not smoke medical cannabis in this state. USE OF MEDICAL CANNABIS —— SMOKING PROHIBITED. The bill provides that a patient shall not consume the medical cannabis by smoking the medical cannabis. USE OF MEDICAL CANNABIS —— AFFIRMATIVE DEFENSES. The bill provides prosecution immunity for a health care practitioner, a medical cannabis manufacturer, and a medical cannabis dispensary, including any authorized agents or employees of the health care practitioner, medical cannabis manufacturer, and medical cannabis dispensary, for activities undertaken by the health care practitioner, medical cannabis manufacturer, and medical cannabis dispensary pursuant to the provisions of the bill. The bill provides that in a prosecution for the unlawful possession of marijuana under the laws of this state, including but not limited to Code chapters 124 (controlled substances) and 453B (excise tax on unlawful dealing in certain substances), it is an affirmative and complete defense to the prosecution that the patient has been diagnosed with a debilitating medical condition, used or possessed medical cannabis pursuant to a certification by a health care practitioner, and, for a patient age 18 or older, is in possession of a valid medical cannabis registration card. The bill provides a similar affirmative defense for a primary caretaker of a patient who has been diagnosed with a debilitating medical condition who is in possession of a valid medical cannabis registration card. The bill provides that an agency of this state or a political subdivision thereof, including any law enforcement agency, shall not remove or initiate proceedings to remove a patient under the age of 18 from the home of a parent based solely upon the parent’s or patient’s possession or use of medical cannabis as authorized under the bill. PENALTIES. The bill provides that a person who knowingly or intentionally possesses or uses medical cannabis in violation of the requirements of the bill is subject to the penalties provided under Code chapters 124 and 453B. In addition, a medical cannabis manufacturer or a medical cannabis dispensary shall be assessed a civil penalty of up to $1,000 per violation for any violation of the bill in addition to any other applicable penalties. REPEAL. The bill repeals Code chapter 124E, the medical cannabidiol Act. EMERGENCY RULES. The bill provides that the department may adopt emergency rules and the rules shall be effective immediately upon filing unless a later date is specified in the rules. EFFECTIVE DATE. The bill takes effect upon enactment. TRANSITION PROVISIONS. The bill provides that a medical cannabis registration card issued under Code chapter 124E (medical cannabidiol Act) prior to the effective date of the bill, shall remain effective and continues in effect as issued for the 12-month period following its issuance. The bill also provides that members of the medical cannabidiol board shall continue to serve until the appointment of the medical advisory board and that rules, forms, orders, licenses, and directives promulgated by the medical cannabidiol board that are in force and effect immediately prior to the appointment of the medical advisory board shall remain in full force and effect until amended, rescinded, or supplemented by affirmative actions of the medical advisory board or they expire by their own terms.