BILL & AMENDMENT SUMMARY

Medical Cannabis
Expansion
HF 732
Status of Bill: House Calendar
Lead Democrat: Rep. Breckenridge
Committee: Public Safety (21-0)
Floor Manager: Rep. Klein
Research Analyst: Alison Ver Schuer; (515) 281-5939; Alison.Ver.Schuer@legis.iowa.gov

Background
HF 524 (current law)
During 2017, the Senate passed HF 524 to correct Iowa’s 2014 cannabidiol (SF 2360) and allow better access
to cannabidiol. Under SF 2360, patients and primary care givers of patients with intractable epilepsy could
receive a cannabidiol card that allowed up to 32 ounces of cannabidiol containing less than 3% THC.
However, Iowa caregivers and patients had zero access to cannabidiol products within in the state.
HF 524 allows the Department of Public Health (DPH) to license two manufacturers (maximum) and allows at
least five dispensaries to locate in the state. Products that are produced and sold within the state must not
contain more than 3% THC. HF 524 expanded the number of eligible debilitating diseases to 9 and created
the Medical Cannabidiol Board (Governor appointed board of eight medical practitioners and one law
enforcement officer). This Board is responsible for working with the DPH regarding requirements and
locations for and manufacturers and dispensaries; the form and quantity of allowable medicine; and
reviewing petitions to add or remove debilitating diseases.
HF 524 required manufacturers to be selected and licensed by December 1, 2017, and begin supplying to
dispensaries by December 1, 2018. Dispensaries are to be licensed by April 1, 2018, and begin selling on
December 1, 2018.
SF 506 (Compassionate use of Medical Cannabis Act)
During the 2017 session, SF 506 passed 45-5 in the Senate and was referred to the House Ways and Means
Committee. Despite receiving overwhelming Senate Republican support, Speaker Upmeyer refused to bring
this version of the bill forward for debate. SF 506’s language is considered less restrictive than HF 524
(current law) and has been used as an amendment for various bills during previous legislative sessions. The
primary differences between HF 524 (current law) and SF 506 include:
Medical Cannabis
SF 506 would have expanded the allowable form of medical cannabis beyond cannabidiol to include any
mixture or preparation of the whole genus cannabis plant species, extracts and resins. Forms beyond
cannabidiol have been found to be more helpful for various medical conditions. The DPH would have been
directed to promulgate administrative rules to establish the form and quantity of medical cannabis allowed
to be dispensed. Smoking of medical cannabis would have remained prohibited.

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 Marijuana, including THC, would have been rescheduled from a Schedule I to a Schedule II controlled
substance. A Schedule I substance is classified as a highly addictive substance with no accepted medical use.
Schedule II is a highly addictive controlled substance that has accepted medical uses.
In contrast, under current law, cannabis/THC remains classified as a ‘Schedule I’ drug.
Health Care Practitioner’s Certification
SF 506 would have required a health care practitioner to provide a written certification attesting to the
patient’s suffering from a debilitating medical condition that is eligible for the medical cannabis program
prior to issuing a registration card. The health care practitioner must also provide explanatory information to
the patient about the therapeutic use of medical cannabis.
Per HF 524, a Medical Advisory Board determines the eligible medical conditions for the medical cannabis
program, which governs physicians issuing of registration cards to patients.
Eligible Conditions & Medical Advisory Board
SF 506 expanded the list of debilitating medical conditions beyond intractable epilepsy, and would have
included: cancer, multiple sclerosis; epilepsy; AIDS/HIV; glaucoma; Hepatitis C; Crohn’s Disease or ulcerative
colitis; ALS; Ehlers-Danlos Syndrome; PTSD; Tourette’s Syndrome; terminal illness; intractable pain;
Parkinson’s disease; muscular dystrophy; Huntington’s disease; complex regional pain syndrome,
Rheumatoid arthritis and Polyarteritis Nodosa.
HF 524’s list of eligible medical conditions is narrower, and only includes: cancer, Multiple Sclerosis,
Seizures/Epilepsy, AIDS/HIV, Crohn’s disease, Amyotrophic lateral sclerosis, Parkinson’s disease and
untreatable pain.
SF 506 would have also required the Director of the DPH to establish a Medical Advisory Board consisting of
nine practitioners 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 by August 15, 2017. The Medical Advisory Board could also
recommend additional conditions and overall improvements to the program.
Currently, the Medical Advisory Board is restricted to eight Governor appointed medical practitioners and
one law enforcement officer.
Manufacturers & Dispensaries
SF 506 required DPH to select up to four medical cannabis manufacturers and license to possess, cultivate,
supply, and transport medical cannabis within the state. Twelve dispensaries were to be licensed by the DPH
across the state for the purpose of selling medical cannabis to patients and caregivers who possess a medical
cannabis registration card. The locations of the dispensaries were to be based on the geographic need across
the state. The DPH would have been directed to solicit applications and license four to 12 manufacturers by
December 1, 2017. Licenses were to be approved or re-issued by December 1 of each year. Dispensaries
required licensing by April 2, 2018, and must have agreed to begin supplying medical cannabis to patients by
July 16, 2018.
Last session, Representative Hall filed an amendment (H-8505 to H-8481) to the Standings bill (HF 2501),
which: (1) contained SF 506 language; (2) would have replaced the current 3% THC cap with 90 grams over 90
days; and (3) would have amended current code language to include ‘chronic or severe pain’. The
amendment failed 55-33 despite having overwhelming Senate Republican support.

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 Currently, MedPharm and Iowa Relief are the only cannabis manufacturers licensed to operate within the
state. MedPharm began selling products this December at five licensed dispensaries, including tinctures,
capsules, and creams, to legally registered patients. These dispensaries are located in Waterloo, Council
Bluffs, Windsor Heights, and Sioux City. Iowa Relief is projected to begin selling their products July 1, 2019.
According to the DPH, currently 1,466 patients and caregivers have been issued registration cards and 363
applications have been approved but not issued. Despite Iowa’s restrictive cannabis rules, four firms applied
this past year for a medical marijuana production permit. Based on the increase in manufacturing interest,
both MedPharm and Iowa Relief continue to strongly advocate for the state to expand Iowa’s current list of
medicinal ailments and raise the 3% THC cap so Iowans may have easier access to pain relief.

Bill Summary
HF 732 would make the following changes to the current medical cannabidiol program (mCBD):
 Amend “debilitating medical condition” under Code definitions by replacing “untreatable pain” with
“severe or chronic pain”.
 Allow licensed physician assistants and registered nurse practitioners to provide written certification
attesting to patients’ eligibility for the medical cannabis program.
 Removes the current 3% THC cap and replaces this with a 20 gram over 90-day period maximum
disbursement.
 Removes prohibition on certain felons applying for medical cannabidiol registration card.
 Allows medical cannabidiol dispensaries to employ licensed pharmacists or pharmacy technicians.
 Directs DPH to adopt rules for collecting and evaluating data relating to patient demographics,
effective treatment options, clinical outcomes, and quality of life outcomes for reporting on benefits,
risks, and outcomes for patients participating in the program.

Fiscal Impact
LSA estimates there will be an increase in patient qualification; healthcare practitioner certifications for
eligible conditions; and increased applications to the DPH for mCBD registration due to HF 732 expansion of
the cannabidiol program. Depending on the application volume increase, DPH may need to hire additional
registration clerks at $47,000 for every 3,000 applications received per year. The community health
consultant addition would be an estimated $70,000 increase in mCBD program expenditures. Required
expenditures for the Seed-to-Sale system changes are estimated to cost $350,000 and would be appropriated
through the FY19 Technology Reinvestment Fund.

Amendment Summary
H-1073 (Shipley): This strike-after amendment adds the following to the bill’s original language:
 Expands the list of eligible medical conditions.
 Places the current card registration process under DPH oversight instead of the Department of
Transportation.
 Allows DPH to issue a medical cannabidiol registration card to individuals receiving inpatient hospice
care and increases the number of dispensaries in the state from five to thirty.
H-1074 (Prichard): This amendment creates a “waiver” process that allows a provider to certify a qualified
patient to receive more than 30 grams of THC over a 90-day period. This waiver is only applicable to the
following debilitating medical conditions: (1) severe or chronic pain; (2) ALS; and (3) cancer.
H-1080 to H-1074 (Prichard): This amendment makes HF 732 effective upon enactment; changes dosage to
25 grams; adds “terminally ill” diagnosis to the waiver’s list of debilitating medical conditions; and directs the
Board of Medicine to promulgate rules that creates a procedure to process waivers in a timely manner.
Ver Schuer, Alison [LEGIS] G:\Caucus Staff\AVS\Public Safety\2019 Session\Bill Summaries\HF 732-Expansion of Medical Cannabis.docx March 26, 2019 4:40 PM

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