HF 732 — A bill for an act relating to the medical cannabidiol Act. (Formerly HSB 244.) Vetoed 5-24-19.

KIMHouse REYNOLDSFile O732 F- FEnrolled ICHouse EFile O732 FAN TACT HRELATING ETO GTHE OMEDICAL VCANNABIDIOL EACT. R N O R ADAM GREGG GOVERNOR LT GOVERNOR May 24, 2019 The Honorable Paul Pate Secretary of State of Iowa State Capitol Des Moines, Iowa 50319 Dear Mr.

Secretary, I hereby transmit House File 732, an Act relating to the medical cannabidiol act.

House File 732 would make a number of changes to expand Iowa's medical cannabidiol ("CBD") program.

Our program was originally established to provide CBD as a treatment option for Iowans suffering from specific medical conditions.

Since our program began, I have heard countless stories of the relief and remarkable improvements that CBD has offered Iowans.

And I support our program and efforts to strengthen and improve the program, so that it continues to be a safe, rational, and compassionate medical CBD program.

Unlike some states, Iowa's medical CBD program is not a medical marijuana program.

To this end, current Iowa law limits the levelf tetrahydrocannabinol ("THC")-the psychoactive chemical in the cannabis plant-in medical CBD products to three percent.

But recognizing the limited experience with medical CBD and potential questions surrounding the three percent limit, the Legislature had the foresight to establish a Medical Cannabidiol Board, primarily made up of medical experts.The Board is tasked with governing our program and advising the Legislature on potential statutory changes to the definition of medical CBD, including the THC limit.

The Legislature was wise to understand that we were entering uncharted territory and could benefit from the Board's expertise in navigating any potential expansionof the program.

Most of the changes included in House File 732 were the result of the Legislature and the Medical Cannabidiol Board corning together to reach agreement on appropriate and positive improvements toour medical CBD program.

I fully support these changes.

But unfortunately, the bill would also remove the three percent limit on THC in medical CBD products and replace it with a limit of 25 grams ofTHC per 90-day period.

This change was not recommended by the Board.

And if approved, it would drastically expand Iowa's medical CBD program far beyond its original scope of CBD-based treatments and could open the door to significant unintended consequences to the health and safetyofIowans.

STATE CAPITOL DES MOINES, IOWA 50319 515.281.5211 FAX 515.725.3527 WWW.GOVERNOR.IOWA.GOV I agree that there should be some change to the three percent THC lmit.

There appears to be consensus, including from the Board, that a gram- based limit would be more appropriate than a percentage-based limit.

But I have not been unable to discern any evidence-based justification for the specific 25-gram limit proposed in this billAnd after its revieof the available evidence, the Board recommended a limit of only 4.5 grams per 90-da y period.

It may be that a THC limit higher than 4.5 gramsisappropriate.

But the 25-gram limit in this bill would allow a person to consume more than 277 milligrams of THC per day-an amount higher than one would typically consume even wi th aggressive recreational marijuana use.

Thisisall the more concerning becau se a participant in the programis not prescribed a particular dosage by a medica l practitioneror monitored on an ongoing basis for any adverse health consequences.

Iowa's program only requires a practitioner to certify that the participant suffefrom a qualifying condition on an annual basis.

Ultimately, I believe Iowa must proceed cautiously to ensure that any expansi on of our medical CBD program isthoughtful and deliber ate-particularly because Iowa's program isin its infancy and the body of research that analyzes the efficacof medical CBD islimited.

So I look forward to working with the Legislature and the Medical Cannabidiol Board to find an evidence-based THC limit that we can work to enact along with the rest ofthe provisions in Hou se File 732 that I support.The health and safety of Iowans istoo important for us not to get this right.

For these reasons, I respectfully disapproveof House File 732 in its entirety.

~ y , - ~ Kim Reyno s Governor of Iowa cc:

Secretary of the Senate Clerk of the House l 1un n n1u ;n mna n m u m nu mm u Dmn m ~I House F ile 732 AN ACT RELATING TO THE MEDICAL CANNABIDIOL ACT.

SSection e1. c tio n 1 S e c tio n 124E.2, su b se c tio n 2, paragraph i , Code 201i .i U n tre a ta b le Severe or ch ro n ic p a in .

Section 124E.2, subsection 2, paragraph i, Code 2019, is amended to read as follows:

i.

Untreatable Severe or chronic pain.

SSection e124E.2, csubsections tio n 124E .2, su b se c tio n s 5 and 6, Code 2019, aare re amended to read as fofollows: llo w s:

'l!ealth“Health care ppractitioner” ra c titio n means an inindividual dlicensed iv id u a l lic e n s e d under cchapter h a p te r 148 to ppractice rmedicine a c tic e m edicine and susurgery rgor eryosteopathic omedicine r o s te o p a th ic m edicine and susurgery, rg e ry , a pphysician hassistant ylicensed sic ia n a s s is ta n t lic e n s e d under cchapter h a p te r 148C, or an advanced rregistered enurse gpractitioner islicensed te r e d n u rse p r a c titio n e r lic e n s e d under cchapter h a p te r 152 or 152E, who iis s a spatient’s hprimary acare llprovider. n e t in c la d e a p h y sic ia n a s s i s t a n t l i censed ttnder c h a p te r 148C e r an advanced re~istered nttrse p r a e titie n e r lic e n s e d p ttrsaan t t e eh ap ter 152 e r 152E.

“Health care practitioner” shall not include a physician assistant licensed under chapter 148C or an advanced registered nurse practitioner licensed pursuant to chapter 152 or 152E.

''Medical“Medical cannabidiolcannabidiol” - means any ppharmaceutical h arm aceu tical grade cannabinoid found in ththe eplant p la n t Cannabis ssativa a tiv a L.

or Cannabis inindica dor ic a o r any oother thpreparation ethereof rthat p re p a ra tio n th e re o f th a t has a tetetrahydrocannabinol tralevel hof yno dmore rethan ethree apercent nand nthat ais bdelivered in e l le v e l o f no mere th an th re e p e rc e n t c a nform nrecommended aby bthe idmedical iocannabidiol l board, approved by ththe e board oof fmedicine, mand edicine, andl adopted by ththe edepartment departmpursuant ent p u rsu an t to rrule. u le .

SSection ectio124E.2, nsubsection 124E8, .2, su b se c tio n 8 , Code 2019, iis s amended by sstriking trthe iksubsection. in g th e su b se c tio n .

House FFile ile732, 732p. , p .

2 SecSec. .

SSection ect124E.4, isubsection on1, 124E .4, su b se c t i on 1 , paragraph ff, , Code 2019, iis s amended by sstriking trthe ikparagraph. in g th e p arag rap h .