Florida Senate - 2016                        COMMITTEE AMENDMENT
       Bill No. SB 460
       
       
       
       
       
       
                                Ì808432ÂÎ808432                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/29/2016           .                                
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       The Committee on Rules (Galvano) recommended the following:
       
    1         Senate Substitute for Amendment (369986) (with title
    2  amendment)
    3  
    4         Delete everything after the enacting clause
    5  and insert:
    6         Section 1. Section 381.986, Florida Statutes, is amended to
    7  read:
    8         381.986 Compassionate use of low-THC and medical cannabis.—
    9         (1) DEFINITIONS.—As used in this section, the term:
   10         (a)“Cannabis delivery device” means an object used,
   11  intended for use, or designed for use in preparing, storing,
   12  ingesting, inhaling, or otherwise introducing low-THC cannabis
   13  or medical cannabis into the human body.
   14         (b)(a) “Dispensing organization” means an organization
   15  approved by the department to cultivate, process, transport, and
   16  dispense low-THC cannabis or medical cannabis pursuant to this
   17  section.
   18         (c)“Independent testing laboratory” means a laboratory,
   19  including the managers, employees, or contractors of the
   20  laboratory, which has no direct or indirect interest in a
   21  dispensing organization.
   22         (d)“Legal representative” means the qualified patient’s
   23  parent, legal guardian acting pursuant to a court’s
   24  authorization as required under s. 744.3215(4), health care
   25  surrogate acting pursuant to the qualified patient’s written
   26  consent or a court’s authorization as required under s. 765.113,
   27  or an individual who is authorized under a power of attorney to
   28  make health care decisions on behalf of the qualified patient.
   29         (e)(b) “Low-THC cannabis” means a plant of the genus
   30  Cannabis, the dried flowers of which contain 0.8 percent or less
   31  of tetrahydrocannabinol and more than 10 percent of cannabidiol
   32  weight for weight; the seeds thereof; the resin extracted from
   33  any part of such plant; or any compound, manufacture, salt,
   34  derivative, mixture, or preparation of such plant or its seeds
   35  or resin that is dispensed only from a dispensing organization.
   36         (f)“Medical cannabis” means all parts of any plant of the
   37  genus Cannabis, whether growing or not; the seeds thereof; the
   38  resin extracted from any part of the plant; and every compound,
   39  manufacture, sale, derivative, mixture, or preparation of the
   40  plant or its seeds or resin that is dispensed only from a
   41  dispensing organization for medical use by an eligible patient
   42  as defined in s. 499.0295.
   43         (g)(c) “Medical use” means administration of the ordered
   44  amount of low-THC cannabis or medical cannabis. The term does
   45  not include the:
   46         1. Possession, use, or administration of low-THC cannabis
   47  or medical cannabis by smoking.
   48         2.The term also does not include the Transfer of low-THC
   49  cannabis or medical cannabis to a person other than the
   50  qualified patient for whom it was ordered or the qualified
   51  patient’s legal representative on behalf of the qualified
   52  patient.
   53         3.Use or administration of low-THC cannabis or medical
   54  cannabis:
   55         a.On any form of public transportation.
   56         b.In any public place.
   57         c.In a qualified patient’s place of employment, if
   58  restricted by his or her employer.
   59         d.In a state correctional institution as defined in s.
   60  944.02 or a correctional institution as defined in s. 944.241.
   61         e.On the grounds of a preschool, primary school, or
   62  secondary school.
   63         f.On a school bus or in a vehicle, aircraft, or motorboat.
   64         (h)(d) “Qualified patient” means a resident of this state
   65  who has been added to the compassionate use registry by a
   66  physician licensed under chapter 458 or chapter 459 to receive
   67  low-THC cannabis or medical cannabis from a dispensing
   68  organization.
   69         (i)(e) “Smoking” means burning or igniting a substance and
   70  inhaling the smoke. Smoking does not include the use of a
   71  vaporizer.
   72         (2) PHYSICIAN ORDERING.—Effective January 1, 2015, A
   73  physician is authorized to order licensed under chapter 458 or
   74  chapter 459 who has examined and is treating a patient suffering
   75  from cancer or a physical medical condition that chronically
   76  produces symptoms of seizures or severe and persistent muscle
   77  spasms may order for the patient’s medical use low-THC cannabis
   78  to treat a qualified patient suffering from cancer or a physical
   79  medical condition that chronically produces symptoms of seizures
   80  or severe and persistent muscle spasms; order low-THC cannabis
   81  such disease, disorder, or condition or to alleviate symptoms of
   82  such disease, disorder, or condition, if no other satisfactory
   83  alternative treatment options exist for the qualified that
   84  patient; order medical cannabis to treat an eligible patient as
   85  defined in s. 499.0295; or order a cannabis delivery device for
   86  the medical use of low-THC cannabis or medical cannabis, only if
   87  the physician and all of the following conditions apply:
   88         (a)Holds an active, unrestricted license as a physician
   89  under chapter 458 or an osteopathic physician under chapter 459;
   90         (b)Has treated the patient for at least 3 months
   91  immediately preceding the patient’s registration in the
   92  compassionate use registry;
   93         (c)Has successfully completed the course and examination
   94  required under paragraph (4)(a);
   95         (a) The patient is a permanent resident of this state.
   96         (d)(b)Has determined The physician determines that the
   97  risks of treating the patient with ordering low-THC cannabis or
   98  medical cannabis are reasonable in light of the potential
   99  benefit to the for that patient. If a patient is younger than 18
  100  years of age, a second physician must concur with this
  101  determination, and such determination must be documented in the
  102  patient’s medical record;.
  103         (e)(c)The physician Registers as the orderer of low-THC
  104  cannabis or medical cannabis for the named patient on the
  105  compassionate use registry maintained by the department and
  106  updates the registry to reflect the contents of the order,
  107  including the amount of low-THC cannabis or medical cannabis
  108  that will provide the patient with not more than a 45-day supply
  109  and a cannabis delivery device needed by the patient for the
  110  medical use of low-THC cannabis or medical cannabis. The
  111  physician must also update the registry within 7 days after any
  112  change is made to the original order to reflect the change. The
  113  physician shall deactivate the registration of the patient and
  114  the patient’s legal representative patient’s registration when
  115  treatment is discontinued;.
  116         (f)(d)The physician Maintains a patient treatment plan
  117  that includes the dose, route of administration, planned
  118  duration, and monitoring of the patient’s symptoms and other
  119  indicators of tolerance or reaction to the low-THC cannabis or
  120  medical cannabis;.
  121         (g)(e)The physician Submits the patient treatment plan
  122  quarterly to the University of Florida College of Pharmacy for
  123  research on the safety and efficacy of low-THC cannabis and
  124  medical cannabis on patients;.
  125         (h)(f)The physician Obtains the voluntary written informed
  126  consent of the patient or the patient’s legal representative
  127  guardian to treatment with low-THC cannabis after sufficiently
  128  explaining the current state of knowledge in the medical
  129  community of the effectiveness of treatment of the patient’s
  130  condition with low-THC cannabis, the medically acceptable
  131  alternatives, and the potential risks and side effects;
  132         (i)Obtains written informed consent as defined in and
  133  required under s. 499.0295, if the physician is ordering medical
  134  cannabis for an eligible patient pursuant to that section; and
  135         (j)Is not a medical director employed by a dispensing
  136  organization.
  137         (3) PENALTIES.—
  138         (a) A physician commits a misdemeanor of the first degree,
  139  punishable as provided in s. 775.082 or s. 775.083, if the
  140  physician orders low-THC cannabis for a patient without a
  141  reasonable belief that the patient is suffering from:
  142         1. Cancer or a physical medical condition that chronically
  143  produces symptoms of seizures or severe and persistent muscle
  144  spasms that can be treated with low-THC cannabis; or
  145         2. Symptoms of cancer or a physical medical condition that
  146  chronically produces symptoms of seizures or severe and
  147  persistent muscle spasms that can be alleviated with low-THC
  148  cannabis.
  149         (b)A physician commits a misdemeanor of the first degree,
  150  punishable as provided in s. 775.082 or s. 775.083, if the
  151  physician orders medical cannabis for a patient without a
  152  reasonable belief that the patient has a terminal condition as
  153  defined in s. 499.0295.
  154         (c)(b)A Any person who fraudulently represents that he or
  155  she has cancer, or a physical medical condition that chronically
  156  produces symptoms of seizures or severe and persistent muscle
  157  spasms, or a terminal condition to a physician for the purpose
  158  of being ordered low-THC cannabis, medical cannabis, or a
  159  cannabis delivery device by such physician commits a misdemeanor
  160  of the first degree, punishable as provided in s. 775.082 or s.
  161  775.083.
  162         (d)An eligible patient as defined in s. 499.0295 who uses
  163  medical cannabis, and such patient’s legal representative who
  164  administers medical cannabis, in plain view of or in a place
  165  open to the general public, on the grounds of a school, or in a
  166  school bus, vehicle, aircraft, or motorboat, commits a
  167  misdemeanor of the first degree, punishable as provided in s.
  168  775.082 or s. 775.083.
  169         (e)A physician who orders low-THC cannabis, medical
  170  cannabis, or a cannabis delivery device and receives
  171  compensation from a dispensing organization related to the
  172  ordering of low-THC cannabis, medical cannabis, or a cannabis
  173  delivery device is subject to disciplinary action under the
  174  applicable practice act and s. 456.072(1)(n).
  175         (4) PHYSICIAN EDUCATION.—
  176         (a) Before ordering low-THC cannabis, medical cannabis, or
  177  a cannabis delivery device for medical use by a patient in this
  178  state, the appropriate board shall require the ordering
  179  physician licensed under chapter 458 or chapter 459 to
  180  successfully complete an 8-hour course and subsequent
  181  examination offered by the Florida Medical Association or the
  182  Florida Osteopathic Medical Association that encompasses the
  183  clinical indications for the appropriate use of low-THC cannabis
  184  and medical cannabis, the appropriate cannabis delivery devices
  185  mechanisms, the contraindications for such use, and as well as
  186  the relevant state and federal laws governing the ordering,
  187  dispensing, and possessing of these substances and devices this
  188  substance. The first course and examination shall be presented
  189  by October 1, 2014, and shall be administered at least annually
  190  thereafter. Successful completion of the course may be used by a
  191  physician to satisfy 8 hours of the continuing medical education
  192  requirements required by his or her respective board for
  193  licensure renewal. This course may be offered in a distance
  194  learning format.
  195         (b) The appropriate board shall require the medical
  196  director of each dispensing organization to hold an active,
  197  unrestricted license as a physician under chapter 458 or as an
  198  osteopathic physician under chapter 459 and approved under
  199  subsection (5) to successfully complete a 2-hour course and
  200  subsequent examination offered by the Florida Medical
  201  Association or the Florida Osteopathic Medical Association that
  202  encompasses appropriate safety procedures and knowledge of low
  203  THC cannabis, medical cannabis, and cannabis delivery devices.
  204         (c) Successful completion of the course and examination
  205  specified in paragraph (a) is required for every physician who
  206  orders low-THC cannabis, medical cannabis, or a cannabis
  207  delivery device each time such physician renews his or her
  208  license. In addition, successful completion of the course and
  209  examination specified in paragraph (b) is required for the
  210  medical director of each dispensing organization each time such
  211  physician renews his or her license.
  212         (d) A physician who fails to comply with this subsection
  213  and who orders low-THC cannabis, medical cannabis, or a cannabis
  214  delivery device may be subject to disciplinary action under the
  215  applicable practice act and under s. 456.072(1)(k).
  216         (5) DUTIES OF THE DEPARTMENT.—By January 1, 2015, The
  217  department shall:
  218         (a) Create and maintain a secure, electronic, and online
  219  compassionate use registry for the registration of physicians,
  220  and patients, and the legal representatives of patients as
  221  provided under this section. The registry must be accessible to
  222  law enforcement agencies and to a dispensing organization in
  223  order to verify the authorization of a patient or a patient’s
  224  legal representative to possess patient authorization for low
  225  THC cannabis, medical cannabis, or a cannabis delivery device
  226  and record the low-THC cannabis, medical cannabis, or cannabis
  227  delivery device dispensed. The registry must prevent an active
  228  registration of a patient by multiple physicians.
  229         (b) Authorize the establishment of five dispensing
  230  organizations to ensure reasonable statewide accessibility and
  231  availability as necessary for patients registered in the
  232  compassionate use registry and who are ordered low-THC cannabis,
  233  medical cannabis, or a cannabis delivery device under this
  234  section, one in each of the following regions: northwest
  235  Florida, northeast Florida, central Florida, southeast Florida,
  236  and southwest Florida. The department shall develop an
  237  application form and impose an initial application and biennial
  238  renewal fee that is sufficient to cover the costs of
  239  administering this section. An applicant for approval as a
  240  dispensing organization must be able to demonstrate:
  241         1. The technical and technological ability to cultivate and
  242  produce low-THC cannabis. The applicant must possess a valid
  243  certificate of registration issued by the Department of
  244  Agriculture and Consumer Services pursuant to s. 581.131 that is
  245  issued for the cultivation of more than 400,000 plants, be
  246  operated by a nurseryman as defined in s. 581.011, and have been
  247  operated as a registered nursery in this state for at least 30
  248  continuous years.
  249         2. The ability to secure the premises, resources, and
  250  personnel necessary to operate as a dispensing organization.
  251         3. The ability to maintain accountability of all raw
  252  materials, finished products, and any byproducts to prevent
  253  diversion or unlawful access to or possession of these
  254  substances.
  255         4. An infrastructure reasonably located to dispense low-THC
  256  cannabis to registered patients statewide or regionally as
  257  determined by the department.
  258         5. The financial ability to maintain operations for the
  259  duration of the 2-year approval cycle, including the provision
  260  of certified financials to the department. Upon approval, the
  261  applicant must post a $5 million performance bond. However, upon
  262  a dispensing organization’s serving at least 1,000 qualified
  263  patients, the dispensing organization is only required to
  264  maintain a $2 million performance bond.
  265         6. That all owners and managers have been fingerprinted and
  266  have successfully passed a level 2 background screening pursuant
  267  to s. 435.04.
  268         7. The employment of a medical director who is a physician
  269  licensed under chapter 458 or chapter 459 to supervise the
  270  activities of the dispensing organization.
  271         (c)Upon the registration of 250,000 active qualified
  272  patients in the compassionate use registry, approve three
  273  dispensing organizations, which must meet the requirements of
  274  subparagraphs (b)2.-7. and demonstrate the technical and
  275  technological ability to cultivate and produce low-THC cannabis.
  276         (d)Allow a dispensing organization to make a wholesale
  277  purchase of low-THC cannabis or medical cannabis from, or a
  278  distribution of low-THC cannabis or medical cannabis to, another
  279  dispensing organization.
  280         (e)(c) Monitor physician registration and ordering of low
  281  THC cannabis, medical cannabis, or a cannabis delivery device
  282  for ordering practices that could facilitate unlawful diversion
  283  or misuse of low-THC cannabis, medical cannabis, or a cannabis
  284  delivery device and take disciplinary action as indicated.
  285         (d) Adopt rules necessary to implement this section.
  286         (6) DISPENSING ORGANIZATION.—An approved dispensing
  287  organization must, at all times, shall maintain compliance with
  288  the criteria demonstrated for selection and approval as a
  289  dispensing organization under subsection (5) and the criteria
  290  required in this subsection at all times.
  291         (a)When growing low-THC cannabis or medical cannabis, a
  292  dispensing organization:
  293         1.May use pesticides determined by the department, after
  294  consultation with the Department of Agriculture and Consumer
  295  Services, to be safely applied to plants intended for human
  296  consumption, but may not use pesticides designated as
  297  restricted-use pesticides pursuant to s. 487.042.
  298         2.Must grow low-THC cannabis or medical cannabis within an
  299  enclosed structure and in a room separate from any other plant.
  300         3.Must inspect seeds and growing plants for plant pests
  301  that endanger or threaten the horticultural and agricultural
  302  interests of the state, notify the Department of Agriculture and
  303  Consumer Services within 10 calendar days after a determination
  304  that a plant is infested or infected by such plant pest, and
  305  implement and maintain phytosanitary policies and procedures.
  306         4.Must perform fumigation or treatment of plants, or the
  307  removal and destruction of infested or infected plants, in
  308  accordance with chapter 581 and any rules adopted thereunder.
  309         (b)When processing low-THC cannabis or medical cannabis, a
  310  dispensing organization must:
  311         1.Process the low-THC cannabis or medical cannabis within
  312  an enclosed structure and in a room separate from other plants
  313  or products.
  314         2.Test the processed low-THC cannabis and medical cannabis
  315  before they are dispensed. Results must be verified and signed
  316  by two dispensing organization employees. Before dispensing low
  317  THC cannabis, the dispensing organization must determine that
  318  the test results indicate that the low-THC cannabis meets the
  319  definition of low-THC cannabis and, for medical cannabis and
  320  low-THC cannabis, that all medical cannabis and low-THC cannabis
  321  is safe for human consumption and free from contaminants that
  322  are unsafe for human consumption. The dispensing organization
  323  must retain records of all testing and samples of each
  324  homogenous batch of cannabis and low-THC cannabis for at least 9
  325  months. The dispensing organization must contract with an
  326  independent testing laboratory to perform audits on the
  327  dispensing organization’s standard operating procedures, testing
  328  records, and samples and provide the results to the department
  329  to confirm that the low-THC cannabis or medical cannabis meets
  330  the requirements of this section and that the medical cannabis
  331  and low-THC cannabis is safe for human consumption.
  332         3.Package the low-THC cannabis or medical cannabis in
  333  compliance with the United States Poison Prevention Packaging
  334  Act of 1970, 15 U.S.C. ss. 1471 et seq.
  335         4.Package the low-THC cannabis or medical cannabis in a
  336  receptacle that has a firmly affixed and legible label stating
  337  the following information:
  338         a.A statement that the low-THC cannabis or medical
  339  cannabis meets the requirements of subparagraph 2.;
  340         b.The name of the dispensing organization from which the
  341  medical cannabis or low-THC cannabis originates; and
  342         c.The batch number and harvest number from which the
  343  medical cannabis or low-THC cannabis originates.
  344         5.Reserve two processed samples from each batch and retain
  345  such samples for at least 9 months for the purpose of testing
  346  pursuant to the audit required under subparagraph 2.
  347         (c)When dispensing low-THC cannabis, medical cannabis, or
  348  a cannabis delivery device, a dispensing organization:
  349         1.May not dispense more than a 45-day supply of low-THC
  350  cannabis or medical cannabis to a patient or the patient’s legal
  351  representative.
  352         2.Must have the dispensing organization’s employee who
  353  dispenses the low-THC cannabis, medical cannabis, or a cannabis
  354  delivery device enter into the compassionate use registry his or
  355  her name or unique employee identifier.
  356         3.Must verify in the compassionate use registry that a
  357  physician has ordered the low-THC cannabis, medical cannabis, or
  358  a specific type of a cannabis delivery device for the patient.
  359         4.May not dispense or sell any other type of cannabis,
  360  alcohol, or illicit drug-related product, including pipes,
  361  bongs, or wrapping papers, other than a physician-ordered
  362  cannabis delivery device required for the medical use of low-THC
  363  cannabis or medical cannabis, while dispensing low-THC cannabis
  364  or medical cannabis.
  365         5.Must Before dispensing low-THC cannabis to a qualified
  366  patient, the dispensing organization shall verify that the
  367  patient has an active registration in the compassionate use
  368  registry, the patient or patient’s legal representative holds a
  369  valid and active registration card, the order presented matches
  370  the order contents as recorded in the registry, and the order
  371  has not already been filled.
  372         6.Must, upon dispensing the low-THC cannabis, medical
  373  cannabis, or cannabis delivery device, the dispensing
  374  organization shall record in the registry the date, time,
  375  quantity, and form of low-THC cannabis or medical cannabis
  376  dispensed and the type of cannabis delivery device dispensed.
  377         (d)To ensure the safety and security of its premises and
  378  any off-site storage facilities, and to maintain adequate
  379  controls against the diversion, theft, and loss of low-THC
  380  cannabis, medical cannabis, or cannabis delivery devices, a
  381  dispensing organization shall:
  382         1.a.Maintain a fully operational security alarm system
  383  that secures all entry points and perimeter windows and is
  384  equipped with motion detectors; pressure switches; and duress,
  385  panic, and hold-up alarms; or
  386         b.Maintain a video surveillance system that records
  387  continuously 24 hours each day and meets at least one of the
  388  following criteria:
  389         (I)Cameras are fixed in a place that allows for the clear
  390  identification of persons and activities in controlled areas of
  391  the premises. Controlled areas include grow rooms, processing
  392  rooms, storage rooms, disposal rooms or areas, and point-of-sale
  393  rooms;
  394         (II)Cameras are fixed in entrances and exits to the
  395  premises, which shall record from both indoor and outdoor, or
  396  ingress and egress, vantage points;
  397         (III)Recorded images must clearly and accurately display
  398  the time and date; or
  399         (IV)Retain video surveillance recordings for a minimum of
  400  45 days or longer upon the request of a law enforcement agency.
  401         2.Ensure that the organization’s outdoor premises have
  402  sufficient lighting from dusk until dawn.
  403         3.Establish and maintain a tracking system approved by the
  404  department that traces the low-THC cannabis or medical cannabis
  405  from seed to sale. The tracking system shall include
  406  notification of key events as determined by the department,
  407  including when cannabis seeds are planted, when cannabis plants
  408  are harvested and destroyed, and when low-THC cannabis or
  409  medical cannabis is transported, sold, stolen, diverted, or
  410  lost.
  411         4.Not dispense from its premises low-THC cannabis, medical
  412  cannabis, or a cannabis delivery device between the hours of 9
  413  p.m. and 7 a.m., but may perform all other operations and
  414  deliver low-THC cannabis and medical cannabis to qualified
  415  patients 24 hours each day.
  416         5.Store low-THC cannabis or medical cannabis in a secured,
  417  locked room or a vault.
  418         6.Require at least two of its employees, or two employees
  419  of a security agency with whom it contracts, to be on the
  420  premises at all times.
  421         7.Require each employee to wear a photo identification
  422  badge at all times while on the premises.
  423         8.Require each visitor to wear a visitor’s pass at all
  424  times while on the premises.
  425         9.Implement an alcohol and drug-free workplace policy.
  426         10.Report to local law enforcement within 24 hours after
  427  it is notified or becomes aware of the theft, diversion, or loss
  428  of low-THC cannabis or medical cannabis.
  429         (e)To ensure the safe transport of low-THC cannabis or
  430  medical cannabis to dispensing organization facilities,
  431  independent testing laboratories, or patients, the dispensing
  432  organization must:
  433         1.Maintain a transportation manifest, which must be
  434  retained for at least 1 year.
  435         2.Ensure only vehicles in good working order are used to
  436  transport low-THC cannabis or medical cannabis.
  437         3.Lock low-THC cannabis or medical cannabis in a separate
  438  compartment or container within the vehicle.
  439         4.Require at least two persons to be in a vehicle
  440  transporting low-THC cannabis or medical cannabis, and require
  441  at least one person to remain in the vehicle while the low-THC
  442  cannabis or medical cannabis is being delivered.
  443         5.Provide specific safety and security training to
  444  employees transporting or delivering low-THC cannabis or medical
  445  cannabis.
  446         (7)DEPARTMENT AUTHORITY AND RESPONSIBILITIES.—
  447         (a)The department may conduct announced or unannounced
  448  inspections of dispensing organizations to determine compliance
  449  with this section or rules adopted pursuant to this section.
  450         (b)The department shall inspect a dispensing organization
  451  upon complaint or notice provided to the department that the
  452  dispensing organization has dispensed low-THC cannabis or
  453  medical cannabis containing any mold, bacteria, or other
  454  contaminant that may cause or has caused an adverse effect to
  455  human health or the environment.
  456         (c)The department shall conduct at least a biennial
  457  inspection of each dispensing organization to evaluate the
  458  dispensing organization’s records, personnel, equipment,
  459  processes, security measures, sanitation practices, and quality
  460  assurance practices.
  461         (d)The department may enter into interagency agreements
  462  with the Department of Agriculture and Consumer Services, the
  463  Department of Business and Professional Regulation, the
  464  Department of Transportation, the Department of Highway Safety
  465  and Motor Vehicles, and the Agency for Health Care
  466  Administration, and such agencies are authorized to enter into
  467  an interagency agreement with the department, to conduct
  468  inspections or perform other responsibilities assigned to the
  469  department under this section.
  470         (e)The department must make a list of all approved
  471  dispensing organizations and qualified ordering physicians and
  472  medical directors publicly available on its website.
  473         (f)The department may establish a system for issuing and
  474  renewing registration cards for patients and their legal
  475  representatives, establish the circumstances under which the
  476  cards may be revoked by or must be returned to the department,
  477  and establish fees to implement such system. The department must
  478  require, at a minimum, the registration cards to:
  479         1.Provide the name, address, and date of birth of the
  480  patient or legal representative.
  481         2.Have a full-face, passport-type, color photograph of the
  482  patient or legal representative taken within the 90 days
  483  immediately preceding registration.
  484         3.Identify whether the cardholder is a patient or legal
  485  representative.
  486         4.List a unique numeric identifier for the patient or
  487  legal representative that is matched to the identifier used for
  488  such person in the department’s compassionate use registry.
  489         5.Provide the expiration date, which shall be 1 year after
  490  the date of the physician’s initial order of low-THC cannabis or
  491  medical cannabis.
  492         6.For the legal representative, provide the name and
  493  unique numeric identifier of the patient that the legal
  494  representative is assisting.
  495         7.Be resistant to counterfeiting or tampering.
  496         (g)The department may impose reasonable fines not to
  497  exceed $10,000 on a dispensing organization for any of the
  498  following violations:
  499         1.Violating this section, s. 499.0295, or department rule.
  500         2.Failing to maintain qualifications for approval.
  501         3.Endangering the health, safety, or security of a
  502  qualified patient.
  503         4.Improperly disclosing personal and confidential
  504  information of the qualified patient.
  505         5.Attempting to procure dispensing organization approval
  506  by bribery, fraudulent misrepresentation, or extortion.
  507         6.Being convicted or found guilty of, or entering a plea
  508  of guilty or nolo contendere to, regardless of adjudication, a
  509  crime in any jurisdiction which directly relates to the business
  510  of a dispensing organization.
  511         7.Making or filing a report or record that the dispensing
  512  organization knows to be false.
  513         8.Willfully failing to maintain a record required by this
  514  section or department rule.
  515         9.Willfully impeding or obstructing an employee or agent
  516  of the department in the furtherance of his or her official
  517  duties.
  518         10.Engaging in fraud or deceit, negligence, incompetence,
  519  or misconduct in the business practices of a dispensing
  520  organization.
  521         11.Making misleading, deceptive, or fraudulent
  522  representations in or related to the business practices of a
  523  dispensing organization.
  524         12.Having a license or the authority to engage in any
  525  regulated profession, occupation, or business that is related to
  526  the business practices of a dispensing organization suspended,
  527  revoked, or otherwise acted against by the licensing authority
  528  of any jurisdiction, including its agencies or subdivisions, for
  529  a violation that would constitute a violation under Florida law.
  530         13.Violating a lawful order of the department or an agency
  531  of the state, or failing to comply with a lawfully issued
  532  subpoena of the department or an agency of the state.
  533         (h)The department may suspend, revoke, or refuse to renew
  534  a dispensing organization’s approval if a dispensing
  535  organization commits any of the violations in paragraph (g).
  536         (i)The department shall renew the approval of a dispensing
  537  organization biennially if the dispensing organization meets the
  538  requirements of this section and pays the biennial renewal fee.
  539         (j)The department may adopt rules necessary to implement
  540  this section.
  541         (8)PREEMPTION.—
  542         (a)All matters regarding the regulation of the cultivation
  543  and processing of medical cannabis or low-THC cannabis by
  544  dispensing organizations are preempted to the state.
  545         (b)A municipality may determine by ordinance the criteria
  546  for the number and location of, and other permitting
  547  requirements that do not conflict with state law or department
  548  rule for, dispensing facilities of dispensing organizations
  549  located within its municipal boundaries. A county may determine
  550  by ordinance the criteria for the number, location, and other
  551  permitting requirements that do not conflict with state law or
  552  department rule for all dispensing facilities of dispensing
  553  organizations located within the unincorporated areas of that
  554  county.
  555         (9)(7) EXCEPTIONS TO OTHER LAWS.—
  556         (a) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
  557  any other provision of law, but subject to the requirements of
  558  this section, a qualified patient and the qualified patient’s
  559  legal representative may purchase and possess for the patient’s
  560  medical use up to the amount of low-THC cannabis or medical
  561  cannabis ordered for the patient, but not more than a 45-day
  562  supply, and a cannabis delivery device ordered for the patient.
  563         (b) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
  564  any other provision of law, but subject to the requirements of
  565  this section, an approved dispensing organization and its
  566  owners, managers, and employees may manufacture, possess, sell,
  567  deliver, distribute, dispense, and lawfully dispose of
  568  reasonable quantities, as established by department rule, of
  569  low-THC cannabis, medical cannabis, or a cannabis delivery
  570  device. For purposes of this subsection, the terms
  571  “manufacture,” “possession,” “deliver,” “distribute,” and
  572  “dispense” have the same meanings as provided in s. 893.02.
  573         (c)Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
  574  any other provision of law, but subject to the requirements of
  575  this section, an approved independent testing laboratory may
  576  possess, test, transport, and lawfully dispose of low-THC
  577  cannabis or medical cannabis as provided by department rule.
  578         (d)(c) An approved dispensing organization and its owners,
  579  managers, and employees are not subject to licensure or
  580  regulation under chapter 465 or chapter 499 for manufacturing,
  581  possessing, selling, delivering, distributing, dispensing, or
  582  lawfully disposing of reasonable quantities, as established by
  583  department rule, of low-THC cannabis, medical cannabis, or a
  584  cannabis delivery device.
  585         (e)An approved dispensing organization that continues to
  586  meet the requirements for approval is presumed to be registered
  587  with the department and to meet the regulations adopted by the
  588  department or its successor agency for the purpose of dispensing
  589  medical cannabis or low-THC cannabis under Florida law.
  590  Additionally, the authority provided to a dispensing
  591  organization in s. 499.0295 does not impair the approval of a
  592  dispensing organization.
  593         (f)This subsection does not preclude a person from being
  594  prosecuted for a criminal offense related to impairment or
  595  intoxication resulting from the medical use of low-THC cannabis
  596  or medical cannabis or relieve a person from any requirement
  597  under law to submit to a breath, blood, urine, or other test to
  598  detect the presence of a controlled substance.
  599         Section 2. Subsections (2) and (3) of section 499.0295,
  600  Florida Statutes, are amended to read:
  601         499.0295 Experimental treatments for terminal conditions.—
  602         (2) As used in this section, the term:
  603         (a)“Dispensing organization” means an organization
  604  approved by the Department of Health under s. 381.986(5) to
  605  cultivate, process, transport, and dispense low-THC cannabis,
  606  medical cannabis, and cannabis delivery devices.
  607         (b)(a) “Eligible patient” means a person who:
  608         1. Has a terminal condition that is attested to by the
  609  patient’s physician and confirmed by a second independent
  610  evaluation by a board-certified physician in an appropriate
  611  specialty for that condition;
  612         2. Has considered all other treatment options for the
  613  terminal condition currently approved by the United States Food
  614  and Drug Administration;
  615         3. Has given written informed consent for the use of an
  616  investigational drug, biological product, or device; and
  617         4. Has documentation from his or her treating physician
  618  that the patient meets the requirements of this paragraph.
  619         (c)(b) “Investigational drug, biological product, or
  620  device” means:
  621         1. A drug, biological product, or device that has
  622  successfully completed phase 1 of a clinical trial but has not
  623  been approved for general use by the United States Food and Drug
  624  Administration and remains under investigation in a clinical
  625  trial approved by the United States Food and Drug
  626  Administration; or
  627         2.Medical cannabis that is manufactured and sold by a
  628  dispensing organization.
  629         (d)(c) “Terminal condition” means a progressive disease or
  630  medical or surgical condition that causes significant functional
  631  impairment, is not considered by a treating physician to be
  632  reversible even with the administration of available treatment
  633  options currently approved by the United States Food and Drug
  634  Administration, and, without the administration of life
  635  sustaining procedures, will result in death within 1 year after
  636  diagnosis if the condition runs its normal course.
  637         (e)(d) “Written informed consent” means a document that is
  638  signed by a patient, a parent of a minor patient, a court
  639  appointed guardian for a patient, or a health care surrogate
  640  designated by a patient and includes:
  641         1. An explanation of the currently approved products and
  642  treatments for the patient’s terminal condition.
  643         2. An attestation that the patient concurs with his or her
  644  physician in believing that all currently approved products and
  645  treatments are unlikely to prolong the patient’s life.
  646         3. Identification of the specific investigational drug,
  647  biological product, or device that the patient is seeking to
  648  use.
  649         4. A realistic description of the most likely outcomes of
  650  using the investigational drug, biological product, or device.
  651  The description shall include the possibility that new,
  652  unanticipated, different, or worse symptoms might result and
  653  death could be hastened by the proposed treatment. The
  654  description shall be based on the physician’s knowledge of the
  655  proposed treatment for the patient’s terminal condition.
  656         5. A statement that the patient’s health plan or third
  657  party administrator and physician are not obligated to pay for
  658  care or treatment consequent to the use of the investigational
  659  drug, biological product, or device unless required to do so by
  660  law or contract.
  661         6. A statement that the patient’s eligibility for hospice
  662  care may be withdrawn if the patient begins treatment with the
  663  investigational drug, biological product, or device and that
  664  hospice care may be reinstated if the treatment ends and the
  665  patient meets hospice eligibility requirements.
  666         7. A statement that the patient understands he or she is
  667  liable for all expenses consequent to the use of the
  668  investigational drug, biological product, or device and that
  669  liability extends to the patient’s estate, unless a contract
  670  between the patient and the manufacturer of the investigational
  671  drug, biological product, or device states otherwise.
  672         (3) Upon the request of an eligible patient, a manufacturer
  673  may, or upon a physician’s order pursuant to s. 381.986, a
  674  dispensing organization may:
  675         (a) Make its investigational drug, biological product, or
  676  device available under this section.
  677         (b) Provide an investigational drug, biological product, or
  678  device, or cannabis delivery device as defined in s. 381.986 to
  679  an eligible patient without receiving compensation.
  680         (c) Require an eligible patient to pay the costs of, or the
  681  costs associated with, the manufacture of the investigational
  682  drug, biological product, or device, or cannabis delivery device
  683  as defined in s. 381.986.
  684         Section 3. (1)Notwithstanding s. 381.986(5)(b), Florida
  685  Statutes, a dispensing organization that receives notice from
  686  the Department of Health that it is approved as a region’s
  687  dispensing organization, posts a $5 million performance bond in
  688  compliance with rule 64-4.002(5)(e), Florida Administrative
  689  Code, meets the requirements of and requests cultivation
  690  authorization pursuant to rule 64-4.005(2), Florida
  691  Administrative Code, and expends at least $100,000 to fulfill
  692  its legal obligations as a dispensing organization; or any
  693  applicant that received the highest aggregate score through the
  694  department’s evaluation process, notwithstanding any prior
  695  determination by the department that the applicant failed to
  696  meet the requirements of s. 381.986, Florida Statutes, must be
  697  granted cultivation authorization by the department and is
  698  approved to operate as a dispensing organization for the full
  699  term of its original approval and all subsequent renewals
  700  pursuant to s. 381.986, Florida Statutes. Any applicant that
  701  qualifies under this subsection that has not previously been
  702  approved as a dispensing organization by the department must be
  703  given approval as a dispensing organization by the department
  704  within 10 days before the effective date of this act, and within
  705  10 days after receiving such approval must comply with the bond
  706  requirement in rule 64-4.002(5)(e), Florida Administrative Code,
  707  and must comply with all other applicable requirements of rule
  708  64-4, Florida Administrative Code.
  709         (2) If an organization that does not meet the criteria of
  710  subsection (1) receives a final determination from the Division
  711  of Administrative Hearings, the Department of Health, or a court
  712  of competent jurisdiction that it was entitled to be a
  713  dispensing organization under s. 381.986, Florida Statutes, and
  714  applicable rules, such organization and an organization that
  715  meets the criteria of subsection (1) shall both be dispensing
  716  organizations in the same region. During the operations of any
  717  dispensing organization that meets the criteria in this section,
  718  the Department of Health may enforce rule 64-4.005, Florida
  719  Administrative Code, as filed on June 17, 2015.
  720         (3) This section does not apply to s. 381.986 (5)(c),
  721  Florida Statutes.
  722         Section 4. This act shall take effect upon becoming a law.
  723  
  724  ================= T I T L E  A M E N D M E N T ================
  725  And the title is amended as follows:
  726         Delete everything before the enacting clause
  727  and insert:
  728                        A bill to be entitled                      
  729         An act relating to the medical use of cannabis;
  730         amending s. 381.986, F.S.; providing and revising
  731         definitions; revising requirements for physicians
  732         ordering low-THC cannabis, medical cannabis, or a
  733         cannabis delivery device; revising the information a
  734         physician must update on the registry; requiring a
  735         physician to update the registry within a specified
  736         timeframe; requiring a physician to obtain certain
  737         written consent; providing that a physician commits a
  738         misdemeanor of the first degree under certain
  739         circumstances; providing that an eligible patient who
  740         uses medical cannabis and such patient’s legal
  741         representative who administers medical cannabis in
  742         specified locations commits a misdemeanor of the first
  743         degree; providing that a physician who orders low-THC
  744         cannabis or medical cannabis and receives related
  745         compensation from a dispensing organization is subject
  746         to disciplinary action; revising requirements relating
  747         to physician education; providing that the appropriate
  748         board must require the medical director of each
  749         dispensing organization to hold a certain license;
  750         revising the information that the Department of Health
  751         is required to include in its online compassionate use
  752         registry; revising performance bond requirements for
  753         certain dispensing organizations; requiring the
  754         department to approve three dispensing organizations
  755         under certain circumstances; providing requirements
  756         for the three dispensing organizations; requiring the
  757         department to allow a dispensing organization to make
  758         certain wholesale purchases from or distributions to
  759         another dispensing organization; revising standards to
  760         be met and maintained by dispensing organizations;
  761         authorizing dispensing organizations to use certain
  762         pesticides after consultation with the Department of
  763         Agriculture and Consumer Services; providing
  764         requirements for dispensing organizations when they
  765         are growing and processing low-THC cannabis or medical
  766         cannabis; requiring dispensing organizations to
  767         inspect seeds and growing plants for certain pests and
  768         perform certain fumigation and treatment of plants;
  769         providing that dispensing organizations may not
  770         dispense low-THC cannabis and medical cannabis unless
  771         they meet certain testing requirements; requiring
  772         dispensing organizations to maintain certain records;
  773         requiring dispensing organizations to contract with an
  774         independent testing laboratory to perform certain
  775         audits; providing packaging requirements for low-THC
  776         or medical cannabis; requiring dispensing
  777         organizations to retain certain samples for specified
  778         purposes; providing delivery requirements when
  779         dispensing low-THC cannabis and medical cannabis;
  780         providing certain safety and security requirements for
  781         dispensing organizations; providing certain safety and
  782         security requirements for transporting low-THC
  783         cannabis and medical cannabis; authorizing the
  784         department to conduct certain inspections; providing
  785         inspection requirements; authorizing the department to
  786         enter into certain interagency agreements; requiring
  787         the department to make certain information available
  788         on its website; authorizing the department to
  789         establish a system for issuing and renewing
  790         registration cards; providing requirements for the
  791         registration cards; authorizing the department to
  792         impose certain fines; authorizing the department to
  793         suspend, revoke, or refuse to renew a dispensing
  794         organization’s approval under certain circumstances;
  795         requiring the department to renew the dispensing
  796         organization biennially under certain conditions;
  797         providing applicability; authorizing an approved
  798         independent testing laboratory to possess, test,
  799         transport, and lawfully dispose of low-THC cannabis or
  800         medical cannabis by department rule ; providing that a
  801         dispensing organization is presumed to be registered
  802         with the department under certain circumstances;
  803         providing that a person is not precluded from certain
  804         criminal offenses under certain circumstances;
  805         amending s. 499.0295, F.S.; revising definitions;
  806         authorizing certain manufacturers to dispense cannabis
  807         delivery devices; requiring the department to
  808         authorize certain dispensing organizations or
  809         applicants to provide low-THC cannabis, medical
  810         cannabis, and cannabis delivery devices to eligible
  811         patients; providing for dispensing organizations or
  812         applicants meeting specified criteria to be granted
  813         authorization to cultivate certain cannabis and
  814         operate as dispensing organizations; requiring the
  815         department to grant approval as a dispensing
  816         organization by a specified date; authorizing two
  817         dispensing organizations in the same region under
  818         certain circumstances; authorizing the Department of
  819         Health to enforce certain rules; providing
  820         applicability; providing an effective date.