Florida Senate - 2017              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. CS for SB 406
       
       
       
       
       
                               Ì8327085Î832708                          
       
       576-04078-17                                                    
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to compassionate use of low-THC
    3         cannabis and marijuana; amending s. 381.986, F.S.;
    4         providing legislative intent; defining and redefining
    5         terms; authorizing physicians to issue physician
    6         certifications to specified patients who meet certain
    7         conditions; authorizing physicians to make specific
    8         determinations in certifications; requiring physicians
    9         to meet certain conditions to be authorized to issue
   10         and make determinations in physician certifications;
   11         specifying certain persons who may assist a qualifying
   12         patient under the age of 18 in the purchasing and
   13         administering of marijuana; prohibiting qualifying
   14         patients under the age of 18 from purchasing
   15         marijuana; providing that a physician may in certain
   16         circumstances certify an amount greater than a 90-day
   17         supply; requiring written consent of a parent or legal
   18         guardian for the treatment of minors; requiring that
   19         certain physicians annually reexamine and reassess
   20         patients and update patient information in the
   21         compassionate use registry; revising criminal
   22         penalties; prohibiting a medical marijuana treatment
   23         center from advertising services it is not authorized
   24         to provide; providing fines; prohibiting a person or
   25         entity from advertising or providing medical marijuana
   26         treatment center services without being registered
   27         with the department as a medical marijuana treatment
   28         center; providing penalties; authorizing a distance
   29         learning format for a specified course and reducing
   30         the number of hours required for the course; providing
   31         that physicians who meet specified requirements are
   32         grandfathered for the purpose of specified education
   33         requirements; authorizing qualifying patients to
   34         designate caregivers; requiring caregivers to meet
   35         specified requirements; prohibiting a qualifying
   36         patient from designating more than one caregiver at
   37         any given time; providing exceptions; requiring the
   38         Department of Health to register caregivers meeting
   39         certain requirements on the compassionate use
   40         registry; prohibiting a nursing home or assisted
   41         living facility from preventing certain residents from
   42         hiring a caregiver; authorizing a nursing home or
   43         assisted living facility to prohibit its employees
   44         from acting as caregivers to residents; providing that
   45         a nursing home or assisted living facility is not
   46         required to provide a caregiver to certain residents;
   47         revising the entities to which the compassionate use
   48         registry must be accessible; requiring the department
   49         to adopt certain rules by a specified date;
   50         authorizing the department to charge a fee for
   51         identification cards; requiring the department to
   52         begin issuing identification cards to qualified
   53         registrants by a specific date; providing requirements
   54         for the identification cards; requiring the department
   55         to register certain dispensing organizations as
   56         medical marijuana treatment centers by a certain date;
   57         requiring the department to register additional
   58         medical marijuana treatment centers in accordance with
   59         a specified schedule; deleting obsolete provisions;
   60         revising the operational requirements for medical
   61         marijuana treatment centers; authorizing the
   62         department to waive certain requirements under
   63         specified circumstances; requiring that certain
   64         receptacles be childproof; requiring that additional
   65         information be included on certain labels; requiring
   66         that a medical marijuana treatment center comply with
   67         certain standards in the production and dispensing of
   68         edible or food products; requiring a medical marijuana
   69         treatment center to enter additional information into
   70         the compassionate use registry; restricting the number
   71         of dispensing facilities that may dispense marijuana;
   72         providing an exception; requiring a medical marijuana
   73         treatment center to keep a copy of a transportation
   74         manifest in certain vehicles at certain times;
   75         requiring the department to establish a quality
   76         control program that requires medical marijuana
   77         treatment centers to submit samples from each batch or
   78         lot of marijuana to an independent testing laboratory;
   79         requiring a medical marijuana treatment center to
   80         maintain records of all tests conducted; requiring the
   81         department to adopt rules to create and oversee the
   82         quality control program; providing that the department
   83         must license independent testing laboratories;
   84         authorizing an independent testing laboratory to
   85         collect and accept samples of, possess, store,
   86         transport, and test marijuana; prohibiting a person
   87         with an ownership interest in a medical marijuana
   88         treatment center from owning an independent testing
   89         laboratory; requiring the department to develop rules
   90         and a process for licensing requirements; authorizing
   91         the department to impose application and renewal fees;
   92         specifying that an independent testing laboratory must
   93         be certified to perform required tests; requiring the
   94         department to suspend or reduce any mandatory testing
   95         if the number of licensed and certified independent
   96         testing laboratories is insufficient to process the
   97         tests necessary to meet the patient demand for medical
   98         marijuana treatment centers; providing that an
   99         independent testing laboratory may only accept certain
  100         samples; requiring the department to adopt rules
  101         related to ownership changes or changes in an owner’s
  102         investment interest; requiring the department to
  103         establish, maintain, and control a seed-to-sale
  104         tracking system for marijuana; providing
  105         applicability; conforming provisions to changes made
  106         by the act; providing that certain research
  107         institutions may possess, test, transport, and dispose
  108         of marijuana subject to certain conditions and as
  109         provided by department rule; providing for the use of
  110         emergency rulemaking procedures by the department;
  111         creating s. 1004.4351, F.S.; providing a short title;
  112         providing legislative findings; defining terms;
  113         establishing the Coalition for Medical Marijuana
  114         Research and Education within the H. Lee Moffitt
  115         Cancer Center and Research Institute, Inc.; providing
  116         a purpose for the coalition; establishing the Medical
  117         Marijuana Research and Education Board to direct the
  118         operations of the coalition; providing for the
  119         appointment of board members; providing for terms of
  120         office, reimbursement for certain expenses, and the
  121         conduct of meetings of the board; authorizing the
  122         board to appoint a coalition director; prescribing the
  123         duties of the coalition director; requiring the board
  124         to advise specified entities and officials regarding
  125         medical marijuana research and education in this
  126         state; requiring the board to annually adopt a Medical
  127         Marijuana Research and Education Plan; providing
  128         requirements for the plan; requiring the board to
  129         issue an annual report to the Governor and the
  130         Legislature by a specified date; specifying
  131         responsibilities of the H. Lee Moffitt Cancer Center
  132         and Research Institute, Inc.; amending ss. 381.987,
  133         385.211, 499.0295, and 1004.441, F.S.; conforming
  134         provisions to changes made by the act; providing a
  135         directive to the Division of Law Revision and
  136         Information; providing an effective date.
  137          
  138  Be It Enacted by the Legislature of the State of Florida:
  139  
  140         Section 1. Section 381.986, Florida Statutes, is amended to
  141  read:
  142         381.986 Compassionate use of low-THC and medical cannabis
  143  and marijuana.—
  144         (1) LEGISLATIVE INTENT.—
  145         (a) It is the intent of the Legislature to implement s. 29,
  146  Art. X of the State Constitution by creating a unified
  147  regulatory structure within the framework of this section for
  148  the acquisition, cultivation, possession, processing, transfer,
  149  transportation, sale, distribution, and dispensing of marijuana,
  150  products containing marijuana, related supplies, and educational
  151  materials to qualifying patients or their caregivers.
  152         (b) The Legislature intends that all rules adopted by the
  153  Department of Health to implement this section be adopted
  154  pursuant to s. 120.536(1) or s. 120.54. The Legislature intends
  155  that the department use emergency rulemaking procedures pursuant
  156  to s. 120.54(4) to adopt rules under this section if necessary
  157  to meet any deadline for rulemaking established in s. 29, Art. X
  158  of the State Constitution.
  159         (c) Further, the Legislature intends that all registrations
  160  for the purposes specified in paragraph (a) be issued solely in
  161  accordance with the requirements of this section and all rules
  162  adopted under this section.
  163         (2) DEFINITIONS.—As used in this section, the term:
  164         (a) “Cannabis delivery device” means an object used,
  165  intended for use, or designed for use in preparing, storing,
  166  ingesting, inhaling, or otherwise introducing marijuana low-THC
  167  cannabis or medical cannabis into the human body.
  168         (b)“Caregiver” has the same meaning as provided in s. 29,
  169  Art. X of the State Constitution.
  170         (c)“Chronic nonmalignant pain” means pain that is caused
  171  by a debilitating medical condition or that originates from a
  172  debilitating medical condition and persists beyond the usual
  173  course of that debilitating medical condition.
  174         (d)“Close relative” means a spouse, parent, sibling,
  175  grandparent, child, or grandchild, whether related by whole or
  176  half blood, by marriage, or by adoption.
  177         (e)(b)Debilitating medical condition” has the same
  178  meaning as provided in s. 29, Art. X of the State Constitution
  179  Dispensing organization means an organization approved by the
  180  department to cultivate, process, transport, and dispense low
  181  THC cannabis or medical cannabis pursuant to this section.
  182         (f)(c) “Independent testing laboratory” means a laboratory,
  183  including the managers, employees, or contractors of the
  184  laboratory, which has no direct or indirect interest in a
  185  medical marijuana treatment center a dispensing organization.
  186         (g)(d) “Legal representative” means the qualifying
  187  qualified patient’s parent, legal guardian acting pursuant to a
  188  court’s authorization as required under s. 744.3215(4), health
  189  care surrogate acting pursuant to the qualifying qualified
  190  patient’s written consent or a court’s authorization as required
  191  under s. 765.113, or an individual who is authorized under a
  192  power of attorney to make health care decisions on behalf of the
  193  qualifying qualified patient.
  194         (h)(e) “Low-THC cannabis” means a plant of the genus
  195  Cannabis, the dried flowers of which contain 0.8 percent or less
  196  of tetrahydrocannabinol and more than 10 percent of cannabidiol
  197  weight for weight; the seeds thereof; the resin extracted from
  198  any part of such plant; or any compound, manufacture, salt,
  199  derivative, mixture, or preparation of such plant or its seeds
  200  or resin that is dispensed only by a medical marijuana treatment
  201  center from a dispensing organization.
  202         (i)(f)Marijuana” has the same meaning as provided in s.
  203  29, Art. X of the State Constitution Medical cannabis means
  204  all parts of any plant of the genus Cannabis, whether growing or
  205  not; the seeds thereof; the resin extracted from any part of the
  206  plant; and every compound, manufacture, sale, derivative,
  207  mixture, or preparation of the plant or its seeds or resin that
  208  is dispensed only from a dispensing organization for medical use
  209  by an eligible patient as defined in s. 499.0295.
  210         (j)“Medical marijuana treatment center” or “MMTC” has the
  211  same meaning as provided in s. 29, Art. X of the State
  212  Constitution.
  213         (k)(g) “Medical use” has the same meaning as provided in s.
  214  29, Art. X of the State Constitution means administration of the
  215  ordered amount of low-THC cannabis or medical cannabis. The term
  216  does not include the:
  217         1. Possession, use, or administration of marijuana low-THC
  218  cannabis or medical cannabis by smoking.
  219         2.Possession, use, or administration of marijuana that was
  220  not purchased or acquired from an MMTC registered with the
  221  Department of Health.
  222         3.2. Transfer of marijuana low-THC cannabis or medical
  223  cannabis to a person other than the qualifying qualified patient
  224  for whom it was ordered or the qualifying qualified patient’s
  225  caregiver legal representative on behalf of the qualifying
  226  qualified patient.
  227         4.Use or administration of any type or amount of marijuana
  228  not specified on the qualifying patient’s physician
  229  certification.
  230         5.3. Use or administration of marijuana low-THC cannabis or
  231  medical cannabis:
  232         a. On any form of public transportation.
  233         b. In any public place.
  234         c. In a qualifying qualified patient’s place of employment,
  235  if restricted by his or her employer.
  236         d. In a state correctional institution as defined in s.
  237  944.02 or a correctional institution as defined in s. 944.241.
  238         e. On the grounds of a preschool, primary school, or
  239  secondary school.
  240         f. On a school bus or in a vehicle, aircraft, or motorboat.
  241         (l)(h) “Qualifying Qualified patient” has the same meaning
  242  as provided in s. 29, Art. X of the State Constitution but also
  243  includes eligible patients, as that term is defined in s.
  244  499.0295, and patients who are issued a physician certification
  245  under subparagraph (3)(a)2. or subparagraph (3)(a)3. A patient
  246  is not a qualifying patient unless he or she is registered with
  247  the department and has been issued a compassionate use registry
  248  identification card means a resident of this state who has been
  249  added to the compassionate use registry by a physician licensed
  250  under chapter 458 or chapter 459 to receive low-THC cannabis or
  251  medical cannabis from a dispensing organization.
  252         (m)(i) “Smoking” means burning or igniting a substance and
  253  inhaling the smoke. Smoking does not include the use of a
  254  vaporizer.
  255         (3)(2) PHYSICIAN CERTIFICATION ORDERING.—
  256         (a) A physician is authorized to issue a physician
  257  certification to:
  258         1.A patient suffering from a debilitating medical
  259  condition, which allows the patient to receive marijuana for the
  260  patient’s medical use;
  261         2.A order low-THC cannabis to treat a qualified patient
  262  suffering from cancer or a physical medical condition that
  263  chronically produces symptoms of seizures or severe and
  264  persistent muscle spasms, which allows the patient to receive
  265  low-THC cannabis for the patient’s medical use;
  266         3.A patient suffering from chronic nonmalignant pain, if
  267  the physician has diagnosed an underlying debilitating medical
  268  condition as the cause of the pain, which allows the patient to
  269  receive marijuana for the patient’s medical use order low-THC
  270  cannabis to alleviate the patient’s pain symptoms of such
  271  disease, disorder, or condition, if no other satisfactory
  272  alternative treatment options exist for the qualified patient;
  273         4.order medical cannabis to treat An eligible patient as
  274  defined in s. 499.0295, which allows the patient to receive
  275  marijuana for the patient’s medical use; or
  276         5.A patient who is not a resident of this state; who
  277  qualifies under subparagraph 1., subparagraph 2., subparagraph
  278  3., or subparagraph 4.; and who can lawfully obtain marijuana
  279  through a medical marijuana program in the state that he or she
  280  resides in.
  281         (b) In the physician certification, the physician may also
  282  specify one or more or order a cannabis delivery devices to
  283  assist with device for the patient’s medical use of marijuana.
  284  low-THC cannabis or medical cannabis,
  285         (c)A physician may certify a patient and specify a
  286  delivery device under paragraphs (a) and (b) only if the
  287  physician:
  288         1.(a) Holds an active, unrestricted license as a physician
  289  under chapter 458 or an osteopathic physician under chapter 459;
  290         (b) Has treated the patient for at least 3 months
  291  immediately preceding the patient’s registration in the
  292  compassionate use registry;
  293         2.(c) Has successfully completed the course and examination
  294  required under paragraph (5)(a) (4)(a);
  295         3.Has conducted a physical examination and made a full
  296  assessment of the medical history of the patient;
  297         4.Has determined that, in the physician’s professional
  298  opinion, the patient meets one or more of the criteria specified
  299  in paragraph (a);
  300         5.(d) Has determined that the medical use of marijuana
  301  would likely outweigh the potential health risks to of treating
  302  the patient with low-THC cannabis or medical cannabis are
  303  reasonable in light of the potential benefit to the patient. If
  304  a patient is younger than 18 years of age:,
  305         a. A second physician must concur with this determination,
  306  and such determination must be documented in the patient’s
  307  medical record;
  308         b. Only a parent, legal guardian, caregiver, or health care
  309  provider may assist the qualifying patient in the purchasing and
  310  administering of marijuana for medical use; and
  311         c. The qualifying patient may not purchase marijuana;
  312         6.(e) Registers as the patient’s physician orderer of low
  313  THC cannabis or medical cannabis for the named patient on the
  314  compassionate use registry maintained by the department and
  315  updates the registry to reflect the contents of the order,
  316  including the amount of marijuana low-THC cannabis or medical
  317  cannabis that will provide the patient with not more than a 90
  318  day 45-day supply and a cannabis delivery device needed by the
  319  patient for the medical use of marijuana low-THC cannabis or
  320  medical cannabis. A physician may certify an amount greater than
  321  a 90-day supply of marijuana if the physician has a reasonable
  322  belief that the patient will use the additional marijuana in a
  323  medically appropriate way. If the physician’s recommended amount
  324  of marijuana for a 90-day supply changes, the physician must
  325  also update the registry within 7 days after the any change is
  326  made to the original order to reflect the change. The physician
  327  shall deactivate the registration of the patient and the
  328  patient’s legal representative when the physician no longer
  329  recommends the medical use of marijuana for the patient
  330  treatment is discontinued;
  331         7.(f) Maintains a patient treatment plan that includes the
  332  dose, route of administration, planned duration, and monitoring
  333  of the patient’s symptoms and other indicators of tolerance or
  334  reaction to the marijuana low-THC cannabis or medical cannabis;
  335         8.(g) Submits the patient treatment plan quarterly to the
  336  University of Florida College of Pharmacy for research on the
  337  safety and efficacy of marijuana low-THC cannabis and medical
  338  cannabis on patients; and
  339         9.(h) Obtains the voluntary written informed consent of the
  340  patient or the patient’s legal representative to treatment with
  341  marijuana low-THC cannabis after sufficiently explaining the
  342  current state of knowledge in the medical community of the
  343  effectiveness of treatment of the patient’s condition with
  344  marijuana low-THC cannabis, the medically acceptable
  345  alternatives, and the potential risks and side effects. If the
  346  patient is a minor, the patient’s parent or legal guardian must
  347  consent to treatment in writing. If the patient is an eligible
  348  patient as defined in s. 499.0295, the physician must obtain
  349  written informed consent as defined in and required by s.
  350  499.0295.;
  351         (d)At least annually, a physician must recertify the
  352  qualifying patient pursuant to paragraph (c).
  353         (i)Obtains written informed consent as defined in and
  354  required under s. 499.0295, if the physician is ordering medical
  355  cannabis for an eligible patient pursuant to that section; and
  356         (e)(j)A physician may not issue a physician certification
  357  if the physician is not a medical director employed by an MMTC a
  358  dispensing organization.
  359         (f) An order for low-THC cannabis or medical cannabis
  360  issued pursuant to former s. 381.986, Florida Statutes 2016, and
  361  registered with the compassionate use registry on the effective
  362  date of this act, shall be considered a physician certification
  363  issued pursuant to this subsection. The details and expiration
  364  date of such certification must be identical to the details and
  365  expiration date of the order as logged in the compassionate use
  366  registry. Until the department begins issuing compassionate use
  367  registry identification cards, all patients with such orders
  368  shall be considered qualifying patients, notwithstanding the
  369  requirement that a qualifying patient have a compassionate use
  370  registry identification card.
  371         (4)(3)PROHIBITED ACTS PENALTIES.—
  372         (a) A physician commits a misdemeanor of the first degree,
  373  punishable as provided in s. 775.082 or s. 775.083, if the
  374  physician issues a physician certification for marijuana to
  375  orders low-THC cannabis for a patient in a manner other than as
  376  required in subsection (3) without a reasonable belief that the
  377  patient is suffering from:
  378         1. Cancer or A physical medical condition that chronically
  379  produces symptoms of seizures or severe and persistent muscle
  380  spasms that can be treated with low-THC cannabis; or
  381         2. Symptoms of cancer or a physical medical condition that
  382  chronically produces symptoms of seizures or severe and
  383  persistent muscle spasms that can be alleviated with low-THC
  384  cannabis.
  385         (b) A physician commits a misdemeanor of the first degree,
  386  punishable as provided in s. 775.082 or s. 775.083, if the
  387  physician orders medical cannabis for a patient without a
  388  reasonable belief that the patient has a terminal condition as
  389  defined in s. 499.0295.
  390         (b)(c) A person who fraudulently represents that he or she
  391  has a debilitating medical condition cancer, a physical medical
  392  condition that chronically produces symptoms of seizures or
  393  severe and persistent muscle spasms, chronic nonmalignant pain,
  394  or a terminal condition as defined in s. 499.0295 to a physician
  395  for the purpose of being issued a physician certification for
  396  marijuana ordered low-THC cannabis, medical cannabis, or a
  397  cannabis delivery device by such physician commits a misdemeanor
  398  of the first degree, punishable as provided in s. 775.082 or s.
  399  775.083.
  400         (c)(d)A qualifying patient an eligible patient as defined
  401  in s. 499.0295 who uses marijuana medical cannabis, and such
  402  patient’s caregiver legal representative who administers
  403  marijuana medical cannabis, in plain view of or in a place open
  404  to the general public, on the grounds of a school, or in a
  405  school bus, vehicle, aircraft, or motorboat, commits a
  406  misdemeanor of the first degree, punishable as provided in s.
  407  775.082 or s. 775.083.
  408         (d)A qualifying patient or caregiver who cultivates
  409  marijuana or who purchases or acquires marijuana from any person
  410  or entity other than an MMTC commits a misdemeanor of the first
  411  degree, punishable as provided in s. 775.082 or s. 775.083.
  412         (e)A caregiver who violates any of the applicable
  413  provisions of this section or applicable department rules
  414  commits, upon the first offense, a misdemeanor of the second
  415  degree, punishable as provided in s. 775.082 or s. 775.083, and,
  416  upon the second and subsequent offenses, a misdemeanor of the
  417  first degree, punishable as provided in s. 775.082 or s.
  418  775.083.
  419         (f)(e) A physician who issues a physician certification for
  420  marijuana orders low-THC cannabis, medical cannabis, or a
  421  cannabis delivery device and receives compensation from an MMTC
  422  a dispensing organization related to issuing the physician
  423  certification for marijuana the ordering of low-THC cannabis,
  424  medical cannabis, or a cannabis delivery device is subject to
  425  disciplinary action under the applicable practice act and s.
  426  456.072(1)(n).
  427         (g) An MMTC that advertises or holds out to the public that
  428  it may provide services other than services for which it is
  429  registered to provide violates this section, and the department
  430  may impose a fine on the MMTC pursuant to paragraph (10)(h).
  431         (h) A person or entity that offers or advertises services
  432  as an MMTC without registering as an MMTC with the department
  433  violates this section. The operation or maintenance of a
  434  facility as an MMTC, or the performance of a service that
  435  requires registration, without proper registration is a
  436  violation of this section.
  437         1. If after receiving notification from the department,
  438  such person or entity fails to cease operation, the department
  439  may impose an administrative fine of up to $10,000 per
  440  violation. Each day of continued operation is a separate
  441  offense.
  442         2. The department or any state attorney may, in addition to
  443  other remedies provided in this section, bring an action for an
  444  injunction to restrain any unauthorized activity or to enjoin
  445  the future operation or maintenance of the unauthorized
  446  dispensing organization or entity or the performance of any
  447  service in violation of this section until compliance with this
  448  section and department rules has been demonstrated to the
  449  satisfaction of the department.
  450         3. If found to be in violation of this paragraph, the
  451  department may assess reasonable investigative and legal costs
  452  for prosecution of the violation against the person or entity.
  453         (5)(4) PHYSICIAN EDUCATION.—
  454         (a) Before a physician may issue a physician certification
  455  pursuant to subsection (3) ordering low-THC cannabis, medical
  456  cannabis, or a cannabis delivery device for medical use by a
  457  patient in this state, the appropriate board shall require the
  458  ordering physician to successfully complete a 4-hour an 8-hour
  459  course and subsequent examination offered by the Florida Medical
  460  Association or the Florida Osteopathic Medical Association which
  461  that encompasses the clinical indications for the appropriate
  462  use of marijuana low-THC cannabis and medical cannabis, the
  463  appropriate cannabis delivery devices, the contraindications for
  464  such use, and the relevant state and federal laws governing the
  465  issuance of physician certifications ordering, as well as
  466  dispensing, and possessing of these substances and devices. The
  467  course and examination shall be administered at least quarterly
  468  annually. Successful completion of the course may be used by a
  469  physician to satisfy 4 hours 8 hours of the continuing medical
  470  education requirements required by his or her respective board
  471  for licensure renewal. This course may be offered in a distance
  472  learning format, including an electronic, online format that is
  473  available on request. Physicians who have completed an 8-hour
  474  course and subsequent examination offered by the Florida Medical
  475  Association or the Florida Osteopathic Medical Association which
  476  encompasses the clinical indications for the appropriate use of
  477  marijuana and who are registered in the compassionate use
  478  registry on the effective date of this act are deemed to meet
  479  the requirements of this paragraph.
  480         (b) The appropriate board shall require the medical
  481  director of each MMTC dispensing organization to hold an active,
  482  unrestricted license as a physician under chapter 458 or as an
  483  osteopathic physician under chapter 459 and successfully
  484  complete a 2-hour course and subsequent examination offered by
  485  the Florida Medical Association or the Florida Osteopathic
  486  Medical Association which that encompasses appropriate safety
  487  procedures and knowledge of marijuana low-THC cannabis, medical
  488  cannabis, and cannabis delivery devices.
  489         (c) Successful completion of the course and examination
  490  specified in paragraph (a) is required for every physician who
  491  issues a physician certification for marijuana orders low-THC
  492  cannabis, medical cannabis, or a cannabis delivery device each
  493  time such physician renews his or her license. In addition,
  494  successful completion of the course and examination specified in
  495  paragraph (b) is required for the medical director of each
  496  dispensing organization each time such physician renews his or
  497  her license.
  498         (d) A physician who fails to comply with this subsection
  499  and issues a physician certification for marijuana who orders
  500  low-THC cannabis, medical cannabis, or a cannabis delivery
  501  device may be subject to disciplinary action under the
  502  applicable practice act and under s. 456.072(1)(k).
  503         (6) CAREGIVERS.—
  504         (a)During the course of registration with the department
  505  for inclusion on the compassionate use registry, or at any time
  506  while registered, a qualifying patient may designate an
  507  individual as his or her caregiver to assist him or her with the
  508  medical use of marijuana. The designated caregiver must be 21
  509  years of age or older, unless the patient is a close relative of
  510  the caregiver; must agree in writing to be the qualifying
  511  patient’s caregiver; may not receive compensation, other than
  512  actual expenses incurred, for assisting the qualifying patient
  513  with the medical use of marijuana, unless the caregiver is
  514  acting pursuant to employment in a licensed facility in
  515  accordance with subparagraph (c)2.; and must pass a level 2
  516  screening pursuant to chapter 435, unless the patient is a close
  517  relative of the caregiver.
  518         (b)A qualifying patient may have only one designated
  519  caregiver at any given time unless all of the patient’s
  520  caregivers are his or her close relatives or legal
  521  representatives.
  522         (c)A caregiver may assist only one qualifying patient at
  523  any given time unless:
  524         1.All qualifying patients the caregiver is assisting are
  525  close relatives of each other and the caregiver is the legal
  526  representative of at least one of the patients; or
  527         2.All qualifying patients the caregiver is assisting are
  528  receiving hospice services, or are residents, in the same
  529  assisted living facility, nursing home, or other licensed
  530  facility and have requested the assistance of that caregiver
  531  with the medical use of marijuana; the caregiver is an employee
  532  of the hospice or licensed facility; and the caregiver provides
  533  personal care or services directly to clients of the hospice or
  534  licensed facility as a part of his or her employment duties at
  535  the hospice or licensed facility.
  536         (d)The department must register a caregiver on the
  537  compassionate use registry and issue him or her a caregiver
  538  identification card if he or she is designated by a qualifying
  539  patient pursuant to paragraph (a) and meets all of the
  540  requirements of this subsection and department rule.
  541         (e) A nursing home or assisted living facility may not
  542  prevent a qualifying patient residing in the nursing home or
  543  assisted living facility from hiring a caregiver. A nursing home
  544  or assisted living facility may prohibit its employees from
  545  acting as caregivers to residents of the nursing home or
  546  assisted living facility. A nursing home or assisted living
  547  facility is not required to provide a caregiver to a resident
  548  who is a qualifying patient.
  549         (7)(5) DUTIES OF THE DEPARTMENT.—The department shall:
  550         (a) Create and maintain a secure, electronic, and online
  551  compassionate use registry for the registration of physicians,
  552  patients, and caregivers the legal representatives of patients
  553  as provided under this section. The registry must be accessible
  554  to:
  555         1.Practitioners licensed under chapter 458 or chapter 459,
  556  to ensure proper care for patients requesting physician
  557  certifications;
  558         2.Practitioners licensed to prescribe prescription drugs,
  559  to ensure proper care for patients before prescribing
  560  medications that may interact with the medical use of marijuana;
  561         3. Law enforcement agencies, to verify the authorization of
  562  a qualifying patient or a patient’s caregiver to possess
  563  marijuana or a cannabis delivery device; and
  564         4.MMTCs, to a dispensing organization to verify the
  565  authorization of a qualifying patient or a patient’s caregiver
  566  legal representative to possess marijuana low-THC cannabis,
  567  medical cannabis, or a cannabis delivery device and to record
  568  the marijuana low-THC cannabis, medical cannabis, or cannabis
  569  delivery device dispensed.
  570  
  571  The registry must prevent an active registration of a patient by
  572  multiple physicians.
  573         (b) By July 3, 2017, adopt rules establishing procedures
  574  for the issuance, annual renewal, suspension, and revocation of
  575  compassionate use registry identification cards for patients and
  576  caregivers. The department may charge a reasonable fee
  577  associated with the issuance and renewal of patient and
  578  caregiver identification cards. By October 3, 2017, the
  579  department shall begin issuing identification cards to adult
  580  patients who have a physician certification that meets the
  581  requirements of subsection (3); minor patients who have a
  582  physician certification that meets the requirements of
  583  subsection (3) and the written consent of a parent or legal
  584  guardian; and caregivers registered pursuant to subsection (6).
  585  In addition to the other requirements of this section, the
  586  department may issue a compassionate use registry identification
  587  card to a patient who is not a resident of this state only after
  588  the department has verified that the patient can lawfully obtain
  589  marijuana through a medical marijuana program in the state that
  590  he or she resides in. Patient and caregiver identification cards
  591  must be resistant to counterfeiting and tampering and must
  592  include at least the following:
  593         1. The name, address, and date of birth of the patient or
  594  caregiver, as appropriate;
  595         2. A full-face, passport-type, color photograph of the
  596  patient or caregiver, as appropriate, taken within the 90 days
  597  immediately preceding registration;
  598         3. Designation of the cardholder as a patient or caregiver;
  599         4. A unique identification number for the patient or
  600  caregiver which is matched to the identification number used for
  601  such person in the department’s compassionate use registry. A
  602  caregiver’s identification number and file in the compassionate
  603  use registry must be linked to the file of the patient or
  604  patients the caregiver is assisting so that the caregiver’s
  605  status may be verified for each patient individually;
  606         5. The expiration date, which shall be 1 year after the
  607  date of issuance of the identification card or the date
  608  treatment ends as provided in the patient’s physician
  609  certification, whichever occurs first; and
  610         6. For caregivers who are assisting three or fewer
  611  qualifying patients, the names and identification number of the
  612  qualifying patient or patients that the caregiver is assisting.
  613         (c)As soon as practicable after the effective date of this
  614  act, update its records by registering each dispensing
  615  organization approved pursuant to chapter 2014-157, Laws of
  616  Florida, or chapter 2016-123, Laws of Florida, as an MMTC with
  617  an effective registration date that coincides with that
  618  dispensing organization’s date of approval as a dispensing
  619  organization. On the effective date of this act, all dispensing
  620  organizations approved pursuant to chapter 2014-157, Laws of
  621  Florida, or chapter 2016-123, Laws of Florida, are deemed to be
  622  registered MMTCs. The department may not require a dispensing
  623  organization approved pursuant to chapter 2014-157, Laws of
  624  Florida, or chapter 2016-123, Laws of Florida, to submit an
  625  application and may not charge the dispensing organization an
  626  application or registration fee for the initial registration of
  627  that dispensing organization as an MMTC pursuant to this
  628  section. For purposes of the requirement that an MMTC comply
  629  with the representations made in its application pursuant to
  630  subsection (8), an MMTC registered pursuant to this paragraph
  631  shall continue to comply with the representations made in its
  632  application for approval as a dispensing organization, including
  633  any revision authorized by the department before the effective
  634  date of this act. After the effective date of this act, the
  635  department may grant variances from the representations made in
  636  a dispensing organization’s application for approval pursuant to
  637  subsection (8). For purposes of the definition of the term
  638  “marijuana” in s. 29, of Art. X of the State Constitution, an
  639  MMTC is deemed to be a dispensing organization as that term is
  640  defined in former s. 381.986(1)(a), Florida Statutes 2014
  641  Authorize the establishment of five dispensing organizations to
  642  ensure reasonable statewide accessibility and availability as
  643  necessary for patients registered in the compassionate use
  644  registry and who are ordered low-THC cannabis, medical cannabis,
  645  or a cannabis delivery device under this section, one in each of
  646  the following regions: northwest Florida, northeast Florida,
  647  central Florida, southeast Florida, and southwest Florida.
  648         (d) By October 3, 2017, register five additional MMTCs with
  649  at least one of the MMTCs being an applicant that is a
  650  recognized class member of Pigford v. Glickman, 185 F.R.D. 82
  651  (D.D.C. 1999), or In re Black Farmers Litig., 856 F. Supp. 2d 1
  652  (D.D.C. 2011), and a member of the Black Farmers and
  653  Agriculturalists Association.
  654         (e)Within 6 months after each instance of the registration
  655  of 75,000 qualifying patients with the compassionate use
  656  registry, register four additional MMTCs if a sufficient number
  657  of MMTC applicants meet the registration requirements
  658  established in this section and by department rule.
  659         (f) Not issue more than one registration as an MMTC to a
  660  person or an entity.
  661         (g)The department shall Develop an application form for
  662  registration as an MMTC and impose an initial application and
  663  biennial renewal fee that is sufficient to cover the costs of
  664  administering this section. To be registered as an MMTC, the an
  665  applicant for approval as a dispensing organization must be able
  666  to demonstrate:
  667         1. That the applicant has been registered to do business in
  668  this state for the previous 5 consecutive years before
  669  submitting the application.
  670         2.1. The technical and technological ability to cultivate
  671  and produce low-THC cannabis and marijuana. The applicant must
  672  possess a valid certificate of registration issued by the
  673  Department of Agriculture and Consumer Services pursuant to s.
  674  581.131 that is issued for the cultivation of more than 400,000
  675  plants, be operated by a nurseryman as defined in s. 581.011,
  676  and have been operated as a registered nursery in this state for
  677  at least 30 continuous years.
  678         3.2. The ability to secure the premises, resources, and
  679  personnel necessary to operate as an MMTC a dispensing
  680  organization.
  681         4.3. The ability to maintain accountability of all raw
  682  materials, finished products, and any byproducts to prevent
  683  diversion or unlawful access to or possession of these
  684  substances.
  685         5.4. An infrastructure reasonably located to dispense low
  686  THC cannabis and marijuana to registered qualifying patients
  687  statewide or regionally as determined by the department.
  688         6.5. The financial ability to maintain operations for the
  689  duration of the 2-year approval cycle, including the provision
  690  of certified financials to the department. Upon approval, the
  691  applicant must post a $5 million performance bond. However, upon
  692  an MMTC a dispensing organization’s serving at least 1,000
  693  qualifying qualified patients, the MMTC dispensing organization
  694  is only required to maintain a $2 million performance bond.
  695         7.6. That all owners and managers have been fingerprinted
  696  and have successfully passed a level 2 background screening
  697  pursuant to s. 435.04.
  698         8.7. The employment of a medical director to supervise the
  699  activities of the MMTC dispensing organization.
  700         (c) Upon the registration of 250,000 active qualified
  701  patients in the compassionate use registry, approve three
  702  dispensing organizations, including, but not limited to, an
  703  applicant that is a recognized class member of Pigford v.
  704  Glickman, 185 F.R.D. 82 (D.D.C. 1999), or In Re Black Farmers
  705  Litig., 856 F. Supp. 2d 1 (D.D.C. 2011), and a member of the
  706  Black Farmers and Agriculturalists Association, which must meet
  707  the requirements of subparagraphs (b)2.-7. and demonstrate the
  708  technical and technological ability to cultivate and produce
  709  low-THC cannabis.
  710         (h)(d) Allow an MMTC a dispensing organization to make a
  711  wholesale purchase of marijuana low-THC cannabis or medical
  712  cannabis from, or a distribution of marijuana low-THC cannabis
  713  or medical cannabis to, another MMTC dispensing organization.
  714         (i)(e) Monitor physician registration in the compassionate
  715  use registry and the issuance of physician certifications
  716  pursuant to subsection (3) ordering of low-THC cannabis, medical
  717  cannabis, or a cannabis delivery device for ordering practices
  718  that could facilitate unlawful diversion or misuse of marijuana
  719  low-THC cannabis, medical cannabis, or a cannabis delivery
  720  devices device and take disciplinary action as indicated.
  721         (8)(6)MEDICAL MARIJUANA TREATMENT CENTERS DISPENSING
  722  ORGANIZATION.—Each MMTC must register with the department. A
  723  registered MMTC An approved dispensing organization must, at all
  724  times, maintain compliance with paragraph (7)(g), the criteria
  725  demonstrated for selection and approval as a dispensing
  726  organization under subsection(5) and the criteria required in
  727  this subsection, and all representations made to the department
  728  in the MMTC’s application for registration. Upon request, the
  729  department may grant an MMTC one or more variances from the
  730  representations made in the MMTC’s application. Consideration of
  731  such a variance shall be based upon the individual facts and
  732  circumstances surrounding the request. A variance may not be
  733  granted unless the requesting MMTC can demonstrate to the
  734  department that it has a proposed alternative to the specific
  735  representation made in its application which fulfills the same
  736  or a similar purpose as the specific representation in a way
  737  that the department can reasonably determine will not be a lower
  738  standard than the specific representation in the application.
  739         (a) When growing marijuana low-THC cannabis or medical
  740  cannabis, an MMTC a dispensing organization:
  741         1. May use pesticides determined by the department, after
  742  consultation with the Department of Agriculture and Consumer
  743  Services, to be safely applied to plants intended for human
  744  consumption, but may not use pesticides designated as
  745  restricted-use pesticides pursuant to s. 487.042.
  746         2. Must grow marijuana low-THC cannabis or medical cannabis
  747  within an enclosed structure and in a room separate from any
  748  other plant.
  749         3. Must inspect seeds and growing plants for plant pests
  750  that endanger or threaten the horticultural and agricultural
  751  interests of the state, notify the Department of Agriculture and
  752  Consumer Services within 10 calendar days after a determination
  753  that a plant is infested or infected by such plant pest, and
  754  implement and maintain phytosanitary policies and procedures.
  755         4. Must perform fumigation or treatment of plants, or the
  756  removal and destruction of infested or infected plants, in
  757  accordance with chapter 581 and any rules adopted thereunder.
  758         (b) When processing marijuana low-THC cannabis or medical
  759  cannabis, an MMTC a dispensing organization must:
  760         1. Process the marijuana low-THC cannabis or medical
  761  cannabis within an enclosed structure and in a room separate
  762  from other plants or products.
  763         2. Have the marijuana tested by an independent testing
  764  laboratory to ensure it meets the standards established by the
  765  department’s quality control program Test the processed low-THC
  766  cannabis and medical cannabis before it is they are dispensed.
  767  Results must be verified and signed by two dispensing
  768  organization employees. Before dispensing low-THC cannabis, the
  769  dispensing organization must determine that the test results
  770  indicate that the low-THC cannabis meets the definition of low
  771  THC cannabis and, for medical cannabis and low-THC cannabis,
  772  that all medical cannabis and low-THC cannabis is safe for human
  773  consumption and free from contaminants that are unsafe for human
  774  consumption. The dispensing organization must retain records of
  775  all testing and samples of each homogenous batch of cannabis and
  776  low-THC cannabis for at least 9 months. The dispensing
  777  organization must contract with an independent testing
  778  laboratory to perform audits on the dispensing organization’s
  779  standard operating procedures, testing records, and samples and
  780  provide the results to the department to confirm that the low
  781  THC cannabis or medical cannabis meets the requirements of this
  782  section and that the medical cannabis and low-THC cannabis is
  783  safe for human consumption.
  784         3. Package the marijuana low-THC cannabis or medical
  785  cannabis in compliance with the United States Poison Prevention
  786  Packaging Act of 1970, 15 U.S.C. ss. 1471 et seq.
  787         4. Package the marijuana low-THC cannabis or medical
  788  cannabis in a childproof receptacle that has a firmly affixed
  789  and legible label stating the following information:
  790         a. A statement that the marijuana low-THC cannabis or
  791  medical cannabis meets the requirements of subparagraph 2.;
  792         b. The name of the MMTC dispensing organization from which
  793  the marijuana medical cannabis or low-THC cannabis originates;
  794  and
  795         c. The batch number and harvest number from which the
  796  marijuana medical cannabis or low-THC cannabis originates; and
  797         d.The concentration of tetrahydrocannabinol and
  798  cannabidiol in the product.
  799         e. Any other information required by department rule
  800         5. Reserve two processed samples from each batch and retain
  801  such samples for at least 9 months for the purpose of testing
  802  pursuant to the audit required under subparagraph 2.
  803         (c) When dispensing marijuana low-THC cannabis, medical
  804  cannabis, or a marijuana cannabis delivery device, an MMTC a
  805  dispensing organization:
  806         1. May not dispense more than the a 45-day supply of
  807  marijuana authorized by a qualifying patient’s physician
  808  certification low-THC cannabis or medical cannabis to a
  809  qualifying patient or caregiver the patient’s legal
  810  representative.
  811         2. Must ensure that the have the dispensing organization’s
  812  employee who dispenses the marijuana low-THC cannabis, medical
  813  cannabis, or marijuana a cannabis delivery device enters enter
  814  into the compassionate use registry his or her name or unique
  815  employee identifier.
  816         3. Must verify that the qualifying patient and the
  817  caregiver, if applicable, both have an active and valid
  818  compassionate use registry identification card and that the
  819  amount and type of marijuana dispensed match the physician
  820  certification in the compassionate use registry for that
  821  qualifying patient that a physician has ordered the low-THC
  822  cannabis, medical cannabis, or a specific type of a cannabis
  823  delivery device for the patient.
  824         4.Must label the marijuana with the recommended dose for
  825  the qualifying patient receiving the marijuana.
  826         5.4. May not dispense or sell any other type of marijuana
  827  cannabis, alcohol, or illicit drug-related product, including
  828  pipes, bongs, or wrapping papers, other than a physician-ordered
  829  cannabis delivery device required for the medical use of
  830  marijuana which is specified in a physician certification low
  831  THC cannabis or medical cannabis, while dispensing low-THC
  832  cannabis or medical cannabis. An MMTC may produce and dispense
  833  marijuana as an edible or food product but may not produce such
  834  items in a format designed to be attractive to children. In
  835  addition to the requirements of this section and department
  836  rule, food products produced by an MMTC must meet all food
  837  safety standards established in state and federal law,
  838  including, but not limited to, the identification of the serving
  839  size and the amount of tetrahydrocannabinol in each serving.
  840         5. Must verify that the patient has an active registration
  841  in the compassionate use registry, the patient or patient’s
  842  legal representative holds a valid and active registration card,
  843  the order presented matches the order contents as recorded in
  844  the registry, and the order has not already been filled.
  845         6. Must, upon dispensing the marijuana low-THC cannabis,
  846  medical cannabis, or marijuana cannabis delivery device, record
  847  in the registry the date, time, quantity, and form of marijuana
  848  low-THC cannabis or medical cannabis dispensed; and the type of
  849  marijuana cannabis delivery device dispensed; and the name and
  850  compassionate use registry identification number of the
  851  qualifying patient or caregiver to whom the marijuana delivery
  852  device was dispensed.
  853         7. May not dispense marijuana from more than three
  854  dispensing facilities. This subparagraph does not apply to MMTC
  855  retail facilities that only dispense low-THC cannabis and sell
  856  marijuana delivery devices to qualified patients.
  857         (d) To ensure the safety and security of its premises and
  858  any off-site storage facilities, and to maintain adequate
  859  controls against the diversion, theft, and loss of marijuana
  860  low-THC cannabis, medical cannabis, or marijuana cannabis
  861  delivery devices, an MMTC a dispensing organization shall:
  862         1.a. Maintain a fully operational security alarm system
  863  that secures all entry points and perimeter windows and is
  864  equipped with motion detectors; pressure switches; and duress,
  865  panic, and hold-up alarms; or
  866         b. Maintain a video surveillance system that records
  867  continuously 24 hours each day and meets at least one of the
  868  following criteria:
  869         (I) Cameras are fixed in a place that allows for the clear
  870  identification of persons and activities in controlled areas of
  871  the premises. Controlled areas include grow rooms, processing
  872  rooms, storage rooms, disposal rooms or areas, and point-of-sale
  873  rooms;
  874         (II) Cameras are fixed in entrances and exits to the
  875  premises, which shall record from both indoor and outdoor, or
  876  ingress and egress, vantage points;
  877         (III) Recorded images must clearly and accurately display
  878  the time and date; or
  879         (IV) Retain video surveillance recordings for a minimum of
  880  45 days, or longer upon the request of a law enforcement agency.
  881         2. Ensure that the MMTC’s organization’s outdoor premises
  882  have sufficient lighting from dusk until dawn.
  883         3. Implement Establish and maintain a tracking system using
  884  a vendor approved by the department which that traces the
  885  marijuana low-THC cannabis or medical cannabis from seed to
  886  sale. The tracking system must shall include notification of key
  887  events as determined by the department, including when cannabis
  888  seeds are planted, when cannabis plants are harvested and
  889  destroyed, and when marijuana low-THC cannabis or medical
  890  cannabis is transported, sold, stolen, diverted, or lost.
  891         4. Not dispense from its premises marijuana low-THC
  892  cannabis, medical cannabis, or a cannabis delivery device
  893  between the hours of 9 p.m. and 7 a.m., but may perform all
  894  other operations and deliver marijuana low-THC cannabis and
  895  medical cannabis to qualifying qualified patients 24 hours each
  896  day.
  897         5. Store marijuana low-THC cannabis or medical cannabis in
  898  a secured, locked room or a vault.
  899         6. Require at least two of its employees, or two employees
  900  of a security agency with whom it contracts, to be on the
  901  premises at all times.
  902         7. Require each employee or contractor to wear a photo
  903  identification badge at all times while on the premises.
  904         8. Require each visitor to wear a visitor’s pass at all
  905  times while on the premises.
  906         9. Implement an alcohol and drug-free workplace policy.
  907         10. Report to local law enforcement within 24 hours after
  908  it is notified or becomes aware of the theft, diversion, or loss
  909  of marijuana low-THC cannabis or medical cannabis.
  910         (e) To ensure the safe transport of marijuana low-THC
  911  cannabis or medical cannabis to MMTC dispensing organization
  912  facilities, independent testing laboratories, or qualifying
  913  patients, the MMTC dispensing organization must:
  914         1. Maintain a transportation manifest, which must be
  915  retained for at least 1 year. A copy of the manifest must be in
  916  the vehicle at all times when transporting marijuana.
  917         2. Ensure only vehicles in good working order are used to
  918  transport marijuana low-THC cannabis or medical cannabis.
  919         3. Lock marijuana low-THC cannabis or medical cannabis in a
  920  separate compartment or container within the vehicle.
  921         4. Require at least two persons to be in a vehicle
  922  transporting marijuana low-THC cannabis or medical cannabis, and
  923  require at least one person to remain in the vehicle while the
  924  marijuana low-THC cannabis or medical cannabis is being
  925  delivered.
  926         5. Provide specific safety and security training to
  927  employees transporting or delivering marijuana low-THC cannabis
  928  or medical cannabis.
  929         (9) MARIJUANA QUALITY CONTROL PROGRAM AND INDEPENDENT
  930  TESTING LABORATORY LICENSURE.—
  931         (a)The department shall establish a quality control
  932  program requiring marijuana to be tested by an independent
  933  testing laboratory for potency and contaminants before sale to
  934  qualifying patients and caregivers.
  935         1. The quality control program must require MMTCs to submit
  936  samples from each batch or lot of marijuana harvested or
  937  processed to an independent testing laboratory for testing to
  938  ensure, at a minimum, that the labeling of the potency of
  939  tetrahydrocannabinol and all other marketed cannabinoids or
  940  terpenes is accurate and that the marijuana dispensed to
  941  qualifying patients is safe for human consumption.
  942         2. An MMTC must maintain records of all tests conducted,
  943  including the results of each test and any additional
  944  information, as required by the department.
  945         3. The department shall adopt all rules necessary to create
  946  and oversee the quality control program, which must include, at
  947  a minimum:
  948         a.Permissible levels of variation in potency labeling and
  949  standards requiring tetrahydrocannabinol in edible marijuana
  950  products to be distributed consistently throughout the product;
  951         b. Permissible levels of contaminants and mandatory testing
  952  for contaminants to confirm that the tested marijuana is safe
  953  for human consumption. This testing must include, but is not
  954  limited to, testing for microbiological impurity, residual
  955  solvents, and pesticide residues;
  956         c.The destruction of marijuana determined to be
  957  inaccurately labeled or unsafe for human consumption after the
  958  MMTC has an opportunity to take remedial action;
  959         d.The collection, storage, handling, recording, and
  960  destruction of samples of marijuana by independent testing
  961  laboratories; and
  962         e.Security, inventory tracking, and record retention.
  963         (b) The department must license all independent testing
  964  laboratories to ensure that all marijuana is tested for potency
  965  and contaminants in accordance with the department’s quality
  966  control program. An independent testing laboratory may collect
  967  and accept samples of, and possess, store, transport, and test
  968  marijuana. An independent testing laboratory may not be owned by
  969  a person who also possesses an ownership interest in an MMTC. A
  970  clinical laboratory that is licensed by the Agency for Health
  971  Care Administration pursuant to part I of chapter 483 and that
  972  performs nonwaived clinical tests is exempt from the requirement
  973  to be licensed by the department pursuant to this paragraph but
  974  must be certified to perform all required tests pursuant to
  975  subparagraph 2.
  976         1. The department shall develop rules establishing
  977  independent testing laboratory license requirements and a
  978  process for licensing independent testing laboratories; develop
  979  an application form for an independent testing laboratory
  980  license; and impose an initial application fee and a biennial
  981  renewal fee sufficient to cover the costs of administering this
  982  subsection.
  983         2. In addition to licensure, an independent testing
  984  laboratory must be certified to perform all required tests by
  985  the department. The department must issue a certification to an
  986  independent testing laboratory that has been certified by a
  987  third-party laboratory certification body approved by the
  988  department. The department shall establish reasonable rules for
  989  the certification and operation of independent testing
  990  laboratories. Rules for certification must, at a minimum,
  991  address standards relating to:
  992         a.Personnel qualifications;
  993         b.Equipment and methodology;
  994         c.Proficiency testing;
  995         d.Tracking;
  996         e.Sampling;
  997         f.Chain of custody;
  998         g.Record and sample retention;
  999         h.Reporting;
 1000         i.Audit and inspection; and
 1001         j.Security.
 1002         3. The department shall suspend or reduce any mandatory
 1003  testing requirement specified in its quality control program if
 1004  the number of licensed and certified independent testing
 1005  laboratories is insufficient to process the tests necessary to
 1006  meet the patients’ demand for marijuana.
 1007         4. An independent testing laboratory may accept only
 1008  samples composed of marijuana which are obtained from a sample
 1009  source approved by the department. At a minimum, these sources
 1010  must include an MMTC, a researcher affiliated with an accredited
 1011  university or research hospital, a qualifying patient, and a
 1012  caregiver.
 1013         (10)(7) DEPARTMENT AUTHORITY AND RESPONSIBILITIES.—
 1014         (a) The department may conduct announced or unannounced
 1015  inspections of MMTCs dispensing organizations to determine
 1016  compliance with this section or rules adopted pursuant to this
 1017  section.
 1018         (b) The department shall inspect an MMTC a dispensing
 1019  organization upon complaint or notice provided to the department
 1020  that the MMTC dispensing organization has dispensed marijuana
 1021  low-THC cannabis or medical cannabis containing any mold,
 1022  bacteria, or other contaminant that may cause or has caused an
 1023  adverse effect to human health or the environment.
 1024         (c) The department shall conduct at least a biennial
 1025  inspection of each MMTC dispensing organization to evaluate the
 1026  MMTC’s dispensing organization’s records, personnel, equipment,
 1027  processes, security measures, sanitation practices, and quality
 1028  assurance practices.
 1029         (d) The department shall adopt by rule a process for
 1030  approving changes in MMTC ownership or a change in an MMTC
 1031  owner’s investment interest. This process must include specific
 1032  criteria for the approval or denial of an application for change
 1033  of ownership or a change in investment interest and procedures
 1034  for screening applicants’ criminal and financial histories.
 1035         (e) The department shall establish, maintain, and control a
 1036  computer software tracking system that traces marijuana from
 1037  seed to sale and allows real-time, 24-hour access by the
 1038  department to data from all MMTCs and independent testing
 1039  laboratories. The tracking system must, at a minimum, include
 1040  notification of when marijuana seeds are planted, when marijuana
 1041  plants are harvested and destroyed, and when marijuana is
 1042  transported, sold, stolen, diverted, or lost. Each MMTC shall
 1043  use the seed-to-sale tracking system selected by the department.
 1044         (f)(d) The department may enter into interagency agreements
 1045  with the Department of Agriculture and Consumer Services, the
 1046  Department of Business and Professional Regulation, the
 1047  Department of Transportation, the Department of Highway Safety
 1048  and Motor Vehicles, and the Agency for Health Care
 1049  Administration, and such agencies are authorized to enter into
 1050  an interagency agreement with the department, to conduct
 1051  inspections or perform other responsibilities assigned to the
 1052  department under this section.
 1053         (g)(e) The department must make a list of all approved
 1054  MMTCs, dispensing organizations and qualified ordering
 1055  physicians who are qualified to issue physician certifications,
 1056  and medical directors publicly available on its website.
 1057         (f) The department may establish a system for issuing and
 1058  renewing registration cards for patients and their legal
 1059  representatives, establish the circumstances under which the
 1060  cards may be revoked by or must be returned to the department,
 1061  and establish fees to implement such system. The department must
 1062  require, at a minimum, the registration cards to:
 1063         1. Provide the name, address, and date of birth of the
 1064  patient or legal representative.
 1065         2. Have a full-face, passport-type, color photograph of the
 1066  patient or legal representative taken within the 90 days
 1067  immediately preceding registration.
 1068         3. Identify whether the cardholder is a patient or legal
 1069  representative.
 1070         4. List a unique numeric identifier for the patient or
 1071  legal representative that is matched to the identifier used for
 1072  such person in the department’s compassionate use registry.
 1073         5. Provide the expiration date, which shall be 1 year after
 1074  the date of the physician’s initial order of low-THC cannabis or
 1075  medical cannabis.
 1076         6. For the legal representative, provide the name and
 1077  unique numeric identifier of the patient that the legal
 1078  representative is assisting.
 1079         7. Be resistant to counterfeiting or tampering.
 1080         (h)(g) The department may impose reasonable fines not to
 1081  exceed $10,000 on an MMTC a dispensing organization for any of
 1082  the following violations:
 1083         1. Violating this section, s. 499.0295, or department rule.
 1084         2. Failing to maintain qualifications for registration with
 1085  the department approval.
 1086         3. Endangering the health, safety, or security of a
 1087  qualifying qualified patient.
 1088         4. Improperly disclosing personal and confidential
 1089  information of a qualifying the qualified patient.
 1090         5. Attempting to procure MMTC registration with the
 1091  department dispensing organization approval by bribery,
 1092  fraudulent misrepresentation, or extortion.
 1093         6. Any owner or manager of the MMTC being convicted or
 1094  found guilty of, or entering a plea of guilty or nolo contendere
 1095  to, regardless of adjudication, a crime in any jurisdiction
 1096  which directly relates to the business of an MMTC a dispensing
 1097  organization.
 1098         7. Making or filing a report or record that the MMTC
 1099  dispensing organization knows to be false.
 1100         8. Willfully failing to maintain a record required by this
 1101  section or department rule.
 1102         9. Willfully impeding or obstructing an employee or agent
 1103  of the department in the furtherance of his or her official
 1104  duties.
 1105         10. Engaging in fraud or deceit, negligence, incompetence,
 1106  or misconduct in the business practices of an MMTC a dispensing
 1107  organization.
 1108         11. Making misleading, deceptive, or fraudulent
 1109  representations in or related to the business practices of an
 1110  MMTC a dispensing organization.
 1111         12. Having a license or the authority to engage in any
 1112  regulated profession, occupation, or business that is related to
 1113  the business practices of an MMTC a dispensing organization
 1114  suspended, revoked, or otherwise acted against by the licensing
 1115  authority of any jurisdiction, including its agencies or
 1116  subdivisions, for a violation that would constitute a violation
 1117  under Florida law.
 1118         13. Violating a lawful order of the department or an agency
 1119  of the state, or failing to comply with a lawfully issued
 1120  subpoena of the department or an agency of the state.
 1121         (i)(h) The department may suspend, revoke, or refuse to
 1122  renew an MMTC’s registration with the department a dispensing
 1123  organization’s approval if the MMTC a dispensing organization
 1124  commits a violation specified any of the violations in paragraph
 1125  (h) (g).
 1126         (j)(i) The department shall renew an MMTC’s registration
 1127  with the department the approval of a dispensing organization
 1128  biennially if the MMTC dispensing organization meets the
 1129  requirements of this section and pays the biennial renewal fee.
 1130         (k)(j) The department may adopt rules necessary to
 1131  implement this section.
 1132         (11)(8) PREEMPTION.—
 1133         (a) All matters regarding the regulation of the cultivation
 1134  and processing of marijuana medical cannabis or low-THC cannabis
 1135  by MMTCs dispensing organizations are preempted to the state.
 1136         (b) A municipality may determine by ordinance the criteria
 1137  for the number and location of, and other permitting
 1138  requirements that do not conflict with state law or department
 1139  rule for, dispensing facilities of MMTCs dispensing
 1140  organizations located within its municipal boundaries. A county
 1141  may determine by ordinance the criteria for the number,
 1142  location, and other permitting requirements that do not conflict
 1143  with state law or department rule for all dispensing facilities
 1144  of MMTCs dispensing organizations located within the
 1145  unincorporated areas of that county.
 1146         (12)(9) EXCEPTIONS TO OTHER LAWS.—
 1147         (a) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
 1148  any other provision of law, but subject to the requirements of
 1149  this section, a qualifying qualified patient, or a caregiver who
 1150  has obtained a valid compassionate use registry identification
 1151  card from the department, and the qualified patient’s legal
 1152  representative may purchase from an MMTC, and possess for the
 1153  qualifying patient’s medical use, up to the amount of marijuana
 1154  in the physician certification low-THC cannabis or medical
 1155  cannabis ordered for the patient, but not more than a 90-day 45
 1156  day supply, and a cannabis delivery device specified in the
 1157  physician certification ordered for the qualifying patient.
 1158         (b) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
 1159  any other provision of law, but subject to the requirements of
 1160  this section, an MMTC an approved dispensing organization and
 1161  its owners, managers, contractors, and employees may
 1162  manufacture, possess, sell, deliver, distribute, dispense,
 1163  administer, and lawfully dispose of reasonable quantities, as
 1164  established by department rule, of marijuana low-THC cannabis,
 1165  medical cannabis, or a cannabis delivery device. For purposes of
 1166  this subsection, the terms “manufacture,” “possession,”
 1167  “deliver,” “distribute,” and “dispense” have the same meanings
 1168  as provided in s. 893.02.
 1169         (c) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
 1170  any other provision of law, but subject to the requirements of
 1171  this section, an approved independent testing laboratory may
 1172  possess, test, transport, and lawfully dispose of marijuana low
 1173  THC cannabis or medical cannabis as provided by department rule.
 1174         (d) An MMTC approved dispensing organization and its
 1175  owners, managers, contractors, and employees are not subject to
 1176  licensure or regulation under chapter 465 or chapter 499 for
 1177  manufacturing, possessing, selling, delivering, distributing,
 1178  dispensing, or lawfully disposing of reasonable quantities, as
 1179  established by department rule, of marijuana low-THC cannabis,
 1180  medical cannabis, or a cannabis delivery device.
 1181         (e) Exercise by an MMTC of An approved dispensing
 1182  organization that continues to meet the requirements for
 1183  approval is presumed to be registered with the department and to
 1184  meet the regulations adopted by the department or its successor
 1185  agency for the purpose of dispensing medical cannabis or low-THC
 1186  cannabis under Florida law. Additionally, the authority provided
 1187  to MMTCs a dispensing organization in s. 499.0295 does not
 1188  impair its registration with the department the approval of a
 1189  dispensing organization.
 1190         (f) This subsection does not exempt a person from
 1191  prosecution for a criminal offense related to impairment or
 1192  intoxication resulting from the medical use of marijuana low-THC
 1193  cannabis or medical cannabis or relieve a person from any
 1194  requirement under law to submit to a breath, blood, urine, or
 1195  other test to detect the presence of a controlled substance.
 1196         (g)This section does not limit the ability of an employer
 1197  to establish, continue, or enforce a drug-free workplace program
 1198  or substance abuse policy. Notwithstanding any other provision
 1199  of law, this section does not require an employer to accommodate
 1200  the ingestion of marijuana in any workplace or any employee
 1201  working while under the influence of marijuana. Notwithstanding
 1202  any other provision of law, this section does not create a cause
 1203  of action against an employer for wrongful discharge or
 1204  discrimination.
 1205         (h) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
 1206  any other provision of law, but subject to the requirements of
 1207  this section, a research institute established by a public
 1208  postsecondary educational institution, such as the H. Lee
 1209  Moffitt Cancer Center and Research Institute established under
 1210  s. 1004.43, or a state university that has achieved the
 1211  preeminent state research university designation pursuant to s.
 1212  1001.7065 may possess, test, transport, and lawfully dispose of
 1213  marijuana for research purposes as provided by department rule.
 1214         (13) RULEMAKING.—
 1215         (a) The department and the applicable boards shall adopt
 1216  emergency rules pursuant to s. 120.54(4) and this subsection
 1217  necessary to implement this section. If an emergency rule
 1218  adopted under this subsection is held to be unconstitutional or
 1219  an invalid exercise of delegated legislative authority and
 1220  becomes void, the department and the applicable boards may adopt
 1221  an emergency rule to replace the rule that has become void. If
 1222  the emergency rule adopted to replace the void emergency rule is
 1223  also held to be unconstitutional or an invalid exercise of
 1224  delegated legislative authority and becomes void, the department
 1225  and the applicable boards must follow the nonemergency
 1226  rulemaking procedures of the Administrative Procedures Act to
 1227  replace the rule that has become void.
 1228         (b) For emergency rules adopted under this subsection, the
 1229  department and the applicable boards need not make the findings
 1230  required by s. 120.54(4)(a). Emergency rules adopted under this
 1231  subsection are exempt from ss. 120.54(3)(b) and 120.541. The
 1232  department and the applicable boards shall meet the procedural
 1233  requirements in s. 120.54(2)(a) if the department or the
 1234  applicable boards have, before the effective date of this act,
 1235  held any public workshops or hearings on the subject matter of
 1236  emergency rules adopted under this subsection. Challenges to
 1237  emergency rules adopted under this subsection are subject to the
 1238  time schedules provided in s. 120.56(5).
 1239         (c) Emergency rules adopted under this section are exempt
 1240  from s. 120.54(4)(c) and shall remain in effect until replaced
 1241  by rules adopted under the nonemergency rulemaking procedures of
 1242  the Administrative Procedures Act. By January 1, 2018, the
 1243  department and the applicable boards shall initiate nonemergency
 1244  rulemaking pursuant to the Administrative Procedures Act by
 1245  publishing a notice of rule development in the Florida
 1246  Administrative Register. Except as provided in paragraph (a),
 1247  after January 1, 2018, the department and applicable boards may
 1248  not adopt rules pursuant to the emergency rulemaking procedures
 1249  provided in this subsection.
 1250         Section 2. Section 1004.4351, Florida Statutes, is created
 1251  to read:
 1252         1004.4351Medical marijuana research and education.—
 1253         (1) SHORT TITLE.—This section shall be known and may be
 1254  cited as the “Medical Marijuana Research and Education Act.”
 1255         (2) LEGISLATIVE FINDINGS.—The Legislature finds that:
 1256         (a) The present state of knowledge concerning the use of
 1257  marijuana to alleviate pain and treat illnesses is limited
 1258  because permission to perform clinical studies on marijuana is
 1259  difficult to obtain, with access to research-grade marijuana so
 1260  restricted that little or no unbiased studies have been
 1261  performed.
 1262         (b) Under the State Constitution, marijuana is available
 1263  for the treatment of certain debilitating medical conditions.
 1264         (c) Additional clinical studies are needed to ensure that
 1265  the residents of this state obtain the correct dosing,
 1266  formulation, route, modality, frequency, quantity, and quality
 1267  of marijuana for specific illnesses.
 1268         (d) An effective medical marijuana research and education
 1269  program would mobilize the scientific, educational, and medical
 1270  resources that presently exist in this state to determine the
 1271  appropriate and best use of marijuana to treat illness.
 1272         (3) DEFINITIONS.—As used in this section, the term:
 1273         (a) “Board” means the Medical Marijuana Research and
 1274  Education Board.
 1275         (b) “Coalition” means the Coalition for Medical Marijuana
 1276  Research and Education.
 1277         (c) “Marijuana”” has the same meaning as provided in s. 29,
 1278  Art. X of the State Constitution.
 1279         (4) COALITION FOR MEDICAL MARIJUANA RESEARCH AND
 1280  EDUCATION.—
 1281         (a) There is established within the H. Lee Moffitt Cancer
 1282  Center and Research Institute, Inc., the Coalition for Medical
 1283  Marijuana Research and Education. The purpose of the coalition
 1284  is to conduct rigorous scientific research, provide education,
 1285  disseminate research, and guide policy for the adoption of a
 1286  statewide policy on ordering and dosing practices for the
 1287  medicinal use of marijuana. The coalition shall be physically
 1288  located at the H. Lee Moffitt Cancer Center and Research
 1289  Institute, Inc.
 1290         (b) The Medical Marijuana Research and Education Board is
 1291  established to direct the operations of the coalition. The board
 1292  shall be composed of seven members appointed by the chief
 1293  executive officer of the H. Lee Moffitt Cancer Center and
 1294  Research Institute, Inc. Board members must have experience in a
 1295  variety of scientific and medical fields, including, but not
 1296  limited to, oncology, neurology, psychology, pediatrics,
 1297  nutrition, and addiction. Members shall be appointed to 4-year
 1298  terms and may be reappointed to serve additional terms. The
 1299  chair shall be elected by the board from among its members to
 1300  serve a 2-year term. The board shall meet no less than
 1301  semiannually, at the call of the chair or, in his or her absence
 1302  or incapacity, the vice chair. Four members constitute a quorum.
 1303  A majority vote of the members present is required for all
 1304  actions of the board. The board may prescribe, amend, and repeal
 1305  a charter governing the manner in which it conducts its
 1306  business. A board member shall serve without compensation but is
 1307  entitled to be reimbursed for travel expenses by the coalition
 1308  or the organization he or she represents in accordance with s.
 1309  112.061.
 1310         (c) The coalition shall be administered by a coalition
 1311  director, who shall be appointed by and serve at the pleasure of
 1312  the board. The coalition director shall, subject to the approval
 1313  of the board:
 1314         1. Propose a budget for the coalition.
 1315         2. Foster the collaboration of scientists, researchers, and
 1316  other appropriate personnel in accordance with the coalition’s
 1317  charter.
 1318         3. Identify and prioritize the research to be conducted by
 1319  the coalition.
 1320         4. Prepare the Medical Marijuana Research and Education
 1321  Plan for submission to the board.
 1322         5. Apply for grants to obtain funding for research
 1323  conducted by the coalition.
 1324         6. Perform other duties as determined by the board.
 1325         (d) The board shall advise the Board of Governors, the
 1326  State Surgeon General, the Governor, and the Legislature with
 1327  respect to medical marijuana research and education in this
 1328  state. The board shall explore methods of implementing and
 1329  enforcing medical marijuana laws in relation to cancer control,
 1330  research, treatment, and education.
 1331         (e) The board shall annually adopt a plan for medical
 1332  marijuana research, known as the “Medical Marijuana Research and
 1333  Education Plan,” which must be in accordance with state law and
 1334  coordinate with existing programs in this state. The plan must
 1335  include recommendations for the coordination and integration of
 1336  medical, nursing, paramedical, community, and other resources
 1337  connected with the treatment of debilitating medical conditions,
 1338  research related to the treatment of such medical conditions,
 1339  and education.
 1340         (f) By February 15 of each year, the board shall issue a
 1341  report to the Governor, the President of the Senate, and the
 1342  Speaker of the House of Representatives on research projects,
 1343  community outreach initiatives, and future plans for the
 1344  coalition.
 1345         (5) RESPONSIBILITIES OF THE H. LEE MOFFITT CANCER CENTER
 1346  AND RESEARCH INSTITUTE, INC.—The H. Lee Moffitt Cancer Center
 1347  and Research Institute, Inc., shall allocate staff and provide
 1348  information and assistance, as the coalition’s budget permits,
 1349  to assist the board in fulfilling its responsibilities.
 1350         Section 3. Paragraph (b) of subsection (3) of section
 1351  381.987, Florida Statutes, is amended to read:
 1352         381.987 Public records exemption for personal identifying
 1353  information in the compassionate use registry.—
 1354         (3) The department shall allow access to the registry,
 1355  including access to confidential and exempt information, to:
 1356         (b) A medical marijuana treatment center registered with
 1357  dispensing organization approved by the department pursuant to
 1358  s. 381.986 which is attempting to verify the authenticity of a
 1359  physician certification physician’s order for marijuana low-THC
 1360  cannabis, including whether the physician certification order
 1361  had been previously filled and whether the physician
 1362  certification order was written for the person attempting to
 1363  have it filled.
 1364         Section 4. Subsection (1) of section 385.211, Florida
 1365  Statutes, is amended to read:
 1366         385.211 Refractory and intractable epilepsy treatment and
 1367  research at recognized medical centers.—
 1368         (1) As used in this section, the term “low-THC cannabis”
 1369  means “low-THC cannabis” as defined in s. 381.986 which that is
 1370  dispensed only from a medical marijuana treatment center
 1371  dispensing organization as defined in s. 381.986.
 1372         Section 5. Present paragraphs (b) and (c) of subsection (2)
 1373  of section 499.0295, Florida Statutes, are redesignated as
 1374  paragraphs (a) and (b), respectively, present paragraphs (a) and
 1375  (c) of that subsection are amended, a new paragraph (c) is added
 1376  to that subsection, and subsection (3) of that section is
 1377  amended, to read:
 1378         499.0295 Experimental treatments for terminal conditions.—
 1379         (2) As used in this section, the term:
 1380         (a) “Dispensing organization” means an organization
 1381  approved by the Department of Health under s. 381.986(5) to
 1382  cultivate, process, transport, and dispense low-THC cannabis,
 1383  medical cannabis, and cannabis delivery devices.
 1384         (b)(c) “Investigational drug, biological product, or
 1385  device” means:
 1386         1. A drug, biological product, or device that has
 1387  successfully completed phase 1 of a clinical trial but has not
 1388  been approved for general use by the United States Food and Drug
 1389  Administration and remains under investigation in a clinical
 1390  trial approved by the United States Food and Drug
 1391  Administration; or
 1392         2. Marijuana Medical cannabis that is manufactured and sold
 1393  by an MMTC a dispensing organization.
 1394         (c) Medical marijuana treatment center” or “MMTC” means an
 1395  organization registered with the Department of Health under s.
 1396  381.986.
 1397         (3) Upon the request of an eligible patient, a manufacturer
 1398  may, or upon the issuance of a physician certification a
 1399  physician’s order pursuant to s. 381.986, an MMTC a dispensing
 1400  organization may:
 1401         (a) Make its investigational drug, biological product, or
 1402  device available under this section.
 1403         (b) Provide an investigational drug, biological product,
 1404  device, or cannabis delivery device as defined in s. 381.986 to
 1405  an eligible patient without receiving compensation.
 1406         (c) Require an eligible patient to pay the costs of, or the
 1407  costs associated with, the manufacture of the investigational
 1408  drug, biological product, device, or cannabis delivery device as
 1409  defined in s. 381.986.
 1410         Section 6. Subsection (1) of section 1004.441, Florida
 1411  Statutes, is amended to read:
 1412         1004.441 Refractory and intractable epilepsy treatment and
 1413  research.—
 1414         (1) As used in this section, the term “low-THC cannabis”
 1415  means “low-THC cannabis” as defined in s. 381.986 which that is
 1416  dispensed only from a medical marijuana treatment center
 1417  dispensing organization as defined in s. 381.986.
 1418         Section 7. The Division of Law Revision and Information is
 1419  directed to replace the phrase “the effective date of this act”
 1420  wherever it occurs in this act with the date the act becomes a
 1421  law.
 1422         Section 8. This act shall take effect upon becoming a law.