What really happened last week with the medical cannabidiol bill?

On Sat­ur­day, March 30, the Des Moines Reg­is­ter report­ed that a mem­ber of the Med­ical Cannabid­i­ol Advi­so­ry Com­mit­tee resigned over com­ments made on the floor of the House dur­ing debate on House File 732.

Iowa House mem­bers who vot­ed this week to allow the sale of stronger med­ical mar­i­jua­na prod­ucts said they were fol­low­ing the advice of physi­cians on a state board — even though that board vot­ed unan­i­mous­ly last fall not to rec­om­mend the change.

The House’s action prompt­ed the res­ig­na­tion this week of a physi­cian who serves on the Iowa Med­ical Cannabid­i­ol Advi­so­ry Board.

Des Moines neu­rol­o­gist Wendy Zadeh was among eight board mem­bers who vot­ed in Novem­ber 2018 to main­tain the state’s 3% cap on THC, the chem­i­cal that can make mar­i­jua­na users high.

Med­ical mar­i­jua­na bill allow­ing stronger med­ica­tions con­tra­dicts stance of state’s expert pan­el, Des Moines Reg­is­ter, March 29, 2019.

The arti­cle incor­rect­ly states that HF 732 was draft­ed sole­ly from the input of the advi­so­ry com­mit­tee.  Video of the debate reveals that the advi­so­ry com­mit­tee and “oth­ers” were involved in draft­ing the bill.  Rep­re­sen­ta­tive Klein said the bill was the result of work­ing with mem­bers of the board “and both par­ties,” not sole­ly of input from the board.

House Video (2019–03-26)

In anoth­er exam­ple of inac­cu­rate report­ing, on March 5, WHO TV report­ed that Sen­ate File 256 would remove the THC lim­it that pro­duc­ers can put in each dose of med­ical cannabid­i­ol.  But SF 256 did not remove the 3% cap on THC.  The next day House Study Bill 244 (now HF 732) was intro­duced and vot­ed out of sub­com­mit­tee at 9:30 a.m. the same day it was intro­duced.  HSB 244 (HF 732) actu­al­ly does remove the 3% cap on THC.

In state­ments made on the floor of the House on March 26, Rep­re­sen­ta­tive Klein, the floor man­ag­er of the bill, said the leg­is­la­ture had worked with the Med­ical Cannabid­i­ol Advi­so­ry Board and oth­ers.  Rep­re­sen­ta­tive Klein nev­er said that the advi­so­ry board had rec­om­mend­ed remov­ing the THC cap.  While it’s true the advi­so­ry board did not rec­om­mend remov­ing the cap, it’s hard to imag­ine the board’s role is to object to a pro­pos­al by law mak­ers to remove the cap.  The board’s duties are clear­ly defined in the statute:

The med­ical cannabid­i­ol board may rec­om­mend a statu­to­ry revi­sion to the def­i­n­i­tion of med­ical cannabid­i­ol con­tained in this chap­ter that increas­es the tetrahy­dro­cannabi­nol lev­el to more than three per­cent, how­ev­er, any such rec­om­men­da­tion shall be sub­mit­ted to the gen­er­al assem­bly dur­ing the reg­u­lar ses­sion of the gen­er­al assem­bly fol­low­ing such sub­mis­sion.  The gen­er­al assem­bly shall have the sole author­i­ty to revise the def­i­n­i­tion of med­ical cannabid­i­ol for pur­pos­es of this chap­ter.

Iowa Code §124E.5(6)

The advi­so­ry board has no author­i­ty to rec­om­mend low­er­ing the THC lim­it or to rec­om­mend leav­ing it at 3%.  Law mak­ers may pro­pose some­thing the advi­so­ry board did not rec­om­mend.  The mem­ber who resigned is mis­tak­en to imply Rep­re­sen­ta­tive Klein attrib­uted that rec­om­men­da­tion to the board.  The advi­so­ry com­mit­tee can only rec­om­mend increas­ing the THC lim­it, so it has no author­i­ty to rec­om­mend leav­ing the cap at 3%.  And, the board’s rea­son for not rec­om­mend­ing an increase wasn’t strong.  Accord­ing to the Des Moines Reg­is­ter, board mem­ber Lon­ny Miller, a fam­i­ly physi­cian from Cre­ston, said at the time, “I’d like to get anoth­er year or two under our belts and see how peo­ple respond with the cur­rent THC cap.”

Here is a time line that will fill in some (but, not all) of the miss­ing details.

Decem­ber 18, 2018:

Activ­i­ties of the Med­ical Cannabid­i­ol Board Report – the board rec­om­mend­ed, among oth­er things:

Leav­ing the THC cap on med­ical cannabid­i­ol prod­ucts man­u­fac­tured in Iowa at 3% in Iowa Code §124E.5(6).

Remov­ing felony dis­qual­i­fiers for patients and pri­ma­ry care­givers in Iowa Code §124E.4(1)(f) and Iowa Code §124E.4(3)©.

Adding physi­cian assis­tant or advanced reg­is­tered nurse prac­ti­tion­er to the def­i­n­i­tion of health care prac­ti­tion­er in Iowa Code §124E.2(5).

Feb­ru­ary 12, 2019:

SF 256 was intro­duced by Sen­a­tor Brad Zaun.

Among oth­er things, Sen­a­tor Zaun’s bill:

Left the THC cap at 3%.

Removed felony dis­qual­i­fiers.

Added physi­cian assis­tant and advanced reg­is­tered nurse prac­ti­tion­er to the def­i­n­i­tion of health care prac­ti­tion­er.

Feb­ru­ary 18, 2019:

SF 256 passed out of sub­com­mit­tee at 3:30 p.m. on Feb­ru­ary 18.

Feb­ru­ary 18, 2019:

Radio Iowa report­ed:

House Speak­er Lin­da Upmey­er, the top Repub­li­can in the House, has said law­mak­ers should wait for rec­om­men­da­tions from a state board appoint­ed to over­see Iowa’s med­ical mar­i­jua­na pro­gram, so these expan­sion plans being dis­cussed in the Sen­ate face an uncer­tain future.

Med­ical mar­i­jua­na expan­sion clears Iowa Sen­ate sub­com­mit­tee, Radio Iowa, Feb­ru­ary 18, 2019.

Feb­ru­ary 23, 2019:

Des Moines Reg­is­ter report­ed that 78% of Iowans want the med­ical mar­i­jua­na pro­gram expand­ed:

House Speak­er Lin­da Upmeyer’s spokesman said recent­ly that she con­tin­ues to doubt the need for leg­is­la­tors to loosen restric­tions on which Iowans can pur­chase the med­ica­tions.  She would pre­fer that any such moves come from a board of physi­cians that was appoint­ed last year to con­sid­er pro­pos­als.

Iowa Poll: 78% want med­ical mar­i­jua­na pro­gram expand­ed, 48% would allow recre­ation­al pot, Des Moines Reg­is­ter, Feb­ru­ary 23, 2019.

Feb­ru­ary 26, 2019:

Cedar Rapids Gazette report­ed:

“There are things that can be done, things we will do, that make it a lit­tle eas­i­er, a lit­tle safer and give the board a lit­tle more lat­i­tude,” House Speak­er Lin­da Upmey­er, R‑Clear Lake, said Tues­day after meet­ing with mem­bers of the Med­ical Cannabid­i­ol Board.

House speak­er eyes more cannabid­i­ol access for Iowans, Cedar Rapids Gazette, Feb­ru­ary 26, 2019.

March 5, 2019:

Sen­ate File 501 passed out of com­mit­tee (for­mer­ly SF 256 — with an amend­ment on exemp­tion from fed­er­al reg­u­la­tion added that same day by a vote of 14–1)

https://www.legis.iowa.gov/committees/meetings/minutes?meetingID=29248

March 5, 2019:

WHO TV report­ed (incor­rect­ly):

The bill would remove the lim­it of THC that pro­duc­ers can put in each dose, allow for more dis­pen­saries in the state, and man­date Iowa’s Med­ical Cannabid­i­ol Board to include PTSD on the list of qual­i­fy­ing con­di­tions.

Med­ical Mar­i­jua­na Expan­sion, E‑Verify Man­date Bills Both Advance Through Fun­nel Week, WHO TV 13, March 5, 2019.

March 6, 2019:

HSB 244 intro­duced by Com­mit­tee on Pub­lic Safe­ty Chair­per­son Rep­re­sen­ta­tive Jarad Klein.  Odd­ly, Rep­re­sen­ta­tive Klein’s bill actu­al­ly does remove the lim­it on THC that WHO TV incor­rect­ly report­ed was in the Sen­ate bill a day ear­li­er.

March 6, 2019:

HSB 244 passed out of sub­com­mit­tee at 9:30 a.m. on the same day it was intro­duced.

March 7, 2019:

HF 732 passed out of com­mit­tee (for­mer­ly HSB 244) by a vote of 21–0.

March 26, 2019:

HF 732 passed in the House by a vote of 96–3.

Rep­re­sen­ta­tive Klein’s bill rec­om­mend­ed remov­ing the lim­it on THC, which the advi­so­ry board did not rec­om­mend.  But Rep­re­sen­ta­tive Klein said the advi­so­ry board and “oth­ers” were includ­ed in prepa­ra­tion of the leg­isla­tive pro­pos­al.  The advi­so­ry board was nev­er giv­en author­i­ty to write leg­is­la­tion.  A good anal­o­gy would be the rec­om­men­da­tion of the phar­ma­cy board in 2010 to remove mar­i­jua­na from state sched­ule 1, which the leg­is­la­ture still hasn’t done.  Chap­ter 124E autho­rizes the advi­so­ry board to rec­om­mend increas­ing the THC lim­it, but not to rec­om­mend low­er­ing it or even keep­ing it at 3%.

Until Feb­ru­ary 26, Speak­er Upmey­er had been say­ing there would be no changes this year which did not leave Chair­man Klein a lot of time to run a bill a week before the fun­nel dead­line.

The Sen­ate start­ed work­ing ear­li­er and gave peo­ple more time to par­tic­i­pate.

Rep­re­sen­ta­tive Klein deserves an award for work extreme­ly well done in a short amount of time and under extreme pres­sure.  HF 732 has been referred to the Sen­ate Judi­cia­ry Com­mit­tee where it will receive fur­ther con­sid­er­a­tion.