Florida Senate - 2016                              CS for SB 460
       
       
        
       By the Committee on Rules; and Senators Bradley, Soto, Sobel,
       and Hutson
       
       595-04427D-16                                          2016460c1
    1                        A bill to be entitled                      
    2         An act relating to the medical use of cannabis;
    3         amending s. 381.986, F.S.; providing and revising
    4         definitions; revising requirements for physicians
    5         ordering low-THC cannabis, medical cannabis, or a
    6         cannabis delivery device; revising the information a
    7         physician must update on the registry; requiring a
    8         physician to update the registry within a specified
    9         timeframe; requiring a physician to obtain certain
   10         written consent; providing that a physician commits a
   11         misdemeanor of the first degree under certain
   12         circumstances; providing that an eligible patient who
   13         uses medical cannabis, and such patient’s legal
   14         representative, who administers medical cannabis in
   15         specified prohibited locations commits a misdemeanor
   16         of the first degree; providing that a physician who
   17         orders low-THC cannabis or medical cannabis and
   18         receives related compensation from a dispensing
   19         organization is subject to disciplinary action;
   20         revising requirements relating to physician education;
   21         providing that the appropriate board must require the
   22         medical director of each dispensing organization to
   23         hold a certain license; revising the information that
   24         the Department of Health is required to include in its
   25         online compassionate use registry; revising
   26         performance bond requirements for certain dispensing
   27         organizations; requiring the department to approve
   28         three dispensing organizations, including specified
   29         applicants, under certain circumstances; providing
   30         requirements for the three dispensing organizations;
   31         requiring the department to allow a dispensing
   32         organization to make certain wholesale purchases from
   33         or distributions to another dispensing organization;
   34         revising standards to be met and maintained by
   35         dispensing organizations; authorizing dispensing
   36         organizations to use certain pesticides after
   37         consultation with the Department of Agriculture and
   38         Consumer Services; providing requirements for
   39         dispensing organizations when they are growing and
   40         processing low-THC cannabis or medical cannabis;
   41         requiring dispensing organizations to inspect seeds
   42         and growing plants for certain pests and perform
   43         certain fumigation and treatment of plants; providing
   44         that dispensing organizations may not dispense low-THC
   45         cannabis and medical cannabis unless they meet certain
   46         testing requirements; requiring dispensing
   47         organizations to maintain certain records; requiring
   48         dispensing organizations to contract with an
   49         independent testing laboratory to perform certain
   50         audits; providing packaging requirements for low-THC
   51         and medical cannabis; requiring dispensing
   52         organizations to retain certain samples for specified
   53         purposes; providing delivery requirements for
   54         dispensing organizations when dispensing low-THC
   55         cannabis and medical cannabis; providing certain
   56         safety and security requirements for dispensing
   57         organizations; providing certain safety and security
   58         requirements for the transport of low-THC cannabis and
   59         medical cannabis; authorizing the department to
   60         conduct certain inspections; providing inspection
   61         requirements; authorizing the department to enter into
   62         certain interagency agreements; requiring the
   63         department to make certain information available on
   64         its website; authorizing the department to establish a
   65         system for issuing and renewing registration cards;
   66         providing requirements for the registration cards;
   67         authorizing the department to impose certain fines;
   68         authorizing the department to suspend, revoke, or
   69         refuse to renew a dispensing organization’s approval
   70         under certain circumstances; requiring the department
   71         to renew the dispensing organization biennially under
   72         certain conditions; providing applicability;
   73         authorizing an approved independent testing laboratory
   74         to possess, test, transport, and lawfully dispose of
   75         low-THC cannabis or medical cannabis by department
   76         rule ; providing that a dispensing organization is
   77         presumed to be registered with the department under
   78         certain circumstances; providing that a person is not
   79         exempt from prosecution for certain offenses and is
   80         not relieved from certain requirements of law under
   81         certain circumstances; amending s. 499.0295, F.S.;
   82         revising definitions; authorizing certain
   83         manufacturers to dispense cannabis delivery devices;
   84         requiring the department to authorize certain
   85         dispensing organizations or applicants to provide low
   86         THC cannabis, medical cannabis, and cannabis delivery
   87         devices to eligible patients; providing for dispensing
   88         organizations or applicants meeting specified criteria
   89         to be granted authorization to cultivate certain
   90         cannabis and operate as dispensing organizations;
   91         requiring the department to grant approval as a
   92         dispensing organization to certain qualified
   93         applicants by a specified date; authorizing two
   94         dispensing organizations in the same region under
   95         certain circumstances; authorizing the Department of
   96         Health to enforce certain rules; providing
   97         applicability; providing an effective date.
   98          
   99  Be It Enacted by the Legislature of the State of Florida:
  100  
  101         Section 1. Section 381.986, Florida Statutes, is amended to
  102  read:
  103         381.986 Compassionate use of low-THC and medical cannabis.—
  104         (1) DEFINITIONS.—As used in this section, the term:
  105         (a)“Cannabis delivery device” means an object used,
  106  intended for use, or designed for use in preparing, storing,
  107  ingesting, inhaling, or otherwise introducing low-THC cannabis
  108  or medical cannabis into the human body.
  109         (b)(a) “Dispensing organization” means an organization
  110  approved by the department to cultivate, process, transport, and
  111  dispense low-THC cannabis or medical cannabis pursuant to this
  112  section.
  113         (c)“Independent testing laboratory” means a laboratory,
  114  including the managers, employees, or contractors of the
  115  laboratory, which has no direct or indirect interest in a
  116  dispensing organization.
  117         (d)“Legal representative” means the qualified patient’s
  118  parent, legal guardian acting pursuant to a court’s
  119  authorization as required under s. 744.3215(4), health care
  120  surrogate acting pursuant to the qualified patient’s written
  121  consent or a court’s authorization as required under s. 765.113,
  122  or an individual who is authorized under a power of attorney to
  123  make health care decisions on behalf of the qualified patient.
  124         (e)(b) “Low-THC cannabis” means a plant of the genus
  125  Cannabis, the dried flowers of which contain 0.8 percent or less
  126  of tetrahydrocannabinol and more than 10 percent of cannabidiol
  127  weight for weight; the seeds thereof; the resin extracted from
  128  any part of such plant; or any compound, manufacture, salt,
  129  derivative, mixture, or preparation of such plant or its seeds
  130  or resin that is dispensed only from a dispensing organization.
  131         (f)“Medical cannabis” means all parts of any plant of the
  132  genus Cannabis, whether growing or not; the seeds thereof; the
  133  resin extracted from any part of the plant; and every compound,
  134  manufacture, sale, derivative, mixture, or preparation of the
  135  plant or its seeds or resin that is dispensed only from a
  136  dispensing organization for medical use by an eligible patient
  137  as defined in s. 499.0295.
  138         (g)(c) “Medical use” means administration of the ordered
  139  amount of low-THC cannabis or medical cannabis. The term does
  140  not include the:
  141         1. Possession, use, or administration of low-THC cannabis
  142  or medical cannabis by smoking.
  143         2.The term also does not include the Transfer of low-THC
  144  cannabis or medical cannabis to a person other than the
  145  qualified patient for whom it was ordered or the qualified
  146  patient’s legal representative on behalf of the qualified
  147  patient.
  148         3.Use or administration of low-THC cannabis or medical
  149  cannabis:
  150         a.On any form of public transportation.
  151         b.In any public place.
  152         c.In a qualified patient’s place of employment, if
  153  restricted by his or her employer.
  154         d.In a state correctional institution as defined in s.
  155  944.02 or a correctional institution as defined in s. 944.241.
  156         e.On the grounds of a preschool, primary school, or
  157  secondary school.
  158         f.On a school bus or in a vehicle, aircraft, or motorboat.
  159         (h)(d) “Qualified patient” means a resident of this state
  160  who has been added to the compassionate use registry by a
  161  physician licensed under chapter 458 or chapter 459 to receive
  162  low-THC cannabis or medical cannabis from a dispensing
  163  organization.
  164         (i)(e) “Smoking” means burning or igniting a substance and
  165  inhaling the smoke. Smoking does not include the use of a
  166  vaporizer.
  167         (2) PHYSICIAN ORDERING.—Effective January 1, 2015, A
  168  physician is authorized to order licensed under chapter 458 or
  169  chapter 459 who has examined and is treating a patient suffering
  170  from cancer or a physical medical condition that chronically
  171  produces symptoms of seizures or severe and persistent muscle
  172  spasms may order for the patient’s medical use low-THC cannabis
  173  to treat a qualified patient suffering from cancer or a physical
  174  medical condition that chronically produces symptoms of seizures
  175  or severe and persistent muscle spasms; order low-THC cannabis
  176  such disease, disorder, or condition or to alleviate symptoms of
  177  such disease, disorder, or condition, if no other satisfactory
  178  alternative treatment options exist for the qualified that
  179  patient; order medical cannabis to treat an eligible patient as
  180  defined in s. 499.0295; or order a cannabis delivery device for
  181  the medical use of low-THC cannabis or medical cannabis, only if
  182  the physician and all of the following conditions apply:
  183         (a)Holds an active, unrestricted license as a physician
  184  under chapter 458 or an osteopathic physician under chapter 459;
  185         (b)Has treated the patient for at least 3 months
  186  immediately preceding the patient’s registration in the
  187  compassionate use registry;
  188         (c)Has successfully completed the course and examination
  189  required under paragraph (4)(a);
  190         (a) The patient is a permanent resident of this state.
  191         (d)(b)Has determined The physician determines that the
  192  risks of treating the patient with ordering low-THC cannabis or
  193  medical cannabis are reasonable in light of the potential
  194  benefit to the for that patient. If a patient is younger than 18
  195  years of age, a second physician must concur with this
  196  determination, and such determination must be documented in the
  197  patient’s medical record;.
  198         (e)(c)The physician Registers as the orderer of low-THC
  199  cannabis or medical cannabis for the named patient on the
  200  compassionate use registry maintained by the department and
  201  updates the registry to reflect the contents of the order,
  202  including the amount of low-THC cannabis or medical cannabis
  203  that will provide the patient with not more than a 45-day supply
  204  and a cannabis delivery device needed by the patient for the
  205  medical use of low-THC cannabis or medical cannabis. The
  206  physician must also update the registry within 7 days after any
  207  change is made to the original order to reflect the change. The
  208  physician shall deactivate the registration of the patient and
  209  the patient’s legal representative patient’s registration when
  210  treatment is discontinued;.
  211         (f)(d)The physician Maintains a patient treatment plan
  212  that includes the dose, route of administration, planned
  213  duration, and monitoring of the patient’s symptoms and other
  214  indicators of tolerance or reaction to the low-THC cannabis or
  215  medical cannabis;.
  216         (g)(e)The physician Submits the patient treatment plan
  217  quarterly to the University of Florida College of Pharmacy for
  218  research on the safety and efficacy of low-THC cannabis and
  219  medical cannabis on patients;.
  220         (h)(f)The physician Obtains the voluntary written informed
  221  consent of the patient or the patient’s legal representative
  222  guardian to treatment with low-THC cannabis after sufficiently
  223  explaining the current state of knowledge in the medical
  224  community of the effectiveness of treatment of the patient’s
  225  condition with low-THC cannabis, the medically acceptable
  226  alternatives, and the potential risks and side effects;
  227         (i)Obtains written informed consent as defined in and
  228  required under s. 499.0295, if the physician is ordering medical
  229  cannabis for an eligible patient pursuant to that section; and
  230         (j)Is not a medical director employed by a dispensing
  231  organization.
  232         (3) PENALTIES.—
  233         (a) A physician commits a misdemeanor of the first degree,
  234  punishable as provided in s. 775.082 or s. 775.083, if the
  235  physician orders low-THC cannabis for a patient without a
  236  reasonable belief that the patient is suffering from:
  237         1. Cancer or a physical medical condition that chronically
  238  produces symptoms of seizures or severe and persistent muscle
  239  spasms that can be treated with low-THC cannabis; or
  240         2. Symptoms of cancer or a physical medical condition that
  241  chronically produces symptoms of seizures or severe and
  242  persistent muscle spasms that can be alleviated with low-THC
  243  cannabis.
  244         (b)A physician commits a misdemeanor of the first degree,
  245  punishable as provided in s. 775.082 or s. 775.083, if the
  246  physician orders medical cannabis for a patient without a
  247  reasonable belief that the patient has a terminal condition as
  248  defined in s. 499.0295.
  249         (c)(b)A Any person who fraudulently represents that he or
  250  she has cancer, or a physical medical condition that chronically
  251  produces symptoms of seizures or severe and persistent muscle
  252  spasms, or a terminal condition to a physician for the purpose
  253  of being ordered low-THC cannabis, medical cannabis, or a
  254  cannabis delivery device by such physician commits a misdemeanor
  255  of the first degree, punishable as provided in s. 775.082 or s.
  256  775.083.
  257         (d)An eligible patient as defined in s. 499.0295 who uses
  258  medical cannabis, and such patient’s legal representative who
  259  administers medical cannabis, in plain view of or in a place
  260  open to the general public, on the grounds of a school, or in a
  261  school bus, vehicle, aircraft, or motorboat, commits a
  262  misdemeanor of the first degree, punishable as provided in s.
  263  775.082 or s. 775.083.
  264         (e)A physician who orders low-THC cannabis, medical
  265  cannabis, or a cannabis delivery device and receives
  266  compensation from a dispensing organization related to the
  267  ordering of low-THC cannabis, medical cannabis, or a cannabis
  268  delivery device is subject to disciplinary action under the
  269  applicable practice act and s. 456.072(1)(n).
  270         (4) PHYSICIAN EDUCATION.—
  271         (a) Before ordering low-THC cannabis, medical cannabis, or
  272  a cannabis delivery device for medical use by a patient in this
  273  state, the appropriate board shall require the ordering
  274  physician licensed under chapter 458 or chapter 459 to
  275  successfully complete an 8-hour course and subsequent
  276  examination offered by the Florida Medical Association or the
  277  Florida Osteopathic Medical Association that encompasses the
  278  clinical indications for the appropriate use of low-THC cannabis
  279  and medical cannabis, the appropriate cannabis delivery devices
  280  mechanisms, the contraindications for such use, and as well as
  281  the relevant state and federal laws governing the ordering,
  282  dispensing, and possessing of these substances and devices this
  283  substance. The first course and examination shall be presented
  284  by October 1, 2014, and shall be administered at least annually
  285  thereafter. Successful completion of the course may be used by a
  286  physician to satisfy 8 hours of the continuing medical education
  287  requirements required by his or her respective board for
  288  licensure renewal. This course may be offered in a distance
  289  learning format.
  290         (b) The appropriate board shall require the medical
  291  director of each dispensing organization to hold an active,
  292  unrestricted license as a physician under chapter 458 or as an
  293  osteopathic physician under chapter 459 and approved under
  294  subsection (5) to successfully complete a 2-hour course and
  295  subsequent examination offered by the Florida Medical
  296  Association or the Florida Osteopathic Medical Association that
  297  encompasses appropriate safety procedures and knowledge of low
  298  THC cannabis, medical cannabis, and cannabis delivery devices.
  299         (c) Successful completion of the course and examination
  300  specified in paragraph (a) is required for every physician who
  301  orders low-THC cannabis, medical cannabis, or a cannabis
  302  delivery device each time such physician renews his or her
  303  license. In addition, successful completion of the course and
  304  examination specified in paragraph (b) is required for the
  305  medical director of each dispensing organization each time such
  306  physician renews his or her license.
  307         (d) A physician who fails to comply with this subsection
  308  and who orders low-THC cannabis, medical cannabis, or a cannabis
  309  delivery device may be subject to disciplinary action under the
  310  applicable practice act and under s. 456.072(1)(k).
  311         (5) DUTIES OF THE DEPARTMENT.—By January 1, 2015, The
  312  department shall:
  313         (a) Create and maintain a secure, electronic, and online
  314  compassionate use registry for the registration of physicians,
  315  and patients, and the legal representatives of patients as
  316  provided under this section. The registry must be accessible to
  317  law enforcement agencies and to a dispensing organization in
  318  order to verify the authorization of a patient or a patient’s
  319  legal representative to possess patient authorization for low
  320  THC cannabis, medical cannabis, or a cannabis delivery device
  321  and record the low-THC cannabis, medical cannabis, or cannabis
  322  delivery device dispensed. The registry must prevent an active
  323  registration of a patient by multiple physicians.
  324         (b) Authorize the establishment of five dispensing
  325  organizations to ensure reasonable statewide accessibility and
  326  availability as necessary for patients registered in the
  327  compassionate use registry and who are ordered low-THC cannabis,
  328  medical cannabis, or a cannabis delivery device under this
  329  section, one in each of the following regions: northwest
  330  Florida, northeast Florida, central Florida, southeast Florida,
  331  and southwest Florida. The department shall develop an
  332  application form and impose an initial application and biennial
  333  renewal fee that is sufficient to cover the costs of
  334  administering this section. An applicant for approval as a
  335  dispensing organization must be able to demonstrate:
  336         1. The technical and technological ability to cultivate and
  337  produce low-THC cannabis. The applicant must possess a valid
  338  certificate of registration issued by the Department of
  339  Agriculture and Consumer Services pursuant to s. 581.131 that is
  340  issued for the cultivation of more than 400,000 plants, be
  341  operated by a nurseryman as defined in s. 581.011, and have been
  342  operated as a registered nursery in this state for at least 30
  343  continuous years.
  344         2. The ability to secure the premises, resources, and
  345  personnel necessary to operate as a dispensing organization.
  346         3. The ability to maintain accountability of all raw
  347  materials, finished products, and any byproducts to prevent
  348  diversion or unlawful access to or possession of these
  349  substances.
  350         4. An infrastructure reasonably located to dispense low-THC
  351  cannabis to registered patients statewide or regionally as
  352  determined by the department.
  353         5. The financial ability to maintain operations for the
  354  duration of the 2-year approval cycle, including the provision
  355  of certified financials to the department. Upon approval, the
  356  applicant must post a $5 million performance bond. However, upon
  357  a dispensing organization’s serving at least 1,000 qualified
  358  patients, the dispensing organization is only required to
  359  maintain a $2 million performance bond.
  360         6. That all owners and managers have been fingerprinted and
  361  have successfully passed a level 2 background screening pursuant
  362  to s. 435.04.
  363         7. The employment of a medical director who is a physician
  364  licensed under chapter 458 or chapter 459 to supervise the
  365  activities of the dispensing organization.
  366         (c)Upon the registration of 250,000 active qualified
  367  patients in the compassionate use registry, approve three
  368  dispensing organizations, including, but not limited to, an
  369  applicant that is a recognized class member of Pigford v.
  370  Glickman, 185 F.R.D. 82 (D.D.C. 1999) or In Re Black Farmers
  371  Litig., 856 F. Supp. 2d 1 (D.D.C. 2011) and a member of the
  372  Black Farmers and Agriculturalists Association, which must meet
  373  the requirements of subparagraphs (b)2.-7. and demonstrate the
  374  technical and technological ability to cultivate and produce
  375  low-THC cannabis.
  376         (d)Allow a dispensing organization to make a wholesale
  377  purchase of low-THC cannabis or medical cannabis from, or a
  378  distribution of low-THC cannabis or medical cannabis to, another
  379  dispensing organization.
  380         (e)(c) Monitor physician registration and ordering of low
  381  THC cannabis, medical cannabis, or a cannabis delivery device
  382  for ordering practices that could facilitate unlawful diversion
  383  or misuse of low-THC cannabis, medical cannabis, or a cannabis
  384  delivery device and take disciplinary action as indicated.
  385         (d) Adopt rules necessary to implement this section.
  386         (6) DISPENSING ORGANIZATION.—An approved dispensing
  387  organization must, at all times, shall maintain compliance with
  388  the criteria demonstrated for selection and approval as a
  389  dispensing organization under subsection (5) and the criteria
  390  required in this subsection at all times.
  391         (a)When growing low-THC cannabis or medical cannabis, a
  392  dispensing organization:
  393         1.May use pesticides determined by the department, after
  394  consultation with the Department of Agriculture and Consumer
  395  Services, to be safely applied to plants intended for human
  396  consumption, but may not use pesticides designated as
  397  restricted-use pesticides pursuant to s. 487.042.
  398         2.Must grow low-THC cannabis or medical cannabis within an
  399  enclosed structure and in a room separate from any other plant.
  400         3.Must inspect seeds and growing plants for plant pests
  401  that endanger or threaten the horticultural and agricultural
  402  interests of the state, notify the Department of Agriculture and
  403  Consumer Services within 10 calendar days after a determination
  404  that a plant is infested or infected by such plant pest, and
  405  implement and maintain phytosanitary policies and procedures.
  406         4.Must perform fumigation or treatment of plants, or the
  407  removal and destruction of infested or infected plants, in
  408  accordance with chapter 581 and any rules adopted thereunder.
  409         (b)When processing low-THC cannabis or medical cannabis, a
  410  dispensing organization must:
  411         1.Process the low-THC cannabis or medical cannabis within
  412  an enclosed structure and in a room separate from other plants
  413  or products.
  414         2.Test the processed low-THC cannabis and medical cannabis
  415  before they are dispensed. Results must be verified and signed
  416  by two dispensing organization employees. Before dispensing low
  417  THC cannabis, the dispensing organization must determine that
  418  the test results indicate that the low-THC cannabis meets the
  419  definition of low-THC cannabis and, for medical cannabis and
  420  low-THC cannabis, that all medical cannabis and low-THC cannabis
  421  is safe for human consumption and free from contaminants that
  422  are unsafe for human consumption. The dispensing organization
  423  must retain records of all testing and samples of each
  424  homogenous batch of cannabis and low-THC cannabis for at least 9
  425  months. The dispensing organization must contract with an
  426  independent testing laboratory to perform audits on the
  427  dispensing organization’s standard operating procedures, testing
  428  records, and samples and provide the results to the department
  429  to confirm that the low-THC cannabis or medical cannabis meets
  430  the requirements of this section and that the medical cannabis
  431  and low-THC cannabis is safe for human consumption.
  432         3.Package the low-THC cannabis or medical cannabis in
  433  compliance with the United States Poison Prevention Packaging
  434  Act of 1970, 15 U.S.C. ss. 1471 et seq.
  435         4.Package the low-THC cannabis or medical cannabis in a
  436  receptacle that has a firmly affixed and legible label stating
  437  the following information:
  438         a.A statement that the low-THC cannabis or medical
  439  cannabis meets the requirements of subparagraph 2.;
  440         b.The name of the dispensing organization from which the
  441  medical cannabis or low-THC cannabis originates; and
  442         c.The batch number and harvest number from which the
  443  medical cannabis or low-THC cannabis originates.
  444         5.Reserve two processed samples from each batch and retain
  445  such samples for at least 9 months for the purpose of testing
  446  pursuant to the audit required under subparagraph 2.
  447         (c)When dispensing low-THC cannabis, medical cannabis, or
  448  a cannabis delivery device, a dispensing organization:
  449         1.May not dispense more than a 45-day supply of low-THC
  450  cannabis or medical cannabis to a patient or the patient’s legal
  451  representative.
  452         2.Must have the dispensing organization’s employee who
  453  dispenses the low-THC cannabis, medical cannabis, or a cannabis
  454  delivery device enter into the compassionate use registry his or
  455  her name or unique employee identifier.
  456         3.Must verify in the compassionate use registry that a
  457  physician has ordered the low-THC cannabis, medical cannabis, or
  458  a specific type of a cannabis delivery device for the patient.
  459         4.May not dispense or sell any other type of cannabis,
  460  alcohol, or illicit drug-related product, including pipes,
  461  bongs, or wrapping papers, other than a physician-ordered
  462  cannabis delivery device required for the medical use of low-THC
  463  cannabis or medical cannabis, while dispensing low-THC cannabis
  464  or medical cannabis.
  465         5.Must Before dispensing low-THC cannabis to a qualified
  466  patient, the dispensing organization shall verify that the
  467  patient has an active registration in the compassionate use
  468  registry, the patient or patient’s legal representative holds a
  469  valid and active registration card, the order presented matches
  470  the order contents as recorded in the registry, and the order
  471  has not already been filled.
  472         6.Must, upon dispensing the low-THC cannabis, medical
  473  cannabis, or cannabis delivery device, the dispensing
  474  organization shall record in the registry the date, time,
  475  quantity, and form of low-THC cannabis or medical cannabis
  476  dispensed and the type of cannabis delivery device dispensed.
  477         (d)To ensure the safety and security of its premises and
  478  any off-site storage facilities, and to maintain adequate
  479  controls against the diversion, theft, and loss of low-THC
  480  cannabis, medical cannabis, or cannabis delivery devices, a
  481  dispensing organization shall:
  482         1.a.Maintain a fully operational security alarm system
  483  that secures all entry points and perimeter windows and is
  484  equipped with motion detectors; pressure switches; and duress,
  485  panic, and hold-up alarms; or
  486         b.Maintain a video surveillance system that records
  487  continuously 24 hours each day and meets at least one of the
  488  following criteria:
  489         (I)Cameras are fixed in a place that allows for the clear
  490  identification of persons and activities in controlled areas of
  491  the premises. Controlled areas include grow rooms, processing
  492  rooms, storage rooms, disposal rooms or areas, and point-of-sale
  493  rooms;
  494         (II)Cameras are fixed in entrances and exits to the
  495  premises, which shall record from both indoor and outdoor, or
  496  ingress and egress, vantage points;
  497         (III)Recorded images must clearly and accurately display
  498  the time and date; or
  499         (IV)Retain video surveillance recordings for a minimum of
  500  45 days or longer upon the request of a law enforcement agency.
  501         2.Ensure that the organization’s outdoor premises have
  502  sufficient lighting from dusk until dawn.
  503         3.Establish and maintain a tracking system approved by the
  504  department that traces the low-THC cannabis or medical cannabis
  505  from seed to sale. The tracking system shall include
  506  notification of key events as determined by the department,
  507  including when cannabis seeds are planted, when cannabis plants
  508  are harvested and destroyed, and when low-THC cannabis or
  509  medical cannabis is transported, sold, stolen, diverted, or
  510  lost.
  511         4.Not dispense from its premises low-THC cannabis, medical
  512  cannabis, or a cannabis delivery device between the hours of 9
  513  p.m. and 7 a.m., but may perform all other operations and
  514  deliver low-THC cannabis and medical cannabis to qualified
  515  patients 24 hours each day.
  516         5.Store low-THC cannabis or medical cannabis in a secured,
  517  locked room or a vault.
  518         6.Require at least two of its employees, or two employees
  519  of a security agency with whom it contracts, to be on the
  520  premises at all times.
  521         7.Require each employee to wear a photo identification
  522  badge at all times while on the premises.
  523         8.Require each visitor to wear a visitor’s pass at all
  524  times while on the premises.
  525         9.Implement an alcohol and drug-free workplace policy.
  526         10.Report to local law enforcement within 24 hours after
  527  it is notified or becomes aware of the theft, diversion, or loss
  528  of low-THC cannabis or medical cannabis.
  529         (e)To ensure the safe transport of low-THC cannabis or
  530  medical cannabis to dispensing organization facilities,
  531  independent testing laboratories, or patients, the dispensing
  532  organization must:
  533         1.Maintain a transportation manifest, which must be
  534  retained for at least 1 year.
  535         2.Ensure only vehicles in good working order are used to
  536  transport low-THC cannabis or medical cannabis.
  537         3.Lock low-THC cannabis or medical cannabis in a separate
  538  compartment or container within the vehicle.
  539         4.Require at least two persons to be in a vehicle
  540  transporting low-THC cannabis or medical cannabis, and require
  541  at least one person to remain in the vehicle while the low-THC
  542  cannabis or medical cannabis is being delivered.
  543         5.Provide specific safety and security training to
  544  employees transporting or delivering low-THC cannabis or medical
  545  cannabis.
  546         (7)DEPARTMENT AUTHORITY AND RESPONSIBILITIES.—
  547         (a)The department may conduct announced or unannounced
  548  inspections of dispensing organizations to determine compliance
  549  with this section or rules adopted pursuant to this section.
  550         (b)The department shall inspect a dispensing organization
  551  upon complaint or notice provided to the department that the
  552  dispensing organization has dispensed low-THC cannabis or
  553  medical cannabis containing any mold, bacteria, or other
  554  contaminant that may cause or has caused an adverse effect to
  555  human health or the environment.
  556         (c)The department shall conduct at least a biennial
  557  inspection of each dispensing organization to evaluate the
  558  dispensing organization’s records, personnel, equipment,
  559  processes, security measures, sanitation practices, and quality
  560  assurance practices.
  561         (d)The department may enter into interagency agreements
  562  with the Department of Agriculture and Consumer Services, the
  563  Department of Business and Professional Regulation, the
  564  Department of Transportation, the Department of Highway Safety
  565  and Motor Vehicles, and the Agency for Health Care
  566  Administration, and such agencies are authorized to enter into
  567  an interagency agreement with the department, to conduct
  568  inspections or perform other responsibilities assigned to the
  569  department under this section.
  570         (e)The department must make a list of all approved
  571  dispensing organizations and qualified ordering physicians and
  572  medical directors publicly available on its website.
  573         (f)The department may establish a system for issuing and
  574  renewing registration cards for patients and their legal
  575  representatives, establish the circumstances under which the
  576  cards may be revoked by or must be returned to the department,
  577  and establish fees to implement such system. The department must
  578  require, at a minimum, the registration cards to:
  579         1.Provide the name, address, and date of birth of the
  580  patient or legal representative.
  581         2.Have a full-face, passport-type, color photograph of the
  582  patient or legal representative taken within the 90 days
  583  immediately preceding registration.
  584         3.Identify whether the cardholder is a patient or legal
  585  representative.
  586         4.List a unique numeric identifier for the patient or
  587  legal representative that is matched to the identifier used for
  588  such person in the department’s compassionate use registry.
  589         5.Provide the expiration date, which shall be 1 year after
  590  the date of the physician’s initial order of low-THC cannabis or
  591  medical cannabis.
  592         6.For the legal representative, provide the name and
  593  unique numeric identifier of the patient that the legal
  594  representative is assisting.
  595         7.Be resistant to counterfeiting or tampering.
  596         (g)The department may impose reasonable fines not to
  597  exceed $10,000 on a dispensing organization for any of the
  598  following violations:
  599         1.Violating this section, s. 499.0295, or department rule.
  600         2.Failing to maintain qualifications for approval.
  601         3.Endangering the health, safety, or security of a
  602  qualified patient.
  603         4.Improperly disclosing personal and confidential
  604  information of the qualified patient.
  605         5.Attempting to procure dispensing organization approval
  606  by bribery, fraudulent misrepresentation, or extortion.
  607         6.Being convicted or found guilty of, or entering a plea
  608  of guilty or nolo contendere to, regardless of adjudication, a
  609  crime in any jurisdiction which directly relates to the business
  610  of a dispensing organization.
  611         7.Making or filing a report or record that the dispensing
  612  organization knows to be false.
  613         8.Willfully failing to maintain a record required by this
  614  section or department rule.
  615         9.Willfully impeding or obstructing an employee or agent
  616  of the department in the furtherance of his or her official
  617  duties.
  618         10.Engaging in fraud or deceit, negligence, incompetence,
  619  or misconduct in the business practices of a dispensing
  620  organization.
  621         11.Making misleading, deceptive, or fraudulent
  622  representations in or related to the business practices of a
  623  dispensing organization.
  624         12.Having a license or the authority to engage in any
  625  regulated profession, occupation, or business that is related to
  626  the business practices of a dispensing organization suspended,
  627  revoked, or otherwise acted against by the licensing authority
  628  of any jurisdiction, including its agencies or subdivisions, for
  629  a violation that would constitute a violation under Florida law.
  630         13.Violating a lawful order of the department or an agency
  631  of the state, or failing to comply with a lawfully issued
  632  subpoena of the department or an agency of the state.
  633         (h)The department may suspend, revoke, or refuse to renew
  634  a dispensing organization’s approval if a dispensing
  635  organization commits any of the violations in paragraph (g).
  636         (i)The department shall renew the approval of a dispensing
  637  organization biennially if the dispensing organization meets the
  638  requirements of this section and pays the biennial renewal fee.
  639         (j)The department may adopt rules necessary to implement
  640  this section.
  641         (8)PREEMPTION.—
  642         (a)All matters regarding the regulation of the cultivation
  643  and processing of medical cannabis or low-THC cannabis by
  644  dispensing organizations are preempted to the state.
  645         (b)A municipality may determine by ordinance the criteria
  646  for the number and location of, and other permitting
  647  requirements that do not conflict with state law or department
  648  rule for, dispensing facilities of dispensing organizations
  649  located within its municipal boundaries. A county may determine
  650  by ordinance the criteria for the number, location, and other
  651  permitting requirements that do not conflict with state law or
  652  department rule for all dispensing facilities of dispensing
  653  organizations located within the unincorporated areas of that
  654  county.
  655         (9)(7) EXCEPTIONS TO OTHER LAWS.—
  656         (a) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
  657  any other provision of law, but subject to the requirements of
  658  this section, a qualified patient and the qualified patient’s
  659  legal representative may purchase and possess for the patient’s
  660  medical use up to the amount of low-THC cannabis or medical
  661  cannabis ordered for the patient, but not more than a 45-day
  662  supply, and a cannabis delivery device ordered for the patient.
  663         (b) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
  664  any other provision of law, but subject to the requirements of
  665  this section, an approved dispensing organization and its
  666  owners, managers, and employees may manufacture, possess, sell,
  667  deliver, distribute, dispense, and lawfully dispose of
  668  reasonable quantities, as established by department rule, of
  669  low-THC cannabis, medical cannabis, or a cannabis delivery
  670  device. For purposes of this subsection, the terms
  671  “manufacture,” “possession,” “deliver,” “distribute,” and
  672  “dispense” have the same meanings as provided in s. 893.02.
  673         (c)Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
  674  any other provision of law, but subject to the requirements of
  675  this section, an approved independent testing laboratory may
  676  possess, test, transport, and lawfully dispose of low-THC
  677  cannabis or medical cannabis as provided by department rule.
  678         (d)(c) An approved dispensing organization and its owners,
  679  managers, and employees are not subject to licensure or
  680  regulation under chapter 465 or chapter 499 for manufacturing,
  681  possessing, selling, delivering, distributing, dispensing, or
  682  lawfully disposing of reasonable quantities, as established by
  683  department rule, of low-THC cannabis, medical cannabis, or a
  684  cannabis delivery device.
  685         (e)An approved dispensing organization that continues to
  686  meet the requirements for approval is presumed to be registered
  687  with the department and to meet the regulations adopted by the
  688  department or its successor agency for the purpose of dispensing
  689  medical cannabis or low-THC cannabis under Florida law.
  690  Additionally, the authority provided to a dispensing
  691  organization in s. 499.0295 does not impair the approval of a
  692  dispensing organization.
  693         (f)This subsection does not exempt a person from
  694  prosecution for a criminal offense related to impairment or
  695  intoxication resulting from the medical use of low-THC cannabis
  696  or medical cannabis or relieve a person from any requirement
  697  under law to submit to a breath, blood, urine, or other test to
  698  detect the presence of a controlled substance.
  699         Section 2. Subsections (2) and (3) of section 499.0295,
  700  Florida Statutes, are amended to read:
  701         499.0295 Experimental treatments for terminal conditions.—
  702         (2) As used in this section, the term:
  703         (a)“Dispensing organization” means an organization
  704  approved by the Department of Health under s. 381.986(5) to
  705  cultivate, process, transport, and dispense low-THC cannabis,
  706  medical cannabis, and cannabis delivery devices.
  707         (b)(a) “Eligible patient” means a person who:
  708         1. Has a terminal condition that is attested to by the
  709  patient’s physician and confirmed by a second independent
  710  evaluation by a board-certified physician in an appropriate
  711  specialty for that condition;
  712         2. Has considered all other treatment options for the
  713  terminal condition currently approved by the United States Food
  714  and Drug Administration;
  715         3. Has given written informed consent for the use of an
  716  investigational drug, biological product, or device; and
  717         4. Has documentation from his or her treating physician
  718  that the patient meets the requirements of this paragraph.
  719         (c)(b) “Investigational drug, biological product, or
  720  device” means:
  721         1. A drug, biological product, or device that has
  722  successfully completed phase 1 of a clinical trial but has not
  723  been approved for general use by the United States Food and Drug
  724  Administration and remains under investigation in a clinical
  725  trial approved by the United States Food and Drug
  726  Administration; or
  727         2.Medical cannabis that is manufactured and sold by a
  728  dispensing organization.
  729         (d)(c) “Terminal condition” means a progressive disease or
  730  medical or surgical condition that causes significant functional
  731  impairment, is not considered by a treating physician to be
  732  reversible even with the administration of available treatment
  733  options currently approved by the United States Food and Drug
  734  Administration, and, without the administration of life
  735  sustaining procedures, will result in death within 1 year after
  736  diagnosis if the condition runs its normal course.
  737         (e)(d) “Written informed consent” means a document that is
  738  signed by a patient, a parent of a minor patient, a court
  739  appointed guardian for a patient, or a health care surrogate
  740  designated by a patient and includes:
  741         1. An explanation of the currently approved products and
  742  treatments for the patient’s terminal condition.
  743         2. An attestation that the patient concurs with his or her
  744  physician in believing that all currently approved products and
  745  treatments are unlikely to prolong the patient’s life.
  746         3. Identification of the specific investigational drug,
  747  biological product, or device that the patient is seeking to
  748  use.
  749         4. A realistic description of the most likely outcomes of
  750  using the investigational drug, biological product, or device.
  751  The description shall include the possibility that new,
  752  unanticipated, different, or worse symptoms might result and
  753  death could be hastened by the proposed treatment. The
  754  description shall be based on the physician’s knowledge of the
  755  proposed treatment for the patient’s terminal condition.
  756         5. A statement that the patient’s health plan or third
  757  party administrator and physician are not obligated to pay for
  758  care or treatment consequent to the use of the investigational
  759  drug, biological product, or device unless required to do so by
  760  law or contract.
  761         6. A statement that the patient’s eligibility for hospice
  762  care may be withdrawn if the patient begins treatment with the
  763  investigational drug, biological product, or device and that
  764  hospice care may be reinstated if the treatment ends and the
  765  patient meets hospice eligibility requirements.
  766         7. A statement that the patient understands he or she is
  767  liable for all expenses consequent to the use of the
  768  investigational drug, biological product, or device and that
  769  liability extends to the patient’s estate, unless a contract
  770  between the patient and the manufacturer of the investigational
  771  drug, biological product, or device states otherwise.
  772         (3) Upon the request of an eligible patient, a manufacturer
  773  may, or upon a physician’s order pursuant to s. 381.986, a
  774  dispensing organization may:
  775         (a) Make its investigational drug, biological product, or
  776  device available under this section.
  777         (b) Provide an investigational drug, biological product, or
  778  device, or cannabis delivery device as defined in s. 381.986 to
  779  an eligible patient without receiving compensation.
  780         (c) Require an eligible patient to pay the costs of, or the
  781  costs associated with, the manufacture of the investigational
  782  drug, biological product, or device, or cannabis delivery device
  783  as defined in s. 381.986.
  784         Section 3. (1)Notwithstanding s. 381.986(5)(b), Florida
  785  Statutes, a dispensing organization that receives notice from
  786  the Department of Health that it is approved as a region’s
  787  dispensing organization, posts a $5 million performance bond in
  788  compliance with rule 64-4.002(5)(e), Florida Administrative
  789  Code, meets the requirements of and requests cultivation
  790  authorization pursuant to rule 64-4.005(2), Florida
  791  Administrative Code, and expends at least $100,000 to fulfill
  792  its legal obligations as a dispensing organization; or any
  793  applicant that received the highest aggregate score through the
  794  department’s evaluation process, notwithstanding any prior
  795  determination by the department that the applicant failed to
  796  meet the requirements of s. 381.986, Florida Statutes, must be
  797  granted cultivation authorization by the department and is
  798  approved to operate as a dispensing organization for the full
  799  term of its original approval and all subsequent renewals
  800  pursuant to s. 381.986, Florida Statutes. Any applicant that
  801  qualifies under this subsection which has not previously been
  802  approved as a dispensing organization by the department must be
  803  given approval as a dispensing organization by the department
  804  within 10 days before the effective date of this act, and within
  805  10 days after receiving such approval must comply with the bond
  806  requirement in rule 64-4.002(5)(e), Florida Administrative Code,
  807  and must comply with all other applicable requirements of rule
  808  64-4, Florida Administrative Code.
  809         (2) If an organization that does not meet the criteria of
  810  subsection (1) receives a final determination from the Division
  811  of Administrative Hearings, the Department of Health, or a court
  812  of competent jurisdiction that it was entitled to be a
  813  dispensing organization under s. 381.986, Florida Statutes, and
  814  applicable rules, such organization and an organization that
  815  meets the criteria of subsection (1) shall both be dispensing
  816  organizations in the same region. During the operations of any
  817  dispensing organization that meets the criteria in this section,
  818  the Department of Health may enforce rule 64-4.005, Florida
  819  Administrative Code, as filed on June 17, 2015.
  820         (3) This section does not apply to s. 381.986 (5)(c),
  821  Florida Statutes.
  822         Section 4. This act shall take effect upon becoming a law.