Florida Senate - 2017                              CS for SB 406
       
       
        
       By the Committee on Health Policy; and Senators Bradley, Young,
       and Hutson
       
       
       
       
       588-03368A-17                                          2017406c1
    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; revising the entities to which the
   41         compassionate use registry must be accessible;
   42         requiring the department to adopt certain rules by a
   43         specified date; authorizing the department to charge a
   44         fee for identification cards; requiring the department
   45         to begin issuing identification cards to qualified
   46         registrants by a specific date; providing requirements
   47         for the identification cards; requiring the department
   48         to register certain dispensing organizations as
   49         medical marijuana treatment centers by a certain date;
   50         requiring the department to register additional
   51         medical marijuana treatment centers in accordance with
   52         a specified schedule; deleting obsolete provisions;
   53         revising the operational requirements for medical
   54         marijuana treatment centers; authorizing the
   55         department to waive certain requirements under
   56         specified circumstances; requiring that certain
   57         receptacles be childproof; requiring that additional
   58         information be included on certain labels; requiring
   59         that a medical marijuana treatment center comply with
   60         certain standards in the production and dispensing of
   61         edible or food products; requiring a medical marijuana
   62         treatment center to enter additional information into
   63         the compassionate use registry; requiring a medical
   64         marijuana treatment center to keep a copy of a
   65         transportation manifest in certain vehicles at certain
   66         times; requiring the department to establish a quality
   67         control program that requires medical marijuana
   68         treatment centers to submit samples from each batch or
   69         lot of marijuana to an independent testing laboratory;
   70         requiring a medical marijuana treatment center to
   71         maintain records of all tests conducted; requiring the
   72         department to adopt rules to create and oversee the
   73         quality control program; providing that the department
   74         must license independent testing laboratories;
   75         authorizing an independent testing laboratory to
   76         collect and accept samples of, possess, store,
   77         transport, and test marijuana; prohibiting a person
   78         with an ownership interest in a medical marijuana
   79         treatment center from owning an independent testing
   80         laboratory; requiring the department to develop rules
   81         and a process for licensing requirements; authorizing
   82         the department to impose application and renewal fees;
   83         specifying that an independent testing laboratory must
   84         be certified to perform required tests; requiring the
   85         department to suspend or reduce any mandatory testing
   86         if the number of licensed and certified independent
   87         testing laboratories is insufficient to process the
   88         tests necessary to meet the patient demand for medical
   89         marijuana treatment centers; providing that an
   90         independent testing laboratory may only accept certain
   91         samples; requiring the department to adopt rules
   92         related to ownership changes or changes in an owner’s
   93         investment interest; requiring the department to
   94         establish, maintain, and control a seed-to-sale
   95         tracking system for marijuana; providing
   96         applicability; conforming provisions to changes made
   97         by the act; providing that certain research
   98         institutions may possess, test, transport, and dispose
   99         of marijuana subject to certain conditions and as
  100         provided by department rule; providing for the use of
  101         emergency rulemaking procedures by the department;
  102         creating s. 1004.4351, F.S.; providing a short title;
  103         providing legislative findings; defining terms;
  104         establishing the Coalition for Medical Marijuana
  105         Research and Education within the H. Lee Moffitt
  106         Cancer Center and Research Institute, Inc.; providing
  107         a purpose for the coalition; establishing the Medical
  108         Marijuana Research and Education Board to direct the
  109         operations of the coalition; providing for the
  110         appointment of board members; providing for terms of
  111         office, reimbursement for certain expenses, and the
  112         conduct of meetings of the board; authorizing the
  113         board to appoint a coalition director; prescribing the
  114         duties of the coalition director; requiring the board
  115         to advise specified entities and officials regarding
  116         medical marijuana research and education in this
  117         state; requiring the board to annually adopt a Medical
  118         Marijuana Research and Education Plan; providing
  119         requirements for the plan; requiring the board to
  120         issue an annual report to the Governor and the
  121         Legislature by a specified date; specifying
  122         responsibilities of the H. Lee Moffitt Cancer Center
  123         and Research Institute, Inc.; amending ss. 381.987,
  124         385.211, 499.0295, and 1004.441, F.S.; conforming
  125         provisions to changes made by the act; providing a
  126         directive to the Division of Law Revision and
  127         Information; providing an effective date.
  128          
  129  Be It Enacted by the Legislature of the State of Florida:
  130  
  131         Section 1. Section 381.986, Florida Statutes, is amended to
  132  read:
  133         381.986 Compassionate use of low-THC and medical cannabis
  134  and marijuana.—
  135         (1) LEGISLATIVE INTENT.—
  136         (a) It is the intent of the Legislature to implement s. 29,
  137  Art. X of the State Constitution by creating a unified
  138  regulatory structure within the framework of this section for
  139  the acquisition, cultivation, possession, processing, transfer,
  140  transportation, sale, distribution, and dispensing of marijuana,
  141  products containing marijuana, related supplies, and educational
  142  materials to qualifying patients or their caregivers.
  143         (b) The Legislature intends that all rules adopted by the
  144  Department of Health to implement this section be adopted
  145  pursuant to s. 120.536(1) or s. 120.54. The Legislature intends
  146  that the department use emergency rulemaking procedures pursuant
  147  to s. 120.54(4) to adopt rules under this section if necessary
  148  to meet any deadline for rulemaking established in s. 29, Art. X
  149  of the State Constitution.
  150         (c) Further, the Legislature intends that all registrations
  151  for the purposes specified in paragraph (a) be issued solely in
  152  accordance with the requirements of this section and all rules
  153  adopted under this section.
  154         (2) DEFINITIONS.—As used in this section, the term:
  155         (a) “Cannabis delivery device” means an object used,
  156  intended for use, or designed for use in preparing, storing,
  157  ingesting, inhaling, or otherwise introducing marijuana low-THC
  158  cannabis or medical cannabis into the human body.
  159         (b)“Caregiver” has the same meaning as provided in s. 29,
  160  Art. X of the State Constitution.
  161         (c)“Chronic nonmalignant pain” means pain that is caused
  162  by a debilitating medical condition or that originates from a
  163  debilitating medical condition and persists beyond the usual
  164  course of that debilitating medical condition.
  165         (d)“Close relative” means a spouse, parent, sibling,
  166  grandparent, child, or grandchild, whether related by whole or
  167  half blood, by marriage, or by adoption.
  168         (e)(b)Debilitating medical condition” has the same
  169  meaning as provided in s. 29, Art. X of the State Constitution
  170  Dispensing organization means an organization approved by the
  171  department to cultivate, process, transport, and dispense low
  172  THC cannabis or medical cannabis pursuant to this section.
  173         (f)(c) “Independent testing laboratory” means a laboratory,
  174  including the managers, employees, or contractors of the
  175  laboratory, which has no direct or indirect interest in a
  176  medical marijuana treatment center a dispensing organization.
  177         (g)(d) “Legal representative” means the qualifying
  178  qualified patient’s parent, legal guardian acting pursuant to a
  179  court’s authorization as required under s. 744.3215(4), health
  180  care surrogate acting pursuant to the qualifying qualified
  181  patient’s written consent or a court’s authorization as required
  182  under s. 765.113, or an individual who is authorized under a
  183  power of attorney to make health care decisions on behalf of the
  184  qualifying qualified patient.
  185         (h)(e) “Low-THC cannabis” means a plant of the genus
  186  Cannabis, the dried flowers of which contain 0.8 percent or less
  187  of tetrahydrocannabinol and more than 10 percent of cannabidiol
  188  weight for weight; the seeds thereof; the resin extracted from
  189  any part of such plant; or any compound, manufacture, salt,
  190  derivative, mixture, or preparation of such plant or its seeds
  191  or resin that is dispensed only by a medical marijuana treatment
  192  center from a dispensing organization.
  193         (i)(f)Marijuana” has the same meaning as provided in s.
  194  29, Art. X of the State Constitution Medical cannabis means
  195  all parts of any plant of the genus Cannabis, whether growing or
  196  not; the seeds thereof; the resin extracted from any part of the
  197  plant; and every compound, manufacture, sale, derivative,
  198  mixture, or preparation of the plant or its seeds or resin that
  199  is dispensed only from a dispensing organization for medical use
  200  by an eligible patient as defined in s. 499.0295.
  201         (j)“Medical marijuana treatment center” or “MMTC” has the
  202  same meaning as provided in s. 29, Art. X of the State
  203  Constitution.
  204         (k)(g) “Medical use” has the same meaning as provided in s.
  205  29, Art. X of the State Constitution means administration of the
  206  ordered amount of low-THC cannabis or medical cannabis. The term
  207  does not include the:
  208         1. Possession, use, or administration of marijuana low-THC
  209  cannabis or medical cannabis by smoking.
  210         2.Possession, use, or administration of marijuana that was
  211  not purchased or acquired from an MMTC registered with the
  212  Department of Health.
  213         3.2. Transfer of marijuana low-THC cannabis or medical
  214  cannabis to a person other than the qualifying qualified patient
  215  for whom it was ordered or the qualifying qualified patient’s
  216  caregiver legal representative on behalf of the qualifying
  217  qualified patient.
  218         4.Use or administration of any type or amount of marijuana
  219  not specified on the qualifying patient’s physician
  220  certification.
  221         5.3. Use or administration of marijuana low-THC cannabis or
  222  medical cannabis:
  223         a. On any form of public transportation.
  224         b. In any public place.
  225         c. In a qualifying qualified patient’s place of employment,
  226  if restricted by his or her employer.
  227         d. In a state correctional institution as defined in s.
  228  944.02 or a correctional institution as defined in s. 944.241.
  229         e. On the grounds of a preschool, primary school, or
  230  secondary school.
  231         f. On a school bus or in a vehicle, aircraft, or motorboat.
  232         (l)(h) “Qualifying Qualified patient” has the same meaning
  233  as provided in s. 29, Art. X of the State Constitution but also
  234  includes eligible patients, as that term is defined in s.
  235  499.0295, and patients who are issued a physician certification
  236  under subparagraph (3)(a)2. or subparagraph (3)(a)3. A patient
  237  is not a qualifying patient unless he or she is registered with
  238  the department and has been issued a compassionate use registry
  239  identification card means a resident of this state who has been
  240  added to the compassionate use registry by a physician licensed
  241  under chapter 458 or chapter 459 to receive low-THC cannabis or
  242  medical cannabis from a dispensing organization.
  243         (m)(i) “Smoking” means burning or igniting a substance and
  244  inhaling the smoke. Smoking does not include the use of a
  245  vaporizer.
  246         (3)(2) PHYSICIAN CERTIFICATION ORDERING.—
  247         (a) A physician is authorized to issue a physician
  248  certification to:
  249         1.A patient suffering from a debilitating medical
  250  condition, which allows the patient to receive marijuana for the
  251  patient’s medical use;
  252         2.A order low-THC cannabis to treat a qualified patient
  253  suffering from cancer or a physical medical condition that
  254  chronically produces symptoms of seizures or severe and
  255  persistent muscle spasms, which allows the patient to receive
  256  low-THC cannabis for the patient’s medical use;
  257         3.A patient suffering from chronic nonmalignant pain, if
  258  the physician has diagnosed an underlying debilitating medical
  259  condition as the cause of the pain, which allows the patient to
  260  receive marijuana for the patient’s medical use order low-THC
  261  cannabis to alleviate the patient’s pain symptoms of such
  262  disease, disorder, or condition, if no other satisfactory
  263  alternative treatment options exist for the qualified patient;
  264         4.order medical cannabis to treat An eligible patient as
  265  defined in s. 499.0295, which allows the patient to receive
  266  marijuana for the patient’s medical use; or
  267         5.A patient who is not a resident of this state; who
  268  qualifies under subparagraph 1., subparagraph 2., subparagraph
  269  3., or subparagraph 4.; and who can lawfully obtain marijuana
  270  through a medical marijuana program in the state that he or she
  271  resides in.
  272         (b) In the physician certification, the physician may also
  273  specify one or more or order a cannabis delivery devices to
  274  assist with device for the patient’s medical use of marijuana.
  275  low-THC cannabis or medical cannabis,
  276         (c)A physician may certify a patient and specify a
  277  delivery device under paragraphs (a) and (b) only if the
  278  physician:
  279         1.(a) Holds an active, unrestricted license as a physician
  280  under chapter 458 or an osteopathic physician under chapter 459;
  281         (b) Has treated the patient for at least 3 months
  282  immediately preceding the patient’s registration in the
  283  compassionate use registry;
  284         2.(c) Has successfully completed the course and examination
  285  required under paragraph (5)(a) (4)(a);
  286         3.Has conducted a physical examination and made a full
  287  assessment of the medical history of the patient;
  288         4.Has determined that, in the physician’s professional
  289  opinion, the patient meets one or more of the criteria specified
  290  in paragraph (a);
  291         5.(d) Has determined that the medical use of marijuana
  292  would likely outweigh the potential health risks to of treating
  293  the patient with low-THC cannabis or medical cannabis are
  294  reasonable in light of the potential benefit to the patient. If
  295  a patient is younger than 18 years of age:,
  296         a. A second physician must concur with this determination,
  297  and such determination must be documented in the patient’s
  298  medical record;
  299         b. Only a parent, legal guardian, caregiver, or health care
  300  provider may assist the qualifying patient in the purchasing and
  301  administering of marijuana for medical use; and
  302         c. The qualifying patient may not purchase marijuana;
  303         6.(e) Registers as the patient’s physician orderer of low
  304  THC cannabis or medical cannabis for the named patient on the
  305  compassionate use registry maintained by the department and
  306  updates the registry to reflect the contents of the order,
  307  including the amount of marijuana low-THC cannabis or medical
  308  cannabis that will provide the patient with not more than a 90
  309  day 45-day supply and a cannabis delivery device needed by the
  310  patient for the medical use of marijuana low-THC cannabis or
  311  medical cannabis. A physician may certify an amount greater than
  312  a 90-day supply of marijuana if the physician has a reasonable
  313  belief that the patient will use the additional marijuana in a
  314  medically appropriate way. If the physician’s recommended amount
  315  of marijuana for a 90-day supply changes, the physician must
  316  also update the registry within 7 days after the any change is
  317  made to the original order to reflect the change. The physician
  318  shall deactivate the registration of the patient and the
  319  patient’s legal representative when the physician no longer
  320  recommends the medical use of marijuana for the patient
  321  treatment is discontinued;
  322         7.(f) Maintains a patient treatment plan that includes the
  323  dose, route of administration, planned duration, and monitoring
  324  of the patient’s symptoms and other indicators of tolerance or
  325  reaction to the marijuana low-THC cannabis or medical cannabis;
  326         8.(g) Submits the patient treatment plan quarterly to the
  327  University of Florida College of Pharmacy for research on the
  328  safety and efficacy of marijuana low-THC cannabis and medical
  329  cannabis on patients; and
  330         9.(h) Obtains the voluntary written informed consent of the
  331  patient or the patient’s legal representative to treatment with
  332  marijuana low-THC cannabis after sufficiently explaining the
  333  current state of knowledge in the medical community of the
  334  effectiveness of treatment of the patient’s condition with
  335  marijuana low-THC cannabis, the medically acceptable
  336  alternatives, and the potential risks and side effects. If the
  337  patient is a minor, the patient’s parent or legal guardian must
  338  consent to treatment in writing. If the patient is an eligible
  339  patient as defined in s. 499.0295, the physician must obtain
  340  written informed consent as defined in and required by s.
  341  499.0295.;
  342         (d)At least annually, a physician must recertify the
  343  qualifying patient pursuant to paragraph (c).
  344         (i)Obtains written informed consent as defined in and
  345  required under s. 499.0295, if the physician is ordering medical
  346  cannabis for an eligible patient pursuant to that section; and
  347         (e)(j)A physician may not issue a physician certification
  348  if the physician is not a medical director employed by an MMTC a
  349  dispensing organization.
  350         (f) An order for low-THC cannabis or medical cannabis
  351  issued pursuant to former s. 381.986, Florida Statutes 2016, and
  352  registered with the compassionate use registry on the effective
  353  date of this act, shall be considered a physician certification
  354  issued pursuant to this subsection. The details and expiration
  355  date of such certification must be identical to the details and
  356  expiration date of the order as logged in the compassionate use
  357  registry. Until the department begins issuing compassionate use
  358  registry identification cards, all patients with such orders
  359  shall be considered qualifying patients, notwithstanding the
  360  requirement that a qualifying patient have a compassionate use
  361  registry identification card.
  362         (4)(3)PROHIBITED ACTS PENALTIES.—
  363         (a) A physician commits a misdemeanor of the first degree,
  364  punishable as provided in s. 775.082 or s. 775.083, if the
  365  physician issues a physician certification for marijuana to
  366  orders low-THC cannabis for a patient in a manner other than as
  367  required in subsection (3) without a reasonable belief that the
  368  patient is suffering from:
  369         1. Cancer or A physical medical condition that chronically
  370  produces symptoms of seizures or severe and persistent muscle
  371  spasms that can be treated with low-THC cannabis; or
  372         2. Symptoms of cancer or a physical medical condition that
  373  chronically produces symptoms of seizures or severe and
  374  persistent muscle spasms that can be alleviated with low-THC
  375  cannabis.
  376         (b) A physician commits a misdemeanor of the first degree,
  377  punishable as provided in s. 775.082 or s. 775.083, if the
  378  physician orders medical cannabis for a patient without a
  379  reasonable belief that the patient has a terminal condition as
  380  defined in s. 499.0295.
  381         (b)(c) A person who fraudulently represents that he or she
  382  has a debilitating medical condition cancer, a physical medical
  383  condition that chronically produces symptoms of seizures or
  384  severe and persistent muscle spasms, chronic nonmalignant pain,
  385  or a terminal condition as defined in s. 499.0295 to a physician
  386  for the purpose of being issued a physician certification for
  387  marijuana ordered low-THC cannabis, medical cannabis, or a
  388  cannabis delivery device by such physician commits a misdemeanor
  389  of the first degree, punishable as provided in s. 775.082 or s.
  390  775.083.
  391         (c)(d)A qualifying patient an eligible patient as defined
  392  in s. 499.0295 who uses marijuana medical cannabis, and such
  393  patient’s caregiver legal representative who administers
  394  marijuana medical cannabis, in plain view of or in a place open
  395  to the general public, on the grounds of a school, or in a
  396  school bus, vehicle, aircraft, or motorboat, commits a
  397  misdemeanor of the first degree, punishable as provided in s.
  398  775.082 or s. 775.083.
  399         (d)A qualifying patient or caregiver who cultivates
  400  marijuana or who purchases or acquires marijuana from any person
  401  or entity other than an MMTC commits a misdemeanor of the first
  402  degree, punishable as provided in s. 775.082 or s. 775.083.
  403         (e)A caregiver who violates any of the applicable
  404  provisions of this section or applicable department rules
  405  commits, upon the first offense, a misdemeanor of the second
  406  degree, punishable as provided in s. 775.082 or s. 775.083, and,
  407  upon the second and subsequent offenses, a misdemeanor of the
  408  first degree, punishable as provided in s. 775.082 or s.
  409  775.083.
  410         (f)(e) A physician who issues a physician certification for
  411  marijuana orders low-THC cannabis, medical cannabis, or a
  412  cannabis delivery device and receives compensation from an MMTC
  413  a dispensing organization related to issuing the physician
  414  certification for marijuana the ordering of low-THC cannabis,
  415  medical cannabis, or a cannabis delivery device is subject to
  416  disciplinary action under the applicable practice act and s.
  417  456.072(1)(n).
  418         (g) An MMTC that advertises or holds out to the public that
  419  it may provide services other than services for which it is
  420  registered to provide violates this section, and the department
  421  may impose a fine on the MMTC pursuant to paragraph (10)(h).
  422         (h) A person or entity that offers or advertises services
  423  as an MMTC without registering as an MMTC with the department
  424  violates this section. The operation or maintenance of a
  425  facility as an MMTC, or the performance of a service that
  426  requires registration, without proper registration is a
  427  violation of this section.
  428         1. If after receiving notification from the department,
  429  such person or entity fails to cease operation, the department
  430  may impose an administrative fine of up to $10,000 per
  431  violation. Each day of continued operation is a separate
  432  offense.
  433         2. The department or any state attorney may, in addition to
  434  other remedies provided in this section, bring an action for an
  435  injunction to restrain any unauthorized activity or to enjoin
  436  the future operation or maintenance of the unauthorized
  437  dispensing organization or entity or the performance of any
  438  service in violation of this section until compliance with this
  439  section and department rules has been demonstrated to the
  440  satisfaction of the department.
  441         3. If found to be in violation of this paragraph, the
  442  department may assess reasonable investigative and legal costs
  443  for prosecution of the violation against the person or entity.
  444         (5)(4) PHYSICIAN EDUCATION.—
  445         (a) Before a physician may issue a physician certification
  446  pursuant to subsection (3) ordering low-THC cannabis, medical
  447  cannabis, or a cannabis delivery device for medical use by a
  448  patient in this state, the appropriate board shall require the
  449  ordering physician to successfully complete a 4-hour an 8-hour
  450  course and subsequent examination offered by the Florida Medical
  451  Association or the Florida Osteopathic Medical Association which
  452  that encompasses the clinical indications for the appropriate
  453  use of marijuana low-THC cannabis and medical cannabis, the
  454  appropriate cannabis delivery devices, the contraindications for
  455  such use, and the relevant state and federal laws governing the
  456  issuance of physician certifications ordering, as well as
  457  dispensing, and possessing of these substances and devices. The
  458  course and examination shall be administered at least quarterly
  459  annually. Successful completion of the course may be used by a
  460  physician to satisfy 4 hours 8 hours of the continuing medical
  461  education requirements required by his or her respective board
  462  for licensure renewal. This course may be offered in a distance
  463  learning format, including an electronic, online format that is
  464  available on request. Physicians who have completed an 8-hour
  465  course and subsequent examination offered by the Florida Medical
  466  Association or the Florida Osteopathic Medical Association which
  467  encompasses the clinical indications for the appropriate use of
  468  marijuana and who are registered in the compassionate use
  469  registry on the effective date of this act are deemed to meet
  470  the requirements of this paragraph.
  471         (b) The appropriate board shall require the medical
  472  director of each MMTC dispensing organization to hold an active,
  473  unrestricted license as a physician under chapter 458 or as an
  474  osteopathic physician under chapter 459 and successfully
  475  complete a 2-hour course and subsequent examination offered by
  476  the Florida Medical Association or the Florida Osteopathic
  477  Medical Association which that encompasses appropriate safety
  478  procedures and knowledge of marijuana low-THC cannabis, medical
  479  cannabis, and cannabis delivery devices.
  480         (c) Successful completion of the course and examination
  481  specified in paragraph (a) is required for every physician who
  482  orders low-THC cannabis, medical cannabis, or a cannabis
  483  delivery device each time such physician renews his or her
  484  license. In addition, successful completion of the course and
  485  examination specified in paragraph (b) is required for the
  486  medical director of each dispensing organization each time such
  487  physician renews his or her license.
  488         (c)(d) A physician who fails to comply with this subsection
  489  and issues a physician certification for marijuana who orders
  490  low-THC cannabis, medical cannabis, or a cannabis delivery
  491  device may be subject to disciplinary action under the
  492  applicable practice act and under s. 456.072(1)(k).
  493         (6) CAREGIVERS.—
  494         (a)During the course of registration with the department
  495  for inclusion on the compassionate use registry, or at any time
  496  while registered, a qualifying patient may designate an
  497  individual as his or her caregiver to assist him or her with the
  498  medical use of marijuana. The designated caregiver must be 21
  499  years of age or older, unless the patient is a close relative of
  500  the caregiver; must agree in writing to be the qualifying
  501  patient’s caregiver; may not receive compensation, other than
  502  actual expenses incurred, for assisting the qualifying patient
  503  with the medical use of marijuana, unless the caregiver is
  504  acting pursuant to employment in a licensed facility in
  505  accordance with subparagraph (c)2.; and must pass a level 2
  506  screening pursuant to chapter 435, unless the patient is a close
  507  relative of the caregiver.
  508         (b)A qualifying patient may have only one designated
  509  caregiver at any given time unless all of the patient’s
  510  caregivers are his or her close relatives or legal
  511  representatives.
  512         (c)A caregiver may assist only one qualifying patient at
  513  any given time unless:
  514         1.All qualifying patients the caregiver is assisting are
  515  close relatives of each other and the caregiver is the legal
  516  representative of at least one of the patients; or
  517         2.All qualifying patients the caregiver is assisting are
  518  receiving hospice services, or are residents, in the same
  519  assisted living facility, nursing home, or other licensed
  520  facility and have requested the assistance of that caregiver
  521  with the medical use of marijuana; the caregiver is an employee
  522  of the hospice or licensed facility; and the caregiver provides
  523  personal care or services directly to clients of the hospice or
  524  licensed facility as a part of his or her employment duties at
  525  the hospice or licensed facility.
  526         (d)The department must register a caregiver on the
  527  compassionate use registry and issue him or her a caregiver
  528  identification card if he or she is designated by a qualifying
  529  patient pursuant to paragraph (a) and meets all of the
  530  requirements of this subsection and department rule.
  531         (7)(5) DUTIES OF THE DEPARTMENT.—The department shall:
  532         (a) Create and maintain a secure, electronic, and online
  533  compassionate use registry for the registration of physicians,
  534  patients, and caregivers the legal representatives of patients
  535  as provided under this section. The registry must be accessible
  536  to:
  537         1.Practitioners licensed under chapter 458 or chapter 459,
  538  to ensure proper care for patients requesting physician
  539  certifications;
  540         2.Practitioners licensed to prescribe prescription drugs,
  541  to ensure proper care for patients before prescribing
  542  medications that may interact with the medical use of marijuana;
  543         3. Law enforcement agencies, to verify the authorization of
  544  a qualifying patient or a patient’s caregiver to possess
  545  marijuana or a cannabis delivery device; and
  546         4.MMTCs, to a dispensing organization to verify the
  547  authorization of a qualifying patient or a patient’s caregiver
  548  legal representative to possess marijuana low-THC cannabis,
  549  medical cannabis, or a cannabis delivery device and to record
  550  the marijuana low-THC cannabis, medical cannabis, or cannabis
  551  delivery device dispensed.
  552  
  553  The registry must prevent an active registration of a patient by
  554  multiple physicians.
  555         (b) By July 3, 2017, adopt rules establishing procedures
  556  for the issuance, annual renewal, suspension, and revocation of
  557  compassionate use registry identification cards for patients and
  558  caregivers. The department may charge a reasonable fee
  559  associated with the issuance and renewal of patient and
  560  caregiver identification cards. By October 3, 2017, the
  561  department shall begin issuing identification cards to adult
  562  patients who have a physician certification that meets the
  563  requirements of subsection (3); minor patients who have a
  564  physician certification that meets the requirements of
  565  subsection (3) and the written consent of a parent or legal
  566  guardian; and caregivers registered pursuant to subsection (6).
  567  In addition to the other requirements of this section, the
  568  department may issue a compassionate use registry identification
  569  card to a patient who is not a resident of this state only after
  570  the department has verified that the patient can lawfully obtain
  571  marijuana through a medical marijuana program in the state that
  572  he or she resides in. Patient and caregiver identification cards
  573  must be resistant to counterfeiting and tampering and must
  574  include at least the following:
  575         1. The name, address, and date of birth of the patient or
  576  caregiver, as appropriate;
  577         2. A full-face, passport-type, color photograph of the
  578  patient or caregiver, as appropriate, taken within the 90 days
  579  immediately preceding registration;
  580         3. Designation of the cardholder as a patient or caregiver;
  581         4. A unique identification number for the patient or
  582  caregiver which is matched to the identification number used for
  583  such person in the department’s compassionate use registry. A
  584  caregiver’s identification number and file in the compassionate
  585  use registry must be linked to the file of the patient or
  586  patients the caregiver is assisting so that the caregiver’s
  587  status may be verified for each patient individually;
  588         5. The expiration date, which shall be 1 year after the
  589  date of issuance of the identification card or the date
  590  treatment ends as provided in the patient’s physician
  591  certification, whichever occurs first; and
  592         6. For caregivers who are assisting three or fewer
  593  qualifying patients, the names and identification number of the
  594  qualifying patient or patients that the caregiver is assisting.
  595         (c)As soon as practicable after the effective date of this
  596  act, update its records by registering each dispensing
  597  organization approved pursuant to chapter 2014-157, Laws of
  598  Florida, or chapter 2016-123, Laws of Florida, as an MMTC with
  599  an effective registration date that coincides with that
  600  dispensing organization’s date of approval as a dispensing
  601  organization. On the effective date of this act, all dispensing
  602  organizations approved pursuant to chapter 2014-157, Laws of
  603  Florida, or chapter 2016-123, Laws of Florida, are deemed to be
  604  registered MMTCs. The department may not require a dispensing
  605  organization approved pursuant to chapter 2014-157, Laws of
  606  Florida, or chapter 2016-123, Laws of Florida, to submit an
  607  application and may not charge the dispensing organization an
  608  application or registration fee for the initial registration of
  609  that dispensing organization as an MMTC pursuant to this
  610  section. For purposes of the requirement that an MMTC comply
  611  with the representations made in its application pursuant to
  612  subsection (8), an MMTC registered pursuant to this paragraph
  613  shall continue to comply with the representations made in its
  614  application for approval as a dispensing organization, including
  615  any revision authorized by the department before the effective
  616  date of this act. After the effective date of this act, the
  617  department may grant variances from the representations made in
  618  a dispensing organization’s application for approval pursuant to
  619  subsection (8). For purposes of the definition of the term
  620  “marijuana” in s. 29, of Art. X of the State Constitution, an
  621  MMTC is deemed to be a dispensing organization as that term is
  622  defined in former s. 381.986(1)(a), Florida Statutes 2014
  623  Authorize the establishment of five dispensing organizations to
  624  ensure reasonable statewide accessibility and availability as
  625  necessary for patients registered in the compassionate use
  626  registry and who are ordered low-THC cannabis, medical cannabis,
  627  or a cannabis delivery device under this section, one in each of
  628  the following regions: northwest Florida, northeast Florida,
  629  central Florida, southeast Florida, and southwest Florida.
  630         (d) By October 3, 2017, register five additional MMTCs with
  631  at least one of the MMTCs being an applicant that is a
  632  recognized class member of Pigford v. Glickman, 185 F.R.D. 82
  633  (D.D.C. 1999), or In re Black Farmers Litig., 856 F. Supp. 2d 1
  634  (D.D.C. 2011), and a member of the Black Farmers and
  635  Agriculturalists Association.
  636         (e)Within 6 months after each instance of the registration
  637  of 75,000 qualifying patients with the compassionate use
  638  registry, register four additional MMTCs if a sufficient number
  639  of MMTC applicants meet the registration requirements
  640  established in this section and by department rule.
  641         (f) Not issue more than one registration as an MMTC to a
  642  person or an entity.
  643         (g)The department shall Develop an application form for
  644  registration as an MMTC and impose an initial application and
  645  biennial renewal fee that is sufficient to cover the costs of
  646  administering this section. To be registered as an MMTC, the an
  647  applicant for approval as a dispensing organization must be able
  648  to demonstrate:
  649         1. That the applicant has been registered to do business in
  650  this state for the previous 5 consecutive years before
  651  submitting the application.
  652         2.1. The technical and technological ability to cultivate
  653  and produce low-THC cannabis and marijuana. The applicant must
  654  possess a valid certificate of registration issued by the
  655  Department of Agriculture and Consumer Services pursuant to s.
  656  581.131 that is issued for the cultivation of more than 400,000
  657  plants, be operated by a nurseryman as defined in s. 581.011,
  658  and have been operated as a registered nursery in this state for
  659  at least 30 continuous years.
  660         3.2. The ability to secure the premises, resources, and
  661  personnel necessary to operate as an MMTC a dispensing
  662  organization.
  663         4.3. The ability to maintain accountability of all raw
  664  materials, finished products, and any byproducts to prevent
  665  diversion or unlawful access to or possession of these
  666  substances.
  667         5.4. An infrastructure reasonably located to dispense low
  668  THC cannabis and marijuana to registered qualifying patients
  669  statewide or regionally as determined by the department.
  670         6.5. The financial ability to maintain operations for the
  671  duration of the 2-year approval cycle, including the provision
  672  of certified financials to the department. Upon approval, the
  673  applicant must post a $5 million performance bond. However, upon
  674  an MMTC a dispensing organization’s serving at least 1,000
  675  qualifying qualified patients, the MMTC dispensing organization
  676  is only required to maintain a $2 million performance bond.
  677         7.6. That all owners and managers have been fingerprinted
  678  and have successfully passed a level 2 background screening
  679  pursuant to s. 435.04.
  680         8.7. The employment of a medical director to supervise the
  681  activities of the MMTC dispensing organization.
  682         (c) Upon the registration of 250,000 active qualified
  683  patients in the compassionate use registry, approve three
  684  dispensing organizations, including, but not limited to, an
  685  applicant that is a recognized class member of Pigford v.
  686  Glickman, 185 F.R.D. 82 (D.D.C. 1999), or In Re Black Farmers
  687  Litig., 856 F. Supp. 2d 1 (D.D.C. 2011), and a member of the
  688  Black Farmers and Agriculturalists Association, which must meet
  689  the requirements of subparagraphs (b)2.-7. and demonstrate the
  690  technical and technological ability to cultivate and produce
  691  low-THC cannabis.
  692         (h)(d) Allow an MMTC a dispensing organization to make a
  693  wholesale purchase of marijuana low-THC cannabis or medical
  694  cannabis from, or a distribution of marijuana low-THC cannabis
  695  or medical cannabis to, another MMTC dispensing organization.
  696         (i)(e) Monitor physician registration in the compassionate
  697  use registry and the issuance of physician certifications
  698  pursuant to subsection (3) ordering of low-THC cannabis, medical
  699  cannabis, or a cannabis delivery device for ordering practices
  700  that could facilitate unlawful diversion or misuse of marijuana
  701  low-THC cannabis, medical cannabis, or a cannabis delivery
  702  devices device and take disciplinary action as indicated.
  703         (8)(6)MEDICAL MARIJUANA TREATMENT CENTERS DISPENSING
  704  ORGANIZATION.—Each MMTC must register with the department. A
  705  registered MMTC An approved dispensing organization must, at all
  706  times, maintain compliance with paragraph (7)(g), the criteria
  707  demonstrated for selection and approval as a dispensing
  708  organization under subsection(5) and the criteria required in
  709  this subsection, and all representations made to the department
  710  in the MMTC’s application for registration. Upon request, the
  711  department may grant an MMTC one or more variances from the
  712  representations made in the MMTC’s application. Consideration of
  713  such a variance shall be based upon the individual facts and
  714  circumstances surrounding the request. A variance may not be
  715  granted unless the requesting MMTC can demonstrate to the
  716  department that it has a proposed alternative to the specific
  717  representation made in its application which fulfills the same
  718  or a similar purpose as the specific representation in a way
  719  that the department can reasonably determine will not be a lower
  720  standard than the specific representation in the application.
  721         (a) When growing marijuana low-THC cannabis or medical
  722  cannabis, an MMTC a dispensing organization:
  723         1. May use pesticides determined by the department, after
  724  consultation with the Department of Agriculture and Consumer
  725  Services, to be safely applied to plants intended for human
  726  consumption, but may not use pesticides designated as
  727  restricted-use pesticides pursuant to s. 487.042.
  728         2. Must grow marijuana low-THC cannabis or medical cannabis
  729  within an enclosed structure and in a room separate from any
  730  other plant.
  731         3. Must inspect seeds and growing plants for plant pests
  732  that endanger or threaten the horticultural and agricultural
  733  interests of the state, notify the Department of Agriculture and
  734  Consumer Services within 10 calendar days after a determination
  735  that a plant is infested or infected by such plant pest, and
  736  implement and maintain phytosanitary policies and procedures.
  737         4. Must perform fumigation or treatment of plants, or the
  738  removal and destruction of infested or infected plants, in
  739  accordance with chapter 581 and any rules adopted thereunder.
  740         (b) When processing marijuana low-THC cannabis or medical
  741  cannabis, an MMTC a dispensing organization must:
  742         1. Process the marijuana low-THC cannabis or medical
  743  cannabis within an enclosed structure and in a room separate
  744  from other plants or products.
  745         2. Have the marijuana tested by an independent testing
  746  laboratory to ensure it meets the standards established by the
  747  department’s quality control program Test the processed low-THC
  748  cannabis and medical cannabis before it is they are dispensed.
  749  Results must be verified and signed by two dispensing
  750  organization employees. Before dispensing low-THC cannabis, the
  751  dispensing organization must determine that the test results
  752  indicate that the low-THC cannabis meets the definition of low
  753  THC cannabis and, for medical cannabis and low-THC cannabis,
  754  that all medical cannabis and low-THC cannabis is safe for human
  755  consumption and free from contaminants that are unsafe for human
  756  consumption. The dispensing organization must retain records of
  757  all testing and samples of each homogenous batch of cannabis and
  758  low-THC cannabis for at least 9 months. The dispensing
  759  organization must contract with an independent testing
  760  laboratory to perform audits on the dispensing organization’s
  761  standard operating procedures, testing records, and samples and
  762  provide the results to the department to confirm that the low
  763  THC cannabis or medical cannabis meets the requirements of this
  764  section and that the medical cannabis and low-THC cannabis is
  765  safe for human consumption.
  766         3. Package the marijuana low-THC cannabis or medical
  767  cannabis in compliance with the United States Poison Prevention
  768  Packaging Act of 1970, 15 U.S.C. ss. 1471 et seq.
  769         4. Package the marijuana low-THC cannabis or medical
  770  cannabis in a childproof receptacle that has a firmly affixed
  771  and legible label stating the following information:
  772         a. A statement that the marijuana low-THC cannabis or
  773  medical cannabis meets the requirements of subparagraph 2.;
  774         b. The name of the MMTC dispensing organization from which
  775  the marijuana medical cannabis or low-THC cannabis originates;
  776  and
  777         c. The batch number and harvest number from which the
  778  marijuana medical cannabis or low-THC cannabis originates; and
  779         d.The concentration of tetrahydrocannabinol and
  780  cannabidiol in the product.
  781         e. Any other information required by department rule
  782         5. Reserve two processed samples from each batch and retain
  783  such samples for at least 9 months for the purpose of testing
  784  pursuant to the audit required under subparagraph 2.
  785         (c) When dispensing marijuana low-THC cannabis, medical
  786  cannabis, or a marijuana cannabis delivery device, an MMTC a
  787  dispensing organization:
  788         1. May not dispense more than the a 45-day supply of
  789  marijuana authorized by a qualifying patient’s physician
  790  certification low-THC cannabis or medical cannabis to a
  791  qualifying patient or caregiver the patient’s legal
  792  representative.
  793         2. Must ensure that the have the dispensing organization’s
  794  employee who dispenses the marijuana low-THC cannabis, medical
  795  cannabis, or marijuana a cannabis delivery device enters enter
  796  into the compassionate use registry his or her name or unique
  797  employee identifier.
  798         3. Must verify that the qualifying patient and the
  799  caregiver, if applicable, both have an active and valid
  800  compassionate use registry identification card and that the
  801  amount and type of marijuana dispensed match the physician
  802  certification in the compassionate use registry for that
  803  qualifying patient that a physician has ordered the low-THC
  804  cannabis, medical cannabis, or a specific type of a cannabis
  805  delivery device for the patient.
  806         4.Must label the marijuana with the recommended dose for
  807  the qualifying patient receiving the marijuana.
  808         5.4. May not dispense or sell any other type of marijuana
  809  cannabis, alcohol, or illicit drug-related product, including
  810  pipes, bongs, or wrapping papers, other than a physician-ordered
  811  cannabis delivery device required for the medical use of
  812  marijuana which is specified in a physician certification low
  813  THC cannabis or medical cannabis, while dispensing low-THC
  814  cannabis or medical cannabis. An MMTC may produce and dispense
  815  marijuana as an edible or food product but may not produce such
  816  items in a format designed to be attractive to children. In
  817  addition to the requirements of this section and department
  818  rule, food products produced by an MMTC must meet all food
  819  safety standards established in state and federal law,
  820  including, but not limited to, the identification of the serving
  821  size and the amount of tetrahydrocannabinol in each serving.
  822         5. Must verify that the patient has an active registration
  823  in the compassionate use registry, the patient or patient’s
  824  legal representative holds a valid and active registration card,
  825  the order presented matches the order contents as recorded in
  826  the registry, and the order has not already been filled.
  827         6. Must, upon dispensing the marijuana low-THC cannabis,
  828  medical cannabis, or marijuana cannabis delivery device, record
  829  in the registry the date, time, quantity, and form of marijuana
  830  low-THC cannabis or medical cannabis dispensed; and the type of
  831  marijuana cannabis delivery device dispensed; and the name and
  832  compassionate use registry identification number of the
  833  qualifying patient or caregiver to whom the marijuana delivery
  834  device was dispensed.
  835         (d) To ensure the safety and security of its premises and
  836  any off-site storage facilities, and to maintain adequate
  837  controls against the diversion, theft, and loss of marijuana
  838  low-THC cannabis, medical cannabis, or marijuana cannabis
  839  delivery devices, an MMTC a dispensing organization shall:
  840         1.a. Maintain a fully operational security alarm system
  841  that secures all entry points and perimeter windows and is
  842  equipped with motion detectors; pressure switches; and duress,
  843  panic, and hold-up alarms; or
  844         b. Maintain a video surveillance system that records
  845  continuously 24 hours each day and meets at least one of the
  846  following criteria:
  847         (I) Cameras are fixed in a place that allows for the clear
  848  identification of persons and activities in controlled areas of
  849  the premises. Controlled areas include grow rooms, processing
  850  rooms, storage rooms, disposal rooms or areas, and point-of-sale
  851  rooms;
  852         (II) Cameras are fixed in entrances and exits to the
  853  premises, which shall record from both indoor and outdoor, or
  854  ingress and egress, vantage points;
  855         (III) Recorded images must clearly and accurately display
  856  the time and date; or
  857         (IV) Retain video surveillance recordings for a minimum of
  858  45 days, or longer upon the request of a law enforcement agency.
  859         2. Ensure that the MMTC’s organization’s outdoor premises
  860  have sufficient lighting from dusk until dawn.
  861         3. Implement Establish and maintain a tracking system using
  862  a vendor approved by the department which that traces the
  863  marijuana low-THC cannabis or medical cannabis from seed to
  864  sale. The tracking system must shall include notification of key
  865  events as determined by the department, including when cannabis
  866  seeds are planted, when cannabis plants are harvested and
  867  destroyed, and when marijuana low-THC cannabis or medical
  868  cannabis is transported, sold, stolen, diverted, or lost.
  869         4. Not dispense from its premises marijuana low-THC
  870  cannabis, medical cannabis, or a cannabis delivery device
  871  between the hours of 9 p.m. and 7 a.m., but may perform all
  872  other operations and deliver marijuana low-THC cannabis and
  873  medical cannabis to qualifying qualified patients 24 hours each
  874  day.
  875         5. Store marijuana low-THC cannabis or medical cannabis in
  876  a secured, locked room or a vault.
  877         6. Require at least two of its employees, or two employees
  878  of a security agency with whom it contracts, to be on the
  879  premises at all times.
  880         7. Require each employee or contractor to wear a photo
  881  identification badge at all times while on the premises.
  882         8. Require each visitor to wear a visitor’s pass at all
  883  times while on the premises.
  884         9. Implement an alcohol and drug-free workplace policy.
  885         10. Report to local law enforcement within 24 hours after
  886  it is notified or becomes aware of the theft, diversion, or loss
  887  of marijuana low-THC cannabis or medical cannabis.
  888         (e) To ensure the safe transport of marijuana low-THC
  889  cannabis or medical cannabis to MMTC dispensing organization
  890  facilities, independent testing laboratories, or qualifying
  891  patients, the MMTC dispensing organization must:
  892         1. Maintain a transportation manifest, which must be
  893  retained for at least 1 year. A copy of the manifest must be in
  894  the vehicle at all times when transporting marijuana.
  895         2. Ensure only vehicles in good working order are used to
  896  transport marijuana low-THC cannabis or medical cannabis.
  897         3. Lock marijuana low-THC cannabis or medical cannabis in a
  898  separate compartment or container within the vehicle.
  899         4. Require at least two persons to be in a vehicle
  900  transporting marijuana low-THC cannabis or medical cannabis, and
  901  require at least one person to remain in the vehicle while the
  902  marijuana low-THC cannabis or medical cannabis is being
  903  delivered.
  904         5. Provide specific safety and security training to
  905  employees transporting or delivering marijuana low-THC cannabis
  906  or medical cannabis.
  907         (9) MARIJUANA QUALITY CONTROL PROGRAM AND INDEPENDENT
  908  TESTING LABORATORY LICENSURE.—
  909         (a)The department shall establish a quality control
  910  program requiring marijuana to be tested by an independent
  911  testing laboratory for potency and contaminants before sale to
  912  qualifying patients and caregivers.
  913         1. The quality control program must require MMTCs to submit
  914  samples from each batch or lot of marijuana harvested or
  915  processed to an independent testing laboratory for testing to
  916  ensure, at a minimum, that the labeling of the potency of
  917  tetrahydrocannabinol and all other marketed cannabinoids or
  918  terpenes is accurate and that the marijuana dispensed to
  919  qualifying patients is safe for human consumption.
  920         2. An MMTC must maintain records of all tests conducted,
  921  including the results of each test and any additional
  922  information, as required by the department.
  923         3. The department shall adopt all rules necessary to create
  924  and oversee the quality control program, which must include, at
  925  a minimum:
  926         a.Permissible levels of variation in potency labeling and
  927  standards requiring tetrahydrocannabinol in edible marijuana
  928  products to be distributed consistently throughout the product;
  929         b. Permissible levels of contaminants and mandatory testing
  930  for contaminants to confirm that the tested marijuana is safe
  931  for human consumption. This testing must include, but is not
  932  limited to, testing for microbiological impurity, residual
  933  solvents, and pesticide residues;
  934         c.The destruction of marijuana determined to be
  935  inaccurately labeled or unsafe for human consumption after the
  936  MMTC has an opportunity to take remedial action;
  937         d.The collection, storage, handling, recording, and
  938  destruction of samples of marijuana by independent testing
  939  laboratories; and
  940         e.Security, inventory tracking, and record retention.
  941         (b) The department must license all independent testing
  942  laboratories to ensure that all marijuana is tested for potency
  943  and contaminants in accordance with the department’s quality
  944  control program. An independent testing laboratory may collect
  945  and accept samples of, and possess, store, transport, and test
  946  marijuana. An independent testing laboratory may not be owned by
  947  a person who also possesses an ownership interest in an MMTC. A
  948  clinical laboratory that is licensed by the Agency for Health
  949  Care Administration pursuant to part I of chapter 483 and that
  950  performs nonwaived clinical tests is exempt from the requirement
  951  to be licensed by the department pursuant to this paragraph but
  952  must be certified to perform all required tests pursuant to
  953  subparagraph 2.
  954         1. The department shall develop rules establishing
  955  independent testing laboratory license requirements and a
  956  process for licensing independent testing laboratories; develop
  957  an application form for an independent testing laboratory
  958  license; and impose an initial application fee and a biennial
  959  renewal fee sufficient to cover the costs of administering this
  960  subsection.
  961         2. In addition to licensure, an independent testing
  962  laboratory must be certified to perform all required tests by
  963  the department. The department must issue a certification to an
  964  independent testing laboratory that has been certified by a
  965  third-party laboratory certification body approved by the
  966  department. The department shall establish reasonable rules for
  967  the certification and operation of independent testing
  968  laboratories. Rules for certification must, at a minimum,
  969  address standards relating to:
  970         a.Personnel qualifications;
  971         b.Equipment and methodology;
  972         c.Proficiency testing;
  973         d.Tracking;
  974         e.Sampling;
  975         f.Chain of custody;
  976         g.Record and sample retention;
  977         h.Reporting;
  978         i.Audit and inspection; and
  979         j.Security.
  980         3. The department shall suspend or reduce any mandatory
  981  testing requirement specified in its quality control program if
  982  the number of licensed and certified independent testing
  983  laboratories is insufficient to process the tests necessary to
  984  meet the patients’ demand for marijuana.
  985         4. An independent testing laboratory may accept only
  986  samples composed of marijuana which are obtained from a sample
  987  source approved by the department. At a minimum, these sources
  988  must include an MMTC, a researcher affiliated with an accredited
  989  university or research hospital, a qualifying patient, and a
  990  caregiver.
  991         (10)(7) DEPARTMENT AUTHORITY AND RESPONSIBILITIES.—
  992         (a) The department may conduct announced or unannounced
  993  inspections of MMTCs dispensing organizations to determine
  994  compliance with this section or rules adopted pursuant to this
  995  section.
  996         (b) The department shall inspect an MMTC a dispensing
  997  organization upon complaint or notice provided to the department
  998  that the MMTC dispensing organization has dispensed marijuana
  999  low-THC cannabis or medical cannabis containing any mold,
 1000  bacteria, or other contaminant that may cause or has caused an
 1001  adverse effect to human health or the environment.
 1002         (c) The department shall conduct at least a biennial
 1003  inspection of each MMTC dispensing organization to evaluate the
 1004  MMTC’s dispensing organization’s records, personnel, equipment,
 1005  processes, security measures, sanitation practices, and quality
 1006  assurance practices.
 1007         (d) The department shall adopt by rule a process for
 1008  approving changes in MMTC ownership or a change in an MMTC
 1009  owner’s investment interest. This process must include specific
 1010  criteria for the approval or denial of an application for change
 1011  of ownership or a change in investment interest and procedures
 1012  for screening applicants’ criminal and financial histories.
 1013         (e) The department shall establish, maintain, and control a
 1014  computer software tracking system that traces marijuana from
 1015  seed to sale and allows real-time, 24-hour access by the
 1016  department to data from all MMTCs and independent testing
 1017  laboratories. The tracking system must, at a minimum, include
 1018  notification of when marijuana seeds are planted, when marijuana
 1019  plants are harvested and destroyed, and when marijuana is
 1020  transported, sold, stolen, diverted, or lost. Each MMTC shall
 1021  use the seed-to-sale tracking system selected by the department.
 1022         (f)(d) The department may enter into interagency agreements
 1023  with the Department of Agriculture and Consumer Services, the
 1024  Department of Business and Professional Regulation, the
 1025  Department of Transportation, the Department of Highway Safety
 1026  and Motor Vehicles, and the Agency for Health Care
 1027  Administration, and such agencies are authorized to enter into
 1028  an interagency agreement with the department, to conduct
 1029  inspections or perform other responsibilities assigned to the
 1030  department under this section.
 1031         (g)(e) The department must make a list of all approved
 1032  MMTCs, dispensing organizations and qualified ordering
 1033  physicians who are qualified to issue physician certifications,
 1034  and medical directors publicly available on its website.
 1035         (f) The department may establish a system for issuing and
 1036  renewing registration cards for patients and their legal
 1037  representatives, establish the circumstances under which the
 1038  cards may be revoked by or must be returned to the department,
 1039  and establish fees to implement such system. The department must
 1040  require, at a minimum, the registration cards to:
 1041         1. Provide the name, address, and date of birth of the
 1042  patient or legal representative.
 1043         2. Have a full-face, passport-type, color photograph of the
 1044  patient or legal representative taken within the 90 days
 1045  immediately preceding registration.
 1046         3. Identify whether the cardholder is a patient or legal
 1047  representative.
 1048         4. List a unique numeric identifier for the patient or
 1049  legal representative that is matched to the identifier used for
 1050  such person in the department’s compassionate use registry.
 1051         5. Provide the expiration date, which shall be 1 year after
 1052  the date of the physician’s initial order of low-THC cannabis or
 1053  medical cannabis.
 1054         6. For the legal representative, provide the name and
 1055  unique numeric identifier of the patient that the legal
 1056  representative is assisting.
 1057         7. Be resistant to counterfeiting or tampering.
 1058         (h)(g) The department may impose reasonable fines not to
 1059  exceed $10,000 on an MMTC a dispensing organization for any of
 1060  the following violations:
 1061         1. Violating this section, s. 499.0295, or department rule.
 1062         2. Failing to maintain qualifications for registration with
 1063  the department approval.
 1064         3. Endangering the health, safety, or security of a
 1065  qualifying qualified patient.
 1066         4. Improperly disclosing personal and confidential
 1067  information of a qualifying the qualified patient.
 1068         5. Attempting to procure MMTC registration with the
 1069  department dispensing organization approval by bribery,
 1070  fraudulent misrepresentation, or extortion.
 1071         6. Any owner or manager of the MMTC being convicted or
 1072  found guilty of, or entering a plea of guilty or nolo contendere
 1073  to, regardless of adjudication, a crime in any jurisdiction
 1074  which directly relates to the business of an MMTC a dispensing
 1075  organization.
 1076         7. Making or filing a report or record that the MMTC
 1077  dispensing organization knows to be false.
 1078         8. Willfully failing to maintain a record required by this
 1079  section or department rule.
 1080         9. Willfully impeding or obstructing an employee or agent
 1081  of the department in the furtherance of his or her official
 1082  duties.
 1083         10. Engaging in fraud or deceit, negligence, incompetence,
 1084  or misconduct in the business practices of an MMTC a dispensing
 1085  organization.
 1086         11. Making misleading, deceptive, or fraudulent
 1087  representations in or related to the business practices of an
 1088  MMTC a dispensing organization.
 1089         12. Having a license or the authority to engage in any
 1090  regulated profession, occupation, or business that is related to
 1091  the business practices of an MMTC a dispensing organization
 1092  suspended, revoked, or otherwise acted against by the licensing
 1093  authority of any jurisdiction, including its agencies or
 1094  subdivisions, for a violation that would constitute a violation
 1095  under Florida law.
 1096         13. Violating a lawful order of the department or an agency
 1097  of the state, or failing to comply with a lawfully issued
 1098  subpoena of the department or an agency of the state.
 1099         (i)(h) The department may suspend, revoke, or refuse to
 1100  renew an MMTC’s registration with the department a dispensing
 1101  organization’s approval if the MMTC a dispensing organization
 1102  commits a violation specified any of the violations in paragraph
 1103  (h) (g).
 1104         (j)(i) The department shall renew an MMTC’s registration
 1105  with the department the approval of a dispensing organization
 1106  biennially if the MMTC dispensing organization meets the
 1107  requirements of this section and pays the biennial renewal fee.
 1108         (k)(j) The department may adopt rules necessary to
 1109  implement this section.
 1110         (11)(8) PREEMPTION.—
 1111         (a) All matters regarding the regulation of the cultivation
 1112  and processing of marijuana medical cannabis or low-THC cannabis
 1113  by MMTCs dispensing organizations are preempted to the state.
 1114         (b) A municipality may determine by ordinance the criteria
 1115  for the number and location of, and other permitting
 1116  requirements that do not conflict with state law or department
 1117  rule for, dispensing facilities of MMTCs dispensing
 1118  organizations located within its municipal boundaries. A county
 1119  may determine by ordinance the criteria for the number,
 1120  location, and other permitting requirements that do not conflict
 1121  with state law or department rule for all dispensing facilities
 1122  of MMTCs dispensing organizations located within the
 1123  unincorporated areas of that county.
 1124         (12)(9) EXCEPTIONS TO OTHER LAWS.—
 1125         (a) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
 1126  any other provision of law, but subject to the requirements of
 1127  this section, a qualifying qualified patient, or a caregiver who
 1128  has obtained a valid compassionate use registry identification
 1129  card from the department, and the qualified patient’s legal
 1130  representative may purchase from an MMTC, and possess for the
 1131  qualifying patient’s medical use, up to the amount of marijuana
 1132  in the physician certification low-THC cannabis or medical
 1133  cannabis ordered for the patient, but not more than a 90-day 45
 1134  day supply, and a cannabis delivery device specified in the
 1135  physician certification ordered for the qualifying patient.
 1136         (b) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
 1137  any other provision of law, but subject to the requirements of
 1138  this section, an MMTC an approved dispensing organization and
 1139  its owners, managers, contractors, and employees may
 1140  manufacture, possess, sell, deliver, distribute, dispense,
 1141  administer, and lawfully dispose of reasonable quantities, as
 1142  established by department rule, of marijuana low-THC cannabis,
 1143  medical cannabis, or a cannabis delivery device. For purposes of
 1144  this subsection, the terms “manufacture,” “possession,”
 1145  “deliver,” “distribute,” and “dispense” have the same meanings
 1146  as provided in s. 893.02.
 1147         (c) 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, an approved independent testing laboratory may
 1150  possess, test, transport, and lawfully dispose of marijuana low
 1151  THC cannabis or medical cannabis as provided by department rule.
 1152         (d) An MMTC approved dispensing organization and its
 1153  owners, managers, contractors, and employees are not subject to
 1154  licensure or regulation under chapter 465 or chapter 499 for
 1155  manufacturing, possessing, selling, delivering, distributing,
 1156  dispensing, or lawfully disposing of reasonable quantities, as
 1157  established by department rule, of marijuana low-THC cannabis,
 1158  medical cannabis, or a cannabis delivery device.
 1159         (e) Exercise by an MMTC of An approved dispensing
 1160  organization that continues to meet the requirements for
 1161  approval is presumed to be registered with the department and to
 1162  meet the regulations adopted by the department or its successor
 1163  agency for the purpose of dispensing medical cannabis or low-THC
 1164  cannabis under Florida law. Additionally, the authority provided
 1165  to MMTCs a dispensing organization in s. 499.0295 does not
 1166  impair its registration with the department the approval of a
 1167  dispensing organization.
 1168         (f) This subsection does not exempt a person from
 1169  prosecution for a criminal offense related to impairment or
 1170  intoxication resulting from the medical use of marijuana low-THC
 1171  cannabis or medical cannabis or relieve a person from any
 1172  requirement under law to submit to a breath, blood, urine, or
 1173  other test to detect the presence of a controlled substance.
 1174         (g)This section does not limit the ability of an employer
 1175  to establish, continue, or enforce a drug-free workplace program
 1176  or substance abuse policy. Notwithstanding any other provision
 1177  of law, this section does not require an employer to accommodate
 1178  the ingestion of marijuana in any workplace or any employee
 1179  working while under the influence of marijuana. Notwithstanding
 1180  any other provision of law, this section does not create a cause
 1181  of action against an employer for wrongful discharge or
 1182  discrimination.
 1183         (h) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
 1184  any other provision of law, but subject to the requirements of
 1185  this section, a research institute established by a public
 1186  postsecondary educational institution, such as the H. Lee
 1187  Moffitt Cancer Center and Research Institute established under
 1188  s. 1004.43, or a state university that has achieved the
 1189  preeminent state research university designation pursuant to s.
 1190  1001.7065 may possess, test, transport, and lawfully dispose of
 1191  marijuana for research purposes as provided by department rule.
 1192         (13) RULEMAKING.—
 1193         (a) The department and the applicable boards shall adopt
 1194  emergency rules pursuant to s. 120.54(4) and this subsection
 1195  necessary to implement this section. If an emergency rule
 1196  adopted under this subsection is held to be unconstitutional or
 1197  an invalid exercise of delegated legislative authority and
 1198  becomes void, the department and the applicable boards may adopt
 1199  an emergency rule to replace the rule that has become void. If
 1200  the emergency rule adopted to replace the void emergency rule is
 1201  also held to be unconstitutional or an invalid exercise of
 1202  delegated legislative authority and becomes void, the department
 1203  and the applicable boards must follow the nonemergency
 1204  rulemaking procedures of the Administrative Procedures Act to
 1205  replace the rule that has become void.
 1206         (b) For emergency rules adopted under this subsection, the
 1207  department and the applicable boards need not make the findings
 1208  required by s. 120.54(4)(a). Emergency rules adopted under this
 1209  subsection are exempt from ss. 120.54(3)(b) and 120.541. The
 1210  department and the applicable boards shall meet the procedural
 1211  requirements in s. 120.54(2)(a) if the department or the
 1212  applicable boards have, before the effective date of this act,
 1213  held any public workshops or hearings on the subject matter of
 1214  emergency rules adopted under this subsection. Challenges to
 1215  emergency rules adopted under this subsection are subject to the
 1216  time schedules provided in s. 120.56(5).
 1217         (c) Emergency rules adopted under this section are exempt
 1218  from s. 120.54(4)(c) and shall remain in effect until replaced
 1219  by rules adopted under the nonemergency rulemaking procedures of
 1220  the Administrative Procedures Act. By January 1, 2018, the
 1221  department and the applicable boards shall initiate nonemergency
 1222  rulemaking pursuant to the Administrative Procedures Act by
 1223  publishing a notice of rule development in the Florida
 1224  Administrative Register. Except as provided in paragraph (a),
 1225  after January 1, 2018, the department and applicable boards may
 1226  not adopt rules pursuant to the emergency rulemaking procedures
 1227  provided in this subsection.
 1228         Section 2. Section 1004.4351, Florida Statutes, is created
 1229  to read:
 1230         1004.4351Medical marijuana research and education.—
 1231         (1) SHORT TITLE.—This section shall be known and may be
 1232  cited as the “Medical Marijuana Research and Education Act.”
 1233         (2) LEGISLATIVE FINDINGS.—The Legislature finds that:
 1234         (a) The present state of knowledge concerning the use of
 1235  marijuana to alleviate pain and treat illnesses is limited
 1236  because permission to perform clinical studies on marijuana is
 1237  difficult to obtain, with access to research-grade marijuana so
 1238  restricted that little or no unbiased studies have been
 1239  performed.
 1240         (b) Under the State Constitution, marijuana is available
 1241  for the treatment of certain debilitating medical conditions.
 1242         (c) Additional clinical studies are needed to ensure that
 1243  the residents of this state obtain the correct dosing,
 1244  formulation, route, modality, frequency, quantity, and quality
 1245  of marijuana for specific illnesses.
 1246         (d) An effective medical marijuana research and education
 1247  program would mobilize the scientific, educational, and medical
 1248  resources that presently exist in this state to determine the
 1249  appropriate and best use of marijuana to treat illness.
 1250         (3) DEFINITIONS.—As used in this section, the term:
 1251         (a) “Board” means the Medical Marijuana Research and
 1252  Education Board.
 1253         (b) “Coalition” means the Coalition for Medical Marijuana
 1254  Research and Education.
 1255         (c) “Marijuana”” has the same meaning as provided in s. 29,
 1256  Art. X of the State Constitution.
 1257         (4) COALITION FOR MEDICAL MARIJUANA RESEARCH AND
 1258  EDUCATION.—
 1259         (a) There is established within the H. Lee Moffitt Cancer
 1260  Center and Research Institute, Inc., the Coalition for Medical
 1261  Marijuana Research and Education. The purpose of the coalition
 1262  is to conduct rigorous scientific research, provide education,
 1263  disseminate research, and guide policy for the adoption of a
 1264  statewide policy on ordering and dosing practices for the
 1265  medicinal use of marijuana. The coalition shall be physically
 1266  located at the H. Lee Moffitt Cancer Center and Research
 1267  Institute, Inc.
 1268         (b) The Medical Marijuana Research and Education Board is
 1269  established to direct the operations of the coalition. The board
 1270  shall be composed of seven members appointed by the chief
 1271  executive officer of the H. Lee Moffitt Cancer Center and
 1272  Research Institute, Inc. Board members must have experience in a
 1273  variety of scientific and medical fields, including, but not
 1274  limited to, oncology, neurology, psychology, pediatrics,
 1275  nutrition, and addiction. Members shall be appointed to 4-year
 1276  terms and may be reappointed to serve additional terms. The
 1277  chair shall be elected by the board from among its members to
 1278  serve a 2-year term. The board shall meet no less than
 1279  semiannually, at the call of the chair or, in his or her absence
 1280  or incapacity, the vice chair. Four members constitute a quorum.
 1281  A majority vote of the members present is required for all
 1282  actions of the board. The board may prescribe, amend, and repeal
 1283  a charter governing the manner in which it conducts its
 1284  business. A board member shall serve without compensation but is
 1285  entitled to be reimbursed for travel expenses by the coalition
 1286  or the organization he or she represents in accordance with s.
 1287  112.061.
 1288         (c) The coalition shall be administered by a coalition
 1289  director, who shall be appointed by and serve at the pleasure of
 1290  the board. The coalition director shall, subject to the approval
 1291  of the board:
 1292         1. Propose a budget for the coalition.
 1293         2. Foster the collaboration of scientists, researchers, and
 1294  other appropriate personnel in accordance with the coalition’s
 1295  charter.
 1296         3. Identify and prioritize the research to be conducted by
 1297  the coalition.
 1298         4. Prepare the Medical Marijuana Research and Education
 1299  Plan for submission to the board.
 1300         5. Apply for grants to obtain funding for research
 1301  conducted by the coalition.
 1302         6. Perform other duties as determined by the board.
 1303         (d) The board shall advise the Board of Governors, the
 1304  State Surgeon General, the Governor, and the Legislature with
 1305  respect to medical marijuana research and education in this
 1306  state. The board shall explore methods of implementing and
 1307  enforcing medical marijuana laws in relation to cancer control,
 1308  research, treatment, and education.
 1309         (e) The board shall annually adopt a plan for medical
 1310  marijuana research, known as the “Medical Marijuana Research and
 1311  Education Plan,” which must be in accordance with state law and
 1312  coordinate with existing programs in this state. The plan must
 1313  include recommendations for the coordination and integration of
 1314  medical, nursing, paramedical, community, and other resources
 1315  connected with the treatment of debilitating medical conditions,
 1316  research related to the treatment of such medical conditions,
 1317  and education.
 1318         (f) By February 15 of each year, the board shall issue a
 1319  report to the Governor, the President of the Senate, and the
 1320  Speaker of the House of Representatives on research projects,
 1321  community outreach initiatives, and future plans for the
 1322  coalition.
 1323         (5) RESPONSIBILITIES OF THE H. LEE MOFFITT CANCER CENTER
 1324  AND RESEARCH INSTITUTE, INC.—The H. Lee Moffitt Cancer Center
 1325  and Research Institute, Inc., shall allocate staff and provide
 1326  information and assistance, as the coalition’s budget permits,
 1327  to assist the board in fulfilling its responsibilities.
 1328         Section 3. Paragraph (b) of subsection (3) of section
 1329  381.987, Florida Statutes, is amended to read:
 1330         381.987 Public records exemption for personal identifying
 1331  information in the compassionate use registry.—
 1332         (3) The department shall allow access to the registry,
 1333  including access to confidential and exempt information, to:
 1334         (b) A medical marijuana treatment center registered with
 1335  dispensing organization approved by the department pursuant to
 1336  s. 381.986 which is attempting to verify the authenticity of a
 1337  physician certification physician’s order for marijuana low-THC
 1338  cannabis, including whether the physician certification order
 1339  had been previously filled and whether the physician
 1340  certification order was written for the person attempting to
 1341  have it filled.
 1342         Section 4. Subsection (1) of section 385.211, Florida
 1343  Statutes, is amended to read:
 1344         385.211 Refractory and intractable epilepsy treatment and
 1345  research at recognized medical centers.—
 1346         (1) As used in this section, the term “low-THC cannabis”
 1347  means “low-THC cannabis” as defined in s. 381.986 which that is
 1348  dispensed only from a medical marijuana treatment center
 1349  dispensing organization as defined in s. 381.986.
 1350         Section 5. Present paragraphs (b) and (c) of subsection (2)
 1351  of section 499.0295, Florida Statutes, are redesignated as
 1352  paragraphs (a) and (b), respectively, present paragraphs (a) and
 1353  (c) of that subsection are amended, a new paragraph (c) is added
 1354  to that subsection, and subsection (3) of that section is
 1355  amended, to read:
 1356         499.0295 Experimental treatments for terminal conditions.—
 1357         (2) As used in this section, the term:
 1358         (a) “Dispensing organization” means an organization
 1359  approved by the Department of Health under s. 381.986(5) to
 1360  cultivate, process, transport, and dispense low-THC cannabis,
 1361  medical cannabis, and cannabis delivery devices.
 1362         (b)(c) “Investigational drug, biological product, or
 1363  device” means:
 1364         1. A drug, biological product, or device that has
 1365  successfully completed phase 1 of a clinical trial but has not
 1366  been approved for general use by the United States Food and Drug
 1367  Administration and remains under investigation in a clinical
 1368  trial approved by the United States Food and Drug
 1369  Administration; or
 1370         2. Marijuana Medical cannabis that is manufactured and sold
 1371  by an MMTC a dispensing organization.
 1372         (c) Medical marijuana treatment center” or “MMTC” means an
 1373  organization registered with the Department of Health under s.
 1374  381.986.
 1375         (3) Upon the request of an eligible patient, a manufacturer
 1376  may, or upon the issuance of a physician certification a
 1377  physician’s order pursuant to s. 381.986, an MMTC a dispensing
 1378  organization may:
 1379         (a) Make its investigational drug, biological product, or
 1380  device available under this section.
 1381         (b) Provide an investigational drug, biological product,
 1382  device, or cannabis delivery device as defined in s. 381.986 to
 1383  an eligible patient without receiving compensation.
 1384         (c) Require an eligible patient to pay the costs of, or the
 1385  costs associated with, the manufacture of the investigational
 1386  drug, biological product, device, or cannabis delivery device as
 1387  defined in s. 381.986.
 1388         Section 6. Subsection (1) of section 1004.441, Florida
 1389  Statutes, is amended to read:
 1390         1004.441 Refractory and intractable epilepsy treatment and
 1391  research.—
 1392         (1) As used in this section, the term “low-THC cannabis”
 1393  means “low-THC cannabis” as defined in s. 381.986 which that is
 1394  dispensed only from a medical marijuana treatment center
 1395  dispensing organization as defined in s. 381.986.
 1396         Section 7. The Division of Law Revision and Information is
 1397  directed to replace the phrase “the effective date of this act”
 1398  wherever it occurs in this act with the date the act becomes a
 1399  law.
 1400         Section 8. This act shall take effect upon becoming a law.