Florida Senate - 2019                        COMMITTEE AMENDMENT
       Bill No. CS for CS for SB 182
       
       
       
       
       
       
                                Ì168684RÎ168684                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/20/2019           .                                
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       The Committee on Rules (Brandes) recommended the following:
    1  
    2         Senate Amendment (with title amendment)
       
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraphs (g) and (j) of subsection (1),
    6  subsection (4), paragraph (e) of subsection (8), and subsections
    7  (14) and (15) of section 381.986, Florida Statutes, are amended
    8  to read:
    9         381.986 Medical use of marijuana.—
   10         (1) DEFINITIONS.—As used in this section, the term:
   11         (g) “Marijuana delivery device” means an object used,
   12  intended for use, or designed for use in preparing, storing,
   13  ingesting, inhaling, or otherwise introducing marijuana into the
   14  human body, and which is dispensed from a medical marijuana
   15  treatment center for medical use by a qualified patient, except
   16  that delivery devices intended for the medical use of marijuana
   17  by smoking need not be dispensed from a medical marijuana
   18  treatment center in order to qualify as marijuana delivery
   19  devices.
   20         (j) “Medical use” means the acquisition, possession, use,
   21  delivery, transfer, or administration of marijuana authorized by
   22  a physician certification. The term does not include:
   23         1. Possession, use, or administration of marijuana that was
   24  not purchased or acquired from a medical marijuana treatment
   25  center.
   26         2. Possession, use, or administration of marijuana in a
   27  form for smoking, in the form of commercially produced food
   28  items other than edibles, or of marijuana seeds or flower,
   29  except for flower in a sealed, tamper-proof receptacle for
   30  vaping.
   31         3. Use or administration of any form or amount of marijuana
   32  in a manner that is inconsistent with the qualified physician’s
   33  directions or physician certification.
   34         4. Transfer of marijuana to a person other than the
   35  qualified patient for whom it was authorized or the qualified
   36  patient’s caregiver on behalf of the qualified patient.
   37         5. The smoking of marijuana in an enclosed indoor workplace
   38  as defined in s. 386.203(5).
   39         6.5. Use or administration of marijuana in the following
   40  locations:
   41         a. On any form of public transportation, except for low-THC
   42  cannabis.
   43         b. In any public place, except for low-THC cannabis.
   44         c. In a qualified patient’s place of employment, except
   45  when permitted by his or her employer.
   46         d. In a state correctional institution, as defined in s.
   47  944.02, or a correctional institution, as defined in s. 944.241.
   48         e. On the grounds of a preschool, primary school, or
   49  secondary school, except as provided in s. 1006.062.
   50         f. In a school bus, a vehicle, an aircraft, or a motorboat,
   51  except for low-THC cannabis.
   52  
   53  For the purposes of this subparagraph, the exceptions for low
   54  THC cannabis do not include the smoking of low-THC cannabis.
   55         (4) PHYSICIAN CERTIFICATION.—
   56         (a) A qualified physician may issue a physician
   57  certification only if the qualified physician:
   58         1. Conducted a physical examination while physically
   59  present in the same room as the patient and a full assessment of
   60  the medical history of the patient.
   61         2. Diagnosed the patient with at least one qualifying
   62  medical condition.
   63         3. Determined that the medical use of marijuana would
   64  likely outweigh the potential health risks for the patient, and
   65  such determination must be documented in the patient’s medical
   66  record. If a patient is younger than 18 years of age, a second
   67  physician must concur with this determination, and such
   68  concurrence must be documented in the patient’s medical record.
   69         4. Determined whether the patient is pregnant and
   70  documented such determination in the patient’s medical record. A
   71  physician may not issue a physician certification, except for
   72  low-THC cannabis, to a patient who is pregnant.
   73         5. Reviewed the patient’s controlled drug prescription
   74  history in the prescription drug monitoring program database
   75  established pursuant to s. 893.055.
   76         6. Reviews the medical marijuana use registry and confirmed
   77  that the patient does not have an active physician certification
   78  from another qualified physician.
   79         7. Registers as the issuer of the physician certification
   80  for the named qualified patient on the medical marijuana use
   81  registry in an electronic manner determined by the department,
   82  and:
   83         a. Enters into the registry the contents of the physician
   84  certification, including the patient’s qualifying condition and
   85  the dosage not to exceed the daily dose amount determined by the
   86  department, the amount and forms of marijuana authorized for the
   87  patient, and any types of marijuana delivery devices needed by
   88  the patient for the medical use of marijuana.
   89         b. Updates the registry within 7 days after any change is
   90  made to the original physician certification to reflect such
   91  change.
   92         c. Deactivates the registration of the qualified patient
   93  and the patient’s caregiver when the physician no longer
   94  recommends the medical use of marijuana for the patient.
   95         8. Obtains the voluntary and informed written consent of
   96  the patient for medical use of marijuana each time the qualified
   97  physician issues a physician certification for the patient,
   98  which shall be maintained in the patient’s medical record. The
   99  patient, or the patient’s parent or legal guardian if the
  100  patient is a minor, must sign the informed consent acknowledging
  101  that the qualified physician has sufficiently explained its
  102  content. The qualified physician must use a standardized
  103  informed consent form adopted in rule by the Board of Medicine
  104  and the Board of Osteopathic Medicine, which must include, at a
  105  minimum, information related to:
  106         a. The Federal Government’s classification of marijuana as
  107  a Schedule I controlled substance.
  108         b. The approval and oversight status of marijuana by the
  109  Food and Drug Administration.
  110         c. The current state of research on the efficacy of
  111  marijuana to treat the qualifying conditions set forth in this
  112  section.
  113         d. The potential for addiction.
  114         e. The potential effect that marijuana may have on a
  115  patient’s coordination, motor skills, and cognition, including a
  116  warning against operating heavy machinery, operating a motor
  117  vehicle, or engaging in activities that require a person to be
  118  alert or respond quickly.
  119         f. The potential side effects of marijuana use.
  120         g. The risks, benefits, and drug interactions of marijuana.
  121         h. The risks specifically associated with smoking
  122  marijuana.
  123         i.h. That the patient’s de-identified health information
  124  contained in the physician certification and medical marijuana
  125  use registry may be used for research purposes.
  126  
  127  A physician may not certify the medical use of marijuana by
  128  smoking for a patient under 18 years of age unless the patient
  129  is diagnosed with a terminal condition, the certifying physician
  130  determines that smoking is the most effective means of
  131  administering medical marijuana for the patient, and a second
  132  physician who is a pediatrician concurs with that determination.
  133  Such determination and concurrence must be documented in the
  134  patient’s medical record.
  135         (b) If a qualified physician issues a physician
  136  certification for a qualified patient diagnosed with a
  137  qualifying medical condition pursuant to paragraph (2)(k), the
  138  physician must submit the following to the applicable board
  139  within 14 days after issuing the physician certification:
  140         1. Documentation supporting the qualified physician’s
  141  opinion that the medical condition is of the same kind or class
  142  as the conditions in paragraphs (2)(a)-(j).
  143         2. Documentation that establishes the efficacy of marijuana
  144  as treatment for the condition.
  145         3. Documentation supporting the qualified physician’s
  146  opinion that the benefits of medical use of marijuana would
  147  likely outweigh the potential health risks for the patient.
  148         4. Any other documentation as required by board rule.
  149  
  150  The department must submit such documentation to the Consortium
  151  Coalition for Medical Marijuana Clinical Outcomes Research and
  152  Education established pursuant to s. 1004.4351.
  153         (c) The Board of Medicine and the Board of Osteopathic
  154  Medicine shall each, by July 1, 2021, adopt by rule practice
  155  standards for the certification of smoking as a route of
  156  administration. The department shall provide the Board of
  157  Medicine and the Board of Osteopathic Medicine information from
  158  the medical marijuana use registry as necessary for the adoption
  159  of practice standards under this paragraph. Such information may
  160  not include a qualified physician’s, a qualified patient’s, or a
  161  caregiver’s personal identifying information.
  162         (d)(c) A qualified physician may not issue a physician
  163  certification for more than three 70-day supply limits of
  164  marijuana or six 35-day supply limits of marijuana in a form for
  165  smoking. The department shall quantify by rule a daily dose
  166  amount with equivalent dose amounts for each allowable form of
  167  marijuana dispensed by a medical marijuana treatment center. The
  168  department shall use the daily dose amount to calculate a 70-day
  169  supply or a 35-day supply, as appropriate.
  170         1. A qualified physician may request an exception to the
  171  daily dose amount limit. The request shall be made
  172  electronically on a form adopted by the department in rule and
  173  must include, at a minimum:
  174         a. The qualified patient’s qualifying medical condition.
  175         b. The dosage and route of administration that was
  176  insufficient to provide relief to the qualified patient.
  177         c. A description of how the patient will benefit from an
  178  increased amount.
  179         d. The minimum daily dose amount of marijuana that would be
  180  sufficient for the treatment of the qualified patient’s
  181  qualifying medical condition.
  182         2. A qualified physician must provide the qualified
  183  patient’s records upon the request of the department.
  184         3. The department shall approve or disapprove the request
  185  within 14 days after receipt of the complete documentation
  186  required by this paragraph. The request shall be deemed approved
  187  if the department fails to act within this time period.
  188         (e)(d) A qualified physician must evaluate an existing
  189  qualified patient at least once every 30 weeks before issuing a
  190  new physician certification. A physician must:
  191         1. Determine if the patient still meets the requirements to
  192  be issued a physician certification under paragraph (a).
  193         2. Identify and document in the qualified patient’s medical
  194  records whether the qualified patient experienced either of the
  195  following related to the medical use of marijuana:
  196         a. An adverse drug interaction with any prescription or
  197  nonprescription medication; or
  198         b. A reduction in the use of, or dependence on, other types
  199  of controlled substances as defined in s. 893.02.
  200         3. Submit a report with the findings required pursuant to
  201  subparagraph 2. to the department. The department shall submit
  202  such reports to the Consortium Coalition for Medical Marijuana
  203  Clinical Outcomes Research and Education established pursuant to
  204  s. 1004.4351.
  205         (f)(e) An active order for low-THC cannabis or medical
  206  cannabis issued pursuant to former s. 381.986, Florida Statutes
  207  2016, and registered with the compassionate use registry before
  208  June 23, 2017, is deemed a physician certification, and all
  209  patients possessing such orders are deemed qualified patients
  210  until the department begins issuing medical marijuana use
  211  registry identification cards.
  212         (g)(f) The department shall monitor physician registration
  213  in the medical marijuana use registry and the issuance of
  214  physician certifications for practices that could facilitate
  215  unlawful diversion or misuse of marijuana or a marijuana
  216  delivery device and shall take disciplinary action as
  217  appropriate.
  218         (h)(g) The Board of Medicine and the Board of Osteopathic
  219  Medicine shall jointly create a physician certification pattern
  220  review panel that shall review all physician certifications
  221  submitted to the medical marijuana use registry. The panel shall
  222  track and report the number of physician certifications and the
  223  qualifying medical conditions, dosage, supply amount, and form
  224  of marijuana certified. The panel shall report the data both by
  225  individual qualified physician and in the aggregate, by county,
  226  and statewide. The physician certification pattern review panel
  227  shall, beginning January 1, 2018, submit an annual report of its
  228  findings and recommendations to the Governor, the President of
  229  the Senate, and the Speaker of the House of Representatives.
  230         (i)(h) The department, the Board of Medicine, and the Board
  231  of Osteopathic Medicine may adopt rules pursuant to ss.
  232  120.536(1) and 120.54 to implement this subsection.
  233         (8) MEDICAL MARIJUANA TREATMENT CENTERS.—
  234         (e) A licensed medical marijuana treatment center shall
  235  cultivate, process, transport, and dispense marijuana for
  236  medical use. A licensed medical marijuana treatment center may
  237  not contract for services directly related to the cultivation,
  238  processing, and dispensing of marijuana or marijuana delivery
  239  devices, except that a medical marijuana treatment center
  240  licensed pursuant to subparagraph (a)1. may contract with a
  241  single entity for the cultivation, processing, transporting, and
  242  dispensing of marijuana and marijuana delivery devices. A
  243  licensed medical marijuana treatment center must, at all times,
  244  maintain compliance with the criteria demonstrated and
  245  representations made in the initial application and the criteria
  246  established in this subsection. Upon request, the department may
  247  grant a medical marijuana treatment center a variance from the
  248  representations made in the initial application. Consideration
  249  of such a request shall be based upon the individual facts and
  250  circumstances surrounding the request. A variance may not be
  251  granted unless the requesting medical marijuana treatment center
  252  can demonstrate to the department that it has a proposed
  253  alternative to the specific representation made in its
  254  application which fulfills the same or a similar purpose as the
  255  specific representation in a way that the department can
  256  reasonably determine will not be a lower standard than the
  257  specific representation in the application. A variance may not
  258  be granted from the requirements in subparagraph 2. and
  259  subparagraphs (b)1. and 2.
  260         1. A licensed medical marijuana treatment center may
  261  transfer ownership to an individual or entity who meets the
  262  requirements of this section. A publicly traded corporation or
  263  publicly traded company that meets the requirements of this
  264  section is not precluded from ownership of a medical marijuana
  265  treatment center. To accommodate a change in ownership:
  266         a. The licensed medical marijuana treatment center shall
  267  notify the department in writing at least 60 days before the
  268  anticipated date of the change of ownership.
  269         b. The individual or entity applying for initial licensure
  270  due to a change of ownership must submit an application that
  271  must be received by the department at least 60 days before the
  272  date of change of ownership.
  273         c. Upon receipt of an application for a license, the
  274  department shall examine the application and, within 30 days
  275  after receipt, notify the applicant in writing of any apparent
  276  errors or omissions and request any additional information
  277  required.
  278         d. Requested information omitted from an application for
  279  licensure must be filed with the department within 21 days after
  280  the department’s request for omitted information or the
  281  application shall be deemed incomplete and shall be withdrawn
  282  from further consideration and the fees shall be forfeited.
  283  
  284  Within 30 days after the receipt of a complete application, the
  285  department shall approve or deny the application.
  286         2. A medical marijuana treatment center, and any individual
  287  or entity who directly or indirectly owns, controls, or holds
  288  with power to vote 5 percent or more of the voting shares of a
  289  medical marijuana treatment center, may not acquire direct or
  290  indirect ownership or control of any voting shares or other form
  291  of ownership of any other medical marijuana treatment center.
  292         3. A medical marijuana treatment center may not enter into
  293  any form of profit-sharing arrangement with the property owner
  294  or lessor of any of its facilities where cultivation,
  295  processing, storing, or dispensing of marijuana and marijuana
  296  delivery devices occurs.
  297         4. All employees of a medical marijuana treatment center
  298  must be 21 years of age or older and have passed a background
  299  screening pursuant to subsection (9).
  300         5. Each medical marijuana treatment center must adopt and
  301  enforce policies and procedures to ensure employees and
  302  volunteers receive training on the legal requirements to
  303  dispense marijuana to qualified patients.
  304         6. When growing marijuana, a medical marijuana treatment
  305  center:
  306         a. May use pesticides determined by the department, after
  307  consultation with the Department of Agriculture and Consumer
  308  Services, to be safely applied to plants intended for human
  309  consumption, but may not use pesticides designated as
  310  restricted-use pesticides pursuant to s. 487.042.
  311         b. Must grow marijuana within an enclosed structure and in
  312  a room separate from any other plant.
  313         c. Must inspect seeds and growing plants for plant pests
  314  that endanger or threaten the horticultural and agricultural
  315  interests of the state in accordance with chapter 581 and any
  316  rules adopted thereunder.
  317         d. Must perform fumigation or treatment of plants, or
  318  remove and destroy infested or infected plants, in accordance
  319  with chapter 581 and any rules adopted thereunder.
  320         7. Each medical marijuana treatment center must produce and
  321  make available for purchase at least one low-THC cannabis
  322  product.
  323         8. Each medical marijuana treatment center must produce and
  324  make available for purchase at least one type of pre-rolled
  325  marijuana cigarette.
  326         9.8. A medical marijuana treatment center that produces
  327  edibles must hold a permit to operate as a food establishment
  328  pursuant to chapter 500, the Florida Food Safety Act, and must
  329  comply with all the requirements for food establishments
  330  pursuant to chapter 500 and any rules adopted thereunder.
  331  Edibles may not contain more than 200 milligrams of
  332  tetrahydrocannabinol, and a single serving portion of an edible
  333  may not exceed 10 milligrams of tetrahydrocannabinol. Edibles
  334  may have a potency variance of no greater than 15 percent.
  335  Edibles may not be attractive to children; be manufactured in
  336  the shape of humans, cartoons, or animals; be manufactured in a
  337  form that bears any reasonable resemblance to products available
  338  for consumption as commercially available candy; or contain any
  339  color additives. To discourage consumption of edibles by
  340  children, the department shall determine by rule any shapes,
  341  forms, and ingredients allowed and prohibited for edibles.
  342  Medical marijuana treatment centers may not begin processing or
  343  dispensing edibles until after the effective date of the rule.
  344  The department shall also adopt sanitation rules providing the
  345  standards and requirements for the storage, display, or
  346  dispensing of edibles.
  347         10.9. Within 12 months after licensure, a medical marijuana
  348  treatment center must demonstrate to the department that all of
  349  its processing facilities have passed a Food Safety Good
  350  Manufacturing Practices, such as Global Food Safety Initiative
  351  or equivalent, inspection by a nationally accredited certifying
  352  body. A medical marijuana treatment center must immediately stop
  353  processing at any facility which fails to pass this inspection
  354  until it demonstrates to the department that such facility has
  355  met this requirement.
  356         11.10. When processing marijuana, a medical marijuana
  357  treatment center must:
  358         a. Process the marijuana within an enclosed structure and
  359  in a room separate from other plants or products.
  360         b. Comply with department rules when processing marijuana
  361  with hydrocarbon solvents or other solvents or gases exhibiting
  362  potential toxicity to humans. The department shall determine by
  363  rule the requirements for medical marijuana treatment centers to
  364  use such solvents or gases exhibiting potential toxicity to
  365  humans.
  366         c. Comply with federal and state laws and regulations and
  367  department rules for solid and liquid wastes. The department
  368  shall determine by rule procedures for the storage, handling,
  369  transportation, management, and disposal of solid and liquid
  370  waste generated during marijuana production and processing. The
  371  Department of Environmental Protection shall assist the
  372  department in developing such rules.
  373         d. Test the processed marijuana using a medical marijuana
  374  testing laboratory before it is dispensed. Results must be
  375  verified and signed by two medical marijuana treatment center
  376  employees. Before dispensing, the medical marijuana treatment
  377  center must determine that the test results indicate that low
  378  THC cannabis meets the definition of low-THC cannabis, the
  379  concentration of tetrahydrocannabinol meets the potency
  380  requirements of this section, the labeling of the concentration
  381  of tetrahydrocannabinol and cannabidiol is accurate, and all
  382  marijuana is safe for human consumption and free from
  383  contaminants that are unsafe for human consumption. The
  384  department shall determine by rule which contaminants must be
  385  tested for and the maximum levels of each contaminant which are
  386  safe for human consumption. The Department of Agriculture and
  387  Consumer Services shall assist the department in developing the
  388  testing requirements for contaminants that are unsafe for human
  389  consumption in edibles. The department shall also determine by
  390  rule the procedures for the treatment of marijuana that fails to
  391  meet the testing requirements of this section, s. 381.988, or
  392  department rule. The department may select a random sample from
  393  edibles available for purchase in a dispensing facility which
  394  shall be tested by the department to determine that the edible
  395  meets the potency requirements of this section, is safe for
  396  human consumption, and the labeling of the tetrahydrocannabinol
  397  and cannabidiol concentration is accurate. A medical marijuana
  398  treatment center may not require payment from the department for
  399  the sample. A medical marijuana treatment center must recall
  400  edibles, including all edibles made from the same batch of
  401  marijuana, which fail to meet the potency requirements of this
  402  section, which are unsafe for human consumption, or for which
  403  the labeling of the tetrahydrocannabinol and cannabidiol
  404  concentration is inaccurate. The medical marijuana treatment
  405  center must retain records of all testing and samples of each
  406  homogenous batch of marijuana for at least 9 months. The medical
  407  marijuana treatment center must contract with a marijuana
  408  testing laboratory to perform audits on the medical marijuana
  409  treatment center’s standard operating procedures, testing
  410  records, and samples and provide the results to the department
  411  to confirm that the marijuana or low-THC cannabis meets the
  412  requirements of this section and that the marijuana or low-THC
  413  cannabis is safe for human consumption. A medical marijuana
  414  treatment center shall reserve two processed samples from each
  415  batch and retain such samples for at least 9 months for the
  416  purpose of such audits. A medical marijuana treatment center may
  417  use a laboratory that has not been certified by the department
  418  under s. 381.988 until such time as at least one laboratory
  419  holds the required certification, but in no event later than
  420  July 1, 2018.
  421         e. Package the marijuana in compliance with the United
  422  States Poison Prevention Packaging Act of 1970, 15 U.S.C. ss.
  423  1471 et seq.
  424         f. Package the marijuana in a receptacle that has a firmly
  425  affixed and legible label stating the following information:
  426         (I) The marijuana or low-THC cannabis meets the
  427  requirements of sub-subparagraph d.
  428         (II) The name of the medical marijuana treatment center
  429  from which the marijuana originates.
  430         (III) The batch number and harvest number from which the
  431  marijuana originates and the date dispensed.
  432         (IV) The name of the physician who issued the physician
  433  certification.
  434         (V) The name of the patient.
  435         (VI) The product name, if applicable, and dosage form,
  436  including concentration of tetrahydrocannabinol and cannabidiol.
  437  The product name may not contain wording commonly associated
  438  with products marketed by or to children.
  439         (VII) The recommended dose.
  440         (VIII) A warning that it is illegal to transfer medical
  441  marijuana to another person.
  442         (IX) A marijuana universal symbol developed by the
  443  department.
  444         12.11. The medical marijuana treatment center shall include
  445  in each package a patient package insert with information on the
  446  specific product dispensed related to:
  447         a. Clinical pharmacology.
  448         b. Indications and use.
  449         c. Dosage and administration.
  450         d. Dosage forms and strengths.
  451         e. Contraindications.
  452         f. Warnings and precautions.
  453         g. Adverse reactions.
  454         13.In addition to the packaging and labeling requirements
  455  in subparagraphs 11. and 12., marijuana in a form for smoking
  456  must be packaged in a sealed receptacle with a legible and
  457  prominent warning to keep away from children and a warning that
  458  states marijuana smoke contains carcinogens and may negatively
  459  affect health. Such receptacles for marijuana in a form for
  460  smoking must be plain, opaque, and white without depictions of
  461  the product or images other than the medical marijuana treatment
  462  center’s department-approved logo and the marijuana universal
  463  symbol.
  464         14. Before dispensing a marijuana delivery device, a
  465  medical marijuana treatment center must ensure that the
  466  marijuana delivery device:
  467         a. Has a firmly affixed, legible, and permanent label
  468  showing the medical marijuana treatment center’s department
  469  approved logo, including each individual marijuana cigarette or
  470  wrapping paper.
  471         b. Does not incorporate colors, shapes, forms, or designs
  472  that are intended to make the marijuana delivery device
  473  attractive to children or are likely, by their nature, to be
  474  attractive to children. The department shall adopt rules
  475  specifying allowable colors, shapes, forms, and designs for
  476  marijuana delivery devices.
  477         15.12. Each edible shall be individually sealed in plain,
  478  opaque wrapping marked only with the marijuana universal symbol.
  479  Where practical, each edible shall be marked with the marijuana
  480  universal symbol. In addition to the packaging and labeling
  481  requirements in subparagraphs 11. and 12. subparagraphs 10. and
  482  11., edible receptacles must be plain, opaque, and white without
  483  depictions of the product or images other than the medical
  484  marijuana treatment center’s department-approved logo and the
  485  marijuana universal symbol. The receptacle must also include a
  486  list all of the edible’s ingredients, storage instructions, an
  487  expiration date, a legible and prominent warning to keep away
  488  from children and pets, and a warning that the edible has not
  489  been produced or inspected pursuant to federal food safety laws.
  490         16.13. When dispensing marijuana or a marijuana delivery
  491  device, a medical marijuana treatment center:
  492         a. May dispense any active, valid order for low-THC
  493  cannabis, medical cannabis and cannabis delivery devices issued
  494  pursuant to former s. 381.986, Florida Statutes 2016, which was
  495  entered into the medical marijuana use registry before July 1,
  496  2017.
  497         b. May not dispense more than a 70-day supply of marijuana
  498  or more than a 35-day supply of marijuana in a form for smoking
  499  to a qualified patient or caregiver. A 35-day supply of
  500  marijuana in a form for smoking may not exceed four ounces.
  501         c. Must have the medical marijuana treatment center’s
  502  employee who dispenses the marijuana or a marijuana delivery
  503  device enter into the medical marijuana use registry his or her
  504  name or unique employee identifier.
  505         d. Must verify that the qualified patient and the
  506  caregiver, if applicable, each have an active registration in
  507  the medical marijuana use registry and an active and valid
  508  medical marijuana use registry identification card, the amount
  509  and type of marijuana dispensed matches the physician
  510  certification in the medical marijuana use registry for that
  511  qualified patient, and the physician certification has not
  512  already been filled.
  513         e. May not dispense marijuana to a qualified patient who is
  514  younger than 18 years of age. If the qualified patient is
  515  younger than 18 years of age, marijuana may only be dispensed
  516  only to the qualified patient’s caregiver.
  517         f. May not dispense or sell any other type of cannabis,
  518  alcohol, or illicit drug-related product, including pipes,
  519  bongs, or wrapping papers, other than a marijuana delivery
  520  device required for the medical use of marijuana and which is
  521  specified in a physician certification.
  522         g. Must, upon dispensing the marijuana or marijuana
  523  delivery device, record in the registry the date, time,
  524  quantity, and form of marijuana dispensed; the type of marijuana
  525  delivery device dispensed; and the name and medical marijuana
  526  use registry identification number of the qualified patient or
  527  caregiver to whom the marijuana delivery device was dispensed.
  528         h. Must ensure that patient records are not visible to
  529  anyone other than the qualified patient, his or her caregiver,
  530  and authorized medical marijuana treatment center employees.
  531         (14) EXCEPTIONS TO OTHER LAWS.—
  532         (a) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
  533  any other provision of law, but subject to the requirements of
  534  this section, a qualified patient and the qualified patient’s
  535  caregiver may purchase from a medical marijuana treatment center
  536  for the patient’s medical use a marijuana delivery device and up
  537  to the amount of marijuana authorized in the physician
  538  certification, but may not possess more than a 70-day supply of
  539  marijuana at any given time and all marijuana purchased must
  540  remain in its original packaging.
  541         (b) Notwithstanding paragraph (a), s. 893.13, s. 893.135,
  542  s. 893.147, or any other provision of law, a qualified patient
  543  and the qualified patient’s caregiver may purchase and possess a
  544  marijuana delivery device intended for the medical use of
  545  marijuana by smoking from a vendor other than a medical
  546  marijuana treatment center.
  547         (c)(b) Notwithstanding s. 893.13, s. 893.135, s. 893.147,
  548  or any other provision of law, but subject to the requirements
  549  of this section, an approved medical marijuana treatment center
  550  and its owners, managers, and employees may manufacture,
  551  possess, sell, deliver, distribute, dispense, and lawfully
  552  dispose of marijuana or a marijuana delivery device as provided
  553  in this section, s. 381.988, and by department rule. For the
  554  purposes of this subsection, the terms “manufacture,”
  555  “possession,” “deliver,” “distribute,” and “dispense” have the
  556  same meanings as provided in s. 893.02.
  557         (d)(c) Notwithstanding s. 893.13, s. 893.135, s. 893.147,
  558  or any other provision of law, but subject to the requirements
  559  of this section, a certified marijuana testing laboratory,
  560  including an employee of a certified marijuana testing
  561  laboratory acting within the scope of his or her employment, may
  562  acquire, possess, test, transport, and lawfully dispose of
  563  marijuana as provided in this section, in s. 381.988, and by
  564  department rule.
  565         (e)(d) A licensed medical marijuana treatment center and
  566  its owners, managers, and employees are not subject to licensure
  567  or regulation under chapter 465 or chapter 499 for
  568  manufacturing, possessing, selling, delivering, distributing,
  569  dispensing, or lawfully disposing of marijuana or a marijuana
  570  delivery device, as provided in this section, in s. 381.988, and
  571  by department rule.
  572         (f)(e) This subsection does not exempt a person from
  573  prosecution for a criminal offense related to impairment or
  574  intoxication resulting from the medical use of marijuana or
  575  relieve a person from any requirement under law to submit to a
  576  breath, blood, urine, or other test to detect the presence of a
  577  controlled substance.
  578         (g)(f) Notwithstanding s. 893.13, s. 893.135, s. 893.147,
  579  or any other provision of law, but subject to the requirements
  580  of this section and pursuant to policies and procedures
  581  established pursuant to s. 1006.62(8), school personnel may
  582  possess marijuana that is obtained for medical use pursuant to
  583  this section by a student who is a qualified patient.
  584         (h)(g) Notwithstanding s. 893.13, s. 893.135, s. 893.147,
  585  or any other provision of law, but subject to the requirements
  586  of this section, a research institute established by a public
  587  postsecondary educational institution, such as the H. Lee
  588  Moffitt Cancer Center and Research Institute, Inc., established
  589  under s. 1004.43, or a state university that has achieved the
  590  preeminent state research university designation under s.
  591  1001.7065 may possess, test, transport, and lawfully dispose of
  592  marijuana for research purposes as provided by this section.
  593         (15) APPLICABILITY.—
  594         (a) This section does not limit the ability of an employer
  595  to establish, continue, or enforce a drug-free workplace program
  596  or policy.
  597         (b) This section does not require an employer to
  598  accommodate the medical use of marijuana in any workplace or any
  599  employee working while under the influence of marijuana.
  600         (c) This section does not create a cause of action against
  601  an employer for wrongful discharge or discrimination.
  602         (d) This section does not impair the ability of any party
  603  to restrict or limit smoking on his or her private property.
  604         (e) This section does not prohibit the medical use of
  605  marijuana, or a caregiver assisting with the medical use of
  606  marijuana, in a nursing home licensed under part II of chapter
  607  400; in a hospice facility licensed under part IV of chapter
  608  400; or in an assisted living facility licensed under part I of
  609  chapter 429, if the medical use of marijuana is not prohibited
  610  in the facility’s policies.
  611         (f) Marijuana, as defined in this section, is not
  612  reimbursable under chapter 440.
  613         Section 2. Section 1004.4351, Florida Statutes, is amended
  614  to read:
  615         1004.4351 Medical marijuana research and education.—
  616         (1) SHORT TITLE.—This section shall be known and may be
  617  cited as the “Medical Marijuana Research and Education Act.”
  618         (2) LEGISLATIVE FINDINGS.—The Legislature finds that:
  619         (a) The present state of knowledge concerning the use of
  620  marijuana to alleviate pain and treat illnesses is limited
  621  because permission to perform clinical studies on marijuana is
  622  difficult to obtain, with access to research-grade marijuana so
  623  restricted that little or no unbiased studies have been
  624  performed.
  625         (b) Under the State Constitution, marijuana is available
  626  for the treatment of certain debilitating medical conditions.
  627         (c) Additional clinical studies are needed to ensure that
  628  the residents of this state obtain the correct dosing,
  629  formulation, route, modality, frequency, quantity, and quality
  630  of marijuana for specific illnesses.
  631         (d) An effective medical marijuana research and education
  632  program would mobilize the scientific, educational, and medical
  633  resources that presently exist in this state to determine the
  634  appropriate and best use of marijuana to treat illness.
  635         (3) DEFINITIONS.—As used in this section, the term:
  636         (a) “Board” means the Medical Marijuana Research and
  637  Education Board.
  638         (b) “Consortium” “Coalition” means the Consortium Coalition
  639  for Medical Marijuana Clinical Outcomes Research and Education.
  640         (c) “Marijuana” has the same meaning as provided in s. 29,
  641  Art. X of the State Constitution.
  642         (4) CONSORTIUM COALITION FOR MEDICAL MARIJUANA CLINICAL
  643  OUTCOMES RESEARCH AND EDUCATION.—
  644         (a) There is established within the H. Lee Moffitt Cancer
  645  Center and Research Institute, Inc., the Consortium Coalition
  646  for Medical Marijuana Clinical Outcomes Research consisting of
  647  public and private universities and Education. The purpose of
  648  the consortium coalition is to conduct rigorous scientific
  649  research and, provide education, disseminate such research, and
  650  guide policy for the adoption of a statewide policy on ordering
  651  and dosing practices for the medical use of marijuana. The
  652  consortium coalition shall be physically located at the H. Lee
  653  Moffitt Cancer Center and Research Institute, Inc.
  654         (b) The Medical Marijuana Research and Education Board is
  655  established to direct the operations of the consortium
  656  coalition. The board shall be composed of a chairperson
  657  appointed by the H. Lee Moffitt Cancer Center and Research
  658  Institute, Inc., a member appointed by the University of
  659  Florida, and a member representing each other participating
  660  university seven members appointed by the president of the
  661  university the chief executive officer of the H. Lee Moffitt
  662  Cancer Center and Research Institute, Inc. Board members must
  663  have experience in a variety of scientific and medical fields,
  664  including, but not limited to, oncology, neurology, psychology,
  665  pediatrics, nutrition, and addiction. Members shall be appointed
  666  to 4-year terms and may be reappointed to serve additional
  667  terms. The chair shall be elected by the board from among its
  668  members to serve a 2-year term. The board shall meet at least
  669  semiannually at the call of the chair or, in his or her absence
  670  or incapacity, the vice chair. Four members constitute a quorum.
  671  A majority vote of the members present is required for all
  672  actions of the board. The board may prescribe, amend, and repeal
  673  a charter governing the manner in which it conducts its
  674  business. A board member shall serve without compensation but is
  675  entitled to be reimbursed for travel expenses by the consortium
  676  coalition or the organization he or she represents in accordance
  677  with s. 112.061.
  678         (c) The consortium coalition shall be administered by a
  679  coalition director, who shall be appointed by the H. Lee Moffitt
  680  Cancer Center and Research Institute, Inc and serve at the
  681  pleasure of the board. The coalition director shall, subject to
  682  the approval of the board:
  683         1. Propose a budget for the consortium coalition.
  684         2. Foster the collaboration of scientists, researchers, and
  685  other appropriate personnel in accordance with the consortium’s
  686  coalition’s charter.
  687         3. Engage individuals in public and private university
  688  programs relevant to the consortium’s work to participate in the
  689  consortium.
  690         4.3. Identify and prioritize the research to be conducted
  691  by the consortium coalition.
  692         5.4. Prepare a plan for medical marijuana research the
  693  Medical Marijuana Research and Education Plan for submission to
  694  the board.
  695         6.5. Apply for grants to obtain funding for research
  696  conducted by the consortium coalition.
  697         7.6. Perform other duties as determined by the board.
  698         (d) The board shall advise the Board of Governors, the
  699  State Surgeon General, the Governor, and the Legislature with
  700  respect to medical marijuana research and education in this
  701  state. The board shall explore methods of implementing and
  702  enforcing medical marijuana laws in relation to cancer control,
  703  research, treatment, and education.
  704         (d)(e) The board shall annually adopt a plan for medical
  705  marijuana research. The plan shall organize a program of
  706  research that contributes to the body of scientific knowledge on
  707  the effects of the medical use of marijuana and informs both
  708  policy and medical practice related to the treatment of
  709  debilitating medical conditions with marijuana. Research shall
  710  include tracking clinical outcomes, certification standards,
  711  dosing standards, routes of administration, efficacy, and side
  712  effects. Research must also include the study of the effects of
  713  smoking marijuana to treat debilitating medical conditions. The
  714  board must award funds to members of the consortium to perform
  715  research consistent with the plan, known as the “Medical
  716  Marijuana Research and Education Plan,” which must be in
  717  accordance with state law and coordinate with existing programs
  718  in this state. The plan must include recommendations for the
  719  coordination and integration of medical, pharmacological,
  720  nursing, paramedical, community, and other resources connected
  721  with the treatment of debilitating medical conditions; research
  722  related to the treatment of such medical conditions; and
  723  education.
  724         (e)(f) By February 15 of each year, the board shall issue a
  725  report to the Governor, the President of the Senate, and the
  726  Speaker of the House of Representatives on research projects,
  727  research findings, community outreach initiatives, and future
  728  plans for the consortium coalition.
  729         (f)(g) Beginning August 1, 2019 January 15, 2018, and
  730  quarterly thereafter, the Department of Health shall submit to
  731  the board a data set that includes, for each patient registered
  732  in the medical marijuana use registry, the patient’s qualifying
  733  medical condition and the daily dose amount, routes of
  734  administration, and forms of marijuana certified for the
  735  patient. The department shall also submit to the board a data
  736  set for all patients registered in the medical marijuana use
  737  registry before August 1, 2019.
  738         (5) RESPONSIBILITIES OF THE H. LEE MOFFITT CANCER CENTER
  739  AND RESEARCH INSTITUTE, INC.—The H. Lee Moffitt Cancer Center
  740  and Research Institute, Inc., shall allocate staff and provide
  741  information and assistance, as the consortium’s coalition’s
  742  budget permits, to assist the board in fulfilling its
  743  responsibilities.
  744         Section 3. Paragraph (h) of subsection (2) and paragraph
  745  (b) of subsection (3) of section 381.987, Florida Statutes, are
  746  amended to read:
  747         381.987 Public records exemption for personal identifying
  748  information relating to medical marijuana held by the
  749  department.—
  750         (2) The department shall allow access to the confidential
  751  and exempt information in the medical marijuana use registry to:
  752         (h) The Consortium Coalition for Medical Marijuana Clinical
  753  Outcomes Research and Education established in s. 1004.4351(4).
  754         (3) The department shall allow access to the confidential
  755  and exempt information pertaining to the physician certification
  756  for marijuana and the dispensing thereof, whether in the
  757  registry or otherwise held by the department, to:
  758         (b) The Consortium Coalition for Medical Marijuana Clinical
  759  Outcomes Research and Education pursuant to s. 381.986 for the
  760  purpose of conducting research regarding the medical use of
  761  marijuana.
  762         Section 4. The proviso following Specific Appropriation 422
  763  in section 3 of chapter 2018-9, Laws of Florida, and the proviso
  764  following Specific Appropriation 424 in section 3 of chapter
  765  2018-9, Laws of Florida, are repealed and the funds appropriated
  766  by those specific appropriations which were affected by those
  767  provisos are released from reserve.
  768         Section 5. This act shall take effect upon becoming a law.
  769  
  770  ================= T I T L E  A M E N D M E N T ================
  771  And the title is amended as follows:
  772         Delete everything before the enacting clause
  773  and insert:
  774                        A bill to be entitled                      
  775         An act relating to the medical use of marijuana;
  776         amending s. 381.986, F.S.; redefining the term
  777         “marijuana delivery device” to eliminate the
  778         requirement that such devices must be purchased from a
  779         medical marijuana treatment center; redefining the
  780         term “medical use” to include the possession, use, or
  781         administration of marijuana in a form for smoking;
  782         restricting the smoking of marijuana in enclosed
  783         indoor workplaces; conforming a provision to changes
  784         made by the act; requiring a patient’s informed
  785         consent form to include the risks specifically
  786         associated with smoking marijuana; prohibiting a
  787         physician from certifying a patient under 18 years of
  788         age to smoke marijuana for medical use unless the
  789         patient is diagnosed with a terminal condition and the
  790         physician makes a certain determination in concurrence
  791         with a second physician who is a pediatrician;
  792         conforming a provision to changes made by the act;
  793         requiring the Board of Medicine and the Board of
  794         Osteopathic Medicine to adopt certain practice
  795         standards by rule; requiring the Department of Health
  796         to provide the boards with certain information from
  797         the medical marijuana use registry, as necessary;
  798         establishing supply limits for physician
  799         certifications for marijuana in a form for smoking;
  800         requiring each medical marijuana treatment center to
  801         produce and make available for purchase at least one
  802         type of pre-rolled marijuana cigarette; requiring that
  803         marijuana in a form for smoking meet certain packaging
  804         and labeling requirements; requiring a medical
  805         marijuana treatment center to ensure that a marijuana
  806         delivery device meets certain packaging and labeling
  807         requirements; requiring the department to adopt rules
  808         specifying certain packaging and labeling requirements
  809         for marijuana delivery devices; prohibiting a medical
  810         marijuana treatment center from dispensing more than a
  811         specified supply limit of marijuana in a form for
  812         smoking; deleting a provision prohibiting a medical
  813         marijuana treatment center from dispensing or selling
  814         specified products; allowing marijuana delivery
  815         devices to be purchased from a vendor other than a
  816         medical marijuana treatment center; providing
  817         applicability; amending s. 1004.4351, F.S.; renaming
  818         the Coalition for Medical Marijuana Research and
  819         Education as the Consortium for Medical Marijuana
  820         Clinical Outcomes Research; establishing the
  821         consortium for a specified purpose; renaming the
  822         Medical Marijuana Research and Education Board as the
  823         Medical Marijuana Research Board; requiring the board
  824         to direct the operations of the consortium; providing
  825         membership of the board; providing for the appointment
  826         of a consortium director; providing duties of the
  827         consortium director; requiring the board to annually
  828         adopt a plan for medical marijuana research; requiring
  829         the plan to include specified information; providing
  830         research requirements for the plan; requiring the
  831         board to issue an annual report to the Governor and
  832         Legislature by a specified date; requiring the
  833         department to submit certain data sets to the board;
  834         amending s. 381.987, F.S.; conforming provisions to
  835         changes made by the act; repealing proviso language in
  836         s. 3, ch. 2018-9, Laws of Florida, relating to
  837         salaries and benefits positions and other personnel
  838         services of the department; providing an effective
  839         date.