Like so many other things in Illinois state government, both past and present, the Medical Cannabis Pilot Program is not progressing exactly as planned. After a decade of legislative negotiations, during which industry groups and progressives made concessions, like giving the program an expiration date and the strictest restrictions in the nation on what conditions qualify patients for medical cards, the Compassionate Use of Medical Cannabis Pilot Program Act was signed into law by then-Governor Pat Quinn on August 1, 2013, making Illinois the 23rd state to legalize medical cannabis in some form.

Almost immediately, the program was tied up in state bureaucracy.

Though well aware that the law only provided four years for the program to be developed, implemented, and reviewed, Governor Quinn’s administration took all of 2014 to establish and adopt the rules for the program. He left office in January 2015 without issuing any business or growing licenses for unclear reasons. The task fell to his successor, Republican Bruce Rauner, whose main accomplishment thus far has been absolutely nothing.

Just 5,000 people have been accepted to the program to date––in a state of nearly 13 million. Clearly, something is wrong here.

On the campaign trail, Rauner told reporters that he would have vetoed the law as governor and criticized the “secret process” by which the Quinn administration was planning on awarding business and grow licenses, saying that the process should be by “public auction.” A month into his governorship, however, Rauner awarded all of the business and grow licenses allotted by law without explaining his quick turnaround or the lack of his public auction. 

Image via WUIS

Still, the program was at least finally moving forward.

Patients began getting approved for medical cards in October, and dispensaries across the state opened their doors in November. In the first week, they sold 13,000 grams of weed––some $210,000 worth. Now, with the battle to open the dispensaries finally over, another problem quickly became apparent: Almost no one in Illinois has a medical marijuana card, despite estimations from state officials that 75-100,000 patients would enroll within the first year.

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To match the baseline state projections, the program would have to enroll at least 6,250 people every month. To reach 30,000 patients, the much more modest initial year-end estimate of Dan Linn, executive director of the Illinois chapter of the National Organization for the Reform of Marijuana Laws (NORML), the program would still need to enroll 2,500 people a month. Just 5,000 people have been accepted to the program to date, according to the program’s director, Joseph Wright––in a state of nearly 13 million. Clearly, something is wrong here.

The catch here is that medical groups all over the state are reluctant (or just refuse) to write the recommendations. 

To be sure, becoming a medical cannabis patient in Illinois isn’t as easy as it is in more open-minded states. First, you have to have one of the truly debilitating conditions specified in the law (a sampler: Lupus, Alzheimer’s, cancer, HIV, Tourette’s, MS, Crohn’s, “traumatic brain injury”). Next, you have to get a doctor who will sign a five-page form saying, among other things, that they’ve treated you before for things unrelated to cannabis, and then mail it into the state Department of Public Health for you. 

The catch here is that medical groups all over the state are reluctant (or just refuse) to write the recommendations. According to NORML's Linn, the low patient numbers are “the result of doctors unwilling or unable to write recommendations.”

“The majority of doctors I’ve spoken to are under the impression that they’re writing a prescription for a medication, when, if you look at the form, it is most certainly not a prescription. What they are doing is certifying that a patient has a qualifying condition, and that the patient might benefit from the use of medical cannabis. Very different from a prescription, but that fundamental difference is something most doctors don’t know,” according to Dina Rollman, a partner at the Chicago cannabis-focused law firm Rollman & Dahlin. Rollman says that the state must do more doctor and patient education outreach about the program for it to succeed.

Image via Brettstebbins/VSCO

Tammy Jacobi, owner of Good Intentions, a Chicago company that helps patients with the extensive paperwork, told the AP in August that she believes the reason why medical groups are so skittish is harsh penalties handed out by state regulators at the beginning of the program to doctors accused of offering pre-approval for medical cannabis cards.

One of the medical groups that prohibits its doctors from writing cannabis recommendations, Southern Illinois University HealthCare, is part of the state university system, which is technically run by the governor. A spokesperson for SIU’s School of Medicine denied that Governor Rauner’s office had anything to do with its decision to ban weed recommendations.

So prospects are grim. Governor Bruce Rauner has twice declined the recommendations of an expert state panel to expand the condition list, and refused to extend the program. 

“I don’t frankly think that the system as it is right now can support itself because of how few patients are in the system,” says Kathleen Kane-Willis, a drug policy expert and director of the Illinois Consortium on Drug Policy at Roosevelt University. “The whole idea was supposed to be, well, once there’s dispensaries open, there’ll be a rush of people going to get medical cards, but I don’t see that happening.… In some ways, I feel as though it’s been set up to fail,” she continues. “I don’t mean the legislators wrote it to, but because it went through so many years of process, water-down, water-down, water-down..… You can have the system and set it up, and I could be wrong, but my sense is not allowing the sunset clause to be from the date of implementation suggests to me that the governor is not interested at all in seeing the results of the pilot program.”

Image via Chicago Tribune

While industry groups say that they don’t anticipate legalization to disappear, that is exactly what will happen after 2017 if Governor Rauner lets the program expire.

As a researcher, Kane-Willis says, “You would really want to have a couple of good years of data to be able to understand what the impact of the legislation is.”

As multiple people pointed out to me in the course of reporting this story, the Illinois public is strongly behind the Pilot Program (80 percent), its benefits (73 percent), and its expansion (69 percent), according to a poll taken in January. “I think long-term we’re gonna get there [legislatively],” attorney Bryna Dahlin, Rollman’s partner at Rollman & Dahlin, says, “but these immediate roadblocks have been frustrating.”

While industry groups say that they don’t anticipate legalization to disappear, that is exactly what will happen after 2017 if Governor Rauner fails to take action and lets the program expire. No one was able to provide me with a clear strategy for ensuring the extension of the program. Linn, of NORML Illinois, says he is counting on getting a bill fast-tracked through the Democratic supermajorities in both houses, which could override a potential veto from Rauner, framing the fight over medical cannabis within Illinois’s current political climate. “There are so many other variables going into everything that’s happening today in Illinois besides the medical program,” he says, that “it’s easy for people to have tunnel vision and only focus on the medical program, but it really does exist as part of a broader fight that’s going on between the governor and the Democratic-controlled legislature," referring to the stalemate between House Speaker Michael Madigan and Rauner, which has resulted in the 2016 state budget being nine months overdue (and counting).


Christopher Mooney, director of the Institute of Government and Public Affairs at the University of Illinois at Springfield, says that though he agrees with Linn that there may be benefits to the issue not being in the forefront of legislators’ minds, he is “less optimistic” about “the General Assembly overriding a Rauner veto of some legislation…This is not a done deal with all Democrats in the GA.” Further complicating this plan are several recent high-profile defections from House Speaker Michael Madigan’s camp, making veto overrides all but impossible.

Ross Morreale, executive director of the Medical Cannabis Alliance of Illinois, says he’s “not concerned” about the program’s future existence, with hopes that “open-minded Republicans will recognize the benefits” of the industry.

Joseph Wright, the director of the Medical Cannabis Pilot Program, said in an email, “The pilot program is moving forward, but remains in an early stage. With only four months of patient sales on record, the State has not had the opportunity to fully evaluate the benefits and costs of the pilot program. The State will continue to evaluate possible changes to the program and areas for improvement as the pilot period unfolds.” 

Governor Rauner's office did not reply to submitted questions.

This is the first installment in contributor Sam Stecklow's two-part, in-depth dispatches from Illinois's failing medical-marijuana pilot program. Check back Thursday, 3/10 as Stecklow explores perceived racism and police obstructionism in the Prairie State. 

Follow Sam on Twitter here.

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