The law took effect January 1, but the rules that would make it available to patients were approved only last month.

The Illinois medical marijuana law, signed by the governor in 2014, became effective last month when the legislative rules committee approved a slew of stringent requirements that will govern the pilot program. It's not clear when patients with covered conditions will be able to get the drug. And it won't be easy.

Known by lawmakers and state agencies as one of the strictest medical marijuana laws in the country, patients who want to participate must get an identification card through the Illinois Department of Public Health certifying that they suffer from one of more than 30 qualifying illnesses, have a relationship with a treating physician, be fingerprinted, and pay a fee. The law is a pilot program, which sunsets at the end of 2017 unless lawmakers decide to extend it.

Four agencies have, for the past year, been crafting rules that would govern who gets to grow the marijuana, which doctors will be licensed to prescribe it, how close dispensaries and agricultural growing centers can be to schools, how the government will monitor seed transport, and a raft of issues large and small. If you live in Chicago, where possession of small amounts of marijuana results in a mere fine, this all might seem quite draconian. But lawmakers intended the law to be the strictest of its kind in the nation.

Implementing the law will be four state agencies: The Illinois Department of Financial and Professional Regulation has promulgated 97 pages of rules, the Illinois Department of Agriculture 101 pages, the Illinois Department of Public Health has a 53-page document, and the Illinois Department of Revenue has 19 pages of rules. The agencies have worked with lawmakers as the rules have evolved. Each will have its role in monitoring compliance with various aspects of the law, including patient accountability, the growing of marijuana, doctor compliance, and dispensaries.

Susan Hofer, a spokeswoman for the Illinois Department of Public Health, said each agency will post applications, for example to grow marijuana, dispense it, and use it, by the end of August. Like the law itself, the application process is stringent, she said, which is why each of the four state agencies is making the applications available on their websites. Since no one knows how many patients, growers, or dispensaries will apply, it is difficult to predict when the first patients will begin receiving medical marijuana, she said.

The legislative rules committee, JCAR, passed the rules on July 15, providing a medicinal antidote for patients with specified health conditions.

Prior to JCAR's action, Rep. Louis Lang (D-Skokie), who sponsored the bill, expressed his strong support for the law and the rules. "The bottom line is I think the agencies have done a stellar job. They started from ground zero and in this short period of time, I think they've [made excellent progress]."

Surprisingly, Lang said he was not hearing from constituents in need of medicinal marijuana. Instead, he is hearing from the entrepreneurs: representatives of the cultivation centers (there will be 22) and dispensaries (there will be 60).

"Neither the bill nor the rules are perfect," Lang said. "The whole program is only a four-year pilot. But I do not intend to let go of this until patients have what they need."

Tight controls

Known formally as the Compassionate Use of Medical Cannabis Pilot Program Act (note the absence of the word "marijuana"), Bob Morgan, the program's statewide project coordinator, said the government held two public hearings on the rules, one in April and another in May. In an interview prior to JCAR's approval of the rules, Morgan said "we've worked very closely with members of staff on JCAR."

No one has been issued a permit to grow, dispense, or prescribe at this time, nor will they be before the application process begins in late August, Hofer said.

Since the bill's passage, it was amended to add seizures to the list of conditions that qualify a patient for medical marijuana. It was also changed to make cannabis available to children with certain health conditions, like cancer. Also, the original three-year sunset provision was extended to four.

The Illinois Department of Financial and Professional Regulation will be in charge of monitoring the dispensing of the drug and monitoring the doctors authorized to dispense, Morgan said. The health department will enroll patients and get physicians certified. The department of agriculture will monitor the growers (marijuana will be grown locally rather than purchased from outside sources).

"From the legislature to the governor, it was very important to everyone that we had tight controls," Morgan said. "We want safe products and safe controls but we want to make sure that those suffering from debilitating illnesses have access to cannabis. It's [a matter of] balancing these two interests."

Morgan noted that other states are looking to Illinois to see how the law works. "We are not the newest kid on the block…. But Illinois has become a model for states looking [to create tightly] controlled programs," he said.

For more about Illinois' medical cannabis law, see the cover story in the April 2014 IBJ. - Janan Hanna