BISMARCK-North Dakota residents won access to medical marijuana in Tuesday's election following the passage of Measure 5, but it's unclear how soon patients will be able to buy the drug.

The measure included a provision for a 30-day window for the North Dakota Department of Health to build out the rules and procedures needed to regulate marijuana production and distribution to qualifying patients.

Arvy Smith, deputy state health officer, said she believes the 30-day timeframe is not enough to get everything done to fit what she described as a measure with a wide scope.

"For some states with broader measures, it takes 18 months to implement," Smith said. "I don't know how long ours will take, but it depends on the answers we get as far as funding and authority and such."

The state health department estimated the cost of the first biennium of medical marijuana at around $8.7 million, about $1.4 million of which would be in one-time spending. Some of that money would go towards personnel needs of about 32 full-time employees tasked with administering the program.

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Those costs were previously challenged by advocates of the measure, but Smith said they were estimated using input from medical marijuana programs in other states.

The broadness of the North Dakota measure, which Smith said allows for "unlimited" marijuana growers and dispensers, about a dozen qualifying medical conditions and an allowance for "any form of use you can imagine" makes implementation a more costly process.

As it's currently structured, the measure would require individuals seeking medical marijuana to first become a qualifying patient by obtaining a statement from a physician asserting they have a qualifying disorder. From there, the patient would forward that statement in an application process with the state health department. If approved by the department, the patient would then be granted a registration card to allow them to purchase marijuana from a designated caregiver or a compassion center-that is, respectively, a small-scale vendor licensed to serve up to five patients or a full dispensary.

Patients would then be allowed to possess up to 3 ounces of medical marijuana, which remains an illegal substance under federal law.

Jennifer Skjod, public information officer at the health department, said representatives from the department are hoping to meet with the North Dakota Office of Management and Budget to secure some emergency funding to begin hiring personnel to oversee the program's development.

Skjod said the costs of implementing the measure are a concern to the department, which has no clear budget for the program and has already absorbed funding cuts passed down in the allotment process.

As of now, Skjod said, it's undecided where the department's future medical marijuana duties-such as inspecting growing facilities and dispensaries, conducting background checks on dispensary staff and issuing clearances to eligible patients to buy the substance-will be organized among the department's offices.

"There's a possibility that we may be creating another section that will address medical marijuana use," Skjod said. "All those checks and balances need to be done to make sure everything's done appropriately."

The department has already heard from parties interested in either purchasing medical marijuana or entering the cultivation business.

Skjod said the turnaround for implementing the measure will be tight, but said the health department is "committed to doing our best to meet the needs" of any timeline set by the state.

For now, parts of the process are still an open conversation. Skjod said the pulling together a group of health professionals to determine which medical disorders should qualify patients to receive cards authorizing them to buy marijuana.

Other parts of the measure will rely on legal consultation to forge a clear path to implementation.

Smith said certain pieces of language in the measure will need to be clarified before they can be addressed in a marijuana program.

As one example, she said the measure states the department won't be able to register designated caregivers unless they have no excluded felony offenses on their record. However, Smith said, the definition of "excluded felony offenses" is not included in the measure itself.

Moving forward, Smith said the department will continue to hammer out the nuances in language and piece together an idea of what falls under its own majority and what will require action from the North Dakota Legislature.

The existing legal and budgetary gray areas made it difficult for her to estimate the actual timeline for implementation. Along with the logistics of the program, Smith said the department also needs to roll out some public education.

"There are already a lot of questions from people coming into our office this morning," she said.