SD Mulls Medical Cannabis Plans

Medical marijuana becomes law July 1 in South Dakota, but the state Department of Health said the drug won’t likely become available for usage until next year.

Health Secretary Kim Malsam-Rysdon hosted two telephone “town halls” Monday, answering call-in questions and taking public input on proposed rules.

Last November, South Dakota voters widely approved Initiated Measure 26, which legalized medical marijuana. IM 26 goes into effect this week, but the manufacturing and distribution of cannabis will take additional time.

Under IM 26, the DOH must enact final administrative rules for medical cannabis by Oct. 29, 2021. The issuance of medical marijuana cards for patients begins Nov. 18, 2021.

Malsam-Rysdon reassured callers that the state will meet that timetable. However, the drug itself won’t likely be immediately available as the rest of the process rolls out for growing, testing, licensing and sales.

“It will be some time before people are able to purchase marijuana that is grown in South Dakota,” she said. “We estimate the marijuana grown in South Dakota and part of the program will be available in the summer or fall of 2022.”

The draft rules were released June 24, and public comments will be taken until July 9. The DOH will begin the formal approval process for the rules, which also require the Legislature’s approval, in September after seeking further feedback from stakeholders and the public.  

“The proposed administrative rules are one of many steps our department has taken to develop a safe and responsible medical cannabis program in South Dakota, as the voters intended,” the secretary said.

Under the measure, the DOH must enact final administrative rules for medical cannabis by Oct. 29, 2021. The issuance of medical marijuana cards for patients begins Nov. 18, 2021.

Malsam-Rysdon strongly disagreed with one caller who accused Gov. Kristi Noem of “dragging her feet” on the medical marijuana issue.

“Gov. Noem has not dragged her feet. We asked the Legislature to clarify some aspects of the implementation of IM 26 as soon it passed (last November),” the secretary said. “IM 26 has had a timeline in order to get different aspects of the program done. … We are implementing the program as one of the quickest states in the entire nation. We have 100 pages of rules for people to comment on.”

A different caller disagreed on the characterization of South Dakota’s response, noting another state, Arizona, with a faster implementation of its medical cannabis regulations.

In response to questions, Malsam-Rysdon said federal law prohibits transporting medical marijuana across state lines and setting up exchanges with each other. In addition, federal agencies, such as the Veterans Administration (VA), cannot dispense medical marijuana because it violates federal law.

In addition, Malsam-Rysdon noted the differences in programs among states.

“The reasons why we don’t see cards good (for transfer) from one state to other states (are because): every state program somewhere is unique in terms of who can qualify, unique in how much medical marijuana you can possess, unique in how the establishments are governed,” she said. “So you see the need to apply if you’re a non-resident of South Dakota and using medical cannabis while in South Dakota. You can apply to our Department of Health (for a card).”

Two callers referred to Hawaii and Iowa seeking federal exemptions for legalizing medical marijuana, with Minnesota as another possibility. Malsam-Rysdon noted South Dakota legislators were visiting Iowa on Monday to learn more about the state’s program.

The secretary outlined basic requirements in determining if a patient qualifies for medical marijuana usage.

“The person applying for a medical cannabis card in South Dakota has to go to a physician within the state and have a bona fide patient-provider relationship,” she said. “The physician has to do an in-person physical examination of the patient. It could be your own provider or another doctor. If your doctor isn’t going to participate in the program, you need to find a different provider for this purpose and still meet the other requirements.”

One caller questioned why the state will charge a fee for using medical marijuana but not for other drugs.

“Medical cannabis is not a prescription in that it is not regulated by the FDA (Food and Drug Administration). It is considered a controlled substance at the federal level,” the secretary said. “A physician would provide a written certification that the patient needs medical cannabis, but it is not a prescription, and it does not include things such as dosage and how many days a week to take it. There is an important distinction between medical cannabis and prescription medications.”

IM 26 does include a provision for a $20 fee for low-income patients, whose gross income comes to 130% or less of the federal poverty level.

On another question, the secretary noted a caregiver administering medical cannabis must be at least 21 years of age, assisting with the qualifying patient with the use of cannabis, not convicted of a disqualifying felony offense and not assisting more than five patients with medical cannabis use unless they are residents admitted to a health care facility.

Questions also arose on taxation and other rules surrounding medical cannabis. The secretary noted local governments can set up regulations, but dispensaries and other aspects must meet state requirements.

“The state sales tax does apply to medical cannabis. It’s not a prescription, so the exemption from taxation for prescription drugs doesn’t apply to medical cannabis. Local governments have the opportunity to pass ordinances regarding dispensaries and other establishments in geographic locations,” she said.

Questions arose about certain conditions, such as mental health, currently not considered as reasons for allowing medical marijuana usage. IM 26 lists the acceptable medical conditions, but petitions can be submitted to expand the list in the future, the secretary said.

On another question, she referred to IM 26’s provisions for determining if a patient can cultivate medical marijuana and the conditions, such as growing at least three plants.

The DOH is following IM 26 while also protecting those using medical cannabis.

“Part of that (process) is making sure facilities and establishments are physically safe,” the secretary said. “We want to make sure the people who need it are able to access medical cannabis.”

The DOH will accept public comments on the draft rules until July 9, Malsam-Rysdon said.

“We will refine the rules and keep moving forward,” she said. “We have been working on this since IM 26 passed. We are 100% committed to having a safe and responsible program consistent with the will of the people.”


For more information, visit To provide input on the proposed rules, email

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(1) comment


In the 9 or more mouths that the voters voted for it why was it not working on it before now to get it ready for use on July 1

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