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Ballot measures to legalize recreational use of cannabis fail in Florida, North Dakota and South Dakota

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Ballot measures to legalize recreational use of cannabis fail in Florida, North Dakota and South Dakota


Nov. 5, 2024, was a tough day for cannabis legalization supporters.

Recreational legalization ballot questions in Florida, North Dakota and South Dakota all failed.

Two medical measures passed in Nebraska but face legal challenges over the validity of the signatures required to get the measures on the ballot. Why two measures? One legalizes the medical use of cannabis, and the second regulates it.

A medical use ballot measure also appeared on the ballot in Arkansas, but the state Supreme Court ruled before the election that the votes can’t be counted because the title and name were “misleading.”

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These failures raise questions about where the movement to legalize cannabis goes from here.

The red wall holds

I’ve been researching cannabis legalization in the U.S. since 2014. I’ve previously written about how the cannabis legalization movement’s primary obstacle is the “red wall,” a term I use to refer to the 20 states where Republicans have total control of state government and recreational cannabis remains illegal.

Another four states without recreational legalization – Kansas, Wisconsin, Kentucky and North Carolina – could be described as “red wall adjacent.” These states have Democratic governors, but Republicans control the state legislatures.

Pennsylvania may become the fifth of these red wall adjacent states if Republicans can win a majority in the state House of Representives.

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Support for recreational legalization is much lower among Republicans than Democrats, which in part explains why red states still have some of the most restrictive marijuana laws in the country.

In both North Dakota and South Dakota, recreational measures were defeated for the third time in 2024. It remains to be seen whether supporters think it’s worth the time and money to try again.

In Florida, the measure failed despite the majority of voters supporting it. State law requires amendments to pass with 60% of the vote, and the measure got approximately 56%.

Medical marijuana has more support. In Nebraska, the two medical measures passed decisively. However, legal challenges could void the results. Things will remain uncertain for weeks or even months, as any decision will probably be appealed to the state Supreme Court.

The red wall fortified by a red wave

In national elections, it was a good night for Republicans.

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Former President Donald Trump won a decisive victory and will return to the White House. Republicans will control the U.S. Senate, though they won’t have the 60 votes needed to overcome a filibuster. The day after the election, it is still unclear whether Republicans will control the U.S. House.

Trump will have the opportunity to set the political agenda in Washington, including for cannabis. He has voiced support for some legalization measures in the past, such as creating safety regulations, rescheduling, preserving states’ rights to pass their own laws and decriminalization of small amounts of marijuana for personal use.

But cannabis legalization was not a priority during his campaign or his previous presidency. Though Trump backed Amendment 3 for recreational use in Florida, his support was tepid compared with priority issues like immigration. The fact that the measure failed and is unpopular within the Republican Party does not create much incentive for him to put the issue at the top of his agenda once he returns to office.

What happens now?

Where the legalization movement goes from here is unclear.

The ballot initiative process has been a key tool of the movement, providing activists with a way to bypass elected officials who oppose legalization. But the results of the Nov. 5 elections suggest that this strategy may no longer be viable in red wall states. This is particularly the case when state officials are committed to keeping legalization measures from being implemented even if they pass, as happened in South Dakota in 2020 and is currently happening in Nebraska.

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A sign in Bismarck, N.D., shows support for legalizing recreational marijuana. The ballot question failed.
AP Photo/Jack Dura

The failed initiative in Arkansas is also significant. On the surface it was a bill to expand and enhance medical access. But it also included a novel provision that would automatically legalize recreational use in the state in the event federal legalization were to happen.

It was this provision, and the failure to highlight it in the proposed amendment’s name and title, that prompted the state Supreme Court to label the measure “misleading” and prevent the votes on it from being counted.

Given that medical cannabis legalization remains significantly more popular than recreational, this strategy made sense in a red state like Arkansas. Had it been successful, it would have provided a new way for activists to navigate the unique challenges posed by red wall states.

Looking ahead, legalization supporters will have to wait and see what’s possible once Trump is in office. The federal rescheduling process that began under President Joe Biden might still go through. If it does, it would move cannabis to Schedule III from Schedule I, the status reserved for substances like heroin and LSD that are considered to have the least medical benefit and highest potential for misuse. But it would not resolve the gaps between state and federal law in states where cannabis is legal.

It also would not create an obvious path toward recreational cannabis legalization – and might even hinder it further. This is because Schedule III drugs include substances like Tylenol with codeine and ketamine – both of which are legally available but require a prescription and are tightly regulated.

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This is a far cry from the “regulate it like alcohol” strategy that helped recreational legalization gain a foothold 10 years ago.



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North Dakota

Suffolk prosecutors intercept, return scammed cash to North Dakota grandmother

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Suffolk prosecutors intercept, return scammed cash to North Dakota grandmother


An 80-year-old North Dakota grandmother scammed out of $8,500 has her money back after Suffolk County prosecutors and postal inspectors traced the package of cash, which was mailed to a Shirley address, and returned it earlier this week, district attorney’s officials said.

Officials said the woman received a call Dec. 12 from someone pretending to be her granddaughter, saying she had been in a traffic accident in Suffolk County and needed bail money.

The caller said she was charged with three crimes and then handed the phone to a man posing as her lawyer, who gave the grandmother instructions on how to send cash through the mail, district attorney’s officials said.

The grandmother mailed the cash, but the man kept calling, pestering her for more money, prosecutors said. The woman, who eventually realized she had been scammed, called police in Devils Lake, North Dakota, and reported the con.

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Detectives, who made no arrests, tracked the package to Shirley. The Suffolk County Financial Crimes Bureau then worked with inspectors from the U.S. Postal Inspection Service to intercept the package two hours after it arrived on Wednesday and returned the money to the North Dakota woman.

“Our office is dedicated to combating scammers who prey on the senior citizen community, who criminals believe to be easy prey,” Suffolk County District Attorney Raymond Tierney said in a statement. “Bad actors should know that Suffolk County will not be a haven for mailing scams, and that we will do everything within our power to prevent citizens from being swindled by predatory scammers.”



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Bill to improve rural veteran health care sees support from North Dakota providers

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Bill to improve rural veteran health care sees support from North Dakota providers


WASHINGTON, D.C. — North Dakota organizations have submitted letters of support for a federal bill that would improve veterans’ access to local health care options, which has been examined by the Senate Veterans’ Affairs Committee.

The bill – the Critical Access for Veterans Care Act – from Sen. Kevin Cramer and Sen. Tim Sheehy would allow veterans living in the rural United States to seek health care services at their local critical access hospitals or rural health clinics, a press release said.

“The Community Care program literally can be a lifeline,” said Cramer, R-N.D. “(What) prevents it from being a lifeline as often as it ought to be is all of the roadblocks that get put up. After hearing from veterans and rural health care providers and leaders across North Dakota, I proposed a solution with Sen. Sheehy to simplify access to the critical access network, whether it’s a critical access hospital (or) rural health clinic.”

Cramer and Sheehy’s (R-Mont.) bill would amend the VA (Veterans Affairs) MISSION Act of 2018 to make a new category under which “care is required to be furnished through community providers, specifically for care sought by a veteran residing within 35 miles of the critical access hospital or rural health clinic,” the release said.

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The release also said a number of veterans live in rural areas and face major challenges to accessing timely and quality health care. In North Dakota, there are 37 critical access hospitals, but only five of those communities housing them also have a VA community-based outpatient clinic. The state has one VA medical center in Fargo and eight community-based outpatient clinics in total.

The bill has received letters of support from the North Dakota Rural Health Association and a coalition of 22 North Dakota rural health care providers, the release said, who wrote that the legislation will offer a streamlined and practical approach building on existing infrastructure and recognized designations in rural health care. The American Hospital Association, America’s Warrior Partnership and the National Rural Health Association have also voiced support for the bill.

Another letter of support for the bill has come from Marcus Lewis, CEO of the North Dakota Veteran and Critical Access Hospital. A veteran himself, he said he lives more than three hours from the nearest VA hospital and works two hours away from it. However, there are three community health care facilities within 50 miles of his home.

“Despite the availability of this high quality local care, I am currently paying out of pocket for needed therapy because accessing services through the Community Care Network has proven prohibitively difficult,” he wrote.

Cramer said the VA system gives veterans less access to care that is readily available, and the goal of the bill is to give rural veterans access to their local critical access hospitals without strings attached.

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“I worry if the bill is watered down, quite honestly, that we turn the authority back over to the bureaucracy to decide,” he said.

Our newsroom occasionally reports stories under a byline of “staff.” Often, the “staff” byline is used when rewriting basic news briefs that originate from official sources, such as a city press release about a road closure, and which require little or no reporting. At times, this byline is used when a news story includes numerous authors or when the story is formed by aggregating previously reported news from various sources. If outside sources are used, it is noted within the story.





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Amid Rural EMS Struggles, North Dakota Lawmakers Weigh Solutions

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Amid Rural EMS Struggles, North Dakota Lawmakers Weigh Solutions


North Dakota lawmakers are exploring using telemedicine technology to ease staffing strains on rural emergency medical services, a potential solution to a growing shortage of paramedics and volunteer responders across the state.

Though some solutions were floated and passed during the 2025 legislative session, lawmakers are working to understand the scope of the problem before proposing additional legislative changes in 2027.

The state has been facing a societal decline in volunteerism, which strains traditional volunteer firefighter and emergency medical services that support rural communities, said Sen. Josh Boschee, D- Fargo. Adding to pressure, when a rural ambulance service shuts down, the responsibility falls to neighboring ambulance services to answer calls in the defunct ambulance service’s coverage area.

How could telemedicine ease strains on rural EMS staffing?

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One idea presented to the Emergency Response Services Committee on Wednesday to potentially alleviate some of the stress on rural ambulances is expanding access to technology in the field for emergency medical personnel.

Emergency medicine technology company Avel eCare presented to the committee its system, which allows ambulance personnel to be connected by video with emergency medicine physicians, experienced medics or emergency nurses in the field wherever there is cell reception. The company already operates its mobile service in South Dakota, Minnesota, Nebraska and Kansas, according to the company’s presentation.

Avel eCare said this allows medics and paramedics to have any questions they have answered and provides a second person to help document actions taken when there is only one person in the back of an ambulance with a patient, which they say is increasingly common in rural areas. This allows one medic or paramedic to put more focus on the patient.

The company said it is innovating the ability to also bring medical personnel into the call from whatever care center the ambulance is heading to, allowing the care center to better prepare for the ambulance’s arrival.

Lawmakers said they were interested in the system and could see how it would provide a benefit to thinly stretched EMS personnel.

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Boschee said the state should consider funding the system, citing its potential to support local EMS providers and help retain volunteers.

Avel eCare did not provide a cost estimate for North Dakota, but offered South Dakota as an example. That state used general fund dollars to provide the Avel eCare service free of charge to agencies. The state paid $1.7 million in up-front costs for equipment — enough to outfit 120 ambulances — and an annual subscription cost of $937,000 to provide their services to 109 ambulances serving 105 communities in the state.

“I think specifically … how affordable that type of solution is for us to not only support our local EMS providers, but also to keep volunteers longer,” he said. “Folks know that they have that support network when they’re in the back of the rig taking care of a patient. That helps add to people’s willingness to serve longer. And so I think that’s a great, affordable option we have to look at, especially as we start going in the next couple months and continue to talk about rural health care transformation.”

Rural EMS shortages go beyond pay, state officials say

There are 28 open paramedic positions in the state, according to Workforce Services Director Phil Davis’ presentation. The difficulty in filling these positions is not just about money, though that certainly plays a factor in recruiting people, his report said.

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“I’ll just speak from my experience with my own agency,” Davis said. “After 18 years, it’s very hard for us to even recruit individuals into Job Service North Dakota because of the lower wages.”

Davis showed that 2024 salaries for emergency medical technicians were fairly even across the eight regions Workforce Services breaks the state into, with a roughly $6,500 gap between the highest and lowest averages. Law enforcement officer pay varied by about $8,320, while firefighter salaries were the biggest outlier, with a $20,000 difference between regions. While state wages may lag nationally, other factors are making rural recruiting particularly difficult.

Davis said it was largely a lifestyle change; people are not seeking to live rurally as often.

“We’re starting to see the smaller communities, for the most part — not all — starting to lose that population. And it is tougher to get individuals to move there or to be employed there,” Davis said.

Job Service North Dakota is holding job fairs to try to recruit more emergency services personnel, with some success, he said, and has nine workforce centers across the state working directly with small communities to help with their staffing shortages.

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Davis advocated for more education in schools about career paths in emergency services and the openings that are available in the state.

© 2025 The Bismarck Tribune (Bismarck, N.D.). Visit www.bismarcktribune.com. Distributed by Tribune Content Agency, LLC.

 



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