The Amador County Board of Supervisors on Tuesday quietly adopted the state's request for a staggering fee increase for its medical marijuana identification card program, more than tripling what county residents currently pay to obtain the voluntary IDs.

The resolution increasing the state's share from $13 to $142 per card was on the Jan. 23 meeting's consent calendar, which was adopted without discussion. The county currently charges $48 per card, ratcheting up the total cost to $190 for an ID card that must be renewed every year.

"They're pretty hefty," said Angel LeSage, public information officer for the Department of Public Health, of the fee increase. "We're looking at our system and what we have to do."

LeSage told the Ledger Dispatch that that means reviewing what, if any, type of outreach has to be done to inform the public.

The reason given by the state Department of Health Services for the 109 percent increase to its share of the fees is that the program has been operating under a major deficit, which is due to a significantly smaller number of ID card applications being filed than expected. The state Legislature passed Senate Bill 420 in 2003, creating the voluntary program that lets people in the state obtain an ID card with a doctor's recommendation. Since then, only 5,631 cards have been issued. California NORML, a nonprofit organization dedicated to reforming the state's marijuana laws, estimates there are 150,000 to 350,000 medicinal marijuana patients in California.

Ione resident Allen Toupe is one of those patients, as well as the holder of his own ID card. A cancer patient who had his bowels and colon removed three years ago, Toupe began taking medicinal cannabis when his doctors could no longer prescribe opiate-derived pain killers like methadone, valium or liquid oxycontin. Instead, his doctor suggested a drug that has been far less invasive yet much more taboo.

Perhaps ironically, the man Toupe says he now is is a far cry from the incapacitated addict legal pharmaceuticals made him.

"I was on so many drugs that it was killing me," he said. "No one, and I mean no one ever documented has died from marijuana."

With the new fee bumped up to nearly $200, Toupe said even more chronic pain sufferers and terminally ill patients will be dissuaded from participating in the ID program, especially since there are no local dispensaries where people like Toupe can fill their prescriptions. He belongs to a group of roughly 30 local medicinal marijuana users who pool their resources and travel to the Bay Area to fill their prescriptions in bulk.

"If they're going to charge that kind of money, they should allow safe access," Toupe said.

But while the county hasn't placed a moratorium on marijuana dispensaries, as many cities and counties across the state have, the requirements for obtaining a use permit have proven restrictive. The board of supervisors last extended an urgency moratorium in August 2005, which ended last year.

Without local access, the end result is that many patients with legal access to medicinal marijuana are turning to illegal procurement to fill their prescriptions, according to Bruce Mirken, director of communications for the Marijuana Policy Project.

And while an ID card isn't required for protection under the Compassionate Use Act of 1996, Mirken said the cards make it easier for patients to navigate law enforcement and dispensary requirements.

"We do worry that there will be some folks who won't be able to get cards because of the cost," he added.

Here in Amador County, a patient with a doctor's recommendation is legally permitted to maintain six mature marijuana plants or 12 immature plants, though a doctor can recommend more.

One reason so few applications have been turned in is that only 23 of the state's 58 counties currently offer the ID card program. San Diego recently filed an unsuccessful lawsuit against the state in an attempt to resist implementing such a program.

While San Diego lost its suit, proponents of the ID card program say the state must now prepare its coffers for future lawsuits from dissenting counties, necessitating the substantial fee increase. Part of the reason counties have bucked against state law comes from the fact that the federal government still considers marijuana an illegal narcotic and doesn't allow for medicinal uses.

"We were a little worried when we first started (our program)," LeSage admitted.

Amador County had one of the first pilot programs offering ID cards, something Toupe praises the county for doing.

"I've never had any problem with law enforcement or the county," he said, adding that police officers will sometimes bring cadets by his house to show them what a legal marijuana garden looks like.

But the argument that the conflict in state and federal law leaves counties in a precarious legal position doesn't sit well with Toupe or Mirken.

"It frankly doesn't make a lot of sense to me," Mirken said. "They're not the ones at risk if the feds want to come in."

That burden rests with the state, which, again, factors into the fee increase that will go into effect this March.

"I'll still get (the ID card) because I believe in the program," Toupe told the Ledger Dispatch, "but some people don't have the same outlook as me."