Following reports of long delays for patients seeking to enroll in the state’s Medical Cannabis Program, State Auditor Tim Keller has written a letter to Department of Health Secretary-designate Lynn Gallagher, warning that if the agency doesn’t start complying with a state law requiring it to process applications within 30 days, he may refer the issue to law enforcement officials.

In the letter sent Monday, Keller said his office has received reports that wait times for patients seeking program ID cards “may be at least double, even triple in some cases” what is required by state law.

He said he understands the department has experienced a surge in applications for the Medical Cannabis Program — enrollment has grown to about 25,000 from about 14,000 in the past year — and has hired additional staff to help eliminate the backlog. “Nevertheless,” Keller said, “the Lynn and Erin Compassionate Use Act requires the Department to approve or deny applications withing 30 days of receipt, regardless of volume or budget constraints.”

Keller asked Gallagher to provide a date when Department of Health officials anticipate they will have cleared the application backlog and said that if the agency continues to violate the law, his office might conduct a special audit of the department or notify law enforcement.

But state Attorney General Hector Balderas already may be on the case.

“The office of the Attorney General has received a complaint regarding this matter and we are looking into it,” spokesman James Hallinan said in an email Tuesday.

Gallagher did not respond to The New Mexican’s request to interview her Tuesday.

Keller said in his letter that the department’s apparent failure to comply with the state’s medical cannabis law “causes significant hardship to New Mexicans suffering from debilitating medical conditions such as cancer, glaucoma, multiple sclerosis, epilepsy, HIV and AIDS. The difference between 30 days and 60 days may not seem like much administratively, but to patients with these conditions it is significant and can be devastating.”

Justine Freeman, deputy chief of staff for the State Auditor’s Office, said Keller wrote the letter after receiving reports from several sources — including an anonymous fraud hotline and members of the public — that the Department of Health was not processing medical cannabis ID cards in a timely manner and that patients were being advised to find other forms of medication in the meantime.

“We felt most state agencies wouldn’t say that about any other medication, so we thought it was worth reminding them of their duty” to comply with state law, Freeman said.

Keller also questioned in his letter why the department reverted $126,249 from the Medical Cannabis Program back to the state’s general fund in 2015 if the program was unable to meet demand for the ID cards in a timely manner.

“It’s not clear why the Department failed to use these funds to hire, or contract for, the necessary additional resources sooner,” he wrote.

“We have received State Auditor’s letter, and we are working as quickly as possible to resolve the situation,” Department of Health spokesman Kenny Vigil wrote in an email in response to a request for comment on the letter.

Vigil also repeated information the department has provided before, saying the agency has hired additional employees to try to keep up with the flood of applications from patients seeking new cards and renewals, and it hopes to be caught up by “sometime this summer.”

He said the department also is hoping to find ways to better anticipate the future needs of the program.

“We did not anticipate this type of growth for the program and could not have predicted it — based off growth in the program in previous years,” Vigil said in the email.

He didn’t respond to questions about why funding from the Medical Cannabis Program reverted back to the state’s general fund.

Keller is not the first state official to broach the issue with Gallagher.

Rep. Nate Gentry, R-Albuquerque, said Tuesday that he met with Gallagher in April to address several problems — including the wait for patient ID cards — after hearing from “a host of people” that the cards were not being issued in a timely manner.

Gentry said Gallagher told him she’d look into the issue and other topics they discussed, including increasing the number of plants that producers can grow and allowing cooperative growing arrangements, but nothing of substance came from the meeting.

Former Human Services Department Secretary Duke Rodriguez, who is now president of Ultra Health, one of the nonprofits that produce medical marijuana for the program, also attended the meeting, Gentry said.

“We got a letter several months later, saying, ‘We aren’t going to do anything about the plant count. Thank you, have a nice day,’ ” Gentry said. “I was surprised by the response. It was very dismissive, and I’ve never quite had a dealing like that with a [department] secretary before.”

Gentry said Gallagher never followed up on the issue of the patient cards.

Anita Briscoe, an Albuquerque-based nurse practitioner who certifies patients for the Medical Cannabis Program, said Tuesday that she and other medical providers are concerned about the effects the delays have on patients, who are forced to go without their medication while their applications are pending.

Briscoe said she has about 84 patients who are waiting for new applications to be approved or cards to be renewed, many of them with severe symptoms of post-traumatic stress disorder, including flashbacks, nightmares, intrusive memories, insomnia, anxiety, panic, rage and depression.

“Sleep is the water that puts out the fire,” she said. “Insomnia is the gasoline on the fire for the anxiety, the panic and the rage. My cannabis patients begin to freak” when they don’t get their medication, she said, “and their whole lives turn around.”

Briscoe said the most severely impacted of her PTSD patients are veterans and women who were molested as children.

“They are telling me their depression is back, and they are thinking about suicide or going back to opioids and drinking,” she said.

“They are calling and begging me for their cards, and I’m having to say, ‘I’m sorry. My hands are tied. The Department of Health is asking me to not to call [until 60 days have elapsed since an application was filed], and they are asking you not to call, too.’ ”

Contact Phaedra Haywood at 505-986-3068 or Follow her on Twitter

Correction, June 23, 2016

This story has been amended to reflect the following correction: a previous version of this story incorrectly identified Ultra Health President Duke Rodriguez as a former secretary of the state General Services Department. Rodriguez is a former secretary of the Human Services Department.