Members of the Maryland House of Delegates debate a measure to ban capital punishment in Annapolis on Friday. (Patrick Semansky/Associated Press)

The Maryland House of Delegates overwhelmingly approved a bill Monday that would legalize medical marijuana, although under such limited circumstances that it remained unclear how many distribution centers would open and when.

The 108 to 28 vote sent the bill to the Senate, where lawmakers have passed separate legislation that would decriminalize small amounts of marijuana. Senators said they would give medical marijuana careful consideration during the final two weeks of the 90-day session.

The action came on one of the General Assembly’s busiest days, as both chambers sent scores of bills to the other to meet a Monday “crossover” deadline. Other bills that advanced would allow illegal immigrants to obtain driver’s licenses, stiffen penalties on domestic abusers and help implement the federal health-care law in Maryland.

The Senate also passed a bill that would make use of a hand-held cellphone while a driving a “primary offense” instead of a “secondary offense,” meaning that alone would be reason enough for a police officer to pull a motorist over and issue a ticket.

Supporters of the House medical marijuana bill hailed it as a significant step toward a compassionate treatment option for people with illnesses such as cancer and multiple sclerosis. Eighteen states and the District of Columbia have enacted similar laws.California was the first, adopting its version in 1996.

Maryland’s bill would limit distribution of marijuana to a small number of qualified academic medical centers. Legislative analysts say it’s unclear whether any of those would be eligible and interested in participating. Two of the state’s most prominent institutions — the University of Maryland Medical System and Johns Hopkins University — have indicated that, at least for now, they are not.

Del. Dan K. Morhaim (D-Baltimore County), the bill’s primary sponsor, said he is confident that if the measure becomes law, qualified academic centers will come forward to take part.

“I can understand them not wanting to be out front on this,” said Morhaim, who is a doctor. “They need to watch and see what the road map is.”

Under the bill, the centers would be required to monitor patients and publish their findings, an approach that officials in the administration of Gov. Martin O’Malley (D) have characterized as cautious enough to win their support. Legislative analysts say the earliest a center is likely to begin distribution is 2016.

“Dispensing marijuana is still a violation of federal law, and we don’t want to put our staff in that position,” said Alex Likowski, spokesman at the University of Maryland at Baltimore, where the university system’s medical school is located. “At this moment, there are a lot of concerns. . . . We are a long way from knowing what to do.”

Kim Hoppe, a spokeswoman for Johns Hopkins Medicine, said that Hopkins “is open to a conversation with the state about how a medical marijuana program could be implemented, but right now it would be premature to commit to administering or participating in such a program.”

Dan Riffle, a lobbyist for the Marijuana Policy Project, which seeks to relax marijuana laws nationally, acknowledged it could take several years for Maryland’s program to get up and running. And he said federal policy on marijuana “presents a substantial obstacle” to its implementation.

“Still, this bill gives us hope that patients could have safe, reliable access through programs that bear the imprimatur of some of the country’s most respected medical institutions,” Riffle said.

Morhaim’s bill, which has been endorsed by several medical organizations, won bipartisan backing in the House. But some delegates said they remained uncomfortable with it. Minority Whip Jeannie Haddaway-Riccio (R-
Talbot) said that “the controls didn’t go far enough.”

The Senate has not taken action during this session on a medical marijuana bill. But last week, the chamber passed a bill that would decriminalize possession of small amounts of the drug.

Under the bill, anyone caught with 10 grams or less would be subject to only a $100 civil fine. Under current law, such offenders face up to 90 days behind bars and a fine of up to $500.

Sen. Brian E. Frosh (D-Montgomery), chairman of the Judicial Proceedings Committee, said that his chamber feels strongly about the merits of the Senate bill but that “it’s too early to tell how this is going to come out.”

“It’s conceivable that both bills could wind up passing,” he said.

On another matter, the Senate brushed aside objections from Republicans and some conservative Democrats and voted 29 to 18 for a bill to allow illegal immigrants to obtain Maryland driver’s licenses.

The measure would make Maryland the only East Coast state to allow illegal immigrants statewide to apply for a license. Applicants would have to produce a birth certificate or other form of identification and two years of Maryland tax filings.

State analysts say the measure could allow tens of thousands of illegal immigrants to obtain licenses in Maryland in coming years. Applicants would have to complete written and road tests, like other drivers.

Sen. David R. Brinkley (R-Frederick) blasted the measure, which was sponsored by Sen. Victor R. Ramirez (D-Prince George’s).

“There is an immigration problem at the federal level that needs to be addressed, but this is not the solution to it,” Brinkley said. “You don’t grant some legitimacy to a person who is not here legitimately.”

Frosh argued that the measure would keep Maryland roads safer.

“If people at least learn how to drive, get insurance and don’t fear that they will be deported as soon as they are in an accident, we can improve the safety of our highways and save lives,” he said.

Earlier in the day, the House voted 132 to 0 for a bill that would allow prosecutors to seek up to five additional years in prison for people convicted of violent crimes committed in front of minors. The bill, which now moves to the Senate, is aimed at domestic abusers and has been a top priority of Attorney General Douglas F. Gansler (D).

During hearings on the measures, advocates for the bill have played chilling 911 recordings of children reporting attacks on their mothers by their fathers. The state’s attorneys from both Montgomery and Prince George’s counties have testified in favor of the bill, sponsored by Del. Luiz R.S. Simmons (D-Montgomery).

The House also passed, on a 93 to 43 vote, a bill that would help implement President Obama’s health-care law in Maryland. The vote split largely along party lines.

House Minority Leader Anthony J. O’Donnell (R-Calvert) objected, saying, “I personally believe it will be the undoing of the state financially.”

Jenna Johnson and Kate Havard contributed to this report.