Missouri voters legalized medical marijuana last week, but the state likely won't be seeing any dispensaries open until late 2019 or early 2020.

Amendment 2, which passed with nearly two-thirds of the vote, beat out two other ballot questions to establish Missouri as the 31st state to allow medical marijuana. Now, the Department of Health and Senior Services will create rules and regulations for the program, with the first deadline in the first week of June.

The first stage of the process will be to create applications for patients, producers and retailers. While the department could move quicker, here are the deadlines the department must meet in creating and accepting licenses:

• First week of June: Applications for patient, cultivation, infused products manufacturer and dispensary licenses become available.

• First week of July: Department begins accepting patient license applications.

• First week of August: Department begins accepting cultivation, infused products manufacturer and dispensary license applications.

Jack Cardetti, spokesman for New Approach Missouri, the backers of Amendment 2, said the deadlines in the amendment were crafted in a manner that ensures a smooth rollout of the program.

"Implementation is always a fine line because we want to bring relief to patients as quickly as possible, but we also want to give the Missouri Department of Health the time to do this right and make sure we have an effective and efficient program," Cardetti said. "The department could make those applications available sooner, and we hope they will, but the first week of June is the first hard deadline."

Once it has received an application, the department has 150 days to award or deny a license. The department, at a minimum, must issue 192 dispensary licenses statewide, 24 in each of the eight congressional districts. The minimums for cultivation and infused-products licenses are 61 and 82, respectively, statewide.

Only those who have a qualifying medical condition will be able to acquire a patient card. Those medical conditions are cancer; epilepsy; glaucoma; intractable migraines unresponsive to other treatment; chronic medical conditions that cause severe, persistent pain or persistent muscle spasms, such as multiple sclerosis; debilitating psychiatric disorders, including post-traumatic stress disorder, if diagnosed by a state-licensed psychiatrist; HIV and AIDS; chronic medical conditions normally treated with a prescription medication that can lead to dependence, when a physician determines medical marijuana can be used as a safer alternative; any terminal illness; and, in the professional judgment of a physician, any other chronic, debilitating or other medical condition.

New Approach has consistently defined the language in the amendment as "patient-friendly," meaning it gives doctors and patients the ability to discuss medical marijuana as a potential treatment option. The law does not require doctors to recommend medical marijuana, and the specific language of the patient application will be left up to the health department.

"This puts the power back in the hands of physicians and doctors to determine when their patient has a serious medical condition that they believe would be better treated with medical marijuana than with opioids," Cardetti said. "Right now, a lot of medical professionals believe their hands are tied. We want the doctor and patient to be able to make that decision."

Those applying for any type of license will also need to pay a licensing fee, both initially and annually. Patient cards are valid for one year, while cultivation, infused products and dispensary licenses are valid for three years. Fees are:

• Patient: $25 per year.

• Cultivation: $10,000 initially, $25,000 annually; after 2021, initial fee drops to $5,000.

• Infused products: $6,000 initially, $10,000 annually; after 2021, initial fee drops to $3,000.

• Dispensary: $6,000 initially, $10,000 annually; after 2021, initial fee drops to $3,000.

The licensing fees should be enough to cover the department's costs of managing the program.

"That’s one of the things that we worked really hard on, is making sure the system would have enough money to be up and running and you wouldn’t have to go to the Legislature to appropriate money," Cardetti said.

The amendment also allows for a patient cultivator license, granting the patient the ability to grow six plants at home, in a locked room that's subject to inspection by the department.

"We believe it’s important to give that option to patients who are either too sick or too poor to access medical marijuana through a dispensary," Cardetti said.


Tyler covers Jasper County, which includes the Carthage City Council, Jasper County Commission and anything in between. Tyler can be reached at twornell@joplinglobe.com or 417.627.7258.