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On November 6, 2018, 65% of Missouri voters passed Amendment 2, legalizing the medical use of marijuana for qualifying Missouri patients. Amendment 2 became Article XIV of the Missouri Constitution, effective December 6, 2018, and granted the Missouri Department of Health and Senior Services (DHSS) the authority and responsibility to create a well-regulated program to ensure the availability of and safe access to medical marijuana. Thus, the Section for Medical Marijuana Regulation (SMMR) was created within DHSS to oversee the Medical Marijuana Regulatory Program (MMRP).

While some states allow both medical and recreational use of marijuana, Article XIV only authorizes the medical use of marijuana. Medical marijuana refers to any strain of cannabis with a tetrahydrocannabinol content of greater than 0.3% on a dry weight basis.

Article XIV Section 1: Right to Access Medical Marijuana

The provisions for medical use of marijuana in Article XIV specifically allows:

  • Missouri licensed physicians (MD and DO) the right to discuss medical marijuana with their patients.
  • Physicians the right to recommend marijuana for medical purposes to patients with qualifying medical conditions. 
  • Patients the right to discuss medical marijuana with their physician and to use marijuana under the supervision of their physician.


The SMMR’s structure is organized to cover four primary functions: Patient Services, Operations, Facility Licensing, and Facility Compliance. Although the SMMR works in unison to meet overarching goals, each function has definitive goals identified to support the development and success of the MMRP.

The Patient Services Unit plays a pivotal role in meeting required constitutional dates, communicating complex rules to the public, streamlining quality patient-centric services, and creating patient education and communication materials. The team’s primary responsibility is reviewing and processing all qualified patient, caregiver, patient cultivator and facility agent ID license applications received through the Department’s secure electronic portal; and, determining eligibility of all applications received based on requirements within Article XIV of the Constitution and regulation. In addition, the Patient Services Unit serves as the SMMR’s frontline team to the public and is responsible for responding to all inquiries received in the call center, and general email account, from all stakeholder throughout all stages of the MMRP implementation.

The Operations Unit is responsible for the cross-cutting administrative functions necessary to support implementation and maintenance of the MMRP and include: budgetary oversight, performance metrics, public communication consisting of both webpage and public education material development, conducting internal and external training, contract management, special project coordination, compilation of reports including the Annual Report to the Governor, strategic planning, and program evaluation.

The Facility Licensing team is instrumental in fairly and effectively licensing facilities in a manner that conveys the SMMR’s commitment to being transparent in its processes and accountable for its decisions. Facility Licensing is responsible for issuing medical marijuana facility licenses and certifications, facility education, response to applicant inquiries, license change application reviews, and facility licenses/certification renewals. 

The Facility Compliance team is responsible for creating compliance education, responding to compliance inquiries, commencement inspections, annual and renewal inspections, issuing violations and remediation directives, seed to sale monitoring, and compliance monitoring. 

SMMR’s Mission and Strategic Priorities

To administer Missouri’s Medical Marijuana Regulatory Program in alignment with the provisions of Article XIV of the Constitution, as determined by the will of the citizens of Missouri.

Strategic Priorities

  • Make medical marijuana accessible for qualifying patients in Missouri;
  • Uphold safety and quality standards for medical marijuana; and
  • Regulate the medical marijuana industry to comply with Missouri law and keep communities safe.