Medical Marijuana Regulation
As of Monday, March 23, the call center will be temporarily closed. All other operations will continue including the processing of patient, caregiver and Agent ID applications, responding to communications received by email, and providing regular updates to this website. If you need assistance, please contact us via email at email@example.com, and allow up to one business day for a response. Your patience and understanding is greatly appreciated during this time.
Notice: The department is now accepting Facility Agent ID applications through the electronic registration system. All individuals who need an agent ID card per rule, including contractors, should begin applying for their cards once the commencement inspection has been scheduled. Get more information about application requirements, fees and how to apply.
The Department of Health and Senior Services is proposing changes to rules pertaining to medical marijuana regulation. For more information regarding proposed rules and how to submit public comments, go to Draft Rules.
Below are Frequently Asked Questions regarding the Department of Health and Senior Services’ (DHSS) implementation of the Medical Marijuana Regulatory Program.
What would be the fiscal impact of regulating 2200+ medical marijuana facilities? How does that cost compare to the cost of litigating appeals from disappointed facility applicants?
Current estimates of litigation costs for DHSS are $2 - $8 million. The AHC would also incur costs related to this litigation.
Based on known budgeting for regulating approximately 370 facilities, the additional cost of regulating 2200+ facilities would be a minimum of $16.2 million the first year and 15.6 million each year thereafter. The fee revenue from these facilities would not cover the additional costs. The Department does not have the discretion to abdicate its compliance or public safety responsibilities under Article XIV.
Other state government agencies that would incur increased costs related to regulating this large number of facilities include: Department of Public Safety, Department of Natural Resources, Department of Revenue, Department of Labor, Department of Agriculture, Department of Commerce & Insurance, and the Office of Administration.
How much medical marijuana would be produced in Missouri if all medical marijuana facility applicants were given a license?
An average indoor cultivation facility produces .5 pounds of marijuana per square foot of growing space annually. Assuming a cultivation facility in Missouri will maximize its growing potential, a Missouri cultivation facility is capable of producing up to 15,000 pounds of marijuana in a year.
Just as we assume maximum production, we will assume maximum purchase, which is 3 pounds of marijuana per year per person. We also assume a more or less steady growth in patient counts. Based on the first 8 months of data in Missouri, we expect at least 146,318 patients to purchase medical marijuana from dispensaries in the third year, at which time the industry should be stabilized.
At 60 cultivation facilities (the current amount), Missouri will be capable of producing up to 900,000 pounds of marijuana in a year. This is enough marijuana to serve 300,000 patients.
At 578 cultivation facilities (the number that applied), Missouri would be capable of producing up to 8,670,000 pounds of marijuana in a year. This is enough marijuana to serve 2,890,000 patients.
Did an individual listed as a Team Lead for Wise Health Solutions in its RFP response have a conflict of interest listed on her LinkedIn page?
The individual at issue posted on her LinkedIn page that she had extensive experience in the legal cannabis industry in several states, including Missouri. She included a list of examples, such as writing marijuana licensing applications, standard operating procedures, compliance procedures, employee training manuals, website content, and regulatory compliant marketing and advertising plans. She has since clarified that the specific instance of her experience in Missouri was with scoring DHSS medical marijuana license applications. No evidence has been found that this individual worked on any Missouri licensing project other than the DHSS project.
Why did DHSS not begin work on the Medical Marijuana program until after Article XIV passed?
No one could be certain the amendment would pass. DHSS decided using general revenue to fund preparations for implementing an amendment that may not become law would not be a prudent use of taxpayer money. It should be noted, DHSS met every constitutional deadline without starting early.
What is the process for a licensee to request and DHSS to consider requests for changes to a licensee’s facility location?
Per rule, a licensee may apply for department approval to change its facility location at any time after licensure. Documentation must be submitted to support this request, and the department will carefully consider, among other things, whether the new location would have resulted in the same or similar score on the facility’s application as did the original location. The same process and similar considerations are applied in requests for greater than 10% change of ownership. Requests for transfers of licenses to new entities must wait until next year.
Why did some facility applicants submit identical responses to application scoring questions and receive different scores?
The most common reason for a facility receiving different scores for the same or similar response is because the responses were submitted as part of different facility type applications and thus scored by different individuals. For example, if an applicant submitted the same or similar response to a question in a cultivation application as they did in a dispensary application, the cultivation response would have been graded by one person and the dispensary response would have been graded by a different person. All questions within a facility type were graded by the same person. So Question 47 in every cultivation application was graded by Person A; Question 47 in every dispensary application was graded by Person B. This is what was provided for in the rules, which were published before any applications were submitted, and this process is fair to all applicants since each facility type only competes against other applications within that facility type. Moreover, the attributes that a grader would look for in an answer for one facility type would not necessarily be the same attributes needed in a different facility type. For example, a high quality security plan for a large scale cultivation greenhouse should differ significantly from a security plan in a manufacturing facility or a retail dispensary.
Did the program review scores prior to awarding licenses? Did the program review allegations of scoring inconsistencies after licensure?
Prior to licensure, the program reviewed scores after all scoring was complete to determine that all scores had been successfully transmitted from the scoring entity. The program did not alter the scores that were transmitted from the scoring entity other than by applying the score adjustments outlined in the rules for geographic location. After licensure, the program investigated allegations of scoring inconsistencies and found no evidence that the scoring was done in anything but a highly professional, competent, and compliant manner by people with the expertise to do so. Allegations to the contrary are based on misunderstanding of the program’s regulations.
How many applicants received a license due to the zip code bonuses?
None. Over 550 scoring adjustments were applied to Cultivation, Manufacturing, Testing, and Dispensary applications for geographic location. However, these adjustments only resulted in, on average, a less than 3% increase in any Cultivation, Manufacturing, or Testing licensee’s final score. For Dispensary applications, the adjustments only resulted in, on average, a less than 5% increase in any licensee’s final scores. Therefore, approximately 95-98% of any licensee’s score was based on elements of the application other than the increases for geographic location, so it would be inaccurate to say any licensee received a license due to the bonus. Any assertions that the zip code adjustments were dispositive of application results are based on a misunderstanding of how the scoring was conducted.
Did medical marijuana program employees have any conflicts of interest in their work for the program? If so, how did DHSS handle those conflicts?
Per DHSS policy, as is the case with other state agencies, employees with potential conflicts or perceived conflicts must notify leadership of those circumstances so that measures may be taken to screen that employee from any decisions related to the entity at issue. DHSS strictly followed its policy in the case of the medical marijuana program, and there was never an instance where an employee with a potential conflict had influence over decisions they should not have.
What did the conflict of interest provision in the scoring RFP include?
See Section 2.8 of the application scoring RFP.
Did DHSS investigate whether Wise Health Solutions had any conflicts of interest?
Yes. DHSS investigated specific and general claims and, in all cases, found no evidence Wise Health Solutions had any relationships or business dealings that would have presented a conflict of interest under the contract.
Was Oaksterdam University’s provision of educational programs in Missouri in April and May of 2019 a conflict of interest under the scoring contract issued in August of 2019?
No. The draft rules showing the application questions that must be answered for Missouri’s facility application were not posted until May of 2019, after the May trainings. The final rules showing final versions of the application questions and their weight/importance were not issued until June of 2019. The RFP on which Wise Health Solutions bid was not issued until July 12, 2019. Finally, Oaksterdam University does not conduct trainings on how to write applications in any state.
What were the qualifications and background of the graders?
All scorers had a professional background qualifying them to score the questions assigned to them. The contract required this, and DHSS reviewed each scorer’s resume to confirm their qualifications. Many scorers had higher education degrees, including masters, JDs, and PhDs, and every scorer went through a training process specific to the Missouri process after the contract was awarded and before they began scoring applications.
If you have questions about this program, check back frequently or send your comments to MedicalMarijuanaInfo@health.mo.gov.