Missouri residents approved medicinal marijuana via Constitutional Amendment 2 back in November 2018. The Missouri Department of Health and Senior Services (“DHSS”) is charged with running the medicinal marijuana program. On June 4, 2019, in preparation for the program to go live in early 2020, the DHSS released application forms to be completed by individuals wishing to become “qualifying patients.” The DHSS will begin accepting the applications on June 28, 2019.
There is a problem, however. Each application must be accompanied by a physician certification that is less than 30 days old. According to a recent story in the St. Louis Dispatch, Missouri doctors are reluctant to issue certifications. This should not come as a huge surprise; both the St. Louis Metropolitan Medical Society and the Missouri State Medical Association (“MSMA”) opposed Amendment 2 back in November. Consistent with that opposition, the MSMA will not recommend the medicinal marijuana program to its members, and its director of legislative affairs, Jeff Howell, came out and said “MSMA believes all treatments and therapies should be studied rigorously and be evidence-based. Marijuana does not currently meet those standards.”
Although the DHSS may receive fewer applications than originally anticipated, it’s not all doom and gloom for hopeful patients in Missouri. Certain physicians, most of whom are unaffiliated with large healthcare systems, are not only willing to sign certifications, but are actively seeking out patients. Indeed new clinics like Green Health Docs are “popping up in the St. Louis Region from Ferguson to west St. Louis County.” The question is whether those clinics will remain open and able to operate uninterrupted. Similar clinics in other states with medicinal marijuana programs have struggled to procure traditional banking because of the illegality of marijuana at the federal level, and that has hindered operations. From our perspective, the certification of medicinal marijuana patients should be far enough removed from the cultivation, growth, and sale of marijuana to avoid too much scrutiny from federally chartered banks, but banks are traditionally risk-averse (much like large healthcare systems) and these clinics often do not have accounts sizeable enough to justify added risk. We would recommend that Missouri clinics certifying medical marijuana patients explore traditional banking and financing opportunities, but be prepared to turn to less traditional alternatives if necessary to continue operations.
We’ll keep an eye on Missouri through the rest of 2019 to see how its medical marijuana program develops.