When they awarded licenses last winter, administrators of Missouri’s medical marijuana program anticipated products being dispensed during the summer.

But only two dispensaries have opened (both in St. Louis), and they don’t yet have products available for patients.

Having medical marijuana on the shelves for patients is imminent, according to Lyndall Fraker, director of the Missouri Department of Health and Senior Services section for medical marijuana regulation.

It is about time for harvest at a couple of Missouri medical marijuana cultivation facilities that have met all the state’s requirements to grow the products, he said.

However, all medical marijuana produced in the state must go through a testing process at a testing facility before being made available to patients.

And no testing facilities have opened yet.

Testing facilities check the levels of THC (the psychoactive ingredient in marijuana) of all marijuana cultivated in the state. They test manufactured products, such as edibles. And they check for dangerous compounds like toxins and bacteria.

A testing facility in eastern Missouri is close to opening, he said.

“That’s the one big piece of the puzzle. We have one testing facility that’s requested their commencement inspection, but they’re actually still waiting on some equipment,” Fraker said. “We’re ready. We know it’s important, but the ball’s in their court on that.”

Missouri’s medical marijuana amendment passed in 2018 with nearly 66 percent of voters’ approval. It made marijuana legal for treatment of cancer; epilepsy; glaucoma; intractable migraines (those persistent migraines that don’t respond to other treatments); chronic medical conditions that cause severe, persistent pain or persistent muscle spasms, including, but not limited to psychiatric disorders (when diagnosed by a state licensed psychiatrist), including, but not limited to, post-traumatic stress disorder; human immunodeficiency virus or acquired dependence (if a physician determines cannabis would be effective and safer); any terminal illness; or (in the professional judgment of a physician) any other chronic debilitating medical condition.

Thousands of potential medical marijuana patients applied for licenses to purchase medical marijuana. The division approved more than 23,000 patients and caregivers in 2019, despite there being no production completed or distribution of products expected until late this summer.

However, since the beginning of 2020, applications for medical marijuana patient or caregiver cards have jumped. Caregivers, by definition, are at least 21 years old and responsible for managing the well-being of a qualified patient.

As of Monday, the division had approved 61,541 patient and caregiver applications.

By December last year, the division received about 4,500 patient applications per month and about 180 caregiver applications.

The division received applications for 5,223 patient and 204 caregiver cards in January this year. For February, 5,717 patient and 193 caregiver; March, 5,077 patient and 191 caregiver; April 4,436 patient and 188 caregiver; May, 5,483 patient and 197 caregiver; June, 5,333 patient and 213 caregiver; July, 5,287 patient and 244 caregiver; and August, 5,188 patient and 213 caregiver.

The division also received more than 1,000 applications monthly for patient cultivator status (so people may grow their own medical marijuana) and more than 100 caregiver cultivator cards monthly.

The licenses to purchase medical marijuana expire after one year.

The medical marijuana division is in the renewal period. It began June 28 last year, accepting applications for patients and cultivators.

In addition to this being a renewal period for the early applicants, new applicants anticipate the dispensaries opening soon, Fraker said

“I believe a lot of people know we’re really close to having dispensaries open,” he said. “Cultivation facilities are running and growing products. So a lot of those people that maybe waited until they could buy the products and aren’t home-cultivating or something — they’re signing up now.

“We kind of expected a pretty impactful time right now, with that one-year renewal, plus facilities are getting ready to open up.”

The division anticipates being really busy in September, October and November, as more and more facilities are expected to come online, Fraker said.

Even before most facilities have opened, annual fees have increased, according to health.mo.gov. DHSS will adjust licensure fees annually (either up or down) based on the previous calendar year’s Consumer Price Index. The adjustment takes effect every July 1.

Patient or caregiver fees each rose from $25 to $25.58. Patient cultivator fees rose from $100 to $102.30.

The annual cultivation fee rose from $25,000 to $25,575; dispensary from $10,000 to $10,230; testing facility from $5,000 to $5,115; manufacturing from $10,000 to $10,230; and transportation from $5,000 to $5,115.

All fees are non-refundable, as were application fees.

The division received applications for more than 2,100 facilities, each requiring applicants to provide non-refundable fees of $5,000, $6,000 or $10,000.

And the division issued only 348 facility licenses.

Following announcement of the license recipients, spurned applicants (many of whom applied for multiple licenses) filed 869 appeals of the decisions.

There have been several appeals withdrawn.

“We’re down to about 788,” Fraker said.

The majority of appeals were based on the blind scoring process used for selection of license recipients.

“I think the first actual hearing is in October,” he said. “Once there are a few of those out there, and they have been decided or ruled on, it will affect the others.”