The plain and simple of it is: The model for Hawai'i's medical marijuana dispensary system is terrible.  

It's terrible because it stems from too much compromise, too much favorable treatment, and not enough forward-thinking and compassion.  The compromise can be seen in its stagnation; things don't move forward because the heavy-handed statutory regulations keep holding it back.  

Favorable treatment can be seen in the limiting of eight licenses (statewide) and the awarding to... well... certain people with connections.  The horizontal model and likely oligarchical control over "legal" cannabis is good for business and bad for patients in need.  Wasn't it last year (two years ago) where lawmakers put a 2018 sunset date on primary caregivers being able to grow for patients?  That serves dispensaries, but not patients.       

I think the DOH is struggling to advance rules/regs because the statutory regulations places too much burden on the agency.  This problem comes from lawmakers.