More than two years after Massachusetts voters overwhelmingly approved a medical marijuana law, no dispensaries or cultivation farms are open for business, and short of growing their own, there is no legal way for patients to buy marijuana for medical use.

Dukes County is one of seven counties sent back to the beginning of the licensing process, after an initial round of qualification that drew strident criticism, and charges of favoritism for politically connected applicants. Even as the medical marijuana law is being implemented, the landscape could change dramatically next year with a drive to legalize, regulate and tax marijuana for adults in Massachusetts.

On May 15, the Massachusetts Department of Public Health (DPH) will release a new application process for acquiring a dispensary license. DPH has significantly revised the application system, to make it more like the process for licensing pharmacies. The old application process will be phased out.

“The initial use of the procurement process for bringing dispensaries online has brought on untimely delays to the dispensary program and prevented certified patients from expedient access to their health care,” said DPH commissioner Monica Bharel in a news release. “Registering dispensaries through a fairer, more efficient, market-driven licensure process similar to other medical facilities will allow the commonwealth to maintain the highest standards of both public safety, care and accessibility.”

State regulators say the new process will insure high safety and suitability standards, especially for security and background checks.

“The commonwealth has an obligation to license dispensaries consistent with the requirements of the law,” said Secretary of Health and Human Services Marylou Sudders. “The current methods we inherited have prevented our ability to do so, requiring changes to deliver a more timely and transparent application process with the end goal of ensuring that patients have safe access to the care they deserve.”

Only two applicants have been issued certificates of registration, one in Salem, and the other in Northampton. All that remains for those dispensaries to open is passing a series of inspections by state regulators.

Under the new law, each county can have up to five registered marijuana dispensaries, and each county is required to have one dispensary.

Geoff Rose is waiting eagerly for the release of the new application process, so he can submit his plan to grow medical marijuana on Martha’s Vineyard and sell it from small retail space at 505 State Road in West Tisbury, doing business as Patient Centric of Martha’s Vineyard. Mr. Rose was one of four Island based applicants who were rejected in the initial license procedure.

“I definitely plan to apply again,” Mr. Rose said. “I’ve continued to retain the building in West Tisbury. Personally, I’m an optimist, as I was almost two years ago. I’m just anxiously waiting to see how the Department of Public Health is going to do this next time around.”

Mr. Rose is a principal in Our Island Club, a discount membership group. Of the four Island based applicants in the initial round of the state process, Mr. Rose scored the highest, but the application fell just short of the cutoff point in the DPH scoring system. Susan Sanford, president and CEO of Vineyard Complementary Medicine, was also one of the four Vineyard-based applicants in the first round of the licensing process. An associate said Ms. Sanford plans to reapply for a medical marijuana dispensary licence, but she was unavailable for comment this week.

West Tisbury, Oak Bluffs and Edgartown have established a special permit process under zoning bylaws for marijuana dispensaries.

As of Feb. 1, a simple letter from a doctor is no longer considered authorization for an individual to possess, cultivate, or use marijuana as medicine. The DPH has established a complex procedure to acquire an identification card. Getting the card requires a visit to a doctor, who must independently register the patient electronically with the DPH. The patient must then go through an online process that includes registration, uploading documents for verification, and finally receiving a card.

It will cost $50 each year to stay registered. If a patient does not have reasonable access to a dispensary, the law allows them to grow a limited amount of marijuana for their own medical use. A hardship cultivation license costs $100 annually.

As of March 31, 14,046 people were certified by their qualified health care provider statewide. Of those, state regulators have reviewed and approved 7,100 people for personal use of medical marijuana. Numbers by county are unavailable.

A group called the Marijuana Policy Project has begun a campaign that would legalize recreational use of marijuana by adults. The same group organized a successful ballot campaign that decriminalized marijuana in the 2008 Massachusetts election, and played a leading role in successful efforts to legalize marijuana in Colorado and Alaska. The group plans to get a question on the November 2016 state ballot that would ask whether voters want to legalize marijuana, regulate it and tax it like alcohol.

The ballot question must first be vetted by the state Attorney General; then the group must gather thousands of signatures to put the referendum question on the ballot.

While medical marijuana is legal under state law, marijuana is still classified as Schedule I drug, in the same category of heroin by the federal government. That raises questions about any licensed dispensary transporting medical marijuana to Martha’s Vineyard by boat, including the Steamship Authority ferries. In a statement, the U.S. Coast Guard wrote that it will enforce federal laws.

“State laws have not altered federal laws prohibiting the manufacture, production, distribution, possession, or use of marijuana,” said Ross Ruddell of the first district Coast Guard public affairs unit in Boston. “The Coast Guard enforces federal laws within navigable waters of the U.S. along with federal partners operating under guidance from the Department of Justice.”