Who is the director of Missouri’s new medical marijuana program?
Like many elderly, frail people, Lyndall Fraker’s parents spent their final days on a morphine drip, drugged into incoherence.
Fraker, appointed in December to lead Missouri’s medical marijuana program, wonders now what the family missed out on in those days — what his parents might have told him and what he could have told them if they’d had an alternative that could dull their pain without dulling their minds so much.
“I’ve often thought about that since I’ve been put in this position,” Fraker said.
Fraker, a Republican grandfather about to turn 60, represents a new type of marijuana advocate — not the fervent, dedicated cannabis user, but a cautious social conservative who is nonetheless curious about what the plant could do and ready to take a step away from total prohibition.
He was an unconventional choice when Gov. Mike Parson tapped him to lead Missouri into the legal marijuana realm.
A termed-out House member, farmer and former Walmart manager who said he had never used cannabis himself, Fraker had no medical background. A powerful House colleague even introduced a bill that would have effectively thrown him out of the job — which pays $95,000.
But the bill requiring that the post be filled by a pharmacist didn’t go anywhere. And since taking over, Fraker and his small team have hit the tight deadlines mandated by the constitutional amendment voters passed in November. So far, things are running smoothly.
“He has really thrown himself into this job,” said Jack Cardetti, a Democratic political strategist who spearheaded the medical marijuana legalization campaign. “The implementation of Missouri’s program to this point far exceeds our expectation.”
Cardetti noted that in other states, medical marijuana programs have been beset by delays and even litigation.
In Oklahoma, for instance, regulators tried to place restrictions on the program that weren’t allowed under the ballot initiative passed by voters there. That led to multiple lawsuits and the state’s attorney general eventually stepped in.
But so far Missouri has seen none of that.
In fact, Fraker’s team got patient applications out a week ahead of schedule — in late June — and Cardetti said some people have already received their medical marijuana cards, again ahead of schedule.
“When he was chosen to lead this agency he clearly took that responsibility seriously,” Cardetti said. “He understood the magnitude of getting this right for patients, and he’s just done a really nice job.”
But the biggest challenges lie ahead for Fraker and his team. On Aug. 3, they will start accepting applications for licenses to grow, manufacture, sell and test marijuana products. A third-party contractor will score them, and the state will have to start doling out licenses by the end of the year.
Nearly 600 businesses statewide have already pre-filed applications (along with non-refundable fees totaling more than $4 million). Many will be turned down, especially in the Kansas City area.
“That’s going to be one of the most contentious parts of the program,” Fraker said.
A traditional conservative
Fraker lives in his hometown of Marshfield, a city of about 6,600 people near Springfield, on a farm that has been in his family for five decades.
He attended Missouri State University, but didn’t finish. After graduating from the Walton Institute of Retailing, he spent 17 years managing Walmart stores, including Marshfield’s, while also serving on about 10 local business, church and government boards.
He was elected to the Missouri House in 2010 by winning a tight three-way GOP primary in a district with no Democratic opponent.
His platform was that of a traditional conservative: anti-abortion, pro-gun, anti-tax, pro-free enterprise. That ensured he was re-elected easily three times in his very red district and also lined him up squarely with the values of Parson, who served in the House and Senate at the same time.
Parson has picked at least a dozen former legislative colleagues for jobs in his administration since he took over for Eric Greitens last year, but it was still a bit of a surprise when he chose Fraker for the marijuana program.
Cardetti said Fraker was basically an unknown quantity for the marijuana industry and patient advocates, and they didn’t know what to expect. But they thought his closeness with Parson boded well for the marijuana program.
Fraker’s appointment sparked a rift within the Republican leadership.
Rep. Rob Vescovo, the House majority leader who had served with Fraker several years, took the rare step of introducing a bill that would have required the position to be filled by a pharmacist, essentially disqualifying Fraker before he even got started.
The governor’s office pushed back and the bill, HB509, never got a hearing.
Vescovo didn’t respond to requests for comment. Fraker was dismissive.
“I guess you’d have to ask the drafter (of the bill) why he filed it, but out of 196 legislators, everybody’s going to have an opinion,” Fraker said. “If it was filed and it didn’t go anywhere, that tells you that it didn’t have much merit, I think.”
Traveling the state
Fraker said his lack of a medical background hasn’t mattered. The Walmart he managed had a pharmacy that stocked controlled substances. In an interview with The Star, he noted several times that his boss at the Missouri Department of Health and Senior Services, Randall Williams, is a doctor.
Williams, for his part, thinks Fraker is doing a great job.
“I have asked Lyndall from Day 1 to create a medical marijuana program in Missouri that puts patients first and exemplifies integrity, and he has done both to the great benefit of Missouri,” Williams said.
But as Fraker travels the state doing presentation after presentation about the new marijuana program, medical questions do come up.
During a recent presentation at the McCrite Plaza senior living community in Kansas City, North, a resident asked who would determine the dosage of medical marijuana for patients, given that the doctor’s certification they need is more like a permission slip than a prescription.
“That has to be determined by the patient,” Fraker said, drawing chuckles from the 20-some seniors in attendance. “And — AND — the doctor can advise.”
He then tried to explain how patients might use trial and error to treat their condition with a marijuana-laced gummy edible.
“I’m really getting out of my purview here, but I’m just trying to give you what other states have told us they do,” Fraker said. “They might try a quarter of that gummy to see if that helps them with their ailment and then, an hour later or whatever, if it hasn’t, they might try another quarter. Those will be conversations that they may have with their doctor.”
That sort of imprecision is one of the reasons all of Missouri’s major physician groups opposed the medical marijuana ballot initiative (though a few individual doctors have said they’re ready to help patients navigate cannabis use).
But McCrite Plaza resident LaVena Nuzman, 83, said Fraker’s job seems more administrative than medical anyway, and he seemed to have that part down pat.
“I think he did a really good job of explaining how it’s going to work,” Nuzman said after the presentation, adding that she’s considering trying cannabis for her Parkinson’s disease.
Fraker’s willingness to crisscross the state talking to industry groups, civic organizations and basically anyone who asks, has been key to making people comfortable with the marijuana program, Cardetti said.
While many government regulators are required to take public comments, it’s more rare to see them actually incorporate those suggestions into their regulations to the extent Fraker has, he said.
“That sort of public engagement is something we weren’t expecting as much of,” Cardetti said. “That’s given a lot of people confidence in the program.”
Fraker may need all of that goodwill as Missouri moves into the next phase of the program: deciding who will get to try to cash in on a medical marijuana industry that one study projected will be worth more than $100 million a year in Missouri alone.
The FBI met with Fraker and Williams earlier this year to let them know that the bureau is keeping an eye on that process because of the amount of money involved.
Williams said the agents seemed happy to hear that the department will be using “blind scoring,” in which applications are given a score by people who don’t know the names, addresses or other information that could potentially allow them to identify the applicant.
“We don’t let the scorers see any of that,” Williams said. “It’s purely the questions and the responses.”
The state’s Office of Administration, which handles contracting, has received seven bids from companies looking to do the scoring work.
A similar bidding process for “seed-to-sale” tracking of marijuana became embroiled in controversy last spring, when a company called BioTrackTHC protested the loss of the contract to a competitor. BioTrackTHC had retained former Missouri House Speaker and Parson supporter Steve Tilley as a lobbyist, but a Parson administration official rebuffed the company’s protest.
That’s the kind of drama state officials hope to avoid as they move into the business licensing phase — where many more companies are going to get excluded.
Fraker has already said that this year his office will approve only the minimum number of licenses required by the constitutional amendment. That’s 192 dispensaries (24 in each of the state’s congressional districts), plus 60 grow operations and 86 product manufacturing plants.
The only area where the state will exceed the minimum is in testing facilities, where the constitutional amendment calls for only two, but Fraker wants 10.
“We think testing is that important, to be able to reach every corner of the state,” he said. “The products we will be overseeing will be highly tested and regulated.”
But the state has already received pre-filed applications for 326 dispensaries, 161 grow operations and 88 manufacturing facilities, which means almost half will be turned down. The most denials will occur in District 5, which includes most of Kansas City, where 73 dispensary applications have been pre-filed.
Some Kansas City residents have expressed concern that Missouri’s marijuana industry will be disproportionately white — which has happened in other states — and said they were disappointed the state didn’t include any provisions to give minority-owned businesses a better shot.
Fraker said he understands their concerns, but he’s just implementing the program that the voters approved.
“We have the constitution to follow, and that’s what we’re trying to do,” Fraker said. “We’re addressing the rules based on how the amendment to the constitution tells us. I think that’s the best we can do. We can’t put more into it than it says we can.”
In the end, that’s how Fraker finds himself in the position he’s in. Marijuana wasn’t really a part of his life. Then the voters spoke — decisively — and now it is.
He would like to see it decriminalized federally and studied more. But it’s legal now in Missouri and somebody needs to regulate it.
“Our job,” Fraker said, “is to make sure it’s a good, safe medical option for patients.”