Title: State ex rel. Department of Health & Senior Services v. Slusher
Citation: N/A
Docket Number: SC99205
State: Missouri
Issuer: Missouri Supreme Court
Date: February 8, 2022

SUPREME COURT OF MISSOURI
en banc 
STATE OF MISSOURI ex rel. 
 
  ) 
DEPARTMENT OF HEALTH AND 
  ) 
SENIOR SERVICES, 
  ) 
  ) 
Appellant, 
  ) 
  ) 
v. 
  ) 
No.  SC99205 
  ) 
RENEE T. SLUSHER, COMMISSIONER, 
  ) 
ADMINISTRATIVE HEARING   
  ) 
COMMISSION, 
 
  ) 
  ) 
Respondent. 
  ) 
APPEAL FROM THE CIRCUIT COURT OF COLE COUNTY 
The Honorable Jon E. Beetem, Judge  
The Missouri Department of Health and Senior Services (hereinafter, 
“Department”) appeals the circuit court’s judgment quashing its preliminary writ of 
prohibition and denying Department’s petition for a permanent writ of prohibition.  
Department contends it cannot be compelled to disclose data submitted by medical 
Opinion issued February 8, 2022
2 
 
marijuana license applicants because the Missouri Constitution requires it to keep that 
information confidential.  The circuit court’s judgment is affirmed.1 
Factual and Procedural History 
Kings Garden Midwest, LLC (hereinafter, “Kings Garden”) applied for two 
medical marijuana cultivation facility licenses.  Department denied both applications.  
Kings Garden appealed to the administrative hearing commission (hereinafter, “the 
AHC”).   
Kings Garden alleged its applications were subjected to an arbitrary and capricious 
scoring process in which other applicants received different scores for answers that were 
the same or substantially the same as the answers Kings Garden submitted.  To prove this 
claim, Kings Garden requested Department to provide complete and unredacted copies of 
successful cultivation license applications in discovery. 
Department objected, claiming the disclosure of this information would violate its 
constitutional mandate to maintain the confidentiality of information submitted by 
applicants and licensees.  Kings Garden filed a motion to compel and limited its request 
to only those questions on the successful applications for which Kings Garden did not 
receive the full 10-point score.  The AHC granted the motion to compel and ordered 
Department to produce substantially all of the documents Kings Garden requested.  
                                              
1 This Court has jurisdiction under article V, section 10 of the Missouri Constitution 
because it granted transfer after opinion by the Missouri Court of Appeals, Western 
District.  Portions of the Western District’s opinion are incorporated without reference. 
3 
 
Department was provided the option of redacting applicants’ identifying information.  
The AHC also entered a protective order regarding the produced documents. 
Department filed a petition for writ of prohibition, seeking the circuit court to bar 
enforcement of the AHC’s order compelling the production of information.  The circuit 
court entered a preliminary writ in prohibition ordering the AHC to “refrain from all 
action in the premises until further order.”  After briefing and argument, the circuit court 
quashed the preliminary writ and denied Department’s petition for a permanent writ.  
Department appeals.   
Proceedings in Prohibition 
Proceedings in prohibition are governed by Rule 97.  “A writ of prohibition may 
issue ‘to remedy an excess of authority, jurisdiction, or abuse of discretion where the 
lower court lacks the power to act as intended.’”  State ex rel. Country Mut. Ins. Co. v. 
May, 620 S.W.3d 96, 98 (Mo. banc 2021) (quoting State ex rel. Manion v. Elliott, 305 
S.W.3d 462, 463 (Mo. banc 2010)).  The issuance of a writ of prohibition is 
discretionary.  State ex rel. Helms v. Rathert, 624 S.W.3d 159, 163 (Mo. banc 2021).  
When the circuit court issues a preliminary order but later denies a permanent writ of 
prohibition, “the proper remedy is an appeal.”  State ex rel. Ashby Road Partners, LLC v. 
State Tax Comm’n, 297 S.W.3d 80, 83 (Mo. banc 2009).   
Standard of Review 
“The validity of a provision of the Missouri Constitution is a question of law this 
Court reviews de novo.”  Doyle v. Tidball, 625 S.W.3d 459, 463 (Mo. banc 2021).  
“Rules applicable to constitutional construction are the same as those applied to statutory 
4 
 
construction, except that the former are given a broader construction, due to their more 
permanent character.”  Mo. Prosecuting Att’ys v. Barton Cnty., 311 S.W.3d 737, 741 
(Mo. banc 2010) (quoting Boone Cnty. Ct. v. State, 631 S.W.2d 321, 324 (Mo. banc 
1982)).  “In interpreting this language, the Court must ensure the words of this provision 
bear the meaning they were understood to have in their proper context when Missouri 
voters adopted this provision.”  Hill v. Mo. Dep’t of Conservation, 550 S.W.3d 463, 467 
(Mo. banc 2018).  “[E]very word contained in a constitutional provision has effect, 
meaning, and is not mere surplusage.”  State v. Honeycutt, 421 S.W.3d 410, 415 (Mo. 
banc 2013). 
Constitutional Confidentiality 
Department contends the circuit court erred in quashing the preliminary writ and 
denying its petition for a permanent writ of prohibition because it claims the AHC acted 
outside of its authority by compelling the disclosure of the requested applicant data to 
Kings Garden.  Department argues it cannot be compelled to disclose data submitted by 
medical marijuana license applicants because the Missouri Constitution requires it to 
maintain the confidentiality of that information.   
 
Following an initiative petition, article XIV of the Missouri Constitution was 
adopted in November 2018.  Article XIV authorizes and regulates medical cannabis.  The 
Missouri Constitution directs Department to administer the state’s medical marijuana 
program, including granting or denying “state licenses … for the cultivation, 
manufacture, dispensing, sale, testing, tracking, and transportation of marijuana for 
medical use as provided by law.”  Mo. Const. art. XIV, sec. 1.3(1)(a).  Article XIV 
5 
 
directs Department to make available to the public license application forms to operate 
“medical marijuana cultivation facilities, medical marijuana testing facilities, medical 
marijuana dispensary facilities, and medical marijuana-infused products manufacturing 
facilities.”  Mo. Const. art. XIV, sec. 1.3(6).  Department may restrict the aggregate 
number of licenses granted in each category of medical marijuana cultivation, medical 
marijuana-infused products manufacturing, and medical marijuana dispensary facilities.  
Mo. Const. art. XIV, sec. 1.3(15)-(17). 
In evaluating license applications, Department must determine whether applicants 
meet minimum standards described in 19 C.S.R. 30-95.025(4).  When more qualified 
applicants apply than there are available licenses in the facility category, both the 
constitution and regulation provide for Department to “use a system of numerically 
scoring ten (10) additional evaluation criteria to rank the applications in each such license 
... category against each other.”  19 C.S.R. 30-95.025(4); Mo. Const. art. XIV, sec. 
1.3(1)(h).  In further discussing how the numerical scoring of evaluation criteria is to be 
conducted, the regulation reiterates, “Each type of facility ... application will be scored 
and ranked against the other applications of the same type.”  19 C.S.R. 30-
95.025(4)(C)2.A.  Further,  an applicant may appeal the denial of a license to the AHC.  
Mo. Const. art. XIV, sec. 1.3(23); 19 C.S.R. 30-95.025(6).  After the exhaustion of 
administrative review, the denial is subject to judicial review.  Mo. Const. art. XIV, sec. 
1.3(23). 
Department argues the intent of the voters in enacting article XIV, section 1.3(5) 
was to mandate that all information filed in medical marijuana license applications be 
6 
 
kept strictly confidential and immune from disclosure under any circumstances, 
including, as in this case, responses to a discovery request in the appeal of a license 
denial.  To support its argument, Department relies on State ex rel. Department of Social 
Services, Division of Children Services v. Tucker, 413 S.W.3d 646 (Mo. banc 2013).  In 
Tucker, this Court examined whether the Children’s Division could be compelled to 
produce information in discovery concerning hotline reports that section 210.150, RSMo 
Supp. 2012,2 mandated be kept confidential.  After determining no exception to the 
general rule of confidentiality applied to allow disclosure of the information, this Court 
stated the statutorily mandated confidentiality “is not overcome by demonstrating 
relevance or the absence of a traditional evidentiary privilege.”  Id. at 648.  While “the 
confidentiality mandated by section 210.150 does not establish a legal privilege,” it does 
mandate that the Children’s Division “keep confidential an entire body of 
information.”  Id. at 649.  Thus, the information was not discoverable, and the circuit 
court abused its discretion in ordering its disclosure.  Id. 
The crucial distinction between Tucker and this case is that, while none of the 
exceptions to confidentiality set forth in section 210.150 applied to allow disclosure of 
the statutorily mandated confidential information, article XIV, section 1.3(5) expressly 
allows the constitutionally mandated confidential information to be “used” for a purpose 
authorized by the section.  Article XIV, section 1.3(5) provides: 
The department shall maintain the confidentiality of reports or other 
information obtained from an applicant or licensee containing any 
individualized data, information, or records related to the licensee or its 
                                              
2 All statutory references are to RSMo Supp. 2012. 
7 
 
operation, including sales information, financial records, tax returns, credit 
reports, cultivation information, testing results, and security information 
and plans, or revealing any patient information, or any other records that 
are exempt from public inspection pursuant to state or federal law.  Such 
reports or other information may be used only for a purpose authorized by 
this section.  Any information released related to patients may be used only 
for a purpose authorized by federal law and this section, including verifying 
that a person who presented a patient identification card to a state or local 
law enforcement official is lawfully in possession of such card. 
 
(Emphasis added). 
An aggrieved license applicant has the right to appeal Department’s denial to the 
AHC and, following the exhaustion of administrative remedies, the right to seek judicial 
review.  Mo. Const. art. XIV, sec. 1.3(23).  Because an appeal to the AHC and judicial 
review is authorized, the plain language of article XIV, section 1.3(5) allows the 
confidential information to be used for the purpose of an appeal of a license denial.  
Furthermore, because article XIV, section 1.3(5) does not limit the use of the information 
in an appeal of a license denial, the information is subject to discovery as provided in 1 
C.S.R. 15-3.420, the regulation governing discovery in contested cases before the AHC. 
In its appeal to the AHC, Kings Garden is seeking to discover information from 
successful applications to prove its applications were subjected to an arbitrary and 
capricious scoring process in which successful applicants received different scores for 
answers that were the same or substantially the same as the answers Kings Garden 
submitted.  Article XIV, section 1.3(1)(h) expressly directs Department to score and rank 
qualified applications against each other to decide which licenses to grant or deny.  
Because applications are not judged solely on their own merits but are ranked 
competitively against other applications, the only way to determine whether Department 
8 
 
denied Kings Garden’s application in an arbitrary or capricious manner is to compare its 
applications against information from those of successful applicants.  Without all of the 
information that formed the basis of Department’s decision, no meaningful review of that 
decision can occur.  To interpret article XIV, section 1.3(5) as not allowing the discovery 
of information from the successful applications in the appeals process would result in 
unsuccessful applicants pursuing an appeal being denied access to information that was 
an integral part of Department’s decision to deny the application in the first instance.  
“Courts should avoid constructions of the Missouri Constitution that are unreasonable or 
would lead to absurd results.”  Mo. Chamber of Com. & Indus. v. Mo. Ethics Comm’n, 
581 S.W.3d 89, 92 (Mo. App. W.D. 2019); see also Wenzlaff v. Lawton, 653 S.W.2d 215, 
216 (Mo. banc 1983). 
Department also asserts that allowing rejected license applicants to discover 
information from successful applications in the appeals process will lead to the erosion of 
the meaning of “confidential.”  Department this not only would affect licensing actions 
before the AHC but also would require disclosure of personal information submitted by 
individual citizens to Department in domestic, personal injury, tort, workers’ 
compensation, and other cases.   
Department’s position would require an unnatural construction of the 
constitutional language.  See State ex rel. Heimberger v. Bd. of Curators of Univ. of Mo., 
188 S.W. 128, 130, 268 Mo. 598 (Mo. banc 1916).  The use of any of this confidential 
information in the types of cases cited by Department would not be for a purpose 
authorized by article XIV, section 1.3, as those cases do not involve an appeal of the 
9 
 
denial of a license, license renewal, or identification card pursuant to section 1.3(23).  
Moreover, article XIV, section 1.3(5) provides extra protection for the disclosure of 
patient information, as it expressly states, “Any information released related to patients 
may be used only for a purpose authorized by federal law and this section.” (Emphasis 
added). 
Because the plain language of article XIV, section 1.3(5) allows confidential 
information to be used for purposes of appealing Department’s decision to deny a license, 
the AHC did not err in sustaining Kings Garden’s motion to compel and ordering the 
production of certain confidential information pursuant to a protective order.  
Consequently, the circuit court did not err in denying Department’s petition for a writ of 
prohibition.  
Conclusion 
The circuit court’s judgment is affirmed. 
 
 
 
 
 
 
 
 
___________________________ 
 
 
 
 
 
 
 
GEORGE W. DRAPER III, JUDGE 
 
All concur.