Colorado Natural Medicine Advisory Bulletin #8: January 2024
By Joshua Kappel, Jeff Fitzgerald, Psychedelic Alpha
Feb 14, 2024
Vicente LLP is proud to collaborate with Psychedelic Alpha—an independent newsletter and community in the field of psychedelics—on the Colorado Natural Medicine Health Act Tracker, which includes high-level statistics, anticipated recommendations, and regularly published Natural Medicine Advisory Bulletins. The bulletins will provide updates from Natural Medicine Advisory Board meetings, along with other important information related to the implementation of the NMHA and psychedelics reform in Colorado.
On January 19th, 2024, Colorado’s Natural Medicine Advisory Board officially adopted its initial set of recommendations for the state’s regulated natural medicine program. This milestone represents the culmination of eight months of hard work, taking place over 75 meetings. Thank you to all of the Board members, non-voting participants, Department of Revenue staff, and the Attorney General’s office for diligently shepherding the charge of the Natural Medicine Health Act to this crucial moment. A special thanks to DORA staff for facilitating this process, and for responding to our many document requests.
From here, recommendations will be fashioned into draft rules by the Department of Revenue and the Department of Regulatory Agencies. Draft rules will be presented to the Board for feedback and revision prior to rulemaking. The draft rules will then go through the official rulemaking process, where the public will have the opportunity to comment on the proposed rules before codification in Colorado regulations. The Department of Regulatory Agencies has indicated it will prioritize rules related to facilitator training programs and facilitator licensure to account for the long lead time involved. The Department of Revenue will prioritize subjects falling within its mandatory rulemaking responsibilities. Mandatory subjects for the Department include eligibility and licensing requirements, permitted financial interests of licensees, testing and labeling requirements, security and transportation, record-keeping, and advertising standards.1
The adopted recommendations range from highly specific prescriptions, such as testing facility accreditation standards, to broad considerations for regulators when drafting rules. Assuming rules promulgated by regulators substantially reflect these recommendations, the overall structure of the program is more or less settled by this set of recommendations. In total, 123 recommendations were adopted, with many having dozens of sub-parts.
Note: This article includes commentary by Vicente LLP, indicated by italics, which do not necessarily reflect the views of Psychedelic Alpha.\
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Colorado’s Regulated Natural Medicine Program At-a-Glance
Facilitators will hold one of three primary license types: Wellness; Behavioral Health; and Medical. All facilitators will be required to complete 150 hours of education, 40 hours of hands-on practicum, a BLS certification, and a 6-month consultation period before they are fully licensed to practice independently. During the 6-month consultation period, facilitators will be eligible for a training license, which will permit charging for services. The Board has also recommended a “Distinguished Educator” license to solve the chicken-and-egg problem created by requiring supervision by a licensed facilitator as part of the licensure process. The “Distinguished Educator” license would permit individuals with significant training and experience with natural medicines to provide natural medicine services only in the context of training — thereby allowing people located outside Colorado to serve as supervisors during the practicum and consultation periods. Applicants meeting certain criteria will be eligible for an accelerated training path. Facilitators will be required to adhere to an ethical code and utilize a screening tool to identify participant risk factors.
Cultivation will be limited to all strains of Psilocybe cubensis. Outdoor cultivation may be permitted at the discretion of DOR but will require additional regulation. Natural medicine products will be limited to orally-administered products which can be produced using whole fruiting bodies or powdered mushrooms. Extractions using solvents other than water and fruit juice are prohibited. The Board chose to defer to regulators on specific cultivation practices, substrate materials, and permitted additives during cultivation. In this area, the Board has erred too far on the side of caution. By restricting extractions and product types, many participants who would benefit most from natural medicine may be shut out of the regulated market and forced underground.
The testing regime will require potency testing on each harvest batch. A “Harvest batch” is defined as all mushrooms harvested from a single flush of a single inoculation. Random, annual testing will be conducted by regulators for species ID, heavy metals, pesticides, solvents, microbial contaminants, and mycotoxins.
Recommendations on healing centers and licensed facilities generally are substantially similar to the Oregon Health Authority rules for Psilocybin Service Centers on which they are based. They consist mainly of run-of-the-mill recommendations around security, storage, alarm systems, video recordings, restrooms, food safety, animals, and general facilities safety.
In addition to concrete recommendations specific to the mechanics of the program, the board adopted recommendations for legislative changes, preferred interpretations of statutes, and the natural medicine program holistically. The Board recommended that regulators interpret statutes defining natural medicine licenses2 to explicitly allow cultivators and producers to sell or transfer natural medicine directly to facilitators. Similarly, the board urged regulators to interpret C.R.S. § 12-170-108(4), which permits unlicensed administration of natural medicine in the context of bona fide religious, culturally traditional, or spiritual ceremonies, broadly to allow remuneration.3 The Board recommended that C.R.S § 44-50-301(4) be revised to permit testing facilities to hold both marijuana and natural medicine testing licenses, due to concerns that the volume of natural medicine testing alone may not be sufficient to sustain a testing business.4
A “Natural Medicine Sales Charge” was also recommended. This recommendation is necessary to support other recommendations, such as programs to expand equity and data collection efforts. Given the cash-fund nature of the natural medicine program,5 a funding source other than license and application fees is necessary to undertake any initiative without increasing fees.
Also included were recommendations encouraging diverse representation in the natural medicine market. One recommendation is to include underrepresented business leaders, facilitators, and the Federally Recognized American Tribes and Indigenous Community Working Group in decision-making related to the natural medicine market. Additional recommendations urge regulators to consider Indigenous guidance, regenerative agriculture practices, commercial composting, and social equity in waste disposal regulations.
The Board adopted a range of recommendations intended to expand equity in access and licensure. Many of these recommendations are contingent upon funding, either via legislative appropriation or some type of natural medicine sales charge. Most are accompanied by disclaimers that they should only be undertaken if feasible, or so long as they do not increase license costs. Recommendations of this variety include social equity licenses for facilitators and natural medicine businesses, social equity grant and loan programs, business mentorship programs, and free, remote facilitator training. More concrete, day-1 recommendations in this area include cost differentials in facilitator licenses, social equity licenses, and ensuring the state complies with C.R.S. § 12-179-113(1)(c). This provision requires that behavioral health services which are already covered under Colorado’s Medicaid plan are covered when delivered in conjunction with natural medicine services. This provision is key to ensuring access to natural medicine services for the treatment of mental health disorders.
Despite over 300 hours of scheduled meetings, some subjects were not addressed in the initial batch of recommendations. Notably absent are specific recommendations regarding “Authorized Locations other than Healing Centers”, though the board did start to contemplate what those rules might look like. Another significant gap is evident in a lack of recommendations bearing on data collection. The Board did, however, recommend that regulators collect data on, and as soon as possible consider rules around, the administration of natural medicine outside of authorized healing centers. Similarly, the Board recommended that regulators generally consider collecting data without making specific recommendations.
Also notably—and laudably—absent are recommendations prescribing dosing limits and administration session lengths. Microdosing advocates will celebrate the absence of a minimum administration session length, which would have created a de facto prohibition on regulated microdosing by imposing unnecessary time and financial costs. Proponents of higher doses, and the mystical experiences they can induce, will celebrate a lack of upper dosage limit. Ultimately, dosage and administration session length should be left to the facilitator’s discretion and the needs of the participant.
Some subjects are still under construction and subject to change, such as the Facilitator Code of Ethics. Although the code was adopted as-is, an addendum was made that the Board will seek to improve points E.4-E.13 of the code dealing with relational boundaries. The code currently prohibits practices that are common in traditional and indigenous settings, such as providing natural medicine services to family members and consuming natural medicine during facilitation. Recommendations from the Indigenous and Religious Use and Outreach subcommittee are also still evolving as that subcommittee works to include more perspectives.
For a deeper dive into the entire first set of recommendations, including commentary by Vicente LLP, check out our Recommendation Roundup here.
Kicking off the January meeting of the Emergency Response, Safety, and Ethics subcommittee, the Psychedelic Public Policy Partnership (“PPPP”) presented an updated version of their participant screening tool. The latest version clearly indicates how a facilitator should proceed based on a participant’s responses to screening questions. Also included is an extensive spreadsheet of pharmacological interactions with natural medicine and associated risks. While the subcommittee unanimously praised the screening tool, the exact use of the tool remains to be determined. If the tool were to be directly incorporated into regulations, any minor changes, such as the addition or revision of a question, would require a lengthy and burdensome rulemaking process. Ultimately, the subcommittee settled on making a general recommendation that facilitators be required to use a screening tool, but not prescribing a specific tool. Any screening tool used will, however, need to collect information regarding a participant’s general health, mental health, medical health, pharmacology, spiritual or religious considerations, and other special considerations such as disability or service animals.
Next the subcommittee turned to discussing a draft set of recommendations for “Authorized Locations other than Healing Centers” where natural medicine services may be provided. The burning questions in this area are 1) whether a facilitator may provide natural medicine services in the facilitator’s home and 2) whether a facilitator may provide natural medicine services in a participant’s home. Concerns around home facilitation include conflicts with local zoning laws, risks associated with entering unknown locations, and the potential circumvention of healing center licenses if facilitators essentially operate a natural medicine business out of their own residence. Sheriff David Lucero dispelled fears of risks to law enforcement. The Sheriff acknowledged that entering unfamiliar locations is in the normal course of police work, further adding that the need to provide access to participants who may be home-bound outweighs the concerns. Erica Messenger, a rural nurse who provides in-home care, explained common safety procedures used in that profession, such as interviews and home visits. An additional consideration for residential facilitation is licensing. Allison Robinette of DOR indicated that the Department would be averse to licensing residences directly and that allowing a facilitator to offer natural medicine services in their own home could potentially circumvent the requirement that healing centers obtain licensure. An alternative would be to license facilitators themselves, through an additional license or an endorsement, to provide natural medicine services in residences. Should the NMAB choose this route, the Qualifications and Licensing subcommittee would likely need to weigh in.
The subcommittee also considered the implications of licensing existing medical and mental healthcare facilities as authorized locations. While SB23-290 clearly contemplates allowing the provision of natural medicine services in mental health and medical facilities, the mechanics of doing so present a host of new questions – such as which regulatory body would oversee that license. Assistant Attorney General Ashley Moller reminded the subcommittee that DOR and DORA are the only entities granted licensing authority under SB23-290. Consequently, the Behavioral Health Administration, which licenses addiction treatment facilities, would not be able to license locations for the administration of natural medicine.
Recognizing the complexities and difficulties inherent in licensing locations other than healing centers, the subcommittee agreed to revisit the subject in more depth in the second round of recommendations. To ensure that the subject was acknowledged in the first round, the subcommittee adopted a generalized recommendation that “[The] regulatory agencies should collect data on processes involved in licensing authorized locations other than healing centers for the facilitation of natural medicine.” This will encourage regulators to, among other things, solicit input on other authorized locations as part of upcoming public engagement work.
Finally, the subcommittee briefly discussed the Facilitator's Code of Ethics. A single subsection, requiring a facilitator to conduct a risk screening, was struck to avoid duplication with an identical recommendation adopted earlier. One non-voting participant suggested including information specific to grievance filing, however, it was agreed that the required informed consent process should sufficiently address that concern.
The meeting concluded with a motion to adopt the recommendations of the subcommittee, including amendments.
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January’s meeting of the Indigenous and Religious Use and Outreach subcommittee focused on ensuring the subcommittee’s perspective was adequately expressed in their draft recommendations, prior to presentation to the full Natural Medicine Advisory Board. Feeling that their task is of a different species than that of the other subcommittees, the subcommittee elected to add a preamble to their recommendations reflecting their position that their work remains ongoing. As a result, the recommendations from the subcommittee will continue to evolve.
First, the subcommittee discussed the wording of their primary recommendation, which suggests allowing donations for Indigenous & Religious Use under the bona fide ceremony exemption from licensure. Rather than suggest that the exemption be interpreted to allow traditional forms of remuneration, the subcommittee chose to change the language to insist on such an interpretation. Members of the subcommittee, as well as non-voting participants, felt that accepting remuneration for provision of natural medicine services, which has historically been integral to community-based healing in the Indigenous context, should not require permission from the government. Further bolstering this position, the group unanimously felt that Indigenous healers should have the ability to earn a living wage from their work. Ashley Carter, representing the attorney general’s office, supplied an opinion that the language prohibiting “for profit and commercial activity” may leave room for unlicensed Indigenous practitioners to receive remuneration. Regulators would need to draw a line between commercial and non-commercial activity, which may be difficult in practice.
On the subcommittee’s second recommendation, a broad suggestion that the state require Indigenous and underrepresented voices in decision-making related to natural medicine, the subcommittee clarified that such representation may be accomplished through the Federally Recognized American Tribes and Indigenous Community Working Group, established by SB23-290. Some subsections of the recommendation, such as what “publication” would mean in practice, are still up for debate. Some members expressed concerns that academic publications are not the most inclusive or accessible outlets for Indigenous knowledge.
The fourth and final recommendation, outlining criteria for an accelerated licensure program for legacy healers, was refined in several ways. Discussing what the apprenticeship requirement may look like and that apprenticeships vary widely, the subcommittee chose 2000 hours as a baseline requirement and added an acknowledgment that blood, family, and maestro/maestra relationships are just some of the possible paths to an apprenticeship.
Other minor language changes were made for clarification, to accommodate for those who may not read or write, and acknowledge that Indigenous communities are not monolithic and may use differing language for similar concepts.
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The Public Health and Health Equity subcommittee held the longest subcommittee meeting in January. Having previously agreed to revisit the longer list of previously suggested equity initiatives, the bulk of the meeting was spent discussing a set of 17 recommendations developed by NMAB chairperson Lundy. The subcommittee chose to advance recommendations to the full board in order to signal their belief in the importance of developing equitable solutions. Recommendations were bifurcated into those that the subcommittee feels are important to implement or consider for the launch of the natural medicine program, and those that are better suited for inclusion in year two. Many of the recommendations took the form of general advice, as opposed to specific policy prescriptions. When the subcommittee did recommend a specific policy, it was often accompanied by a disclaimer that the policy should only be pursued to the extent that it does not increase licensing costs.
The first recommendation, that the state offer ‘Social Equity” licenses with lower license fees for qualifying individuals, was discussed at length. While it would be possible to achieve this arrangement by subsidizing social equity licenses with other license fees, it would be preferable to fund lower-cost licenses through another vehicle. The Cannabis Business Office (“CBO”), for example, funds social equity licenses through the Marijuana Cash Tax fund. The CBO and tax fund were both approved by ballot measure, making a corollary in natural medicine a significant hurdle. Tristan Watkins from the CBO described some difficulties in administering social equity licenses, primarily that creative tax maneuvering can result in social equity licenses being granted to individuals who ostensibly are not the target of the program. Allison Robinette of DOR shared that only in 2023 was the Department of Revenue, which oversees the Marijuana Enforcement Division, able to offer lower-cost social equity licenses to cannabis business operators. The subcommittee voted to adopt this recommendation, adding a caveat that any social equity license program should not increase the base costs of other licenses. A similar recommendation that would have the state vary license costs by type or level, was also adopted.
Recommendations that the regulators promulgate rules that encourage facilitator autonomy from healing centers, such as the ability for facilitators to purchase natural medicine directly from cultivators, were adopted without discussion. A recommendation that virtual oversight of group administration be permitted was adopted with minor language adjustments to require at least one facilitator to be physically present.
Next up was a recommendation of a 10% tax on natural medicine, to be utilized for Indigenous and religious, environmental, social equity, and harm reduction purposes. While the subcommittee generally agreed this recommendation could provide a useful funding vehicle, they also identified several hurdles. Commissioner Wendy Buxton-Andrade suggested positioning the tax as a fee or charge, potentially circumventing TABOR requirements and placing decision-making power and revenues into the hands of local governments. Recognizing that the sale of natural medicine itself is likely to comprise a small fraction of the total cost of natural medicine services, it was suggested to assess the fee on the service as a whole. The subcommittee discussed the possibility of tribal lands, which are tax-exempt, being inundated with healing centers. Given the complexities, the subcommittee agreed to revisit this recommendation at a later date, opting to make a general recommendation that a charge be taken under consideration. Two additional recommendations for the first year included a general recommendation that regulators consider regenerative agriculture principles, commercial composting, and indigenous perspectives in developing waste disposal rules, as well as a recommendation that regulations be kept to the minimum necessary to ensure a safe market, specifically for cultivation licenses.
Noting the need to allow the natural medicine market to develop prior to some suggestions becoming feasible, several recommendations were directed to the second year of the regulated natural medicine program. Such recommendations may require additional funding sources or significant regulatory resources. These recommendations included mentorship for social equity licensees, free virtual facilitator training, natural medicine business loans, social equity business grants, payment-over-time options for license fees, integrating insurance providers into the license application process, and the creation of a psychedelic research working group.
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With most of their recommendations solidified coming into January, the Products, Research, and Data subcommittee spent the bulk of its meeting fine-tuning language and providing the rationale underlying the recommendations at the request of the Department of Revenue.
A previous conversation regarding proficiency testing for licensed testing facilities was revisited. Given the nascent nature of regulated markets for psychedelics and the resulting lack of true, third-party proficiency tests available, the subcommittee is broadly recommending that regulators develop a proficiency testing process, leaving regulators significant leeway on the specifics. While some members expressed concerns about round-robin testing, until third-party testing is developed, round-robin testing is likely to be the best option.
Due to concerns that a wholly separate license would impose unreasonable costs, a recommendation regarding outdoor cultivation was amended to give regulators flexibility in determining requirements for outdoor cultivation. The recommendation now only stipulates that, if outdoor cultivation is permitted, the inherent difficulties and risks are reflected in licensing requirements. A prohibition on manure substrates was stricken, leaving the specifics of substrate regulation to the discretion of the regulatory authority. A recommendation defining permitted and prohibited additives was split to differentiate additives to substrates and additives to natural medicine products. Substrate additives that do not increase risks are left to regulatory discretion, while additives to consumable natural medicine products are limited to foods and the USDA’s inactive ingredients database. This recommendation is somewhat problematic, as many ingredients commonly consumed with natural medicine, for example niacin, which is used in many microdosing protocols, would be prohibited under this recommendation.
Labeling requirements were also discussed. Although the subcommittee is recommending that pesticides and fungicides are prohibited during cultivation, in the event they are not they should be included on product labels. The recommendation that labels contain a number representing the total potential strength of the product was revised to provide more clarity.
A broad prohibition on solvent extractions was amended to exclude water and fruit juice from the prohibition. The justification given for prohibiting common solvents, such as ethanol and methanol, is that allowing them would require more testing, ultimately increasing the costs of the program. This led to a discussion about the difference between “production”, which would require a DOR license, and “preparation”, which would not require a production license and may include anything from making tea to a sandwich. After some back-and-forth, the subcommittee settled on defining preparation as combining natural medicine with foods or inactive ingredients, as defined by the FDA’s inactive ingredient database. This set of recommendations is also problematic, again prohibiting commonly combined ingredients as well as effectively shutting out participants who cannot consume natural medicine orally.
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The Qualifications, Licensing, and Training subcommittee began its January meeting by adding clarifying language to several of its existing recommendations.
The Wellness Natural Medicine Facilitator license was clarified so that it is clearly available to anyone who does not hold another professional license, including indigenous and religious practitioners. Language describing risk factor diagnosis was revised to clearly exclude diagnoses in remission. Additional language permitting facilitators to provide natural medicine services to participants with risk factors was added, allowing clearance to be provided by a professional licensed to treat the risk factor, as well as allowing out-of-state doctors to clear their patients for natural medicine services in Colorado.
Revisiting the Distinguished Educator discussion from December, the subcommittee added language that prohibits a Distinguished Educator from independently owning or operating a healing center.
Since the previous meeting, Dr. Bradley Conner restructured the training curriculum outline, eliminating redundancies and adding a new “Relational Boundaries and Touch” module. Substance abuse as a topic was moved into the “Mental & Physical State” course module. The recommended training curriculum now totals 150 hours, not including practicum and consultation hours.
A more robust discussion took place on the topic of accelerated training requirements. Some non-voting participants expressed concern that the current language requiring an applicant to demonstrate the provision of natural medicine to 40 participants is too demanding. The recommendation was revised to make it clear that an applicant does not need to show proof of directly facilitating 40 participants. The new language requires an applicant for accelerated training to demonstrate experience of facilitating or assisting with the facilitation of, 40 sessions.
Next, the subcommittee reviewed recommendations regarding the 6-month supervised consultation period. The thrust of the consultation period is to reinforce the training curriculum and ensure the facilitator is fully prepared to provide natural medicine services independently. The subcommittee will now recommend that the consultation period include at least 50 hours of consultation with a supervisor over 6 months. Additionally, the facilitator applicant must be actively engaged in the delivery of natural medicine services throughout the consultation. Supervisees will be required to maintain documentation of their consultation hours, which supervisors will verify. The language was added to clarify that the supervisor’s role in consultation includes evaluating the supervisee’s competencies in the use of a non-directive approach, relational boundaries, use of touch, cultural competence, non-ordinary states of consciousness, self-care, and ethics.
In the final segment of the meeting, the subcommittee reviewed the consolidated recommendations broadly. Joining several other subcommittees, Qualifications, Licensing, and Training adopted a general recommendation that the state should allow the facilitation of natural medicine services outside of healing centers. In order to avoid a multiplicity of municipal hearings related to zoning and placement of natural medicine businesses, the subcommittee also adopted a general recommendation that the state promulgate rules to encourage local governments to apply current rules for healthcare facilities to licensed natural medicine businesses.
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Opening the January meeting of the full Natural Medicine Advisory Board, Chairperson Lundy opened the meeting by celebrating the work of the Board to date and praising the Board’s focus on safety, equity, and cultural responsibility. Lundy set a clear goal for the Board to officially adopt version 10 of the consolidated recommendations by the end of the day.
DORA program director Lorey Bratten gave a brief update from DORA. According to Director Bratten, the Board and its subcommittees have conducted more than 75 meetings over more than 300 hours to get to this point. Ms. Bratten also shared that during the first phase of rulemaking, DORA will focus on facilitator licensing and training programs.
In an update from the Attorney General’s office, Assistant Attorney General Ashley Moller described the path forward for the recommendations. Following official adoption by the Board, DORA and DOR will draft initial rules, taking the Board’s recommendations into account. Regulators will present draft language at monthly meetings of the NMAB for Board feedback. The official rulemaking process begins when regulators post the draft rules in Notices of Proposed Rulemaking in the Colorado Register. At this point, the public, many members of which have expressed frustration in the lack of opportunities for participation, will have the chance to comment on proposed rules through public hearings and written comments. Regulators will collect the feedback and present it to the Board, which may recommend changes to the proposed language. Rules may be revised through public comment and NMAB collaboration multiple times. Regulators will then publish Final Rulemaking notices. Rules become effective when published on the Colorado Secretary of State website. The fastest possible turnaround from an initial notice of proposed rulemaking to a published, effective rule is around 120 days. Concurrently with the development of official rule language by regulators, the Board will need to develop the next round of recommendations.
Department of Revenue representatives shared the Department’s perspective on the next phase of the natural medicine program. DOR, in collaboration with other state agencies such as CDPHE, will provide written feedback to the NMAB to identify gaps, implementation challenges, and fiscal impacts related to the Board’s recommendations. Additionally, the Department will rely on the Board’s recommendations and underlying reasoning in public hearings. DOR aims to hold the first public rulemaking hearings at the end of March 2024. Before then, the Department will host two additional Listening Sessions. A catch-all meeting to revisit previously-covered topics and address any residual subjects will take place on Friday, February 23rd from 9 am-12 pm MST. The final Listening Session will occur on Monday, March 4th, from 1-3 pm MST and focus on the Department’s official duties, rulemaking priorities, and the rulemaking process generally.
Before getting into the substance of the recommendations, the Board addressed several administrative matters. The DORA Welcome Center and website were designated as official public notice locations for Natural Medicine Advisory Board meetings in 2024. The NMAB bylaws were also amended to no longer require monthly subcommittee meetings. The full NMAB will continue to meet monthly, while subcommittees will meet on an as-needed basis.
Turning to the portion of the meeting committed to subcommittee updates, chairperson Lundy requested that subcommittees give only high-level updates of any changes since the previous meeting of the full board.
Speaking on behalf of the Emergency Response, Safety, and Ethics Subcommittee, Dr. Alisa Hannum shared that the subcommittee had refined recommendations around the adulteration of natural medicine. Unable to complete recommendations for Authorized Locations other than Licensed Healing Centers, the subcommittee had adopted a general recommendation that the state consider other authorized locations. Skippy Upton-Mesirow, who is not a member of the subcommittee, voiced concerns about adopting the current version of the Ethical Code. Specifically, Mr. Upton-Mesirow opposed a section of the code related to interpersonal relationship dynamics. The version of the ethical code before the Board prohibits a variety of practices, such as facilitators providing natural medicine services to family members and consuming natural medicine while facilitating, which are commonly used in traditional training and administration. NMAB members Dr. Sue Sisley and Dr. Sophia Chavez echoed Upton-Mesirow’s concerns, with Dr. Sisley suggesting that the Board not adopt the code at this time. Assistant Attorney General Ashely Moller felt that it was important for the code to be adopted so it could be developed into draft rules. As a compromise, language was added to indicate that the Board will seek to improve on E.4-E.13 of the Ethical Code.
Billy Wynne gave a high-level update from Public Health and Health Equity, which officially adopted a range of recommendations including social equity licenses and related programs such as grants, loans, and mentorship. Mr. Wynne, acknowledging that many of the suggestions won’t be feasible initially, shared that the subcommittee wanted to send a clear message to regulators regarding the need to consider social equity. The subcommittee has also recommended a natural medicine sales charge, intended to fund initiatives related to Indigenous and Religious Use, environmental, harm reduction, and social equity programs. At the suggestion of Skippy Upton-Mesirow, the sales charge recommendation was amended to include data collection initiatives. Any funding allotted to data collection must not exceed funding allotted to social equity, harm reduction, environmental, or Indigenous programs.
Dr. Clarissa Pinkola-Estés spoke about the work of the Indigenous and Religious Use and Outreach subcommittee as a work in progress. Dr. Pinkola-Estés spoke of the difficulty in finding and including many diverse voices in their work and a need for continuing dialogue with Indigenous groups as the regulated natural medicine program develops. She also spoke to the deeper implications of the subcommittee’s work – healing intergenerational trauma caused by oppressive, western institutions and the inherent complexities of this work.
Dr. Sue Sisley, on behalf of the Products, Research, and Data subcommittee, thanked all the members and non-voting participants for their expertise in navigating the subcommittee’s highly technical subject matter. Dr. Sisley briefly mentioned that the subcommittee will revisit recommendations on solvents, which are prohibited in the current recommendations, and additives, which will likely require more nuanced revisions. The subcommittee will also need to address data collection.
Dr. Alisa Hannum gave a second update, this time for the Qualifications, Licensing, and Training subcommittee. Updates included a re-organized training curriculum, the addition of chronic pain to the curriculum, assessment standards for the consultation period, and a general recommendation that the state consider authorized locations other than licensed healing centers. By far the most substantial update was the official addition of the Distinguished Educator License type, which will allow experienced facilitators from other states to provide natural medicine services for the sole purpose of educating facilitators-in-training, without requiring full licensure.
Following the final subcommittee update, NMAB chair Lundy moved the Board toward the adoption of the consolidated recommendations. With the expectation that Lundy and Skippy Upton-Mesirow will provide specific language at a later date for the amendments to the ethical code and allocation of the natural medicine charge, the board unanimously adopted the consolidated recommendations. The Natural Medicine Advisory Board will meet again in full on February 16th, 2024, where regulators are expected to present the first draft rules based on the Board’s recommendations.
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Footnotes
- See C.R.S. § 44-50-203(1).
- See C.R.S. §§ 44-50-401 to 404.
- C.R.S. § 12-170-108(4) “Nothing in this section prohibits an individual from performing a bona fide religious, culturally traditional, or spiritual ceremony, if the individual informs an individual engaging in the ceremony that the individual is not a licensed facilitator, and that the ceremony is not associated with commercial, business, or for-profit activity.”
- Under current statutory language a Natural Medicine Testing Facility licensee may not also hold a Marijuana Testing Facility license.
- In a cash-fund program, administration of the program must be funded purely through licensing and application fees. As a consequence, any additions to the program with fiscal impacts necessarily increase licensing and application costs.