Written by the Vicente LLP team as part of our Colorado Natural Medicine Health Act Tracker.
On February 16th, 2024, the Department of Regulatory Agencies (“DORA”) presented the first draft rules for Colorado’s regulated natural medicine market to the Natural Medicine Advisory Board. The first round of draft rules focuses on facilitator qualifications, education requirements, and training programs. These functions will be overseen by the Department of Regulatory Agencies (”DORA”) through an Office of Natural Medicine (“ONM”). It is important to note that these draft rules will be subject to additional review, including stakeholder engagement and public comment, prior to becoming final rules. The first DORA stakeholder engagement meeting is March 8th.
These draft rules mark a significant milestone in the development of Colorado’s regulated natural medicine market, giving Coloradans the first glimpse into how regulatory agencies will implement the Natural Medicine Health Act approved by voters in November 2022. They also represent a leap forward for regulated psychedelics more broadly, providing a framework for integrating psychedelic healing into traditional healthcare systems by permitting medical and mental health professionals to incorporate psychedelic care in their existing practices. This framework is a significant improvement from that seen in Oregon, where psilocybin services and mental health care are separated by law.
The draft rules provide for two full-scope facilitator licenses, “Facilitator” and “Clinical Facilitator.” As a baseline, both licenses require a Basic Life Support (BLS) certification, 150 hours of didactic education on natural medicine services, 40 hours of supervised practice, and 50 hours of consultation with a supervisor. The Facilitator license will be available to anyone who completes an approved training program, while the Clinical Facilitator license will be available to individuals who hold a secondary license that involves diagnosing and treating medical or mental health conditions.
The rules also provide several educational equivalence pathways for people with significant prior experience facilitating with natural medicines. Both license types will be available through accelerated licensure, allowing facilitators to waive parts of the core requirements based on previous experience and education. The only requirement that cannot be waived is a 25-hour course specific to Ethics and Colorado Natural Medicine. Facilitators licensed in another state can apply for licensure in Colorado through an Occupational Credential Portability Program, which mirrors many other DORA-licensed professions in Colorado.
Two secondary licenses are permitted in the draft rules. The “Distinguished Educator” license is designed to allow experienced natural medicine practitioners to serve as faculty in facilitator training programs, specifically as practicum supervisors. This license is necessary at the launch of the program to ensure facilitation students are able to complete the supervised practice and consultation requirements, both of which require the student to work with an experienced supervising facilitator. The Distinguished Educator license is fairly restrictive, allowing the holder to provide facilitation services only in the context of a training program with which they are affiliated. The license must be renewed annually, and licensees may not independently own a healing center.
A temporary “Training License” is available to students who have completed the 150-hour education and BLS certification requirements. Following completion of the 40-hour supervised practice, an individual holding a Training license will be permitted to provide natural medicine services while they are completing the consultation period. During the consultation period, a Training Licensee may provide, and charge for, natural medicine services while meeting regularly with their consulting supervisor to discuss their experiences facilitating. The exact mechanics and requirements of the Training license are somewhat murky in the draft rules, however the overall intent and direction is laudable.
The content and regulation of training programs is also detailed in the draft rules.
Facilitator training programs must offer at least 150 hours of didactic education on the following topics:
- Facilitator Best Practices (5 hours)
- Ethics and Colorado Natural Medicine Rules and Regulations (25 hours)
- Relational Boundaries and Introduction to Physical Touch (10 hours)
- Physical and Mental Health and State (25 hours)
- Drug Effects, Contraindications, and Interactions (5 hours)
- Introduction to Trauma Informed Care (10 hours)
- Introduction to Suicide Risk (5 hours)
- Indigenous, Social, and Cultural Considerations (10 hours)
- Screening (5 hours)
- Preparation (10 hours)
- Administration (10 hours)
- Integration (10 hours)
- Group Facilitation (10 hours)
- Facilitator Development and Self-Care (10 hours)
To receive “Approved Facilitator Training Program” status from the Office of Natural Medicine, training programs must satisfy requirements related to reporting, organization, and administration. Approved programs must have, among other things, a governing body and at least two full-time faculty members, one of whom must be the “Program Director.” The director of an approved training program must hold a Facilitator license, or a secondary professional license that would qualify them for a Clinical Facilitator license. Specific duties are imposed on the director by rule. Beginning January 1st, 2026, approved programs will be required to employ at least one full-time faculty who is a licensed facilitator. Mechanisms for ensuring continued compliance with the requirements of approved status, as well as procedures for withdrawal and reinstatement of approval, are defined.
Ahead of the full approval process being implemented in March 2025, training programs may apply for pre-approval by submitting an application to the Office of Natural Medicine which will ensure facilitators are able to be trained and licensed in time for the January 1st, 2025 launch of the regulated program.
It is important to note that these are draft rules and are not yet complete or official. Some topics – such as ethical rules, standards of practice, and disciplinary procedures are notably absent. Some draft rules, such as requirements that participants seek medical clearance in certain situations, are controversial in their current form. The draft rules also leave open many questions – Is a training license required, or optional? Is the 6-month consultation period required, and if so does that imply a mandatory training license? What roles exactly is a Distinguished Educator permitted to play in the training & education framework? DORA is expected to revise and update these rules prior to official rulemaking proceedings, anticipated to begin in May 2024. The rulemaking process will include opportunities for public comment and feedback before the rules are made official.
DORA will hold a Virtual Stakeholder Meeting regarding the draft rules on Friday, March 8, 2024, at 2:00 P.M. Members of the public are invited to provide oral comments on the draft rules during the meeting and submit written comments to dora_dpo_rulemaking@state.co.us by March 6th.
For an in-depth breakdown of the full 39 page draft rule set, see our Draft Rule Breakdown.
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