The Natural Medicine Health Act of 2022: A Measure to Access Psychedelic Medicine in Colorado

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If approved by Colorado voters, Proposition 122—The Natural Medicine Health Act of 2022—would create a regulated system for adults aged 21 and older to access natural psychedelic medicine, such as psilocybin, in a supervised setting to treat various mental health conditions. It would also allow for the cultivation, possession, personal use, and gifting of psychedelic medicine for adults aged 21 and older. Read on for an overview of the proposition’s key components.

Regulated Natural Medicine Access Program

Proposition 122 requires the Department of Regulatory Agencies (DORA) to promulgate regulations upon the recommendation of the Advisory Board governing the operation of Healing Centers that will provide Natural Medicine Services to participants aged 21 and older.

  • Healing Centers are DORA-licensed entities authorized to acquire, possess, cultivate, manufacture, deliver, transport, sell or dispense Natural Medicine and related supplies and provide Natural Medicine Services to participants at permitted locations

  • Natural Medicine includes dimethyltryptamine, ibogaine, mescaline (excluding lophophora williamsii (peyote)), psilocybin, or psilocyn. However, until June 1, 2026, natural medicine for the regulated access program will only include psilocybin and psilocyn. After June 1, 2026, DORA may add one or more of the previously listed psychedelics based on a recommendation from the Natural Medicine Advisory Board

  • Natural Medicine Services are services provided by a DORA-licensed facilitator before, during, and after a participant’s consumption of the natural medicine, including, at a minimum, a preparation session, administration sessions, and an integration session

  • A Facilitator is an adult over the age of 21 who is licensed by DORA to provide natural medicine services to participants

Healing Center Licensing and Oversight

No later than September 30, 2024, DORA will begin accepting applications for licensure, with decisions made within 60 days of receiving the application. DORA will also adopt rules governing the licensing and operations of healing centers by that date, which will include the following:

  • Qualifications and procedures for healing center licensure, renewal, suspension, or revocation, including provisions to ensure:

    • Statewide access to healing centers and natural medicine services

    • All applicant entities meet certain environmental, social, and governance standards set by DORA

    • No single individual has a financial interest in greater than five healing centers

    • Healing centers can share the same premise with other healing centers or healthcare facilities

    • Facilitators can provide natural medicine services at locations not owned by healing centers, such as healthcare facilities and private residences

  • Oversight of healing center operations, including:

    • Requirements and standards for testing natural medicines

    • Security requirements

    • Recordkeeping and confidentiality of participant information requirements

    • Advertising and Marketing standards

  • Operational standards and requirements, such as:

    • Educational materials and health & safety warnings required to be provided to participant(s) prior to natural medicine services

    • Signed consent forms by every participant, facilitator, and authorized healing center representative

    • Provisions for group administrative sessions, monitored by facilitator(s)

    • Provisions to allow Healing centers to refuse to provide natural medicines to potential participant(s)

    • Holding and verifying completion of a preparation session, an administration session, and an integration session with a facilitator(s)

    • Proper supervision and monitoring of participants during administration session with safe transportation for participant(s) after completion

Facilitator Training

Proposition 122 requires DORA to establish requirements governing the licensure and practice of facilitators. This includes the qualifications, education, and training requirements that licensed facilitators must meet in order to provide Natural Medicine Services. These rules will include the following:

  • Tiered education and training requirements based on the type of participants that the facilitator will be working with and the specific services they will provide

  • Education and training on client safety, contraindications, mental health, mental state, physical health, physical state, social and cultural considerations, physical environment, preparation, integration, and ethics

  • Waivers of education and training requirements based on a facilitator applicant’s prior experience, training, or skill, including, but not limited to, natural medicines

  • Provisions to ensure there are no unreasonable financial or logistical barriers that would prevent low-income people from applying for a facilitator license

  • No obligations for facilitator applicants to have a professional license or degree

Localities

Proposition 122 permits individual localities to regulate the time, place, and manner of the operation of Healing centers. Localities may not:

  • Ban or prohibit the establishment or operation of healing centers

  • Ban or prohibit licensed healthcare facilities or individuals from providing natural medicine services if licensed pursuant to Proposition 122

  • Prohibit transportation of natural medicine through its jurisdiction

  • Adopt ordinances or regulations that are unreasonable or in conflict with Proposition 122, but it may enact laws imposing lesser criminal or civil penalties

Social Equity

The implementation of Proposition 122 will establish procedures, policies, and programs to provide affordable, equitable, ethical, and culturally responsible access for persons with a traditional or Indigenous history of natural psychedelic medicines, low-income individuals, persons facing barriers to healthcare access, and military veterans. This includes:

  • Provision of natural medicine services at reduced costs for low-income individuals

  • Incentives for geographic and cultural diversity in licensing, provision, and availability of natural medicines

  • Reduced fees for healing center licensure and facilitator training

  • Annual review process to ensure program efficiency

  • The creation of a Natural Medicine Access Program Fund to support social equity programs

  • Promoting the licensing and provision of natural medicines to persons and communities disproportionately harmed by high rates of controlled substance arrests

  • Providing Colorado insurance coverage for natural medicine services that otherwise would be covered under the Colorado Medical Assistance Act.

Personal Use and Cultivation of Natural Medicines

In addition to creating a regulatory structure for licensed healing centers to provide natural medicine services, Proposition 122 will permit adults aged 21 and older to process, store, use, process, transport, purchase, obtain, and ingest natural medicine for personal use and give away natural medicine, without payment, to other adults for personal use. This section also provides for limited protections to share natural medicines for spiritual and community use, along with bona fide harm reduction and bona fide therapy.

Proposition 122 also permits the growing, cultivating, or processing of plants or fungi capable of producing natural medicine for personal use, so long as the cultivation takes place in a private residence and is secured from access by underage individuals. Any person who cultivates natural medicines in a manner that is not secure from underage access will be subject to a civil fine of up to $250.

It should be noted that the sale of natural medicines for compensation is still subject to criminal penalties, regardless of if the sale is between adults over age 21. Underage use and possession of natural medicine are subject to a drug penalty offense which will require up to four hours of drug education or counseling at no cost to the participant. Additionally, the giving away of natural medicine as part of a business promotion or advertisement is prohibited. Individuals may not operate any vehicle under the influence of natural medicines or ingest natural medicines in public spaces.

Civil Rights and Protections

Proposition 122 protects conduct permitted by the Natural Medicine Health Act, by itself, for constituting the basis:

  • For punishing or penalizing an individual currently on parole, probation, other state supervision, or released awaiting trial or other hearing

  • To disqualify a person from medical care or medical insurance

  • Of declaring child abuse or neglect

  • To restrict parenting time

  • To deny eligibility for any public assistance program unless required by federal law

Record Sealing

Proposition 122 includes provisions to seal the criminal records of individuals who have completed a sentence for a conviction that is no longer considered a crime pursuant to this legislation. Individuals will be able to file a petition to seal the record of their conviction at no cost as long as there is no objection from the District Attorney. If the DA objects, a hearing process is outlined.

Natural Medicine Advisory Board

Proposition 122 would create a Natural Medicine Advisory Board comprised of 15 members appointed by the Governor with the consent of the State Senate. By September 30, 2023, and annually thereafter, the Advisory Board must make recommendations to DORA related to the following areas:

  • Public health approaches regarding natural medicine use, effect, and risk reduction

  • Product safety, harm reduction, and cultural responsibility

  • The content of training programs and educational/experiential requirements for facilitators

  • Affordable, equitable, ethical, and culturally responsible recommendations to ensure the program is equitable and inclusive

  • The content and scope of educational campaigns

  • Regulatory considerations for each type of natural medicine

  • The addition of natural medicines to the Regulated Natural Medicine Access Program based on medical, psychological, and scientific studies/research

  • Requirements for accurate data collection, reporting, and publication of information related to the Natural Medicine Health Act

  • All rules related to the Natural Medicine Health Act promulgated by DORA

On an ongoing basis, the Advisory Board is also responsible for the following:

  • Reviewing and evaluating research, studies, and data related to natural medicines, and making recommendations to the Legislature and relevant state agencies, to determine whether natural medicine services may be covered under Health First Colorado or other insurance programs as a cost-effective intervention for various mental health conditions

  • Reviewing and evaluating sustainability issues and the impact on Indigenous communities, including documenting existing reciprocity efforts and detailing what continuing support measures are needed

  • Publishing an annual report relaying its activities, including all recommendations and advice provided to DORA and the Legislature

Natural Medicine Access Program Fund

Proposition 122 would establish a Natural Medicine Access Program Fund administered by DORA to implement the program. This fund will support the initial establishment and support of the regulatory activities required to implement the program, such as the formation of the Natural Medicine Advisory Board, promotion of natural medicine public education campaigns, and development of social equity policies and programs.

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