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Oregon Overcomes Bureaucratic Delays to Therapist Training Program Approvals

Oregon Overcomes Bureaucratic Delays to Therapist Training Program Approvals

As Oregon moves towards providing supervised psilocybin treatment next year, regulators are navigating a series of challenges including a delay in the launch of facilitator training centers. 

Some Oregon municipalities and counties are also looking to ban psilocybin service centers in their jurisdictions and determining whether to put this to a vote in November. 

The Oregon Health Authority will begin a final review of regulations governing psilocybin therapy on October 14. A group of experts providing advice on rules for the industry, the Oregon Psilocybin Advisory Board (OPAB), is now working on a strategic plan to submit to the Health Authority which has final say on regulations. 

During two of the three hours of a public online meeting August 4, the Oregon Psilocybin Advisory Board vice-chair Angela Carter elicited ideas about priorities from the group for the strategic plan, writing them on digital Post-it notes. They were later compiled as written notes.

Contributors gave the sense that Oregon’s psilocybin law is fragile and could be reversed in future. Concerns included the need for a review of federal laws around psilocybin, since future changes could radically undo the new industry. 

Participants agreed to an action item of “Meeting with U.S. Attorney’s office to discuss federal enforcement policies (after 2 years).” They also resolved to study the Cole Memo which argues that federal prosecutors did not prosecute producers and users in states that legalized cannabis early. Also proposed for study is the Ogden Memo which directed U.S. Attorneys on how to enforce federal drug laws in states that decriminalized cannabis. 

As one commenter, Barb Hansen, the CEO of the Oregon Hospice and Palliative Care Association, said in the meeting, “I almost think our most important work is still ahead of us. We have to be open to revisions in the future as we learn from experiences over the next year and a half. I think the whole country is watching this experiment in Oregon, and it’s important that we get it right.”

Facilitator Training Center Licensing Delays

Fledgling psilocybin facilitator training centers were caught short on May 27 when the Oregon Health Authority announced that they were required to apply for licensure with the hitherto unmentioned Oregon Higher Education Coordinating Commission (HECC). HECC normally deals with trade schools such as those for hairdressing and tattooing. A mix-up in validating the syllabi that training centers for psilocybin facilitators must offer has delayed the licensing of these facilities. 

“While the OHA certification requirement was clearly spelled out in Measure 109, it was not clearly spelt out that there would be additional requirements, specifically a license requirement, for the Higher Education Committee as well. And that was news to frankly, everyone involved,” said an OHA e-mail.

Sam Chapman, Executive Director at the Healing Advocacy Fund, said this delay posed a serious problem, since without the facilitators, there is no viable program for legal therapy. “It was going to push the entire psilocybin program launch out, nine-plus months,” Chapman told Lucid News. 

Chapman was the campaign manager for Measure 109 which legalized psilocybin therapy in Oregon. The Healing Advocacy Fund aims to educate policymakers and the public about the state’s psilocybin therapy program.

After much back and forth, on August 11, HECC revealed that it would make it easier for psilocybin facilitator training programs to attain its required licensure. 

Training programs that were having difficulty obtaining general liability insurance, as required for licensure by HECC, can also now pay into HECC’s Tuition Protection Fund instead. Health and liability insurance companies appear to be hesitant to support psilocybin services at this early stage.

The definition of “qualified instructor” was also determined to be too high a barrier because, so far, no one is officially trained and psilocybin is still illegal. Now HECC says training facility staff are qualified if they are “identified with a program approved by” the Oregon Health Authority. 

The HECC snafu is typical of the bureaucratic speed bumps that could happen in any state, as unregulated psilocybin providers turn their underground culture into a professional industry regulated by the government.

Chapman concluded that a couple of months delay was preferable to nine months plus. “I am incredibly happy about how all of the stakeholders, governmental agencies and training programs came together to create creative solutions to ensure that this program would still launch on time,” he said. 

The Governor-appointed Oregon Psilocybin Advisory Board set rules around psilocybin products, testing and training in July. Courtesy of The Healing Advocacy Fund.

The next phase of rulemaking sessions is scheduled for September, for adoption by the end of the year. Training and licensing for the industry are projected to happen in the first part of 2023. By the latter half of the year, veterans, people in hospice or palliative care, and those experiencing substance use disorder, severe anxiety or depression will be able to access this new therapy.

Lessons in Bureaucracy

Nathan Howard is the co-creator and Director of Operations of InnerTrek, a psilocybin facilitator training program that he organized with Tom Eckert who spearheaded Measure 109 with his late wife Sheri. Eckert resigned as chair of the Oregon Psilocybin Advisory Board earlier this year. Some board members cautioned that Eckert should not serve on an advisory body that could suggest rules applying to his training school and similar programs run by his close associates. 

InnerTrek intends to train facilitators in time for its new businesses to open in 2023. Howard says the training will be mostly online, with six in-person instruction days at a leafy meditation retreat in Damascus, just outside Portland, formerly called Still Meadow Retreat Center, now run by The Forest Refuge, as well as at least 40 hours of required practicum.  

Tom Eckert and Nathan Howard. Courtesy of InnerTrek.

Howard explained to Lucid News that the issue was sorted out quite quickly. “We needed to figure out how HECC could get the bandwidth to process all these applications in a timely manner,” said Howard. “That is underway, HECC has been awesome on that. We needed to find a way to have two years of previous experience in the field.”

Howard added that developing a community of psilocybin facilitators offers some unique challenges that others may encounter. “While working with psilocybin mushrooms is an ancient tradition spanning millennia, it’s brand new in the eyes of the government, so there are no government-recognized educators on the topic,” says Howard. “And then how do we deal with acquiring general liability insurance?” 

Howard notes that the question of insurance was sorted out with a waiver.  “Credit to everyone for figuring out how to gently apply pressure to the HECC,” said Howard. “Go forth, HECC, and get these programs to where they are diligent and not focused on profiteering, we don’t want any Trump Universities here.”

According to Howard, InnerTrek was ready as early as January 2022. Even back then, he said the company had several underground guides and medical doctors ready to train. Howard says he still expects his company to be one of the first of the twenty schools preparing to launch in Oregon next year.

Shroom Summer ’23

Howard believes that some Oregon treatment centers will be open by summer 2023. “We will certainly have licensed practitioners, we will have people who are growing government check-marked psilocybin mushrooms, and a bunch of people who are ready to open service centers. It remains to be seen whether we’ll be anywhere close to satisfying the demand.”

To help reduce the costs and make the services more accessible, Howard also expects some patients/customers to do their pre-psilocybin work with their regular therapist, and bill it to insurance as usual. Then they will go to a service center for the actual plant medicine session. This approach should help keep costs down and make psilocybin services more accessible.

As for growing mushrooms, it won’t be in the thousands of tons, like cannabis, filling fields and warehouses across the state. He says just a few hundred pounds annually would be enough for Oregon’s entire legal psilocybin industry. “You could grow all the psilocybin you need for the first year in Oregon in my shed in the backyard,” Howard said.

Some Counties Want To Opt Out

Californians have long crossed their northern border for Shakespeare plays in Ashland Oregon and for legal cannabis, when it was illegal in their home state. Soon they will be close to a psilocybin retreat center at historic Buckhorn Springs Resort, a 124-acre resort nine miles south of Ashland. The retreat was purchased by the Synthesis Institute of the Netherlands, doing business as Oregon Retreat Centers, in June 2021. 

Southern Oregon might be weed and wine country, but it has seen some counties push back against psilocybin recently. Howard was in Jackson County for a meeting of psilocybin-friendly people who want to keep challenges to these services off the ballot in November. 

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“It would be one more notch in the urban-rural divide,” said Howard, whose family lives in rural Josephine County, near Cave Junction. “People who want this [psilocybin] treatment would have to go to Medford or Grants Pass, or Portland, which is expensive.” 

More than forty Oregon cities and counties will vote on whether to ban psilocybin service centers. On the coast, Coos County commissioners will ask voters whether to allow psilocybin to be manufactured in the county. 

Civic leaders in cities like Coquille, North Bend, and Coos Bay are talking about banning the service in their cities. In Coos County, while 16,000 voted yes to the measure, more than 19,000 residents voted no to psilocybin for medical use. Ordinance 22-07 prohibits psilocybin manufacturing and licensing in unincorporated Coos County. Voters can undo that measure on November 8, 2022.

Chapman, of the Healing Advocacy Fund, says, “It’s no secret that all eyes are on Oregon right now, as the first state to pass a licensed and regulated psilocybin therapy program. We take our responsibility incredibly seriously, founded in safety, and access for all who stand to benefit.”

Chapman says it is a media myth, however, that a majority of Oregon counties are heading towards opting out of the program in the November election. “Counties are not the only jurisdiction that has something to consider here,” says Chapman. “Cities make up the majority of Oregon’s population and eighteen of the top twenty most populated cities in Oregon, are actually moving forward to allow access to psilocybin therapy in their jurisdiction.”

A county can ban these services for all unincorporated entities in its jurisdiction, but that does not impact cities that are incorporated, which is where the vast majority of the population of Oregonian lives. “Around two million plus Oregonians stand to have legal access in their hometown,” says Chapman.

Chapman said HAF is working with rural Oregonians to ensure them access to psilocybin therapy, especially as they may already have limited medical and mental health services. “We’ve had a mental health crisis in Oregon, prior to the pandemic, and Covid-19 has only compounded the rate at which people are experiencing symptoms of depression and anxiety,” Chapman said. 

Chapman sees many local officials fearing a repeat of the legalization of cannabis. “There’s not going to be any retail, people cannot take psilocybin home, and the services have to be performed at a licensed and regulated service center under the constant supervision of a licensed and trained facilitator.”

Mushroom Merch

In Oregon alternative remedies are not just the preserve of better educated city folk and people who can afford to shop at tincture and crystal stores. Mushroom imagery is mainstream in Oregon right now, from stickers in gift shops, to the dresses and bags on sale at the blue-collar Oregon state fair in Salem. Urban Outfitters is slapping them on everything

In August, in downtown Portland on West Burnside Street, an empty storefront put up signs saying it would soon be offering medicinal mushrooms including turkey tail and reishi. But its logo is a red and white-topped psilocybin-bearing, poisonous amanita muscaria. That could be a sign that commerce is lining up with the zeitgeist, and bureaucracy may have a hard time controlling either. 

In the meantime, businesses are moving forward. Oregon Psilocybin Services (OPS) and the Secretary of State’s Office of Small Business Assistance will host a virtual Psilocybin Fall Business Forum on October 19, 2022 from 9am to 5pm Pacific Time. 

These topics will also soon be discussed at Horizons which will hold Perspectives on Psychedelics, a west coast edition of its conference, at the Portland Art Museum on Sept. 15-18, 2022. 

This story has been updated.

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