FILE: A cluster of Psilocybe ovoideocystidiata mushrooms found growing in a Portland city park on April 13, 2023. It’s been just over a year since Oregon’s first regulated service centers began providing therapeutic psilocybin trips to clients.
Arya Surowidjojo / OPB
It’s been just over a year since Oregon’s first regulated service centers began providing therapeutic psilocybin trips to clients. There are now 29 licensed service centers across the state, as well as 12 manufacturers, two testing labs and more than 300 facilitators who supervise clients during sessions.
Angie Allbee is the manager of the Psilocybin Services Section at the Oregon Health Authority. She joins us with an update on how the first-in-the-nation program is going and its goals for the next year.
This transcript was created by a computer and edited by a volunteer.
Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. It’s been just over a year since Oregon’s first regulated service center began providing supervised psilocybin trips to clients. There are now 29 such licensed centers around the state, along with 12 licensed manufacturers, two testing labs, and more than 300 licensed facilitators. Those are the people who supervise clients during sessions. Angie Allbee is the manager of the Psilocybin Services Section at the Oregon Health Authority. She joins us now with an update on Oregon’s first in the nation program. Welcome back.
Angie Allbee: Thank you. Happy to be here.
Miller: So I mentioned some of those numbers that all come from the OHA about licensure. One of the ones that has stood out to me and to a lot of people is the ratio here, about 10 times more licensed facilitators than licensed service centers. Even if some of those centers have to hire a lot of staff for big groups or for a high number of high dose clients, does that ratio make sense to you?
Allbee: Thank you for the question. First of all, it’s important to acknowledge that the Oregon Psilocybin Services Act, which is now part of Oregon law, requires that the Oregon Health Authority – our section – license any applicant that meets the licensing criteria. So we can’t limit licenses, and we really don’t have control over the evolving ecosystem in that sense.
However, I think that because we’ve only begun licensing in the early spring of 2023, and really haven’t issued as many licenses in that early part of 2023, really starting to license more folks towards the latter part of the year and then the beginning of this year, we have a lot of room for growth. And there are a lot of folks interested in being licensed, and setting up a service center, that are looking for property, looking to be placed in a city or county that they’re able to be licensed in. I think that there’s a lot of interest, and I think that there’s a lot of folks graduating from psilocybin facilitator training programs in order to be licensed under this model.
I do think that even if we have smaller service centers that don’t serve as many clients as far as group administration sessions, that we will see more service centers licensed that are offering larger spaces with group administration sessions, that could lead to a need for more licensed facilitators. So I think that because we’re still a very early and new growing ecosystem within the regulated model, that we have a lot to see in the coming years in order to truly decide if we have adequate numbers and if the ratios are meeting the needs, and not exceeding.
Miller: Although as you noted, you don’t have the authority to change that business ecosystem. Your authority has to do with making sure that everybody who needs to be licensed or everything that needs to be licensed is, and then the free market, I guess, will sort out the rest.
Allbee: That’s true. And it’s really important to recognize that while we license and regulate licensees, we adopt minimal requirements in our administrative rules and conduct a lot of community outreach, provide presentations and materials, this is a growing ecosystem or industry. And just like other businesses, these folks are getting set up around the state. And there’s a lot of interest in these services. It’s really up to these licensees as small business owners to set their operating guidelines and to make business decisions that are going to lead to the success of their models. While a lot of that has to do with our focus on creating more equitable licensing fees over time, and ensuring that our administrative rules meet the needs and the requirements for public health and safety without creating too much administrative burden that’s unnecessary, and really figuring out that balance.
Really, these are small businesses. We have collaborated closely with the Office of Small Business Assistance, because we’re not a business agency, we’re a health-focused agency, and we’re really focused on client services and meeting public health goals under this model. And so the Office of Small Business Assistance supported us in conducting a fall forum to put on for folks that needed information that were thinking about setting up businesses. And then we’ve created an OPS Business Resource Guide, for those folks that are either already licensees or considering being licensed, so that they understand other requirements, whether that’s BOLI requirements, OSHA, tax filing, employment information.
We want folks to be successful. And again, a lot of this work is outside of the licensing and regulatory functions.
Miller: We’ve heard that individual sessions can be upwards of $1,000, sometimes significantly more. It is a hugely important question because it gets to the exact equity and accessibility issues you were just talking about. Basically, are we looking at a system that could primarily be a luxury for people who have lots of money to spend?
Allbee: I think that it’s important to talk about our social equity plan requirements. We require all licensees to submit a social equity plan when they submit their application for licensure. And this social equity plan acknowledges systemic inequities, and really sets goals. These are licensees setting their own goals on ways that they’ll contribute to social equity. So while some service centers might have higher prices than others, the social equity plans allow for philanthropy to subsidize cost of services or completely cover those services, creating sliding scales, and also ensuring that there’s a lot of information being shared about ensuring that culturally-responsive and appropriate services are being provided to clients coming in the door for services.
Miller: Is there any way though for you to see if the service centers are actually following through? My understanding is that lawmakers have not required that you ask how much, for example, each service costs, how much clients are paying, or how many are getting scholarships. So will you even be able to track that?
Allbee: Well, we don’t have the authority to set or regulate the cost of products or services. However, the social equity plans have to be evaluated every year upon renewal of the license. And these licensees have to determine and evaluate how they’ve reached their goals, and maybe update their plans. That requirement is part of our administrative rules. But to your point, we don’t have the authority to set or regulate the cost of products or services. And insurance doesn’t cover at this time. I think as we continue to build a continuum of care, and we have providers and physicians referring folks into services, and providers following up with clients after services, and we continue to build this, hopefully there’s a discussion and more opportunities for insurance coverage of services over time.
Miller: One issue that I’ve heard about is frustrations on the part of service center owners about advertising. They have to, for example, make sure that fewer than 30% of people viewing any ad that they put up are under the age of 21. Basically, that the vast majority of people who are likely to see the ads are going to be old enough to be able to take part in these services. I have to say, I see a ton of billboards for cannabis shops, which has the same age restriction. Do they just have more lenient rules?
Allbee: So I can’t speak to the cannabis industry and the regulation of that advertising. What I can say is that this requirement is important because in ORS 475A – the law that created this regulated model – there’s a prohibition, no one under the age of 21 years can be a licensee or can be at the licensed premises. And so because of that prohibition, I think it’s really important to ensure that we’re not incentivizing folks under the age of 21, and that’s been a part of our rule making process. We sort of took that requirement from work that has already been done previously in other industries, as kind of an accepted standard. And it’s just requiring that those licensees work with whoever their advertising companies or vendors are to ensure that they’re taking steps, and can demonstrate that they’re not marketing to or advertising to minors or folks under 21.
Miller: Angie Allbee, thanks very much.
Allbee: Thank you. Have a great day.
Miller: Angie Allbee is the manager of the Psilocybin Services Section at the Oregon Health Authority. It’s been just over a year since Oregon’s first regulated service center began providing supervised psilocybin trips to clients.
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