Eight Core Principles of Massage and Bodywork Legislation

In deciding whether to hear a case, the United States Supreme Court considers whether the issue in question has been sufficiently "ripened" by broad exploration and adjudication in lower courts.

In considering whether it is timely for a state to adopt massage therapy licensing, ABMP is guided centrally by the sentiment and freedom to practice enjoyed by its members in that state. In some states currently without massage licensing there remains a benign environment -- no pattern of harm to the public requiring protection and broad freedom for therapists to practice without burdensome, expensive regulation.

From time to time, certain states arrive at a point where the case for massage licensing has "ripened." Sometimes a clear majority of massage therapists decide they want greater professional recognition and believe being licensed will confer that. More often, a pattern emerges of inconsistent, especially burdensome, local regulation of massage, often driven by well-meaning but misguided local law enforcement authorities whose underlying premise is that massage therapy is a cover for unsavory activities. At such a point, ABMP member sentiment in the state often shifts to favor state licensing.

If "ripeness" has been reached and ABMP begins working with its members to achieve state licensing, then we bring to bear our legislative activity and bill-drafting experiences in many states over the past seven years. That experience has led to the development of positions we consider essential on eight core elements in massage and bodywork legislation.

 1. Pre-emption of local licensing rules
2. Educational requirements
3. Institutional education approval process
4. Grandfathering
5. Reciprocity
6. Modality exclusions/exemptions
7. Board composition/powers
8. Examination/temporary licensure
 
Pre-emption means that a state regulation governing massage and bodywork is indeed an all-encompassing statewide ordinance. Any state regulation that allows existing local massage licensing or registration ordinances to remain in effect adds burden without appropriate protection, and makes a state law just another layer of requirements and expense. Thoughtful, balanced state licensing makes local licensing or registration superfluous.

Licensure is usually implemented in a profession to ensure a minimum standard of training in a field in order to protect consumers. The minimum standard is exactly that - a training floor that all practitioners should possess, an accepted common denominator - not necessarily an amount of training sufficient for particularly sophisticated massage practices. The widely-accepted minimum education standard in the massage profession (as recognized by ABMP, AMTA, and the National Certification Board for Therapeutic Massage and Bodywork is 500 clock hours of training. Indeed, the absence of a pattern of substantial public harm from massage treatments in Texas, which requires only 300 hours of education plus an exam, suggests that an educational standard below 500 hours may possibly be sufficient, especially for therapists providing seated massage or basic restorative Swedish massage. In any case, ABMP does not believe that a minimum training standard should exceed 500 hours, and will not support legislation with a minimum exceeding that number.

Several recent legislative proposals have vested instructional curriculum approval with a board or advisory committee charged with overseeing the massage profession. Such boards, however well qualified to perform other duties, typically lack experience in assessing educational institution policies and curricula. We believe instead that massage training institution approval responsibility should be vested with the state board or department of post-secondary education, which has experience evaluating diverse types of educational institutions.

Prior to a state adopting massage licensing requirements, a number of massage therapists, with diverse amounts and types of formal massage education, have been practicing and contributing to community well-being. The adoption of licensing should not create a class of individuals who will have their livelihood taken from them. Rather, grandfathering provisions should be included in legislation that credits (under a reasonable formula) already practicing massage professionals for their experience as well as for their formal massage education. Provisional licensure for a limited, prescribed period of time until each already practicing massage therapist meets the new education standard is not grandfathering; ABMP does not support this "temporary hall pass" alternative because it does not give any permanent weight to prior practice experience.

Reciprocity allows a person moving from another state, in which they already are licensed to practice massage, to practice in their new state in an expeditious manner. To benefit as many professionals as possible, reciprocity should not be reserved only between states with identical qualifications. ABMP supports recognition of similar training and experience requirements, along with recognition of the National Certification Examination, as tools for obtaining licensure in these circumstances.

Most state massage and bodywork regulations define and govern the practice of massage therapy. However, there are many related modalities practiced that may or may not fall under the statutory description of massage. During the development of legislation, practitioners in these related fields need to have a voice as to whether or not their work should be covered by massage therapy statutes. Wherever practitioners in these fields make a persuasive consensus case for exemption, ABMP will support their position.

Any governing board overseeing the massage and bodywork profession should exclude from its service any representatives from training institutions that serve the field. The potential for self-serving decisions is simply too great. It is acceptable and can be helpful for school owners, directors, officers or other representatives to serve in an advisory capacity to such a board. Board service terms should not exceed 3 years, with a maximum of two consecutive terms for any individual.

If passing an examination to qualify for a massage license is mandated, applicants should be allowed to qualify for a temporary license (as currently in Texas). In particular, states that require applicants to pass the National Certification Exam should provide an opportunity for a 90-day temporary license for those who meet educational requirements but have yet to take the examination. This provision should be available both to new massage school graduates and to those moving from another state.

We encourage you to stay abreast of local legislative activities, and alert ABMP if you feel any activity is inconsistent with the principles presented here. Should you have questions or comments about the eight core principles, please e-mail Jean Robinson at jean@abmp.com
 

sent by Rebecca 3/18/2008

 Survey Questions and issues to be addressed submitted so far:

National Exam and Licensing
1. Did you know there is more than one national exam?
a. There are currently two national exams. The NCBTMB is truly national, in that it is accepted by every state. 
b. The other test, the MBLEx was recently created, and ABMP had much to do with it's creation. It is similar to the national exam, but is less expensive, and more specific to Swedish, therapeutic, and integrative massage (whereas the NCBTMB has random questions that not all MT's should know, for example, questions on animal massage and energy work).

c. (To find out more about the MBLEx, visit http://www.fsmtb.org/ )
d. Acceptance of the MBLEx has to be aquired on a state by state basis. It is currently accepted as an equal alternative to the NCBTMB exam in: Arkansas, Georgia, Iowa, Maine, Mississippi, New Mexico, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington and West Virginia.

2. Do you support the NCBTMB (National Certification Board for Therapeutic Massage & Bodywork) test?
a. Do you support written and practical exam?
3. What exemptions should be considered? 
a. Who does not need to be licensed?
b. Will chiropractors & other health care practitioners be allowed to have massage in their offices by people without massage training?
4. Which Licensing System do you support?
a. One license standard
b. Two-tier system (separates a Basic Massage technician license (ex:  500 hrs) from a Massage Therapist license (ex:  750 hrs)  or Diplomat license (1000-1200 hrs)
5. Are you currently Nationally Certified?

Costs
6. If you had to get certified what would it cost?
a. Travel/Air Fare (to travel to Anchorage or "outside"-Seattle, for example from where you currently reside
b. Lodging
c. Food & Incidentals
d. Ground transportation
e. Loss of wages while you are away
f. Child care-if applicable
g. Other

Continuing Education Units
7. In the area of Continuing Education (CEU's), what do you think a minimum requirement should be?
a. Proposed legislation requires 48 documented hours over a four year period.

8. If you had to travel to Anchorage or "outside, what would the cost to you be?
a. Travel/Air Fare (travel from your home to Anchorage or "outside"-Seattle)
b. Lodging
c. Food & Incidentals
d. Ground transportation
e. Loss of wages while you are away
f. Child care-if applicable
g. Other

9. Do you think there should be a minimum requirement of hours of formal education?
a. How many hours would you recommend?

Insurance & Association Memberships
10. Are you a member of AMTA, ABMP, IMA or other?

a. Why did you choose this membership?
 i. For insurance or other reason-please state the reason, i.e. school recommended it, reputation, cost, friend recommended it, etc.

Massage Board
11. How do you respond to Powers of the Massage Board:

a. Authority to increase:
 i. Minimum hrs of education for licensing
 ii. Composition of supervised instruction

b. Investigate complaints
 i. Revoke license pending results of investigation

12. How do the stakeholders have input in the process?
a. Teleconferencing?
b. Meeting venues around the state in your local gathering area?
c. Email list?  Do you wish to be added to this list? 
d. Online Blog

13. Who are the stakeholders?
 i. Often Physical Therapy or Chiropractic Associations try to add language restricting use of passive movement or otherwise limiting the scope of massage practice.

14. How should copies of proposals and revisions be distributed? 
15. How are stakeholders notified in a timely manner of:
a. Opportunities for input
b. Legislative actions & reactions

16. What is the role of Anchorage massage schools in shaping the law?

Personal Questions
17. Do you think licensing "legitimizes" massage?

18. Have you ever been refused employment by a health professional because you are not licensed or nationally certified?

19. Were you ever told you would be paid more money if you were nationally certified?

20. How much formal education in massage have you had?