AMTA Government Relations Overview

Why license the massage therapy profession?

Under U.S. law authority rests with states to regulate professions that have an impact on the health, safety and welfare of the public. This isn’t something that is done through national legislation.

AMTA recognizes that state government regulation of the practice of massage therapy is the best way to meet the needs of the public and the massage therapy profession. Leaving massage therapy regulation decisions to local government results in inconsistent regulation or none at all. The association believes that state licensure is the most effective means for the states to regulate our profession.

State licensure requires that only a person who holds a valid license from the state can engage in the practice of massage therapy or advertise to the public that they are practicing massage therapy. It also applies criminal penalties for people who practice without a valid massage therapy license. Professional licensure laws establish a minimum level of competency necessary to safely and effectively practice.

What are the benefits of professional licensure?

AMTA believes that the following benefits come from professional licensure:

• Protection of the public through the establishment of high standards for entry into the profession.
• Protection of the public through the regulation of practice and recourse to effective disciplinary action.
• Fair and consistent regulation applying to the whole state.
• The right of massage therapists to define their practice, through proposed legislation and through regulation under an authoritative or advisory board of massage therapy.

These are some reasons AMTA is proactively pursuing state licensure in all states. These regulations are designed to protect the general public by demanding accountability from the profession. They also seek to unify the profession by providing a common governing structure, minimum competency, culture and language.

How can we achieve fair, consistent massage therapy licensure laws?

The most significant problem associated with professional massage therapy licensure is the lack of consistency among the thirty-six (36) states and District of Columbia that have some form of regulation in place. This could be due, in part, to a lack of a centralized government relations strategy which has left us with a patchwork of state and city laws. The wide-ranging massage therapy regulations have presented many challenges for therapists who relocate from one city or state to another, for health care professionals trying to refer patients for massage therapy, for the patients themselves, and for third party reimbursement.

The American Massage Therapy Association supports consistent massage therapy licensure standards that encourage reciprocity between states and eventually achieve overall portability of massage therapy credentials. Portability, quite simply, means that the education and training credentials of a licensed massage practitioner could be more easily accepted when a practitioner moves to or opens a location in another state. AMTA is working to improve the current regulatory environment through the creation of a centralized government relations strategy designed to achieve fair and consistent licensing in all states. This is the top advocacy priority for AMTA and it will require a long-term commitment.

The first step in the effort to achieve consistent licensure standards is to guarantee the inclusion of “must have” and “should have” elements in any and all baseline massage therapy practice acts. The association feels these necessary elements will provide consistency and clarity to state licensure regulations. And, they form the basis of the AMTA Government Relations policy we begin working with on May 1, 2006.

Must Have Elements of a Baseline Massage Therapy Practice Act

In order for the association (national or chapter) to support massage therapy legislation, the following content and practice conditions are must have elements of a baseline practice act:

• At least the minimum scope of practice for massage based on a definition of those massage procedures which are observable by the common person (i.e. the physical action of the therapist touching the client is observable.)
• A licensure qualification requiring successful completion of a professional course of study consisting of at least five hundred hours of in-class, supervised education authenticated by a single education provider, with content well distributed in the subjects of anatomy, physiology, hygiene, ethics, massage theory and research, and massage practice.
• A licensure qualification that requires passing an examination that has met national accreditation standards and which is administered by a recognized body independent of the education provider, with content that covers the subjects in a professional course of study, as described above.
• Authority, which may be tacit, of licensees to practice within the scope of massage therapy practice, free from any requirement to obtain any other occupational license.
• Powers and duties of the massage therapy regulatory agency which are customary for the regulation of other healthcare professions in the state.
• Disciplinary and penalty provisions which are customary for the regulation of other healthcare professions in the state.
• An authoritative or advisory board of massage therapy, with a majority comprised of massage therapists, and special provisions for the initial appointment of qualified massage therapists as board members whose terms will begin before any licenses have been issued.

Should Have Elements of a Baseline Massage Therapy Practice Act

The association advises chapters that the following content and practice conditions are should have elements of a baseline practice act:

• A means of recognizing, for the purpose of licensure, a valid license held by a practitioner that has been granted by another state government.
• Exemption from licensure for any person whose practice is not conducted in a way to imply that it is the practice of massage therapy and who does not hold out to the public that their practice is massage therapy.
• Free from any requirement to obtain an establishment license not required of other state licensed healthcare practitioners.
• Permission for visiting massage therapists from other states, who may not be licensed by the subject state, to practice massage therapy in the context of time-limited events on a pro bono basis or in the course of instruction.
• Waiver of education and examination provisions for any practitioner seeking licensure who can establish that their occupational practice began by the date the legislation is passed.
• An effective date for the licensure requirement which is at least one year from the time the legislation is passed.
• Pre-emption of local regulation that would in any way treat massage therapy differently from local regulation of other healthcare professions.
• Inclusion of the following Suggested Movement Practices Exemption Language:

Nothing in this Article shall be construed to prevent or restrict the practice of any person in this state who uses touch, words and directed movement to deepen awareness of existing patterns of movement in the body as well as to suggest new possibilities of movement while engaged within the scope of practice of a profession with established standards and ethics, provided that their services are not designated or implied to be massage or massage therapy. Such practices include, but are not limited to the Feldenkrais Method of somatic education, the Rolf Institute’s Rolf Movement Integration, the Trager Approach to movement education, and Body-Mind Centering. Practitioners must be recognized by or meet the established standards of either a professional organization or credentialing agency that represents or certifies the respective practice based on a minimal level of training, demonstration of competency, and adherence to ethical standards.

• Inclusion of the following Suggested Energy Practices Exemption Language:

Nothing in this Article shall be construed to prevent or restrict the practice of any person in this state who uses touch to affect the energy systems, acupoints or Qi meridians (channels of energy) of the human body while engaged within the scope of practice of a profession with established standards and ethics, provided that their services are not designated or implied to be massage or massage therapy. Such practices include, but are not limited to Polarity, Polarity Therapy, Polarity Bodywork Therapy, Asian Bodywork Therapy, Acupressure, Jin Shin Do, Qi Gong, Reiki and Shiatsu. Practitioners must be recognized by or meet the established standards of either a professional organization or credentialing agency that represents or certifies the respective practice based on a minimal level of training, demonstration of competency, and adherence to ethical standards.