resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
May, 2014, Vol. 14, Issue 05
CAMTC Sunset Hearings Reveal Concerns
Prostitution, human trafficking, law enforcement and operational questions come to light at legislative hearings.
By Kathryn Feather, Senior Associate Editor
In the midst of its Sunset Review process, the California Massage Therapy Council (CAMTC) finds itself addressing concerns from law enforcement agencies, city and county leaders, as well as a former board member, all urging the California legislature to sunset - or put an end to - the CAMTC and put massage therapy regulation under the California Department of Consumer Affairs.
When the CAMTC was established in 2009, many saw this as an opportunity for the profession to show it could govern itself, harness the estimated millions in potentiall annual licensing fees and provide a model for other states to follow. However, as the sunset review process continues, this experiment could be coming to an end.
Senate Bill 731 (passed in September 2008) established a two-tier voluntary certification system that allowed a massage therapist to practice lawfully throughout the state without being subject to city or county ordinances. It also established the CAMTC, a private nonprofit organization acting as the regulator of massage therapy certification.
Prior to the passage of SB731, massage therapists in California were subjected to the ordinances enacted by individual cities and counties providing for the licensing and regulation of the business of massage. It was a patch work of various regulations many therapists were eager to see disappear as they were often paying multiple fees to practice in more than one city or county.
The sunset review process is a normal assessment of state regulatory programs, established to determine whether they should be continued by the legislature. The process for CAMTC began in 2013 when the group began drafting its sunset review report and continued on March 10, 2014 with a joint hearing before the Assembly Business, Professions and Consumer Protection Committee and the Senate Business, Professions and Economic Development Committee.
Without legislative action, the CAMTC in its current form is set to sunset - or cease to exist - on December 31, 2014.
Law Enforcement Concerns
The CAMTC has had to garner support from law enforcement and city and county officials from its inception. CAMTC CEO Ahmos Netanel said the group has "a robust communication protocol with the majority of local jurisdictions. In December 2013, we reached out to more than 400 police chiefs and sheriffs and offered a no-cost training for their officers. So far, we have received more than 120 requests for our specialized training. In the past 90 days, we trained approximately 500 law enforcement officials, including police chiefs, sheriffs, FBI agents and district attorneys."
However, the League of California Cities was quick to trot out legislators, mayors, council members and law enforcement agencies to urge the legislature to sunset SB731 and the CAMTC, as they believe this process as it stands lends to the proliferation of illegitimate massage establishments, prostitution and human trafficking.
The League is seeking a restoration to local control over massage therapy businesses. The League's Legislative representative, Kirstin Kilpitcke, outlined several priorities in her testimony at the joint hearing, including having a state agency oversee certification and licensing of massage professionals rather than a nonprofit; requiring owners of massage establishments to be responsible for what occurs in their businesses; modifying the language that authorizes local governments to regulate massage businesses to the extent a jurisdiction "uniformly" regulates all other business professionals; and clarify the statue so that local governments can charge fees to recoup the costs of enforcing the statue.
These issues stem from the fact that under the current legislation, CAMTC is only responsible for certified employees and owners. If an owner of a massage business is not certified, CAMTC can take no action against that owner and local governments have, "their hands tied and cannot regulate these businesses," according to the League. The League also said that, "because cities and counties do not uniformly regulate business professionals, the existing law effectively prevents the regulation of the massage industry."
In her testimony, San Francisco Supervisor Katy Tang expressed concerns with SB 731, saying certain provisions leave the city unable to regulate and manage massage establishments and that the city has lost significant oversight authority. Tang said many establishments closed by the city have since reopened under the CAMTC certification process.
Prior to the hearing, staff for the joint committee issued 19 recommendations related to CAMTC and its operational structure. CAMTC addressed much of these recommendations in its testimony before the committee.
In his testimony, CAMTC board member Michael Callagy, a former deputy police chief, said that, "CAMTC recommends that it be given the authority to implement a voluntary registration program for establishments. Establishments that are not registered with CAMTC would be subject to whatever regulation a local jurisdiction would see fit to impose, regardless of whether all massage providers are certified or not." Callagy said the funds for such a program would come from existing CAMTC financial resources.
Also in response to the issues presented regarding increased local control, Callagy testified that, "CAMTC agrees that legislation should be passed which strikes a better balance between the needs of massage professionals and local control. For this reason, it has proposed legislation in 2014 that will provide local government with the explicit authority to address establishments that use massage as a subterfuge for prostitution and supports CAMTC voluntary registration of massage establishments."
Netanel said he "found the issues the committee staff raised to be sensible and predictable" and that "CAMTC is in the process of formulating a response."
In his testimony, CAMTC former board member and ABMP Chairman Bob Benson acknowledged some successes from CAMTC but sided with the staff's recommendation that "a strong argument can be made for the continuation of some form of professional regulation: statewide regulation is more efficient, consistent and the norm across the majority of states."
Benson, who served as the initial Vice-Chair and participated in 51 of the 52 board meetings held during his 2009-2013 tenure, stated in his testimony that, "the model of voluntary certification by a nonprofit organization was a good one for a five-year transition from a confusing hodge-podge of local massage regulation, often administered by individuals with little understanding of the health benefits of massage therapy and limited capability to assess whether someone seeking to provide massage was in fact well prepared to do so."
But, Benson went on to state that, "unfortunately, CAMTC approaches to managing its affairs have not matured. With no state funds provided, CAMTC initially had to make several expedient choices about cobbling together resources. As financial stability was secured, though, senior management turned a deaf ear to suggestions for building a stronger, lasting management structure."
"Weaknesses in CAMTC's underpinnings keep emerging. The staff background report cites numerous areas of CAMTC administrative weakness:
Benson went on to state that, "despite CAMTC spending over $500,000 a year for outside lawyers, a continuing backlog of hundreds of applications still awaits CAMTC attorney action to issue proposed denial or revocation letters and final letters of determination."
"The organization lacks a seasoned Controller/COO. Information systems are inadequate for needed controls." To prove his point, Benson cited the original report submitted by CAMTC to the legislative committee. Benson said it was, "riddled with errors on matters as fundamental as the number of certified individuals by category and the status of those who had been referred to PSD ... and it took CAMTC staff five weeks to produce corrected data."
"That's a portrait of an organization lacking sufficient administrative control. And now, on top of these deficiencies, CAMTC is seeking to shoulder additional responsibility for approving massage establishments and inspecting massage schools. It's delusional," said Benson.
Benson instead urged the committee to:
"The state board model works well in scores of other states. It is time for that model in California," said Benson.
CAMTC is currently formulating its response to the staff recommendations and concerns cited by those providing testimony during the legislative hearings. According to Netanel, April 29th is the last date for the sunset bill to be out of the committee and CAMTC is waiting to receive the proposed bill language.
In the meantime, there are currently four bills before the state assembly that could potentially impact the massage therapy profession (AB 1904, AB 1147, AB 1747 and AB 2739).
The purpose of AB 1147 is to "enhance the competency requirements for persons seeking certification as a massage practitioner by requiring an applicant to take and pass a massage and bodywork competency examination in addition to the 250 hours of education currently required." Assembly Bill 2739 would extend the provisions of the existing law until January 1, 2019.
With passionate testimony from both those advocating the success of CAMTC and those advocating for sunset and a state board, several scenarios remain. The legislature could sunset CAMTC and the state could revert back to the patch work pre-2009 regulations. The legislature could extend existing law to 2019 and keep CAMTC in operation as is or with various modifications found in the four bills currently before the legislature. The legislature could make licensure mandatory and put the process under state control as suggested by Benson and many local government officials and law enforcement agencies.
"CAMTC is proud of its successes and we look forward to working with the police chiefs, the local communities and other stakeholders to do great things for the massage profession and the public," said Netanel.
Massage Today will continue to report any updates to the sunset review process as details become available. To contact your legislature and let them know about your experience with CAMTC, visi www.leginfo.ca.gov/ to find the representative for your area. If you wish to contact the committee directly, visit http://abp.assembly.ca.gov/membersstaff or call (916) 319-3301.
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