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We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
The Modern Acupuncturist
You studied ancient Chinese medicine, but I'll bet you don't practice it! Contrary to popular belief, our medicine has evolved A LOT over the years. Let's take a brief walk through history and discover the differences between ancient and modern acupuncturists.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients, in May 2014, researchers showed that drinking the equivalent of 2 to 4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
TMF 2015 Scholarships
The Trudy McAlister Foundation (TMF), a nonprofit organization established to support students who are on track to make contributions either to clinical practice and/or to the understanding of the role of Traditional Oriental Medicine, has announced the 2015 scholarship recipients.
Marijuana, Apathy and Chinese Medicine, Part 2
A talented young woman presented herself with emotional mood swings, which included being nervous, anxious and jittery.
Use Technology to Gain New Patients and Improve Efficiency
From the smartphone in your pocket to your microwave oven, advancements in technology have made almost every aspect of our lives easier.
Breath: The Movement of Oxygen and Energy
I remember with surprising clarity the first time a patient started crying during an acupuncture treatment I was giving. This is now quite a long time ago, back in 1999, when I was a student.
What Does Success Mean to You?
Recently, I was asked to speak to young, budding businesswomen about running a successful business — and at first I thought, "Me? You want me to speak to others about success?!"
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
The Source-Luo Point Combination
The luo collaterals are part of the acupuncture channel system presented in the Su Wen and the Ling Shu (The Nei Jing). The function and clinical application of the luo mai are primarily presented in chapter 10 of the Ling Shu, however, they are also found in others chapters in the Su Wen and the Ling Shu.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
The Nectar of Plants: Essential Oils and Chinese Medicine
Essential oils are a very hot topic these days, especially with the likes of the Ebola virus and the resurgence of measles lurking in our awareness, but when I first became interested in Chinese medicine, essential oils weren't on the radar screen for acupuncturists.
Acupuncture in the U.K. Today: A Personal View
When asked to write a short piece on the current state of the U.K. acupuncture profession, my first response was to say it has all been relatively quiet.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
The Year to Make Things Happen
It is hard to believe that the Year of the Ram – 2015 is half over. Time seems to be moving especially fast. This is the year for things to happen for the acupuncture profession.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Acupuncture and the Pulse
In 1991, I attended a martial arts workshop hosted coincidentally by Sung Baek, a martial artist and the head of his lineage as a Korean trained acupuncturist. I was enamored by the details Sung could attain from the pulse, as told to me by some of his apprentices.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
Calculating Billable Units
I recently learned of an office that was audited based on the number of acupuncture sessions performed in one day. Is there a maximum number of sessions that can be performed in one day?
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
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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