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Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
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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