Massage therapy legislative trends so far in 2019 have primarily focused on board authority, scope of practice and title protection, establishment licensing, and human trafficking. Meanwhile, efforts have continued toward achieving licensure in the four states that do not currently regulate the profession statewide. And, massage therapy continues to be included in discussions about non-pharmacologic therapies for pain relief, as the country struggles with the opioid crisis.

Establishment licensing has become a big topic in several states. The goal is to regulate locations that provide massage, as well as massage therapists. This has meant ongoing debates about the need for state establishment licensing versus city or municipality control. States often lack the resources to physically investigate every massage establishment within the state, and not all local municipalities have ordinances and policy in place beyond a requirement for a business license. Much of this has been pushed forward to control prostitution under the guise of massage.

Recent news media attention also has been used in some localities to justify an overreach of a massage regulatory board’s authority. While this began with some good intentions related to the problem of human trafficking and prostitution, the outcomes have proven that regulatory boards do not have the manpower, money, or resources to solve this worldwide criminal activity. And, it has often confused the regulation of legitimate massage therapy with attempts to stop human trafficking, with potentially negative and overly burdensome results for massage therapists.

In some states, continuing education requirements and changes to existing rules are issues being examined. Washington focused on the definition of ‘in-person and directly supervised’, with 8 of the 24 hours required for continuing education to be in-person learning, as opposed to distance or web-based. Oregon is just beginning the rules process, and they are working to add language that would require completion of a pain management course, as well as approving it for a CE topic. Alaska just completed their rules, with the inclusion of a requirement for 2 hours of study on blood-borne pathogens. Alaska’s rules were set to go into effect in April.

Michigan and the District of Columbia have also proposed rule changes related to continuing education. Michigan includes human trafficking awareness as both a requirement of licensure, as well as an approved CE topic. Michigan also made marginal changes and clarifications of approved CE topics. The District of Columbia seeks to increase CE hours from 12 to 14 hours to be completed within the 2 year renewal cycle. Both Washington and Michigan are increasing their initial hours of education to 625 hours.

The North Carolina State Board has been in the rule-making process to revise continuing education hours and definitions, as well as establishment licensing requirements. In February, SB 92 was filed to disapprove existing rules. This was a setback after the amount of time, effort, and energy put into the process by AMTA and others. North Carolina also is considering increasing initial education hours, either through the rule process or opening the practice act.

Tennessee Senate Bill 161 sought to move up by a year the sunset hearing for the Board of Massage Licensure. AMTA and its Tennessee Chapter, in particular, were deeply engaged with Senate leadership and their intent to hold the board accountable for a nearly three year deficit. The legislature has been staunchly opposed to raising fees for massage therapists, and AMTA’s representatives spoke to this issue at the Joint Government Operations Committee Self-Sufficiency hearing on February 25^th. As of mid-March, the Tennessee Board filed a Notice of Rulemaking Hearing with the intent to raise fees.

Deregulation efforts are still popping up in some states, but draft legislation has so far been unsuccessful. The New Mexico Executive Order 2018-48 fizzled out, and the consolidation of several regulatory boards in Arkansas led to massage therapy being included under the Department of Health, which can be considered a win for the profession.

In Oregon, concerns were raised about a loophole that allows chiropractic assistants to administer 60-90 minute massages. As of publication deadline, it is at a stalemate.

Connecticut has attempted to remove the sales tax exemption for massage therapy (and many other professional services) as part of the state’s proposed sales tax reform in the Governor’s budget. Massage therapy services would become taxable beginning January 1, 2020. Significant opposition to these proposed changes exists and the voices of massage therapists are being heard through letters, phone calls and public testimony from before the legislature’s Joint Committee on Finance, Revenue and Bonding.

Florida (H 1073), Maine (LD 1082), Rhode Island (S 0576) and Virginia (S 1518) each introduced bills concerning the need for health insurers within their respective states to cover non-pharmacological therapies (including massage). Several of these bills mandate the prescription of massage and/or other physical medicine pain therapies either prior to (or in conjunction) with prescribing opioid medication. 

There are still 4 states that don’t have statewide regulation of the profession. But, progress is being made. KS HB 2184 was introduced in January and has laid solid groundwork for a pathway to licensure in Kansas. Minnesota massage therapists and schools have worked hard to draft language that could be amenable to all, but has fallen short so far in getting the legislature to approve it.  Conversations with Wyoming and Vermont about statewide licensure continue and seem to be gaining traction – but slowly.