Public Policy and Licensing
PR/Media Contact:
Leslie Young
800-458-2267 ext. 648,
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Overview - Challenges in Licensing/Regulation/Certification
Perhaps because massage therapy did not broadly etch itself into American consciousness until the latter half of the 20th century, licensing of the profession has lagged compared to other healthcare professions. While Ohio initiated state-level massage licensing in 1916, as recently as the mid-1990s only 22 states had statewide massage licensing statutes on the books. The following bar graph illustrates the path to 43 state-level massage licensing laws today. Several have passed legislation but are not fully advanced to the licensing stage.

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In the 43 states with licensing, uniform rules apply throughout each particular state, though the detailed requirements vary. Requirements in the current seven non-licensed states vary considerably, from essentially no rules in several states to highly variegated sets of local requirements in others. The District of Columbia and U.S. territories are not included here but may have regulations of their own.

ABMP believes licensing isn't automatically required. We advocate that lawmakers and members of the massage profession periodically examine whether public protection and easing of public confusion trump an instinct for only the government that is necessary. It's an evolving calculus, but one that should be navigated rather than leaping to a conclusion that "licensing is good" without examining the factors. Prestige for the profession and gaining insurance company embrace of bills for massage therapy services are insufficient reasons to create licensing. A sound licensing foundation addresses public protection and consumer information needs.

When licensing is warranted, ABMP supports consistent rules throughout a state rather than confusing diverse local rules. Local requirement inconsistency leads to consumer confusion, massage school curriculum planning that has to try to serve many masters and gross government inefficiency because each city or county has to develop expertise in reviewing applicant transcripts. State rules should be developed by a broadly diverse coalition of providers, consumers and educators operating in a transparent, inclusive manner.

ABMP's government relations professionals have been actively involved over the past 14 years, playing roles in most of the 22 states adopting massage rules for the first time during that period. In addition to on-the-scene involvement as necessary, ABMP has developed materials setting forth the organization's core principles for this arena.

ABMP has also exerted its voice whenever it has felt the balance of regulatory/certification/accreditation forces has gotten out of whack. The National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) has received its full share of barbs as it drifted away from its original purpose of voluntary certification for individuals with predominantly core Swedish massage training.

ABMP believes that passage of the examination offered as part of NCBTMB's certification regime should constitute an alternative way of qualifying for a state license rather than be imposed as a requirement for all licensees. Graduates of massage programs approved by a state department of education will likely have completed a written and practical (hands-on) evaluation as a requirement for graduation already, so there is no need to make them reinvent the wheel (an expensive wheel at that). Requiring the NCBTMB's National Certification Exam (NCE) does three things:
  • Makes the candidate for licensure pay an additional $225.
  • Postpones their entry into the profession.
  • Undermines the efforts of state-approved schools providing the education, and denies the incorporation of touch — the essence of massage — into the evaluation process.
In some professions, school accreditation is the norm. Nearly 100 percent of four-year colleges, for example, are accredited. That is not the norm among massage schools today. Only 29 percent of the approximately 1,500-plus state-approved massage schools are accredited by one or more of the six bodies approved by the U.S. Department of Education to accredit massage programs. Accordingly, we believe the three states that only license graduates of accredited massage schools are misguided. We believe that the state agency assigned to approve schools should do its oversight job. When it does, that provides sufficient regulation of schools. Voluntary accreditation of massage schools has value for the individual school, but requiring such status should not be established as a barrier to entry.

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