The committee on Senate Ways and Means to whom was referred the Senate Bill relative to the licensure of massage therapists in Massachusetts
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
SECTION 1. Chapter 140 is hereby amended by striking out section 51 of the General Laws, as appearing in the 2004 Official Edition, and replacing it with the following new section:-
Section 51. (a) No person shall practice massage therapy unless licensed in accordance with sections 227 to 236, inclusive, of chapter 112, except that a person registered as a barber or apprentice under section 87H or 87I of said chapter 112 or as a hairdresser, operator or student under sections 87T to 87JJ, inclusive, of said chapter 112 may practice facial and scalp massaging without a license. Local boards of health may regulate other fields not licensed as massage therapy under said sections 227 to 236, inclusive, of said chapter 112.
(b) No person shall establish businesses for vapor, pool, shower or bath houses unless authorized by the board of health in the municipality where the establishment is to be operated. The board of health may grant the authorization upon such terms and conditions, and may make such rules and regulations in regard to the carrying on of the occupation so licensed, as it considers proper and may revoke any authorization granted by it for such cause as it considers sufficient, without a hearing. A person authorized to establish the giving of vapor, pool, shower or other baths in a municipality may, at the request of a physician, attend patients in another municipality without additional authorization from the other municipality. No massage therapist, whose license to practice massage therapy is revoked or suspended for more than 1 year with regard to insurance claims, shall own, operate, practice in, or be employed by a massage therapy office, clinic, or other place designated for the practice of massage therapy, physical therapy or chiropractic.
SECTION 2. Chapter 13 of the General Laws is hereby amended by adding the following 2 sections:-
Section 98. (a) There shall be within the division of professional licensure, a board of registration of massage therapy. The board shall consist of 7 members who shall be appointed by the governor for terms of 3 years. The members appointed shall be residents of the commonwealth, 3 of whom shall be licensed massage therapists who have been actively engaged in the practice of massage therapy in the commonwealth for at least 5 years immediately before their appointments; 1 of whom shall be a health agent, board member or other health professional employed by or elected to a municipal board of health within the commonwealth; 1 of whom shall be an individual who is actively engaged in the operation of a licensed massage school; and 2 of whom shall be consumers who are familiar with the massage therapy field. All board members shall be subject to chapter 268A.
(b) Of the initial members appointed to the board, 3 shall serve for terms of 3 years, 2 shall serve for terms of 2 years and 2 shall serve for terms of 1 year. Each member of the board shall hold office until his successor has been appointed. A vacancy in the membership of the board shall be filled for the unexpired term in the manner provided for the original appointment. A member may be removed by the governor for cause.
(c) The board shall at its first meeting and, annually thereafter, elect from among its members, by majority vote, a chairman and vice-chairman. The board shall meet at least once every 3 months and may hold additional meetings as necessary to discharge its duties. Members shall receive no compensation but shall be entitled to reasonable travel expenses. The members of the board shall be public employees for the purposes of chapter 258 for all acts or omissions within the scope of their duties as board members.
Section 99. (a) The board shall have the following powers and duties: (i) to administer and enforce the provisions of section 227 to 236, inclusive, of chapter 112; (ii) to adopt rules and regulations governing the licensure of massage therapists, the practice of massage therapy and the operation of massage schools to promote the public health, welfare and safety of citizens of the commonwealth; (iii) to establish standards of professional and ethical conduct; (iv) to establish standards for continuing education reflecting acceptable national standards; and (v) to investigate complaints, conduct inspections, review billing and treatment records and set and administer penalties as defined in sections 61 to 65E, inclusive, and sections 232 to 236, inclusive, of chapter 112 for fraudulent, deceptive or professionally incompetent and unsafe practices and for violations of rules and regulations promulgated by the board.
The board shall make available to the public a list of licensed massage therapists. The board shall establish by regulation a code of ethics.
SECTION 3. Chapter 112 of the General Laws is hereby amended by adding the following 9 sections:-
Section 227. As used in this section and sections 228 to 236, inclusive, the following terms shall have the following meanings, unless the context requires otherwise:
"Board", the board of registration of massage therapy established pursuant to section 98 of chapter 13.
"Licensed massage school", a facility which is licensed by the board after meeting minimum standards for training and curriculum as determined in accordance with said sections 228 to 236, inclusive.
“Licensed massage therapy salon”, a place, office, clinic, or establishment licensed by the board to offer massage services.
"Massage", the systematic treatment of the soft tissues of the body by use of pressure, friction, stroking, percussion, kneading, vibration by manual or mechanical means, range of motion for purposes of demonstrating muscle excursion or muscle flexibility and nonspecific stretching. Massage therapy may include the use of oil, ice, hot and cold packs, tub, shower, steam, dry heat or cabinet baths, in which the primary intent is to enhance or restore the health and well-being of the client. Massage therapy shall not include diagnoses, the prescribing of drugs or medicines, spinal or other joint manipulations, nor any services or procedures for which a license to practice medicine, chiropractic, occupational therapy, physical therapy or podiatry is required by law.
"Massage therapist" or "Massage practitioner", a person licensed by the board who instructs or administers massage or massage therapy for compensation.
Section 228. (a) No person shall hold himself out to others as a massage therapist or practice massage or massage therapy unless he holds a valid, license issued in accordance with this chapter. No person licensed to practice massage or massage therapy shall perform any of the following: diagnosis of illness or disease; high velocity, low-amplitude thrust applied to a joint; electrical stimulation; application of ultrasound; exercise and prescription of medicines. The following practitioners shall be exempt from the licensure requirements under this section:
(1) a person who is otherwise licensed, certified or registered under the General Laws, performing services within his authorized scope of practice, and who does not hold themselves out to be a massage therapist;
(2) a person duly licensed, registered or certified in another state, territory, the District of Columbia or a foreign country when temporarily called into the commonwealth to teach a course related to massage therapy or to consult with a person licensed as a massage therapist under this chapter;
(3) a student of massage therapy enrolled in a licensed massage school program for massage, performing work as a required component of his course of study at such school, but the student shall not hold himself out as a licensed massage therapist under this chapter and shall not receive compensation for his work;
(4) a person giving massage to a member of that person's immediate family for which he received no compensation;
(5) a person, duly licensed, registered, or certified in another state, territory, the District of Columbia, or a foreign country, who is incidentally in the commonwealth to provide service as part of an emergency response team working in conjunction with disaster relief officials;
(6) a person giving massage in a sporting, health or other event that is non-compensatory and under the supervision of a licensed massage therapist.
(b) Nothing in this section shall prevent or restrict the practice of a person who uses touch, words or directed movement to deepen awareness of patterns of movement in the body, or the affectation of the human energy system or acupoints or Qi meridians of the human body while engaged within the scope of practice of a profession with established standards and ethics, but such services shall not be designated or implied to be massage or massage therapy. Such practices shall include, but not be limited to the Feldenkrais Method; Reflexology; The Trager Approach; Ayurvedic Therapies, Rolf Structural Integration, Polarity or Polarity Therapy; Polarity Therapy Bodywork; Asian Bodywork Therapy that does not constitute massage as defined in this chapter; Acupressure; Jin Shin Do; Qi Gong; Shiatsu; Body-Mind Centering and Reiki. These exempt practitioners may use the terms “bodywork”, “bodyworker” and “bodywork therapist” in their promotional literature.
Section 229. (a) A person desiring to engage in the practice of massage therapy shall make application upon a form furnished by the board, which application shall be signed and sworn to by the applicant. Each application shall be accompanied by payment of the fee prescribed by the executive office of administration and finance pursuant to section 3B of chapter 7. Upon submission of a completed application to the board and the payment of the required fees, the board may issue a license to practice as a massage therapist to an applicant who satisfies the following minimum qualifications: (1) he shall have obtained a high school diploma or its equivalent; (2) he is 18 years of age or older; (3) he has submitted 2 professional letters of reference, with at least 1 being from an employer or professional in the massage therapy or medical field; (4) he shall be of good moral character as determined by the discretion of the board; (5) he shall have successfully completed a course of study consisting of at least 500 classroom hours or an equivalent number of credit hours of supervised instruction at a licensed massage school; (6) he shall have not been convicted in any jurisdiction of sexually-related crime or crime involving moral turpitude for the 10 years immediately before the date of application; (7) he shall provide proof of professional liability coverage; and (8) he demonstrates such professional competence as may be required by the board’s regulations.
(b) The director of the division of professional licensure shall determine the renewal cycle and renewal period for massage therapy licenses. Each person licensed in accordance with these sections shall apply to the board for renewal of his license on or before the expiration date, as determined by the director, unless such license was revoked, suspended or canceled earlier by the board as a result of a disciplinary proceeding instituted pursuant to this chapter. Applications for renewal shall be made on forms approved by the board and accompanied by payment of a renewal fee, as prescribed by the executive office of administration and finance pursuant to section 3B of chapter 7, which fee shall not be less than $100.
As a condition for renewal of his license, each licensed massage therapist shall furnish the board with satisfactory proof that: (1) he shall not have been convicted in any jurisdiction of a sexually-related crime or crime involving moral turpitude since the original application for licensure; (2) he shall have professional liability coverage; and (3) he shall have completed such continuing education regarding massage therapy and business practices reflecting acceptable national standards, as reviewed and approved by the board. Upon satisfactory compliance with the licensing requirements for massage therapists and successful completion of the continuing education requirements, the board shall issue a renewal license showing that the holder is entitled to be licensed for the renewal period. The board may provide for the late renewal of a license which has lapsed and may require payment of a late fee. All licensing and application fees collected pursuant to sections 227 to 235, inclusive, shall be deposited into the trust fund established in section 35V of chapter 10.
Section 230. The board may provide reciprocal licenses for registered, certified or licensed massage therapists from other jurisdictions if the standards of registration, certification or licensure in their jurisdictions are reasonably equivalent to those set forth in section 229. The board shall adopt rules and regulations, consistent with the laws of the commonwealth, for the implementation of this section. The fee for a reciprocal license shall be prescribed by the executive office of administration and finance pursuant to section 3B of chapter 7 and shall not be less than $100. An applicant shall not be granted reciprocity if his license to practice is revoked or suspended by any other jurisdiction. The board, subject to a vote of the majority of its members, is authorized to revoke a license if the license, certificate, registration or authority issued by another state or territory of the United States, the District of Columbia, or a foreign state or nation is revoked, cancelled, suspended, or otherwise acted against, or if the holder has been disciplined in that jurisdiction, if the basis for the action would constitute a basis for disciplinary action in the commonwealth.
Section 231. The board may grant a license to an applicant who: (1) either: (a) provides documentation acceptable to the board demonstrating the applicant has provided at least 500 hours of massage to members of the public for compensation; (b) has been authorized to practice massage therapy by the municipal board of health within the commonwealth, such authorization being valid within 2 years of the date of application; or (c) provides proof of the successful passage of a board-approved examination administered by a national organizational or board accredited by the national commission of certifying agencies and approved by the national organization for competency assurance; (2) submits a completed application and pays the necessary fee prescribed by the executive office of administration and finance pursuant to section 3B of chapter 7; (3) is of good moral character as determined by the discretion of the board; and (4) provides proof of professional liability coverage.
Section 232. (a) The board shall conduct inspections and investigate all complaints filed relating to the proper practice of massage therapy, the operation of a massage school, and any violation of sections 227 to 236, inclusive, or any rule or regulation of the board. Such complaints may be brought by any person, or the board may, on its own, initiate a complaint.
(b) The board shall be under the supervision of the division of professional licensure and shall have all the authority conferred under sections 61 to 65E, inclusive. For the purposes of this section and sections 61 to 65E, inclusive, conduct which places into question the holder’s competence to practice massage therapy shall include, but not be limited to:
(1) committing fraud or misrepresentation in obtaining a license; (2) criminal conduct which the board determines to be of such a nature as to render such a person unfit to practice as a licensed massage therapist, as evidenced by criminal proceedings which resulted in a conviction, guilty plea or plea of nolo contendere or an admission of sufficient facts; (3) violating any rule or regulation of the board; (4) failing to cooperate with the board or its agents in the conduct of an inspection or investigation; (5) failing to fulfill any continuing education requirements set out by the Board; (6) violating any ethical standard which the board determines to be of such a nature as to render such person unfit to practice as a massage therapist, such as:
(i) inappropriate conduct or touching in the practice of massage therapy;
(ii) offering any type of medical opinion or diagnosis; or
(iii) negligence in the course of professional practice.
The board shall be empowered to issue an order to a licensee directing him or her to cease and desist from unethical or unprofessional conduct if the board finds, after the opportunity for a hearing, that the licensee has engaged in such conduct.
(c) A massage therapist, whose license to practice is suspended for more than 1 year for professional misconduct with regard to insurance claims, shall not own, operate, practice in or be employed by any other any massage therapist, physical therapist or chiropractor, in any capacity, until the license is reinstated by the board. A massage therapist, whose license is suspended for a second offense with regard to insurance claims, shall have the license permanently revoked and may not own, operate, practice or be employed in a business that provides massage therapy, physical therapy or chiropractic care.
(d) Nothing in this section shall limit the board's authority to impose sanctions by consent agreement that are considered reasonable and appropriate by the board. Any person aggrieved by any disciplinary action taken by the board pursuant to this section or section 235 may, pursuant to section 64, file a petition for judicial review.
Section 233. The board shall, upon the application of any school desiring to teach massage therapy in the commonwealth, inspect the school and notify the governing body thereof in writing if the school is approved for licensure by the board, or if not, what action the school must take in order to be licensed by the board. The application shall be on a form furnished by the board, which application shall be signed and sworn to by the applicant. Each application shall be accompanied by a fee as prescribed by the secretary of administration and finance in accordance with section 3B of chapter 7. Licenses to operate a massage school shall be valid for a period determined by the director of the division of professional licensure and may be renewed for a like period upon application therefore on forms to be furnished by the board. The fee for each such renewal shall be determined under the aforementioned provision. The board shall further establish standards to be met by the massage therapy school and shall require the school to maintain a curriculum that meets the criteria established by the board. When in the opinion of the board the standards have been met by the school, the school shall be licensed. No school or entity not so licensed may teach massage therapy. Instructors in licensed schools shall be licensed by the board. No person may instruct in any massage school in the commonwealth unless he is so licensed. If at any time a licensed school has in the opinion of the board lowered its standards below those established by the board or violated any law, rule or regulation of the board, the license may, after notice and a hearing, be revoked by the board. Any applicant aggrieved by the refusal of the board to license a massage school shall be entitled to have the board’s decision reviewed by a justice of the superior court pursuant to chapter 30A.
Section 234. The board shall promulgate regulations necessary to ensure the safe and lawful practice of massage therapy. Every person receiving a license from the board shall conspicuously display the same in his place of business.
Section 235. Only persons duly licensed under this chapter are designated as "massage therapists" and entitled to use the term "massage" when advertising or printing promotional material. Anyone not authorized to use the term “massage” in his professional title, and who uses that term, shall be subject to discipline by the board. Anyone who (i) knowingly aids and abets one or more persons in using the term “massage” as part of a professional title when the person is not authorized to do so; or (ii) knowingly employs persons not authorized to use the regulated professional title in the course of such employment, shall also be subject to a disciplinary proceeding before the board. It shall also be a violation of this chapter for any person to advertise: (1) as a massage therapist, also known as a muscular therapist, myotherapist, masseur, masseuse or a massage therapy establishment unless a person in its employment holds a valid license under this chapter; (2) by combining advertising for a licensed massage therapy service with escort or dating services; (3) as performing massage in a form in which the person has not received training, or of a type which is not licensed or otherwise recognized by statute or administrative rule; or (4) by using any term other than therapeutic massage or massage therapy to refer to the service. The term "advertise" as used in this section shall include, but not be limited to, the issuance of any card, sign, or device to any person; the causing, permitting, or allowing of any sign or marking on or in any building, vehicle or structure; advertising in any newspaper or magazine; advertising on television; any listing or advertising in any directory under a classification or heading that includes the word "massage" or commercials broadcast by airwave transmission.
Any persons who are otherwise licensed, certified, or registered under laws of this commonwealth, who are performing services within their authorized scope of practice, and who do not hold themselves out to be massage therapists, are exempt from this section.
SECTION 4. The board of registration of massage therapy shall receive applications for licenses under section 231 of chapter 112 of the General Laws, added by section 3, no later than 2 years after the effective date of this act.