Coronavirus and Massage Therapist Resources

Laura Allen

We are living in extraordinary times. Everyone I know has experienced hard times at some point, individually, but as a whole nation, and as the collective of massage therapists, we are currently going through things that we didn’t expect to go through. When this started (before it was acknowledged as a pandemic, and unfortunately even since), some people had the belief that it was something that existed on the other side of the world and wouldn’t affect us. Others have claimed it’s just a germ, or just the flu, or a political conspiracy. As a nation, we were ill prepared. I will save my political rant about that for another day (or another book). Right now, people need help.

Many massage therapists have voluntarily shut down their practice, and that includes those who have no savings and are worried about where their next rent payment will come from. Others are continuing to work, citing their finances. Others work for chains that threaten that they will have no job if they refuse to work. Harder times are coming, unless we do everything we can to stem the spread of this illness.

I have put together some information and some resources that massage therapists will hopefully find beneficial.

Financial Help

    • Today (Saturday March 21) as I am writing this, the Senate and the House are in session, putting differences aside, and working with White House negotiators trying to finalize the details of the economic stimulus plan. Current thought is that individuals and small businesses will receive $1000-$1200 checks, and the plan is to get them out there very quickly, hopefully April, and there may be an additional payment in May. The current thought is that if you filed taxes last year, you will not have to do anything special in order to receive it; it will automatically be mailed to you. I suggest watching national news shows to keep updated on this.

 

    • The Department of Labor has several important announcements on their website. While there is a statement to contact your individual state, the Federal  government has issued specific new guidance for the states. Under the guidance, federal law permits significant flexibility for states to amend their laws to provide unemployment insurance benefits in multiple scenarios related to COVID-19. For example, federal law allows states to pay benefits where:
    • An employer temporarily ceases operations due to COVID-19, preventing employees from coming to work;
    • An individual is quarantined with the expectation of returning to work after the quarantine is over; and
    • An individual leaves employment due to a risk of exposure or infection or to care for a family member.
    • In addition, federal law does not require an employee to quit in order to receive benefits due to the impact of COVID-19.

 

    • Obviously, I cannot list resources for specific states. My suggestions are for you to contact your state unemployment office to find out. There are local offices in most towns. I live in a very small town, but there is one here.

 

    • If you are a business owner, the Small Business Administration is helping small businesses with long-term (up to 30 years) loans at 3.75% interest that can cover operating expenses, payroll, etc. When you call your local office, say you are inquiring about the Economic Injury Disaster Loan (the name they are giving to this instance).

 

    • If you have credit card debt, don’t panic. Call your card company. Many of the major credit card companies are offering cardholders the opportunity to skip payments without interest. 

 

 

    • If you have a student loan, now is a good time to ask for forbearance. Contact your particular lender.

 

    • Many utility, phone, and internet companies are giving people a break right now by easing shutoffs and forgoing late payments. Call your utility company to find out what they are doing.

 

    • There is further help for both renters and for homeowners. The Forbes website states that they will update this list as more information becomes available.  Best advice, though, is if you feel your are going to get behind on your mortgage, call the lender now. Don’t wait until you’re in real trouble of being foreclosed on. In this environment, and because lenders often get the information about financial developments before they do, they will often be sympathetic and help you out by deferring payments or accepting partial payments, or even refinancing at a favorable rate. They do not want to get stuck with a bunch of defaulted foreclosure properties in the midst of a recession, which we are undoubtedly heading for. They would probably rather take some money that no money, or give you a grace period on making payments.

 

If you rent, or your home (or office space) is financed by an individual, all the more reason to handle it and call them now. See if they are able and willing to work with you. I have seen quite a few therapists on FB who said that their landlords were very sympathetic and willing to work with them. If you don’t ask, you’ll never know. Some landlords may take a hard line or just not be in a financial position to do so themselves and refuse, but if they think about it carefully, they may decide that they would have difficulty replacing their reliable tenants in this environment, and work with you.

 

    • Seek LOCAL resources. Now is not the time for pride to stand in the way of doing things you wouldn’t normally do, such as going to a food bank or going to local charities to ask for assistance. Rutherford County NC, where I live, is NC’s largest county, area-wise, largely rural, and only has a population of about 60,000. There are probably at least 20 food pantries here that are operated by churches and community organizations. There is also a soup kitchen open somewhere every day of the week. There are several local non-profits that help people with rent, heating expenses (thank God the need for that is close to over in most places).

 

    • Insurance tip from Allissa Haines: If you buy your health insurance on the national or your state exchange, you can probably edit your application to reflect your new income and get a lower rate. Allissa and Michael Reynolds have also made a lot of their podcasts available for free at https://www.massagebusinessblueprint.com/free-stuff

      Speaking of insurance, keep in mind that your liability insurance will not cover you in the event of a client catching the virus in your practice. Allissa, incidentally, was exposed to the virus, and was in the uncomfortable position of having to call her clients to tell them that they had been exposed. You do not want to find yourself in that position.

 

Seek a temporary job. Go to a local temp agency and see what’s available. MANY grocery stores are currently hiring due to the food panic that’s going on. Yes, you will still be in contact with people. However, grocers are not a licensed profession, and they do not swear to a code of ethics that they will First Do No Harm. Amazon is hiring. Walmart announced  yesterday that they plan to hire 150,000 additional workers. Ingle’s announced the same.

There are many massage therapists that have other degrees, other trade experience, and/or other skills. I personally know many who are everything from CNAs, nurses, truck drivers, and formerly (or still part-time) work in other professions. Medical personnel are in great demand right now, and so are all kinds of support staff in hospitals, from the janitor to billing coders.

I’ve also seen some enterprising therapists who are doing home deliveries for people who can’t get out…doing errands, going to pick up groceries or to the drugstore for the elderly or immune-compromised. Some are even doing it as volunteers. If you are in the position of being able to do that, what a service to your fellow inhabitants of the planet.

Now that schools and day care centers have been shut down in many places, it’s possible that neighbors who are still able to work may need reliable temporary child care.

  • Unless you are 100% self-quarantining, there is hardly any work situation we can be in where we will not be exposed to someone. Social distancing is the best way to flatten the curve. It gives us the best chance of not passing this on to anyone. Going out anywhere to work is a risk, but again, those who work outside of licensed health professions do not swear that they are going to uphold a code of ethics to first do no harm. If you are a license therapist, you took that oath. Uphold it.We cannot maintain any social distance with our hands on unclothed bodies and our face inches away from theirs.

Be creative. You may possess skills that other people need that you can do at home, such as website building skills or baking bread (since there seems to be a run on that at the grocery store), proofreading, sewing, preparing taxes if you’re that savvy, or any number of things.

  • If you are a member of a professional massage association, contact their leadership and ask for their assistance in getting unemployment coverage for massage therapists during this unusual circumstance. They pay lobbyists in nearly every state. You will find the links to their leadership on their websites.

ABMP has a link on their website supporting the effort to obtain benefits for massage therapists. It allows you to send a pre-written letter that they have supplied to your congressperson by filling in your info and submitting a form. PLEASE take advantage of this call to action. They also have updates on their website about the actions in different states as far as shutting down or limiting massage therapy. ABMP also has a link to state shutdown orders on their website. 

AMTA has a link on their website supporting the effort to obtain benefits for massage therapists. It allows you to send a pre-written letter that they have supplied to your congressperson by filling in your info and submitting a form. PLEASE take advantage of this call to action. AMTA also has a link to state actions on their website. 

Keep Up with the Latest Updates

PLEASE keep abreast of your state’s situation by checking the website of your governor, your local health department, and your state massage board. There has been a lot of criticism of state boards, due to confusion that state boards have the legal authority to shut down the practice of massage on a statewide basis, which is not true. They are regulatory boards, not legislative. They can and should make announcement once your governor has signed an executive order to curtail massage, or order the shutdown of anything in your state, but they cannot personally mandate that massage therapists have to shut it down.

City councils have in some cases taken it on themselves to shut it down on a local basis. Here in my state of NC, Asheville’s council has shut it down. Other places may do the same.

Some state boards have extended the deadline for CE/license renewal and/or made allowances for taking your CE, due to the cancellation of massage meetings and conventions. In my state of NC, we are allowed to do all 24 hours online this time, instead of the usual 12. Check your board website for info.

Professional association members can get CE online at no additional charge; it’s included in your membership dues.

Centers for Disease Control

World Health Organization

 

Wise Words from Massage Therapists that I Listen to:

From Ruth Werner:
Ignore My Earlier Advice. Shut It Down.

My friends and colleagues, it’s time to shut it down. It’s past time to shut it down.
I wrote a piece two weeks ago that provided some ideas about how to take care of your practice, assuming you were still seeing clients. I hereby rescind that advice, and I apologize to anyone who was misled.

Close your practice.

For how long? Who knows?

If it were me, I would start with four weeks and re-evaluate after three.
Wouldn’t it be great if we had all the information we needed to make informed, non-panicky decisions that we knew would maximize effectiveness against the spread of COVID-19 virus, and minimize financial hardship? Sadly, we don’t have that data.

No one is going to make this decision for you. Not your membership organization, not your state board, only you.

No one is going to make this any easier for you.

This is your call. And if you want my opinion (and presumably you’re interested, because you’re reading this), here it is: close your practice.

Here are some things we know that have led me to this point of view:

1. The time between exposure and symptoms can be up to 14 days.

2. The virus is contagious for days before symptoms develop, so your “healthy client” might not be.

3. The virus stays intact on surfaces for several days; it stays intact in the air for several hours (at least).

4. COVID-19 is extremely contagious, and it doesn’t take a lot of exposure to spread from one person to another.

5. The virus appears to be contagious after symptoms subside—but we don’t know how long.

6. At this point, older people and those with impaired immune systems are not necessarily more likely than others to catch the virus, but they are more likely to need extensive medical interventions. (Although that may be changing. In some countries the number of people in hospital care are skewing much younger.)

7. We don’t have enough medical capacity to manage what’s coming—which makes it even more vital not to add to that load in any way.

There are so many things about this situation that should have been different. I could list a bunch, but (A) it wouldn’t help and (B) isn’t our blood pressure high enough without recounting all the ways our systems have failed us? And this frustration doesn’t even include some of the nutso crazypants stuff I’ve seen on Facebook and other outlets. For the record, keeping your throat moist will not prevent you from getting sick with COVID-19. Neither will holding your breath for 10 seconds.

But if we all commit to extreme social isolation, it is practically for sure that the impact of COVID-19 in this country will be less extreme, at least in the short run. While roughly the same number of people will get sick, it will happen over a longer period of time. This “flattening of the curve” means our health-care facilities might be able to keep up with our needs (see link here), which means the mortality rate will fall. And the day will come when we might be able to look back and say, “Wow, that wasn’t so bad—weren’t we silly to over-react?”

This will demonstrate that we did it right.

The naysayers and virus-skeptics and my-immune-system-is-strong-so-I’ll-do-what-I-want folks will point fingers and scoff and say we all fell for a huge hoax. Let them. They are wrong.

There’s a parallel in our recent history. In the 1970s, massive changes were put in place to limit the type of air pollution that caused acid rain. At that time, rain was literally melting our forests and corroding our buildings, not to mention what it was doing to groundwater. The changes, while expensive and inconvenient for many industries, worked. Acid rain is no longer considered a threat. And the result: some people (including some politicians who should *swearword* know better) suggest that the changes were unnecessary, because look: acid rain isn’t really a problem! Argle bargle. You can’t *swearword* win.

Let’s Make Some Lemonade!

The financial burden of losing several weeks’ of business is undeniable. I’m sorry, there’s no easy way out of this. Once this crisis has passed, it will be important to plan ahead for the next one. Financial planners recommend having at least a month’s worth of expenses put in an accessible savings account—just for events like this.

That said, having some dedicated but unscheduled time to devote to business holds a lot of potential.

This is a great time to do a really thorough cleaning of your office. Go in when it’s empty, and disinfect your equipment and surfaces. Do a top-to-bottom refresh. Dust, launder, swab, decontaminate, and shine up all your stuff. Listen to loud music while you do it. It will be fun. And when you go back to work—oh, such a joy it will be to enter your gorgeous, sparkling workplace!

This is a great time to take some continuing education online. Go shopping in the rich ABMP collection of online CE classes, here. You could take some business classes, and use this time to make plans for a grand re-opening. You could take some research literacy classes, and go on a PubMed.gov treasure hunt for articles that are up your alley. Have you always been curious about a certain technique or approach to bodywork? Here’s an opportunity to explore it to see what you might want to pursue in live classes.

Do you send out blogs or newsletters for your clients? Get ahead on your writing, and put some pieces away for later. It’s more important than ever to keep those lines of communication open, so this is a good investment of your energy. Let your clients know that while you can’t see them in person, you’re thinking of them.

It’s tax time: get ahead of your taxes for this year, and set up your books for easy use next year.

If you are caring for children during this time, include them in appropriate activities. Make them your model while you watch a technique video. Learn, or re-learn, some anatomy together. Make this time a gift.

Most of all, breathe deeply and be kind. Let’s take care of each other and help each other through a scary time. We’re going to be OK. We will emerge, poorer in money, but richer in experience, because we took the right actions. And we will be ready to help our clients and our communities come back up to full speed when the time is right.

From Cal Cates

Dear everyone who offers a service or type of care that is (when we’re being truly ego-free and honest) non-essential, but who is still staying open and touching/interacting in close proximity with people, but who is “being careful” and “prescreening”,
I have taken the liberty of creating a simplified form to support said caution and prescreening.
1. Please use the space below to list every surface you have touched, every place you have gone and the names of every person who has been within 6 feet of you over the last 14 days.
2. Please use the space below to do the same for each person that you listed above.
When you’re done thoroughly completing this form, the COVID-19 crisis should be over and we’ll be cool to proceed.

From Tracy Walton:
I understand that professional organizations are finding it hard–really hard–to discern right action right now. I have compassion for them and for all of us.
At the same time, this directive falls short (note–she was speaking of the original statement from AMTA, which did not advise therapists to stop doing massage).
The guidelines and messages from other countries are crystal-clear:
Social distancing now. Not tomorrow, now.
Massage is not in accord with social distancing.
Massage therapy may be health care, and important and essential, but it is elective and requires close contact by its nature.
Asymptomatic clients and therapists can and most likely are transmitting the virus.
We cannot afford to miss this. The stakes are unfathomably high.
My practice is closed for 3 weeks and probably longer.

About Me
I started taking bodywork classes back in 1993, finished massage school in 1999, and was in the first wave of people to get licensed in NC. I taught Ethics and marketing classes to my own class in massage school. They needed an instructor and I was qualified, so I was hired. I love massage therapy. I received my first one over 30 years ago when I woke up one morning and couldn’t turn my head. My enlightened mother took me to get a massage. After spending over 20 years in the restaurant business, I sold out and started massage school. I became an Approved Provider of Continuing Education, and since that time, I’ve taught more classes than I can count, mainly in the areas of Ethics, but also teacher training classes, marketing, and massage classes.

I also spent several years volunteering as a Unit Coordinator, and later as the administrator of all the coordinators for the NC Chapter of AMTA. I spent five years serving on the North Carolina Board of Massage & Bodywork Therapy, and was twice a delegate to the FSMTB. I’m the author of Heart of Bodywork, the Ethics column of ABMP’s Massage & Bodywork Magazine and the author of numerous books. Most are massage related; a few are on other topics, including one on the state of healthcare in every nation in the world.

I spent 13 years as a clinic owner employing a chiropractor, numerous massage therapists, a naturopath, an acupuncturist, an esthetician, and at various times, other practitioners. I closed it in 2016 when my deceased husband, Champ Allen, was sick. I spent three years working as the Massage Division Director of Soothing Touch, the massage product company, and for a little over a year, I have been working for CryoDerm, the pain relief and massage product company. They are a family-owned company located in FL; I live in NC. I am fortunate to get to work from home. I was recently promoted to President of Sales & Marketing there.

I have also maintained a very small client list for massage that I see in a local spa, usually about 6-8 clients per month. I am not seeing anyone at this time, and don’t intend to until I can be sure it’s safe to do so. I don’t know when that will be. None of us do. I am practicing social distancing and as close to self-quarantine as I can get. My mother, who lives a few miles away from me, is 81, in compromised health, and needs help at times, so I will continue to go there as needed. She has a  home  health care aid most days. I will run necessary errands to keep her from going out. Otherwise, my husband James Clayton (I remarried last year) and I are staying at home with our dogs. Even my brother, who lives directly behind me, and I are maintaining 6 feet between each other. He was injured in a serious accident last year, has had 7 surgeries as a result of that, and has implanted antibiotics. James is a two-time cancer survivor who has had a lot of chemo and radiation, which does a whammy on the immune system, so I certainly don’t want to bring anything home to him.

I wish you all the best in these trying times and I hope you all remain well.

Laura Allen Clayton

The Financial Health of Our Organizations: NCBTMB

I’ve been on hiatus from blogging about the politics of massage and the massage organizations since 2016. It’s time-consuming, and I was just too overwhelmed during the sickness and subsequent passing of my spouse. Plenty has happened in the interim; on a happy note, I got married on July 5 of this year. In February of 2019, I accepted a job as VP of Sales & Marketing at CryoDerm. I also still do a couple of massages every week to keep my hand in, so to speak. During the past few years while I was on break, people have continued to contact me almost daily to report something going on and encouraging me to blog about it. I will probably never be as prolific a blogger as I once was, but I feel I can take a little time to jump back into the fray.

For several years, I reported on the financial status of our massage organizations, which except for ABMP, are all non-profit organizations that are obligated to release their 990 filings. Non-profits are on a different filing schedule than the rest of us, so this report is based on their latest filing for the year 2017. I thought that was a good place to begin again, so I’ll start with the finances of the NCBTMB, which I haven’t reported on since 2014. Click here to read that blog, as it will give you further insight into where things have been, and the direction it appears to be heading. As most of Massage Land is aware, the NCBTMB got out of the licensing business after the MBLEx nearly obliterated their status as the sole path to licensing, except for the few states that had their own. They now offer Board Certification, several specialty certifications, and still administrate the Approved Provider program as sources of revenue.

No announcement has been made about it by the NCBTMB, but Steve Kirin, CEO for the past 8 years, departed in October and has not been replaced. Portia Resnick, the current president of the Board, is acting as interim CEO. Kirin’s salary was reported less than $150,000 a year, which was a very big come-down from some of the previous CEOs. In 2007, when the NCBTMB was in its heyday, the CEO was making over $250,000 and the organization’s revenue was over 8.6 million dollars. Things are obviously not what they used to be back when they were administering thousands of National Certification exams every year. The figures don’t lie, so any comments or criticism from me seem extraneous at this time.

You can set up a free account at Guidestar to see 990 filings from any non-profit (or pay a premium to get more information).

2018 filing (for the tax year beginning 03/01/2017- 02/28/2018)Note that the NCBTMB filed a change of accounting period in 2017. This return covers only two months from 01/01/2017-02/28-2017. 2017 filing (for the tax year beginning 01/01/2016- 12/31/2016)2016 filing (for the tax year beginning 01/01/2015-12/31/2015
Program Service Revenue1,324,304225,7751,509,4902,015,353
Investment Income34,2151,84815631,568
Other Revenue21,3523,86631,118188,939
Total Revenue1,379,871231,4891,540,7642,235,860
Salaries, other employee compensation, benefits838,837136,246897,2061,066,871
Other expenses689,053188,0391,031,6861,137,897
Total expenses1,527,890324,2851,928,8922,204,768
Revenue less expenses-148,019-92,796-388,12831,092
Total Assets885,018964,5001,006,4541,338,085
Total Liabilities265,700245,257218,547221,017
Net Assets or Fund Balances619,318719,249787,9071,117,068

Arkansas Massage Therapists: Be(a)ware

The state of Arkansas has more massage legislation going on than you can shake a stick at.  Here’s a quick recap of this legislative bonanza:

AB 145 would dissolve the Arkansas Board of Massage Therapy and transfer duties to the Department of Health, effective Oct. 1, 2015. This has passed both the House and the Senate and been sent to the Governor, and it’s almost a 100% certainty that licensing massage therapists is going to be turned over to the DOH. It’s beyond incredible to me that the current board members apparently did not protest the dissolution of their Board. However, from the mess that they seem to be in, perhaps the Board members felt it’s best to just go along with the change. Unfortunately, in the past few years, the Arkansas Board has apparently been on a downhill slide with their finances.

According to past Board member Susie Byrd, the current board took power in ’09 when Byrd left. At that time, there were 3550 therapists, two people running the board office, and an annual budget of $74,5000. Marilyn Graham was hired as the Executive Director in ’09. As of 2014, 5 years into Graham’s tenure, there are 1990 therapists, four people in the board office, and an annual budget of $248,000. According to Byrd, when she departed from the the Board, the Board had $250,000 in reserves. That $250,000 has been spent, and according to Byrd, Graham has asked for an additional $60,000 twice in the past year. The Dept of Finance and Administration told the board they had to either fire two people or raise fees, and that the legislators would not grant a fee raise. Considering that Arkansas has lost so many licensees, while doubling their staff and moving to bigger, better offices, their spending definitely seems out of control, and it’s no wonder the state feels compelled to do something.

Derick Corbin, a massage therapist in Russelville, Arkansas, has used his social media pages to try and rally the troops to get in touch with their legislators to prevent the dissolving of the Board, but I am almost certain that due to the mismanagement that has been allowed to go on for the past 5 years, it will in fact be dissolved. Corbin initially brought these legislative issues to my attention. He confirms that the present Board has allowed Graham to run the agency unchecked and unmonitored and believes that has caused the insolvency. When he first contacted me about it, I suggested that the Board needed to reach out to the Federation of State Massage Therapy Boards, who helps guide member Boards in situations like this. Unfortunately, this administration also saw fit to drop their membership in the Federation. Corbin states that the previous Board was comprised of honest, hardworking people. As he truthfully pointed out to me, the burden is on a Board to oversee an Executive Director, and to question it when finances (or any other executive decisions and actions) seem improper. It looks like this Board should have been asking some hard questions long ago, and didn’t, or they wouldn’t be in this mess right now.

I read all the minutes from Board meetings that appear on the website. Donna McGriff, a former Board member who has served three different tenures on the Board, told me that she and Byrd had repeatedly asked the Board to require a review of Board finances in the meeting once per quarter. According to McGriff, that never happened, and there is no mention of it in any meeting minutes.

AR: HB 1729 will require all boards to be subjected to a sunset review every 12 years as of 2017 by a Sunset Review Committee. The Committee will also review board finances.  I’d be very interested to see a detailed accounting of the past five years myself.

AR: HB 1589 would have exempted Bowen Therapy/Technique practitioners from licensure requirements for massage therapists. This bill was defeated yesterday and is just waiting on the Governor’s signature.

AR: SB 546 eliminates  a former requirement of a  general education development and changes  the requirement to a high school diploma or high school equivalency diploma approved by the Department of Career Education and is just waiting on the Governor’s signature.

AR: HB 1562 changes the requirements for CE hours for instructors to 250 CE hours, requiring the 125 hours for a master massage therapist license (only 18 are allowed to be taken online); Master Massage Therapist licensure requires 125 CE hours (with no more than 10% online); adds human trafficking, sexual misconduct, and lewd behavior to reasons for license denial and revocation; provides exemption from licensing for cosmetologists and Bowen Therapy practitioners (the Bowen exemption was defeated yesterday on a separate bill), if they are certified by a professional organization or credentialing agency; adds new sanitation requirements; requires massage schools to maintain board licensing examination pass/fail rates and includes the provision and that if a school has a pass rate of below 75%, the board can place the school on probation; requires massage therapy clinics and spas to register with the board; provides policies for probation and addresses military active duty considerations, and is just waiting on the Governor’s signature .

According to Byrd, 4 schools were previously given probationary status because of low pass rates, and three of the four school owners went screaming to the legislature that the Board members had a vendetta against them. One of them only had a 50% pass rate–actually up 2% from the 48% they had a few years ago. That’s pitiful, in my estimation, and I can’t imagine spending my money to attend a school with that kind of record. Any school can experience a temporary setback for a number of reasons–incompetent instructors, management changes or upheaval of some sort–but a school consistently having that low a pass rate ought to be out of business altogether, if they can’t get up to snuff within a probationary period. If they can make a case for why they’ve had a short-term lapse in pass rates, that’s one thing, but just being allowed to carry on permanently with that kind of rate is beyond the pale.

I’ve seen it happen time after time that when some detrimental legislation gets passed–many times directly due to the failure of people to contact their legislators to express their concerns and ask them to vote the other way–within a few weeks people will start calling me or asking on social media what to do. I applaud Byrd and Corbin for trying to motivate massage therapists to take action,and applaud those therapists that did take action. I’d like to be proven wrong here, but I fear the Arkansas Board is going down the river. Those of us who have been around for awhile will recall when a previous director, now deceased, almost single-handedly bankrupted the National Certification Board for Therapeutic Massage & Bodywork. Board members–on any board–need to keep in mind that they are charged with running a board in a fiscally and ethically responsible manner, and that includes questioning the decisions of an executive director, and intervening before things deteriorate to the point they have deteriorated here. This Board is one of the oldest massage boards, formed in 1952. To see it lost in this way is a travesty, and one that could have been prevented.

Board Certification: Just Do the Right Thing

In my last blog, I was critical of the fact that  the NCBTMB‘s new Board Certification exam has been adopted by VA and CA for licensing purposes. I have heard through the grapevine that Oregon intends to do the same, but nothing is on their website to that effect yet.

After the blog was released, I was contacted by the NCBTMB’s CEO, Steve Kirin, and Board Chair Leena Guptha, who were upset with my criticism and wanted to set the record straight. Kirin sent me a timeline of the events leading up to the acceptance of the exam by the states, stated to me that the NCBTMB had no prior knowledge that it was going to happen, and that they notified the FSMTB as soon as these developments came to their attention. I appreciate that they contacted me. I appreciate that they notified the Federation; it was the right thing to do.

They also stated to me that the NCBTMB has no control over the state boards, and that’s very true; the NCBTMB is not a regulatory agency, and has never been one.

However, the NCBTMB can and should take control of this situation by putting some controls in place with Pearson Vue, the vendor that administers the exam, and I stated this directly to Kirin and Dr. Guptha during our conference call.

Board Certification was introduced as “the highest voluntary credential attainable to massage therapists and bodyworkers in the profession today. Board Certification demonstrates a much higher level of achievement beyond entry level licensure—including completing more education, hands-on experience, and a background check—that will be a differentiator for you as you advance through your career, especially in a time where health care and other pivotal third-party professions require Board Certification in order to fill stable and rewarding positions.” From the NCBTMB’s website, here are the qualifications:

  • Pass the Board Certification exam
  • Complete 750 hours of education*
  • Complete 250 hours of professional hands-on experience**
  • Pass a thorough national background check
  • Maintain a current CPR certification
  • Signed commitment to the NCBTMB’s Standards of Practice and Code of Ethics
  • Signed commitment to opposing Human Trafficking

It’s my opinion that the NCBTMB should put the policy in place that if a candidate wants to take the Board Certification exam, they should have to demonstrate proof that they have completed the other requirements. VA and CA both require 500 hours of education, and in fact, as is the case with the MBLEx, people can take it while still a student. That does nothing to indicate advanced practice.

I became Nationally Certified in Therapeutic Massage & Bodywork in 2000, and I have maintained it ever since. I transitioned to Board Certification when the new credential was introduced. I allowed it to expire a couple of weeks ago, after these new developments came to my attention. My own state, NC, is also a 500-hour state. The school I attended was 525 hours, and in the past 15 years, I have taken more than enough continuing education to meet the 750-hour requirement. And that’s my complaint: I’ve met the requirements. It is just my opinion that allowing people who have not met those requirements to take the exam is minimizing this credential.

This is easily fixable. No, the NCBTMB cannot control the states. But they can control what happens to their credential, by the simple act of having applicants submit proof of meeting all the other the requirements to the NCBTMB, and then issuing them permission to test.

The NCBTMB’s agreement with the FSMTB put the NCBTMB out of the licensing exam business. While I appreciate the fact that the NCBTMB had no prior knowledge of what happened with the exam (and will continue to happen, if the controls aren’t put in place), I urge them not to sit on their hands.  I am dismayed that this happened at all, because if the stipulations had been put in place to begin with, this situation could have been avoided. I implore the NCBTMB to just do the right thing. Seize control of your exam, if you really want it to mean anything above being an entry-level licensing exam.

 

 

Exam Wars: The Sequel

As I reported in my blogs of October 3 and October 20, 2014, FSMTB and NCBTMB reached an agreement where “…NCBTMB will no longer provide examinations for licensure purposes and will now focus exclusively on delivering quality certification programs.” That’s a direct quote from the joint press release issued by both organizations.

In the wake of this news, cheers were heard ’round the profession, as it signaled an end to the ugly and costly “exam wars” between the two organizations. In case you forgot, NCBTMB darn near bankrupted itself trying to fight the FSMTB and their upstart licensing exam. The fact is that the Federation offered the better testing solution for state massage boards, and the profession has migrated to the MBLEx – leaving NCBTMB with ever-shrinking exam revenues.

With so few people taking their rebranded National Certification exams for state licensure, NCBTMB was compelled to strike a deal with the FSMTB to throw in the towel in exchange for some amount of money. And we don’t know how much cash, because the terms have not been made public. As part of this agreement, NCBTMB said it was going to stop taking new applications for its National Certification Exams on November 1, 2014, and will cease administering these two tests on February 1, 2015.

Sounds like we’re finally moving towards the single licensing exam solution for the massage therapy profession, doesn’t it? Well, don’t head for the lobby to get your tub of buttered popcorn yet, because the next installment of Exam Wars is heating up!

NCBTMB may be bringing down the curtain on the two National Certification exams, but they are now reported to be offering their Board Certification Exam for state licensure purposes. Doesn’t that fly in the face of the agreement with FSMTB?

In October 2014, the Massage Therapy Advisory Committee of the Virginia Board of Nursing voted to accept NCB’s Board Cert exam to meet their statutory certification requirements (in place of the sunsetting National Cert exams). On December 11, 2014, the California Massage Therapy Council voted to accept NCB’s Board Cert exam, along with the MBLEx and the two NCB National Cert exams taken before 2/1/15.
If that weren’t bad enough, NCBTMB is now allowing people to take the Board Cert exam BEFORE they have met all eligibility requirements for Board Certification. Since NCBTMB is touting it as the “highest voluntary credential attainable to massage therapists and bodyworkers in the profession today”, this policy cheapens the credential. It’s already a stretch for NCBTMB to make these claims, but their use of the Board Cert exam to stay in the state licensure game is a real howler. In fact, I think it cheapens it to the point that I will not renew mine in a few days when it expires. I don’t have anything to prove. And after 15 years of practice, I am not going to spend my money to maintain a voluntary credential that is supposed to indicate you are an advanced practitioner that someone fresh out of massage school is being allowed to get. It doesn’t say anything about my knowledge and years of experience at all. It’s apparently turning into just another entry-level credential instead of what it was designed to be, and that truly distresses me.

Are NCB’s actions in violation of their agreement with FSMTB? That may have to get worked out between the attorneys for each side. Whatever the agreement actually says, we’re headed right back to the same old conflicts between FSMTB and NCBTMB. And we didn’t even have to wait long for the Sequel!

Deal, or No Deal?

In my last blog, The Good, the Bad and the Ugly, I reported that the only good thing that came out of the recent FSMTB Annual Meeting was the announcement that NCBTMB and FSMTB had reached an agreement on licensing exams, which promised to spell the end of the long “exam wars”. FSMTB trumpeted this news in their October 3rd press release, which stated:

“FSMTB and the NCBTMB have worked cooperatively to reach an agreement that the NCBTMB will no longer provide examinations for licensure purposes and will now focus exclusively on delivering quality certification programs. This supports the common goal of the FSMTB, Associated Bodywork and Massage Professionals (ABMP), American Massage Therapy Association (AMTA) and the Alliance for Massage Therapy Education (AFMTE), for the Massage & Bodywork Licensing Examination (MBLEx) to be utilized as the sole licensure exam for the profession, thus facilitating licensure portability for therapists.”

Too bad that we really can’t celebrate this news because the so-called “agreement” did not include the Approved Continuing Education Provider Program operated by NCBTMB (which 27 state massage boards use in one way or another). Like rubbing salt in the wound, the FSMTB turned right around and passed a resolution to create their very own CE approval program–as if NCBTMB didn’t exist.

It actually gets worse. I received word that at last week’s Florida Board of Massage Therapy meeting in Orlando, it was stated publicly that there was really only a “letter of intention” between the two organizations that was signed before the FSMTB Annual Meeting, and that the details of this letter would be worked out later in a formal agreement.

Now I’m no attorney, but a letter of intention is NOT the same thing as a legally-binding agreement. It’s more like putting a small deposit down on a house to get the process started, with the purchase contract and the mortgage money to come later. A lot can happen between those two steps.

So I’m confused here… is there a deal, or is it no deal? For the FSMTB to send out a national press release with the subject line “FSMTB AND NCBTMB REACH AGREEMENT” when no final document appears to have been signed, raises all kinds of red flags and ethical questions.

We never needed two competing licensing exams, and we sure as blazes don’t need two competing national CE approval programs. Looks like it’s time for the heads of these two organizations to get back to the negotiating table and work out the rest of this deal, for the benefit of the CE community and the profession as a whole.  And don’t come out until you get it settled!

The Good, the Bad, and the Ugly

With apologies to Clint Eastwood, I’m using the title of his classic Western to talk about three major announcements from the Federation of State Massage Therapy Boards, and what they mean to the rest of the profession. This all came down at the recent FSMTB Annual Meeting, held in Tucson on October 3-4.

The Good: FSMTB and NCBTMB reach an agreement on licensing exams.
Woo hoo! Praise the Lord and pass me the MBLEx! After six years of costly and damaging “exam wars” between the two organizations, NCB was unable to keep its market share of the entry-level testing business. As FSMTB’s exam revenue grew each year, NCB’s declined. NCB finally saw the handwriting on the wall and agreed to stop offering its national certification exams for state licensure as of November 1, 2014 – in exchange for an unspecified amount of money.

This is a huge benefit for the profession, as we can finally move towards having a single licensing exam that is under the direct oversight of state massage boards. (Only Hawaii and New York are still hanging on to their own state exams.) It means less confusion for students and massage schools, and a boon to portability of licensure in the future. This has been a long and painful struggle between FSMTB and NCB, and I for one am thrilled to see it come to a peaceful end.

The Bad: FSMTB adopts CE standards and license renewal recommendations.
Two years ago, FSMTB proposed a radical shift to the continuing education landscape, as outlined in their Maintenance of Core Competency proposal. The MOCC was slammed by organizations, schools, CE providers and individual therapists alike – and yet, the worst of it has made its way into FSMTB’s new continuing education and license renewal standards.

This is a classic case of “If it ain’t broke, then don’t try to fix it.” Overall, our existing CE system works reasonably well, so the last thing we need is yet another organization coming in with an agenda to transform and/or grab control of it. Last year, we suffered through an attempt by NCB to do just that. After a massive grassroots effort, NCB toned down most of the unacceptable changes they were trying to force on providers and sponsors of continuing education. They’ve been behaving themselves since then, and their CE approval processes have been operating more smoothly, although personally some of the classes they have approved are still an issue with me. I’d like to see some sort of designation for those of us who don’t practice or teach pseudoscience and don’t want to be lumped in the same category as those who do.

Now we have the FSMTB trying to flex its muscles. It’s like we just got King Kong calmed down, and now we have to do the same with Godzilla!

At the recent FSMTB Annual Meeting, state board reps passed a resolution from their CE Task Force to “implement a program that provides reliable, unbiased and appropriate vetting of continuing education providers and the classes offered to the consuming public.” That sounds high and mighty, but there is no reference to NCB and their existing national Approved CE Provider program in the resolution, and there was no mention of NCB when this resolution and the license renewal standards were presented to the Delegate Assembly for consideration. Did they think that no one would notice this sin of omission?
The LAST thing we need is another CE approval program! FSMTB could have easily solved their delegation of authority issue by entering into a partnership agreement with NCB to use their existing program. This should have gotten rolled into the exam deal between the two organizations, so that CE approvals could be consolidated.

It’s hard to believe, but the resolution was passed without any details on how FSMTB actually plans to vet CE providers and classes. Why should we trust that FSMTB can do this in an effective manner? They’ve been offering the MBLEx for six years now, and they still don’t have an online practice exam and exam study guide for massage students. The very worst of it is that FSMTB’s plan for CE and license renewal centers on “public safety”, while minimizing the role of CE for “professional development”. The problem is that there is no evidence that we have a widespread “public safety” crisis in our profession, so there’s no factual basis for what FSMTB is trying to do. (There are a lot of specific flaws in the CE standards and license renewal recommendations FSMTB has adopted. I’ll detail those in a future blog.)

What I can see from all this is a major threat to the existing CE provider and sponsor system in our field. FSMTB’s proposal is so completely out-of-synch with how CE is organized and delivered, and FSMTB stands to consolidate even more money and power if this model is adopted by state massage boards. We’re just coming out of a period where NCB tried to dominate the field. Now FSMTB is acting like they’ve picked up the NCB playbook and are trying to run with it.

The Ugly: FSMTB publishes the Model Massage Therapy Practice Act (MPA).
As I wrote about in my previous blog, the MPA was released after three years of behind-the-scenes work and two rounds of public comment. Most of its content is the kind of standard stuff found in all templates for occupational licensure. However, FSMTB really blew it in a number of key areas, and the final version contains both technical errors and some awful policy decisions. As FSMTB’s leaders had final say, the responsibility for correcting these fatal flaws rests on them.

Judging from how few comments were made on the three blogs I posted about the MPA, it looks like it doesn’t register as all that important. Wake up people! A model practice act is one of the bedrock components of a profession. It contains the Scope of Practice definition and other essential elements that influence both education and practice. If you haven’t taken time to read our new MPA, I urge you to get familiar with it and keep up the pressure on FSMTB to fix it. Remember that it doesn’t become law unless it’s adopted by a state legislature.

Let’s celebrate the Good, and get to work on the Bad and the Ugly!

Final Draft of Model Practice Act Released

The Model Practice Act was released in its final draft this week, after more than three years of work on it and two periods of public comment. The introduction does state that it will be an evolving document as changing times and circumstances dictate, but as of now, it still has many of the school owners on my social media pages up in arms.

The language requiring accreditation from previous drafts (Section 103(B) ) was modified to say “Approved Massage Therapy Education Program means a school or educational program that meets the criteria established in rule by the Board, at a minimum includes 625 Clock Hours, and is both authorized in the jurisdiction in which it is located and that reflects a curriculum acceptable to an accrediting body recognized by the U.S. Department of Education…” While the requirement has been downgraded to a suggestion, the comment section makes it clear that the eventual goal is required accreditation for one and all.

Personally, I have some mixed feelings on this. Accreditation is a process of quality control–to a point. (Disclosure: I am a peer reviewer for COMTA). Obtaining accreditation is not cheap, it’s rigorous and it’s time-consuming. It sends the message that you have voluntarily gone over and above what the state requires. Other health care professions require it. And therein lies the clincher.

There are no other health professions that I am aware of accrediting programs that teach psuedoscience, and many massage school programs, including those accredited by COMTA and other accrediting bodies–and in the case of community colleges, even the regional accrediting bodies–do. So what does that really mean? Is it really a hallmark of excellence when we accredit things that have no basis in fact, just because it’s tradition, and been around for a long time, even though it’s been shot down by science?

I am not a school owner, but if I was, I wouldn’t be hitting the panic button just yet. The FSMTB has no power of legislation and they can’t lobby. In order for accreditation to become the law of the land, that’s what will have to happen: it will have to become the law of the land, literally, through legislative changes. There may be some FSMTB member states who are gung-ho to see it happen, but remember, state boards can’t lobby, either. That is the domain of the professional associations. In my state, our AMTA chapter has paid a lobbyist for many years. Since the chapter fees are now optional, I have heard that he volunteered to continue working at a lesser fee, but I bet some of the state chapters have lost their lobbyist altogether, if they had one to start with. The wheels of government don’t turn that quickly unless they’re greased.

The MPA is a template for the states. It isn’t the law and it may never be. For the few unregulated states, should they finally get out of the Dark Ages and decide to regulate, this will be very time-saving for them. It isn’t perfect; nothing is. Obviously a lot of work went into it. Only time will tell what effect it is really going to have.

NCBTMB and FSMTB: Long-awaited Collaboration in the Works

The NCBTMB and the FSMTB made a joint announcement this morning that I have long been hoping for. Leena Guptha, Chair of the NCBTMB, confirmed to me that the NCB will sign a letter of intent to withdraw completely from licensing examinations, which will mean the MBLEx will be the only licensing exam in the US, excepting New York and Hawaii, which both have their own state exams. This change is taking place November 1.

The FSMTB will support Board Certification, according to Guptha. “We are getting back to the roots of certification,” she stated, “honoring our original purpose.” Further details will be forthcoming soon, but for now, Guptha expressed to me that she hopes that the other massage organizations and the profession at large will support this action. I hope they do, too.

 

Model Practice Act Causing an Uproar

Disclosure: I am a peer reviewer for COMTA.

I have complained a lot about massage therapists sitting on their hands, not having any interest or involvement in governance, and not caring or being informed about what is going on until it’s too late to do anything about it. I can’t make that complaint about massage school owners in the past couple of weeks. I’ve never seen such a hue and cry over any other issue.

The Model Practice Act is on its second period of public comments, and I’m pretty sure the FSMTB is hearing from a lot of upset people. I had a few issues with the first draft, and I hear it got about 1300 comments. I’m willing to bet this one will get twice that, caused by a one-word change in the following definition, found in Section 103(B):

Approved Massage Therapy Education Program means a school or educational program that meets the criteria established in rule by the Board, at a minimum includes 625 clock hours and is both authorized in the jurisdiction in which it is located and is accredited by an accrediting body recognized by the US Department of Education. Education received outside of the United States must be substantially equivalent to the criteria of this Act and must be recognized by the jurisdiction in which it is located.

In the first MPA draft, this requirement for schools was stated as state authorization AND/OR accreditation. The removal of just one word here makes a world of difference, which has set the massage education community into a tizzy.

My Facebook is buzzing with comments from school owners, teachers, and other interested parties. Overwhelmingly, the feeling is that this is going to put a lot of schools out of business. There are also people that feel that we have about twice as many massage schools in the US as what are really needed, and that this has led to churning out too many graduates, which has led to a glut in the job market, and contributed to the proliferation of franchised massage (or maybe it’s because of franchised massage).

Rick Rosen is the co-owner of Body Therapy Institute in Siler City, NC, one of only two schools in our state that are accredited by COMTA, shared some of his comments on it with me:

There are two primary reasons this accreditation requirement is inappropriate and potentially damaging: First is the fact that about half of all massage schools in the U.S. are not accredited. In general, these are smaller proprietary institutions that only offer massage programs. It is doubtful that most of these schools could qualify for accreditation even if they wanted it, because of the lack of financial resources. Smaller schools that are undercapitalized are unlikely to be able to meet the financial ratio requirements of COMTA and the other accreditors, not to mention the initial and ongoing costs of accreditation.

These massage-only institutions embody the lineage of massage therapy and the healing arts, as contrasted with for-profit career colleges and publicly-funded community colleges where massage is one program among dozens (if not hundreds). Mandatory accreditation WILL cause many of these smaller schools to close, which would be a tremendous loss for our field.

Second, COMTA is the only specialized accreditor in the massage therapy field, and the only agency with competency-based curriculum standards. Institutional accreditation by the other six vocational accreditors and the seven regional higher education accreditors fails to provide a meaningful measure of quality assurance for the massage program itself.

Therefore, it makes no sense for FSMTB to include an institutional accreditation requirement in its Model Practice Act when such accreditation (in the case of non-COMTA-accredited schools) ignores the elements that are critical to producing a well-trained massage therapist. It is the integrity of the program’s curriculum, the competency of the instructors and the consistent application of admissions criteria that are the critical elements that make a sound massage therapy program — far more so than the financial and operational standards that comprise the bulk of institutional accreditation.

So, if roughly half the massage schools in the U.S. cannot qualify for accreditation, and the other half (minus the 67 schools and branch campuses that are under COMTA accreditation) are accredited under institutional standards that do not reliably produce skilled and employable massage therapists who last more than two years in practice — where does that leave us?

We need a regulatory structure for schools that can satisfy the minimum requirements of state massage statues for protection of the public, while preserving the ability of our smaller massage schools to exist. In addition, we need a mechanism to bring all massage programs under single set of programmatic standards to establish consistency of entry-level training that is impossible to achieve within the current system.

Rosen’s solution is for COMTA to add a non-accreditation level program approval to its scope, which would require the blessing of the USDE. In addition, all massage schools with institutional accreditation from other agencies would also need to seek programmatic accreditation from COMTA – a structure that is common in other regulated professions. The language in Section 103(B) of the MPA would then need to be changed to include programmatic accreditation OR approval by COMTA – along with approval or licensure by the educational authority in the jurisdiction in which the school operates.

There are a lot of other school owners out there that don’t feel any accreditation should be required at all, particularly owners of small schools who have long-standing, successful programs that have lasted for decades without accreditation. Accreditation is not cheap. It’s time-consuming to initially obtain, and time-consuming and expensive to renew. While I have heard many small school owners talk about the expense as a deterrent to getting accreditation, I’ve heard as many others say “I’m not going to have anyone telling me how I have to run my school.”

Sandy Fritz, who has owned a school (not accredited) for more than 30 years and is a well-known author and advocate for massage education, stated on her blog that accreditation was a good thing–and then it moved away from a process to determine excellence and became a hurdle to jump across to access the cash cow of financial aid.

Actually, institutional accreditation has always been about being a financial gateway rather than a hallmark of excellence. When COMTA came on the scene, it was the first accreditor to offer programmatic standards that were meaningful to massage education. Unfortunately, they’re also the smallest player on the accreditation field and have no real ability to affect the whole.

I can’t speak to the other accrediting agencies, for my experience as a peer reviewer for COMTA is that a school that seeks the accreditation is sending a powerful message: “I do more than the state requires me to do.” Accreditation involves an in-depth self-study, and documentation, documentation, documentation. If it isn’t in writing, it doesn’t exist. But that’s a good thing. It ensures that policies and procedures are in place that are for the good of the student, the good of the school, and the good of the profession.

COMTA has been criticized for including pseudoscience (energy work) amongst the things that are acceptable for curricula in accredited schools. Without have read the standards of the other accrediting agencies, my guess is that they do, as well. The NCBTMB condones it, the AMTA and ABMP both condone it, the FSMTB condones it, so COMTA is hardly the lone ranger. It just goes to show, once again, that massage therapy accreditation is not being held to the same standards as medical professions do with their accreditation, which is why we’re still a vocation and not a profession.

The period of public comment ends on August 15. If you want your voice to be heard, you should seize the opportunity by clicking here.