Tag Archives: Approved Providers

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!

NCBTMB Call for Comments: 911 for Approved Providers

The NCBTMB has decided to call for comments on their latest revisions for the CE/Approved Provider program–something they should have done before they ever unrolled the plan to start with–and I can virtually guarantee they aren’t going to like the responses they receive. I have been cc’d on numerous letters to them from providers, and so far, the only responses I have seen are anger and disgust.

I’m not one to get too bent out of shape about paperwork, and in reality, the revised new requirements are not adding that much of a burden, time-wise. One wants to assume if you are teaching a class that you actually have all the paperwork they are asking to see. Uploading it shouldn’t be such a big deal.

The flash point here is the almighty dollar. It is no secret that the NCBTMB has lost a lot of revenue to the MBLEx in the past few years, and there’s no indication that trend will ever reverse itself. The NCB is proposing quite a drastic increase in approved provider fees, no doubt hopeful that it will increase their financial coffers.

I personally have organizational approval. In their new paradigm, I am considered a “small” organization. In spite of that, my renewal fee is jumping from $300 to $750. Larger organizations are taking a much bigger hit. The biggest increase is going to fall on trade shows and conferences….something I personally enjoy attending. There are already some conferences out there that don’t pay the instructors (or only pay those who are at the top of the big heap), but instead provide them with a table to sell their wares. That’s well and good, but I don’t carry my wares around, personally. My publisher is usually at big conferences, so I don’t go to the expense of shipping books to sell. They’re there selling mine and those of the other authors they represent, and in reality, if I were to pay to ship them myself, my profit would be so miniscule it wouldn’t be worth the trouble. Those conferences, as well as those that do pay instructors, are going to see a big increase in the amount of money they have to pay, so the fallout is going to be either paying the instructors less, charging the students more, or both.

While I frequently get invited to teach in other places, I sometimes host as few as six classes a year at my own facility. I spend several thousand dollars a year to advertise these events. I handle all the registrations, I provide massage tables and linens so people don’t have to worry about transporting those, and I provide snacks for the classes. I pay the instructor 70%–and sometimes more. In the past, when I’ve had a teacher scheduled to come from out of state and they didn’t get the minimum number of students they wanted, I have forgone my percentage altogether in order to make the class happen.

Like many instructors, money isn’t my primary motivation. It’s the love of education, and the thrill that I get when a student calls me up a year or two later and says “Thank you so much. What I learned in  your class that day has really increased my business.”

Providers will really not have any choice at all except to pass this increase in costs on to those who attend our classes.

Adding insult to injury, the FSMTB seems to be charging ahead with their ill-conceived plan to do away with continuing education requirements altogether, except for the classes centered around “public protection” that they plan to offer from their own website.

I’m beginning to think we might as well give up continuing education altogether. We have a couple of national organizations here, one who is in dire need of money and looking at CE providers as the cash cow that will keep them afloat, and the other who is already rolling in money and wants to force their ownership of continuing education down our throats. I don’t like either scenario.

While I am glad that the NCBTMB decided to send out the call for comments, I am wondering how they are going to yet again revise this plan after they see that those comments are all negative. So far, I haven’t seen one single comment on my networks that is in support of this plan and these price increases.

If you have not added your two cents worth yet, I urge you to view this video and then fill out the survey. The NCB has left plenty of space for comments, and you should seize this opportunity to give them your opinion.

An Alternative to CE Regulation (just in the nick of time)

As I’ve written about on this blog, the NCBTMB has been trying to roll out an “upgraded” scheme to regulate the entire world of continuing education. After all, their stated mission is “To define and advance the highest standards in the massage and bodywork profession.” (Doesn’t that give them free rein to tell the rest of us what to do?) Apparently, NCB wasn’t satisfied with just approving CE providers – now they want to require the thousands of CE courses to pass through their hands as well. Go back to my posts from November 18, December 28 and January 8 to read about the many problems that are likely to come up if NCB’s new Board Approved Continuing Education Provider Program comes to pass.

If this wasn’t bad enough, along comes the FSMTB who have announced they are jumping into the CE approval game with their own new approval process. They’re calling for volunteers to serve on three different committees that will build and operate a whole deal that will be separate from what NCB is planning.

We already have too many different CE approval hoops for providers to jump through. It’s just plain crazy for FSMTB to be looking at putting another national approval scheme on the map. The feedback I get is that many CE providers are already struggling with the challenges of the economy and the burdens of CE regulation. If nothing changes, things are about to go from bad to worse in the CE community.

Fortunately, some people outside of these two silos have had their thinking caps on. My NC colleague Rick Rosen has just put out a major white paper on this subject, which will give you everything you need to know to understand this issue (and then some). Most importantly, he has come up with a very interesting and practical alternative to the formal regulation of CE, to be called the National Continuing Education Registry.

In this paper, Rosen poses four big questions that challenge the basic assumptions that have driven our regulation of CE. He says these must be addressed before NCB and FSMTB do anything else with their approval schemes.

He provides a lot of useful background information along with detailed answers to these questions. All of that serves as a lead-in to an overview of the National Continuing Education Registry. It is designed to be an online listing service that will replace all existing national and state CE approval processes:

  • CE providers will be screened by a designated entity to determine that: 1) the provider is a legitimate business entity, and 2) where required, the provider has a valid state-issued massage therapy license, registration or certification. Providers will sign a participation agreement that includes adherence to a code of ethics.
  • Each CE course will be screened to determine that it is within established subject matter standards that are broadly relevant to the professional practice of massage therapy.
  • The Registry may be utilized by state massage regulatory agencies as the means to determine whether a CE course is acceptable for renewal of a licensee’s credentials to practice. In a similar way, NCBTMB (or other certification agencies in the future) could utilize this service to determine whether a course taken by a certificant meets the criteria for recertification.
  • This service will give massage therapists a basic level of assurance that listed courses will be accepted for license renewal and/or recertification, and that the course is offered by a credible individual or institutional provider.

The overall structure of the Registry is similar in ways to the Multiple Listing Service concept in real estate. It will be based on a voluntary participation of CE providers, who agree to conduct their business according to a code of ethics. Like shopping for a house, therapists will have to perform their due diligence to find the courses and providers that meet their learning needs. There are no guarantees, but a provider’s reputation for integrity will be a great asset.

So instead of making CE regulation more burdensome, complex and costly, he is offering a way to simplify, streamline and consolidate the whole process. That sounds damn good to me!

If you care about this issue, I highly recommend that you read Rosen’s paper to get the complete picture, and then contact the leaders of NCB and FSMTB and urge them to set aside their own approval programs in favor of this National Continuing Education Registry. The power of grassroots lobbying is the only tool we have to get the small group of people who lead these two organizations to wake up and smell the coffee on this vital issue.

You can download the white paper from this link:
http://tinyurl.com/NCER-Proposal-FEB2013

There are few people who understand how all the pieces fit together in the massage therapy profession. As someone who was a co-founder of both FSMTB and AFMTE, served as a state massage board chair, and is a school director, CE provider and CE sponsor, Rosen takes the long view in looking at the problems in our profession. Frankly, I don’t know where he finds the time to research and write these papers, but I’m sure grateful that someone cares enough to do it! I urge everyone to share this with their networks.

 

Caught Between Hubris and The Grudge

All the talk in recent weeks of the “fiscal cliff” and the refusal of the Republicans and the Democrats to play nice together in the interest of the highest common good reminds me of the current situation between the NCBTMB and the FSMTB.

The NCB is operating from hubris (not to mention cluelessness), as they continue to put forth wrong-headed initiatives for the field. The latest plan to do away with organizational approval for CE providers is just the latest in a stream of missteps from the organization. They rolled that sudden announcement out like it was the best thing since sliced bread, and providers are choking on it. The application to become an approved provider has been totally removed from their website in the last day or two. I think they might be revisiting some of that plan in response to the unfavorable reception, which has included rumblings of boycotting the organization.

FSMTB is doing their own thing with the MBLEx well enough–in fact, extremely well, but when it comes to dealing with NCBTMB, it appears that the leadership of the FSMTB would rather see the organization fail than lift a hand to help them. They appear to be bearing a huge grudge over the way NCB has treated the Federation, and their unwillingness to move beyond that is stopping progress at the whole-profession level.

In case you’re uninformed, the NCBTMB has had their exam removed in a few states, and they have successfully legally challenged and won those challenges. That doesn’t sit well with the Federation, who would like to see the MBLEx as the only exam for entry-level massage licensing.

The NCB needs to get out of the entry-level exam business, in my opinion, but they can’t afford to right now. I believe they were depending on the increased revenue from the new requirement of CE course approvals to be the cash cow that would bail them out and make them financially viable again. The problem is that it’s unfair and unreasonable to put this burden on the backs of the CE provider community that is already challenged in so many ways.

FSMTB could provide that bridge through a transfer agreement and compensation package, which would resolve the “Exam Wars” once and for all. That type of action is not without precedent; it has happened in other licensed professions when it became apparent that it was time to evolve into a more streamlined process for the good of all concerned, including licensees.

It’s insane for FSMTB to even be meeting about building its own CE approval program, which they are in fact doing, when it would create more problems than it would solve. If these two organizations would sit down and hammer out such an agreement, the NCBTMB could remain the administrator of a dialed-back CE registry program, which state boards could reference, and which could finally serve as the one unified solution that the CE provider community has been needing. If the Federation jumps into the fray with yet another approval program and persuade the states to accept that, it will take but a few short years for them to put the NCBTMB out of business once and for all, which I would prefer not to see happen.

It’s time to put the hubris and the grudge and the egos aside and come to the table. The board members of both of these organizations have the power to make that happen. Your directors serve at your discretion and you ought to remember that you are not there to blindly follow the leader. A meeting of the minds is not possible when a meeting hasn’t taken place. If I were serving on either of these boards, I would be making the motion to sit down together and come to an agreement that will serve the profession on the whole.
 

 

NCBTMB Making Major Changes to CE Provider Approvals

Disclosure: I have agreed to pass along comments, questions and concerns to the NCBTMB on this matter, and the management there reads my blog. They are fully aware that I use this blog to express my own opinion whether it is in line with theirs or not. Your comments here will be seen by the CEO, Mike Williams, and the Board of Directors.

The NCBTMB has announced major changes in the works to their Approved Provider program for continuing education. You can read those here.They have also set up a page for Frequently Asked Questions about it, and you can read those here.

As soon as they sent out the press release I started getting emails and FB messages from people asking questions about it, some applauding it, and some complaining about it.The biggest change is that they will no longer be offering organizational approval. Every individual who teaches a continuing education class will need to obtain individual approval as a provider. That’s going to affect a LOT of entities: AMTA, the American Massage Conference, massage schools, and other organizations who have previously been able to take people in under their umbrella.

It’s affecting me, personally. I have organizational approval myself. I normally host a dozen or more teachers at my facility each year, and while 90% of them are approved providers in their own right, a couple are not. I don’t perceive it to be such a big deal for me…it’s not going to be a problem for them to get their own approval, and I have until the end of 2013 to prod them along into doing so. All who are approved as organizations have until the end of 2013 to get your act together and come into compliance under the new rules.

One of the first complaints, naturally, was about money, and people having to pay yet another expense. Organizational approval up to this point has cost $400. In reality, an organization that only has two teachers has been paying the same amount as one that has twenty, and that’s not really fair. Under the new paradigm, approvals will cost $175 and will last for three years. You must also pay a $25 fee for each class you submit to be reviewed. As a clarification to one point that has been brought up, if you have a full class and you teach portions of that, as sometimes happens at conferences and conventions, you are not having to pay $25 for each version of it…just the one fee. That’s good. I teach for a lot of AMTA chapters and I am often asked to cut an 8 hour class down to 6 hours or make a 3 hour class last for 4, so it’s good to know you’re not paying $25 for all derivatives of the same course.

People have also stated issues with them requiring a criminal background check. Some state boards require that, and some don’t. My particular state does, and if memory serves I think the fee is $30 or $35. It may be duplicating efforts for the NCBTMB to require it in some instances, but not in others.

I have personally had discussions with the powers that be at the NCBTMB over the approval of course content. They are now vetting individual courses again–to a point. The first concern I got wind of was from a colleague who was concerned that they would throw out everything that doesn’t fit in the box of Western medicine. Have no fear. My own wish is that they would get rid of some of the more questionable classes that are approved….at least they were questionable to me, and of course, I’m just one person with an opinion in a sea of many.

They have no intent of getting rid of energy work courses and other classes that don’t have any basis in science…as long as the course content shows some connection to or lineage from massage, it will still likely be approved. I say likely because during the vetting process, they are paying more attention to quality, whatever that truly means. For one thing, they are asking you to turn in your complete handouts, which has never been done before and which also has some people concerned about letting their proprietary information out of the bag. I have expressed my own concern that some of these courses people have invented that don’t have any basis in science and in fact have in some instances been proven to be totally contrary to accepted scientific principles are still going to be approved, so I’m not sure how “quality” that is. A lot of people disagree with me on that front. There is obviously a very huge demand for those types of classes, or they wouldn’t continue to exist.

What I would personally like to see happen is a national certification for science-based education. I’m going to keep after them about that; you can count on it. People can do all the unsubstantiated things they like, but there are some who would like to have a credential that is based on the actual evidence-informed practice of massage. I am one of them. Does that mean I am claiming to be better than you? No, it does not. It just means I would like for there to be something out there that differentiates those who want to be known as evidence-based practitioners as opposed to those who don’t.

Other questions I’ve been asked include exactly who is doing this, and the names of the committee members have not been released that I am aware of. They just state on their website (which is new and snappy-looking, incidentally) that it is a team of experienced practitioners and educators.

People ought to be aware that the buck doesn’t really stop with the NCBTMB. They, along with numerous other certification agencies,  are accredited by the Institute for Credentialing Excellence (formerly NCCA, National Commission for Certified Agencies).  They are the only national accreditation body for private certification organizations, in all disciplines, to demonstrate adherence to established standards. Among the certifying agencies that this organization accredits include healthcare programs in chiropractic, dentistry, EMT, nursing, medical assisting, nutrition, prosthetics and orthotics, and pharmacy. They also accredit certification programs in the arts, construction trades, and a host of other things. And ICE is accountable to the Council for Higher Education.

Bottom line: changes are coming, and you can either go with the flow or go away…while a few states have their own approval process, the vast majority still depend on the NCBTMB for approving continuing education.

I’d like to state for the record that I personally am acquainted with the majority of the people at the NCBTMB, and I have certainly written my share of criticism of the organization in the past–and patted them on the back when I thought they deserved it. The fact is that if they stand on their head and whistle Dixie, it is never going to suit all of the people all of the time. I think they are a dedicated and hard-working group of people. I certainly don’t agree with everything they do, and I take frequent advantage of my status as a certificant and an approved provider to let them know that.

Here’s your opportunity to comment, so take it. As I said, these comments will be seen by the CEO and Board members.

NCBTMB Revamping Approved Provider Program

Alexa Zaledonis, the new Chair of the National Certification Board for Therapeutic Massage & Bodywork, is starting off her term with a bang. In a joint statement issued today with Paul Lindamood, Executive Director, Zaledonis states that the NCBTMB is about to undertake a major initiative to improve the CE Approved Provider program. The statement acknowledges that this evolution is necessitated by the fact that there are now over 1700 providers, and that what worked in the beginning is not necessarily going to serve the purpose in the future. The folks at the NCBTMB are aware that times are changing, and it’s time for a Spring cleaning.

The statement says in part:

We also anticipate a move toward comprehensive course-by-course review and auditing of all AP offerings. NCBTMB has reviewed the processes in place, as well as the needs of the profession, and the conclusions suggest:

  • a review of course content against a more robust set of criteria for every class is imminent
  • the requirement for a specific set of teaching qualifications is compelling
  • a stratified system of course designations is fast approaching to differentiate entry-level and advanced CE

In the old paradigm, once an instructor was approved as a provider, additional classes could be added to the list of offerings without the individual class being vetted for content. Unfortunately, some people have taken advantage of that to bend the rules.

According to the Approved Provider Reference Guide, appropriate continuing education is meant to go beyond what is expected of an entry-level therapist who has 500 hours of education.

Inappropriate content includes, but is not limited to, classes that are about diagnosing clinical conditions, implementing allopathic medical or surgical procedures, physically invasive procedures such as ear candling or colonics, techniques that incorporate osteopathic/chiropractic procedures such as ballistic thrusting and joint manipulations, procedures that require additional licensure or certification such as physical therapy, Pilates instructor training, personal training, etc.; any class that is about how to prescribe herbs, nutritional supplements, and/or pharmaceuticals; any class about how to perform hypnosis, aesthetic facials, electrical stimulation, ultrasound, or acupuncture, and any class that is about psychological counseling, or psychic, clairvoyance, telepathic, astrology, religious or spiritual practices. There is also a prohibition of any class that is based on a product that the student is expected to buy, which some providers have also ignored.

The NCBTMB has sent out letters inviting participation on a Massage Approved Provider Panel to the leadership of the professional membership organizations, regulatory boards, providers, certificants, and leaders of the profession. I think this is a great initiative, and since it’s meant to improve the CE/AP program that serves almost every state, I certainly hope that politics are put aside here for the greater good of the profession. It’s the right thing to do.