Tag Archives: Continuing Education

NCBTMB Call for Comments: 911 for Approved Providers

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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.

MOCC-ERY Redux

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I have received the following from the Federation of State Massage Therapy Boards. I personally think they are far off the mark on what they intend to do with continuing education, and with their refusal to consider any joint effort with the NCBTMB to organize and streamline the approval process for the good of all concerned. This is their MOCC-ERY plan redux, and it’s giving me a bad case of acid reflux. The first time this plan rolled around, the national office of AMTA responded by shooting 20 holes into it. Those holes are still there, and it is my fond hope that AMTA will reiterate its position.

This is nothing more than another ill-conceived ploy to put the NCBTMB out of business by taking CE out of their hands, making only what THEY want to be required–and furthermore, to require you to get it from them. To add insult to injury, the FSMTB proposes that THEY will choose the experts who will create the courses that YOU will be required to take from them on their website and occasional live classes. CE Providers might as well kiss your income goodbye. Give me a break. If this isn’t a naked power grab, I have never seen one. Here is the communication:

February 27, 2013
 
Dear Colleagues:
 
A White Paper circulating in professional and social media circles proposes the creation of a new organization to approve continuing education providers. FSMTB has not indicated support for such a move and would like to correct certain assumptions pertaining directly to the FSMTB that are made in the paper.
 
The most important reason for regulating the massage and bodywork profession is to ensure public protection and consumer confidence without unduly restricting the ability of licensed, professional therapists to make a living. To better address needs in the area of license renewal, the FSMTB was directed by a vote of its members (State boards and agencies that regulate massage and bodywork therapy) to develop and deliver a solution.
 
To do this, FSMTB looked at research and listened to experts, including consumers, educators, and the therapists themselves. Our recommendation was published in October 2012 in a paper called “Standardized Licensure Renewal Recommendation for Continuing Professional Competence“.  
   
Standardized Licensure Renewal Recommendation
Here’s what we believe is fair and reasonable to ensure competent licensed professionals and protection for the public they serve.
 
Licensed massage and bodywork therapists will be required to complete six (6) hours of license renewal requirements annually. At least three (3) of the six hours must meet the State-sponsored Ethics and Professional Practice course requirements that specifically address content pertaining to public safety. The remaining three (3) hours could be exchanged for certain Professional Development Activities, including but not limited to meeting accredited certification standards, community service, and research.
 
We further believe that it is preferable for all six hours of the license renewal requirements to be in the Ethics and Professional Practice areas, thus eliminating the need for therapists to engage in other activities or classes in order to renew their license. The rationale for limiting the licensing renewal requirements to the Ethics and Professional Practice areas is to ensure that therapists have standardized, current knowledge necessary for safe and competent practice. Additional activities and classes, though beneficial and encouraged, should not be required for re-licensure.
 
Recognizing that there will be a transition phase as the profession progresses, we will establish standards for acceptance of other Professional Development Activities for licensure renewal, such as attaining certifications and attending professional conferences. Again, these activities are to be encouraged but are beyond what should be required to maintain a license.
 
Our goal is to create easily accessible online courses each year on the topics that matter to the State boards, not just to address complaints or sub-standard practice, but to focus on issues such as ethical concerns and therapist safety. Our intent is not to compete with agencies already providing certifications or CE, but to ensure adequate attention to our area of emphasis, Ethics and Professional Practice.
 
For those without access to computers we are considering live classes at events where therapists already gather. We will select experts to work with our licensing boards to create the best courses and we encourage your participation.
 
For States that already have CE requirements, the FSMTB will establish Standards to assist States in determining Professional Development Activities that are acceptable during the transition. We are not proposing that we approve CE Providers, Instructors or Courses; instead, we are concentrating on an alternative solution to address the needs of the regulatory community and the therapists.
 
Considering licensure, we must keep in mind that a license does not reflect that a therapist is brilliant, enthusiastic, nice, or possesses a healing gift. Licensure demonstrates that a therapist has met basic professional standards and is entitled to legally practice.
 
Licensing boards:
-work for the public, not the profession.
-are created to regulate the profession, not elevate it.
-cannot require a double standard – education for experienced professionals that is different from that of entry level therapists.
-must provide the public with an avenue to address harm.
-ensure only that a licensed therapist meets standard competency levels to receive or renew a license.
 
In summary, our role and intent is to work with State boards to protect and to serve the public while at the same time offering a simplified, standardized and relevant solution for therapists.

All providers of continuing education need to contact dpersinger@fsmtb.org and jhuffman@fsmtb.org and let them know we do not want this plan shoved down our throats. Furthermore, providers and licensees can send a letter to your own state massage therapy board letting them know that you do not support this plan of the FSMTB to take over the CE business. Does a practitioner who has been in business 25 years really need to repeat the FSMTB-ordained ethics class for every renewal? Do not sit on your hands–send those emails right now and let the leadership of the FSMTB know you are against this plan.

Blowin’ in the Wind

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Whether you prefer the Bob Dylan original version, or the popular treatment by Peter, Paul & Mary, we have our own version of Blowin’ in the Wind being sung by the leaders of FSMTB and NCBTMB.

My last blog (February 11) focused on problems with regulation of continuing education in the massage profession, and put the spotlight on a comprehensive white paper written by Rick Rosen that offers a innovative solution to a very confusing situation. There’s been a lot of activity around this issue, and from what I hear, a lot of CE providers have contacted FSMTB and NCB to express their displeasure with the programs each one has in the works. I believe that Rosen’s concept of a National Continuing Education Registry is the right tool for the job at this point in the massage therapy profession. It will require cooperation and collaboration from both organizations, and would utilize the talents and resources of both. To me that is a far superior state of affairs than the animosity and one-upmanship that has been the prevailing atmosphere between these two organizations for the past half-dozen years or so.

Over the past two weeks, information has come out of NCB that suggests they may be having second thoughts about their “upgraded” Board Approved CE Provider Program. Donna Sarvello, NCB’s CE manager, said, “Providers do not need to renew until their renewal date because while we are reviewing the new program we have reinstated the past program. I can’t give the exact details on the Organization status at this time because we are tweaking the details and then will put it out for public comment.”

If you look on the Continuing Education page on NCB’s website, there is no evidence of what Ms. Sarvello is talking about. The new Board Approved CE Provider Program is right there in all of its convoluted and excessive glory, with a demand that all providers have to renew with the new system by December 31 of this year. What are providers supposed to believe? I am personally choosing to believe Ms. Sarvello, and I advise the NCB to update the website immediately! Any time there is an update in information and/or policy, the stakeholders need to know that, and having incorrect information on the website for these past few weeks is just inexcusable. I am calling out the NCB to clear up this mass confusion right now by making DAILY updates if necessary. Even a message that says “Sorry, we haven’t decided what to do, so no action is expected of you at this time” would be superior to the incorrect instructions that are still posted.

The FSMTB is no clearer about their plans. Their President, Jaime Huffman, claims that FSMTB is not going to create a CE approval program. That just doesn’t jive with their Call for Participants to create three different volunteer workgroups as part of a new Licensure Renewal Committee. And their Standardized Licensure Renewal Recommendations adopted last year by the Board of Directors states that “FSMTB will establish standards for acceptance of professional development activities, including those offered by membership and voluntary certification organizations.” If that doesn’t sound like some kind of approval program, then what is it supposed to be?

The very latest word I’ve received is that the top two leaders from FSMTB and NCB have had “a conversation” about the continuing ed issue in the past week. That’s a positive development, but we don’t know a darn thing about what was discussed or what these two organizations might be willing to do. Whatever it is, it isn’t going to  happen overnight, but I am very pleased that they are finally at the point of having a discussion, something that Rick Rosen and I both have been calling for for a couple of years now.

In the meantime, keep those emails flowing in to Debra Persinger and Jaime Huffman at FSMTB, and Mike Williams and Sue Toscano at NCBTMB. Let ‘em know that you expect them to work together to forge a unified solution for how CE should be handled, while easing the regulatory burden on CE providers. The contact information for these two organizations is on page 17 of Rosen’s white paper, which can be accessed from this short link: http://tinyurl.com/NCER-Proposal-FEB2013

It’s time we harnessed the hot air that’s been blowing from these two stakeholder organizations, and direct it towards a positive solution that gives the massage profession what it’s really needing.

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

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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

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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.
 

 

CE Providers React to NCBTMB’s New Approval Plan

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In the past couple of weeks since the NCBTMB unveiled their new plan for CE providers, which includes doing away with organizational approval, the reaction of providers has for the most part been very negative–and frankly I’m not surprised. The long-standing organizations who are providing quality continuing education approved feel, for the most part, that the organization they have supported for many years is throwing them under the bus.

Some of the main concerns that I  have heard are from providers who have created proprietary classes and who have trained and approved their own instructors to go out and teach their work. They are now faced with the instructors that they have invested time and money in training and marketing classes for going out on their own, taking copyrighted teaching manuals and proprietary handouts with them, and acting as if they are under no obligation pay the percentage or per-student charge that they have agreed to pay as teaching members of the organizations. Those same instructors who have been mentored and marketed under our organizations are now saying “we’ll just be out on our own after 2014.” They are making it clear that they feel free to take our proprietary materials away with them—because the new rules are basically blessing that—and never give the organization that put them where they are another dime.

Those who have organizational approval do not want unqualified people teaching for their organizations and misrepresenting their good names, and have gone to considerable effort and expense to make sure that is not the case. While there is certainly nothing wrong with requiring us to provide proof of that, taking all instructors from under our organizational umbrella and putting them out there on their own is also going to create logistical nightmares. The organization has been responsible for collecting and maintaining registration forms, evaluation forms, etc. and issuing CE. In the case of Upledger, for example, now instead of one organization handling those administrative tasks, there will be more than 100 separate instructors keeping up with that. The organization will have no control and no more quality assurance that they will be able to exercise.

The organizations and schools that sponsor CE workshops at the national, state, and local levels will suffer from these changes as well. This is also financially crippling and over-burdensome to smaller organizations who may not teach that many classes each year. When it comes to education, quality and quantity are not the same thing.

The notion that having people turn in all their lesson plans as proof that they are a competent teacher is also flawed. My publisher hires me to write lesson plans all the time to go with their textbooks and for career schools who want customized plans. I’ve written at least 20 this year alone. If you have the money to hire me, I will write one for you. It still will not make you a competent teacher. A well-written lesson plan doesn’t necessarily indicate that you’re a great teacher; it indicates that you are either a competent writer, or that you hired someone like me to write it for you. Requiring people to send in a video of themselves teaching would be more indicative of whether or not they are competent, since the organization obviously cannot afford to vet every class in person.

In response to the outcry since the NCBTMB announced the plan, they have stated that they will consider some of these issues on a case-by-case basis. I would like to know how they plan to carry that out with volunteers—volunteers whose qualifications to judge us we have no knowledge of, as they are not releasing the names of the people on that committee. Are they experienced educators? Are they trained in teaching methodology? Are the research literate? We don’t know; we can only hope so.

I find it necessary to bring up that the reason the NCBTMB changed from vetting individual classes years ago was because the task became too overwhelming for the paid staff to handle and getting volunteers together to do it caused the process to move at the pace of molasses. It is unacceptable for someone to wait six months—as has been common at several points in time—to get their approval or denial. It is very apparent from the latest 990 filing that the NCBTMB cannot afford to hire new staff and that they will indeed be depending on volunteers until such time as this might generate enough money to enable that. This is one of the service problems that has come very close to knocking this organization to its knees in the past, and they do not need to go backwards instead of forward.

Considering things on a “case-by-case” basis also leaves this organization open to accusations of favoritism, if not worse. The massage community is a tight-knit and close community, in spite of the fact that there are thousands of us. Those of us who are organizational providers tend to attend the same events, and travel in the same circles. What you allow for one, you must allow for all. To do otherwise is simply unethical and unprofessional, and the first time it comes to light, and it certainly will, that any consideration given to one has not been given to all, it is going to be another public relations nightmare for the NCBTMB. I don’t think they can stand to have many more of those.

Let’s look at a few facts.

There are currently a half dozen states with their own CE approval process. The NCBTMB is not the only game in town…and it is that same complacency of thinking that has resulted in the FSMTB kicking their butt with the MBLEx. I would not fall into the mistake of thinking that the Federation isn’t willing to step up and do something about CE approval as well. They may seize upon the dissatisfaction of the current environment; they already have the infrastructure, and big cash reserves at their disposal. The Federation doesn’t “need” the money, and the perception here from providers is that the NCBTMB is trying to bail themselves out of the red with this plan.

There is no evidence to support that regulation, including requiring CE, has contributed to the safety of the public. There have always been unethical and incompetent practitioners, and for that matter unethical and/or incompetent CE providers, and they will continue to exist, regardless of the amount of rules and regulations. Look at how things stand in other professions. There are 17 states that don’t require nurses to obtain CE. There are 10 states that don’t require PTs to obtain CE. Even MDs have 7 states that don’t require them to obtain CE—but all three of these professions are licensed in all 50 states.

Other than the 30 or so of us (including myself) who were present at the meeting the NCBTMB convened in Chicago to discuss this issue a couple of years ago, there has been no attempt to gather the input of the (hundreds of) providers that are currently under the auspices of the NCBTMB.  I believe this organization is in need of our support, not our animosity and distress.

I urge them to abandon this plan, and gather input from a much broader slice of the profession before considering such drastic measures again.

The Financial Health of Our Organizations: NCBTMB

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Note: For the past few years I have done a series of reports on the financial status of the non-profit organizations that represent the massage therapy profession. I obtain this information from Guidestar, a financial information clearinghouse for non-profits. The organizations can provide their Form 990 (Return of Organization Exempt from Income Tax) to Guidestar, and if they don’t, the IRS does it for them. I will state for the record that I am not an accountant or a financial analyst; I just report what I see (and maybe offer a few opinions). I usually get asked the question every year why I am not reporting on ABMP. Associated Bodywork & Massage Professionals is a privately-owned for-profit company, and they are not obligated to release their financial information. Non-profits are on a different filing schedule than the rest of us, and there is variance amongst them in when their fiscal year ends. The deadline for filing is the 15th day of the fifth month after the end of their fiscal year. An organization can also request and receive up to two 90-day extensions, and due to the number who haven’t filed yet for 2011, it appears that some of them have done that.

The National Certification Board for Therapeutic Massage & Bodywork has filed their 2011 Form 990 in a timely manner so I’m going to start with them this year. I’ll be following that up with my report on the Federation of State Massage Therapy Boards. The financial status of these two organizations are intertwined for one reason: since it’s introduction in 2008, the MBLEx has taken a substantial market share of the entry-level exam market away from the NCBTMB. For many years, the NCBTMB exams were enjoying a monopoly, except for the few states that require their own exam.

In 2008, the first year that the MBLEx was available, the NCBTMB’s revenue from exams was in excess of $6 million. By 2011, that had dropped to $3,380,813. Instead of a monopoly, they had a 47% share of the market. I confess that I was expecting it to be even less, since the Federation has relentlessly encouraged their member states to use the MBLEx exclusively. I think the fact that the NCBTMB has retained as much as they have is proof that plan has not yet come to fruition. The income at the NCBTMB from people recertifying dropped by a little over $5k, and sales of their exam guide were down about $17k. Sales of their mailing list also took about a $20k hit this year.

They are showing a total revenue of $5,357,738 for 2011. From 2010 to 2011, the NCBTMB’s total revenue went down to the tune of $443,312. That’s not exactly a shocking figure in this time of recent recession.

The 2011 return, due to the timing of the NCB’s fiscal year, reports the salary of former CEO Paul Lindamood; although the filing was signed by his replacement Mike Williams. Lindamood’s compensation and benefits amounted to over $257,000. No word on what Mike Williams is doing the job for. Non-profits have to report the breakdown of compensation of officers, directors, trustees, key employees, highest compensated employees, and independent contractors. All together, the NCBTMB paid out over $1.7 million in compensation during 2011. Their other major expense is over $1.3 million in exam administration fees.

The bottom line is what tells the tale for most businesses–for profit or not–and their net revenue after expenses for 2011 is $227,326 which is down over $240,000 from 2010.When you consider that during Paul Lindamood’s reign at the helm, the organization went from being almost $270,000 in the hole in 2009 to having a net income of over $469,000 in 2010, it looks like it’s time to either slash expenses, the way he did, or generate more money.

That’s exactly what the NCBTMB hopes will happen in the coming year(s) on both fronts. They are rolling out the new rules for national certification, as well as the new rules for continuing ed providers, and doing away with organizational approval. The requirement that each individual be approved as a provider in their own right should generate some additional funds. The new rules for becoming nationally certified, in my humble opinion, is initially going to cause a further decrease for them. Since the new rules are jacking up the education requirement from 500 hours to 750, and requiring 250 hours of work experience, that will automatically disqualify people who might have otherwise taken the exam for entry-level licensing. The NESL is still an option in some states, but with the entry-level exam revenue steadily declining for the past four years, and the MBLEx becoming more firmly entrenched with the member states as time goes on, I’d be surprised if they don’t continue to lose ground in that market.

Their expenses could go back down. The application and recertification processes are online, and that’s going to knock a few staff members out of a job. They spent about $40k more in 2011 attending conventions than in 2010. I feel that they should be present at all major massage meetings, so I don’t begrudge that money…conventions are never held at Motel 6 so unless I’m an invited speaker, I feel that one in my own pocketbook. Legal expenses also increased by about $13k this year, but lobbying decreased by almost that same amount. It does cost money to go in and challenge a state that is considering dropping your exam–or appealing to one that has already dropped it to reinstate it.

On a positive note, total assets increased by about $70k, while total liabilities decreased by about $142,000.

All in all, it wasn’t the best year they’ve ever had–and it wasn’t the worst, either. The NCBTMB has had some administrations in years gone by that seemed hellbent on bankrupting the organization. I feel pretty safe in saying that isn’t the case here; they have some dedicated staff and board members that are determined to make it work, and we’ll just have to wait and see what happens. In the meantime, their new website is very snappy. You can check it out and all the new changes they are implementing at www.ncbtmb.org

NCBTMB Making Major Changes to CE Provider Approvals

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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.

MOCC-ERY

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Last week, the Federation of State Massage Therapy Boards presented their long-awaited proposal for a new national continuing education approval program. They are calling it Maintenance of Core Competencies – or MOCC for short. As I indicated in my previous post, this proposal not only failed to deliver on the original promises made by FSMTB, it has turned the entire professional landscape on its ear by recommending that most continuing education should be voluntary, not mandatory for license renewal.

Under this “MOCC-ERY” of a plan, the only mandatory components of continuing education would be those FSMTB deems to be relevant to “public safety”. If that’s not bad enough, FSMTB is proposing to take control over the design and delivery of these courses. Except it isn’t continuing education … it’s proving that you still know the things you should have learned in entry-level massage training as it pertains to protection of the public.

As a licensed therapist, do you want to be taken back to subjects like Ethics 101, principles of hygiene and sanitation, and the naming of unsafe massage practices – EVERY TIME YOU HAVE TO RENEW YOUR LICENSE? I’ve been teaching professional ethics for 14 years, and frankly, I find this proposal to be an insult to my intelligence.

I was very gratified today to receive the press release from AMTA denouncing the plan. In part, important communication states:

“AMTA reviewed the proposal and has many concerns with the approach of the FSMTB, the proposal itself, its inconsistencies and the lack of support provided for their view. Some of our specific areas of concern are:

  • –Overall, the impact of this proposal is to lower standards for massage therapy practice. It would shift the focus of professional development from building on the entry level education massage therapists receive to that of maintaining very minimal requirements of public protection.
  • –The proposal contradicts its stated intent, previous FSMTB statements on the need for continuing professional education and the mission of FSMTB.
  • –The proposal would take away the freedom of choice of massage therapists to determine their own practice focus and to choose the continuing education providers they prefer to meet their own professional needs by creating a “one-size-fits-all” approach for license renewal.
  • –The proposal provides no empirical data to support the efficacy, efficiency or necessity for a transition to this model.”

AMTA goes on to list 20 objections in their press release.

Although ABMP as an organization has not yet made an official statement, ABMP President Les Sweeney came out in support of the MOCC Proposal in his recent blog. In addition to being a member of AMTA, I am also a member of ABMP. I think highly of Les and the rest of the management there, but this is one of those times when we’ll have to agree to disagree. Les does state that he supports the role of the NCBTMB in the arena of continuing education; but he personally thinks CE should be voluntary. That is a major policy statement coming from the top guy at the largest professional membership association in our field.

The thing that is most outrageous and unacceptable about the MOCC Proposal is not the “public protection” course material that could be mandatory for therapists. It is the fact that leaders of four of our major stakeholder organizations in the field came together behind closed doors and decided that the majority of continuing education should no longer be mandatory.

It looks like there may have been major flaws in the process that led to this consensus document. Was the work of the eight-member Task Force shared with the full leadership of AMTA, ABMP, AFMTE and FSMTB with sufficient time to review and comment on this plan before it was published? Something doesn’t line up when AMTA comes out with a total smackdown of the plan, while their Immediate Past President was part of the team that was responsible for its development. Does that seem odd to you?

What we do know is that the decision making process took place in a vacuum, and there was no opportunity for public comment. Yes, the disclaimer says that “The MOCC is just a proposal and we’re seeking your feedback”, but input should have been sought from a broad range of constituents in the field before such a proposal was even made.

Continuing education classes that actually teach you anything new, under their plan, will become optional. Only the classes from the Federation, which they plan to make available on their website, will be required for license renewal. My opinion is that instead of being satisfied that the MBLEx has taken most of the exam revenue away from the NCBTMB, they would now like to take the continuing education dollars away, too. This plan will not only take dollars away from the NCBTMB, but also away from continuing education providers. (Disclosure: I am an NCBTMB Approved Provider of Continuing Education.)

The Task Force intentionally excluded representatives from the NCBTMB, and that’s another point that disturbs me. The Federation should be working in collaboration with NCBTMB. I was present at the AFMTE 2011 Annual Conference during FSMTB Executive Director Debra Persinger’s initial presentation about the Federation’s intent to create a CE approval program. NCBTMB Chair Alexa Zaledonis was in the audience at this session, and she publicly stated that her organization was willing to cooperate with FSMTB. It’s a shame to me that in light of their 20 years of experience in administering CE provider approvals, they are being left out of this loop. I’m gratified to see they’re not waiting around for an invitation, but instead, have gotten on with the business of making their own improvements.

In May 2011, NCBTMB convened a meeting of the Massage Approved Provider Panel, which was intended to improve and enhance their current CE approval program. Most of the stakeholder organizations in the field were represented there, including FSMTB. Based on feedback from the participants, NCBTMB will begin reviewing and approving CE courses as well as CE providers this summer.

Personally, I did learn what I needed to know about protection of the public while I was in massage school. I am one of those people who enjoy attending continuing education courses. I don’t want it to be mandated to me that I have to take a no-fail test—which isn’t really a test if you can’t fail it, is it, of things that I already know—to meet my license renewal requirements. I don’t think that serves me, as a massage therapist, and I can’t see how it’s going to serve the public. The Federation seems to think this will wipe out complaints of unethical or unsafe behavior. I don’t believe that for one minute. Anyone who is going to act unethically is going to do it, no matter how many classes they take or whom they take them from. Unsafe behavior needs to be addressed in entry-level massage school. I would much prefer to see the FSMTB come up with a model program of public safety education for schools, instead of requiring therapists who have been practicing for years to take a ridiculous no-fail test.

Times are changing, as Les said in his blog, and our organizations are changing with them. It remains to be seen whether it’s for the better or the worse. I have supported the FSMTB in the past, because I believe the state boards coming together in an effort to solve common problems is a good thing. I still believe that’s a good thing. Unfortunately, I do not believe that this is an example of the kind work they should be doing, or the way they should be doing it. You can let them know how you feel about it here.

CE Providers: Expenses Going Up, Income Going Down

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In January of this year, I blogged Continuing Education Providers: Sink or Swim, and followed up that one with the report from the meeting convened by the NCBTMB, where profession leaders were invited to give input into the revamping of their Approved Provider program.

Last week at the wonderful annual meeting of the AFMTE, one of the presentations was by Debra Persinger, Executive Director of the FSMTB, who talked about the intention of the FSMTB to start approving continuing education. One of the burning questions from the audience was “how much is this going to cost us?”, a question without an answer as of yet, since their program is still in the planning stages. Knowing the folks at the FSMTB, I don’t expect it to be anything I would classify as exorbitant, but unless it’s free, it will still be one more expense for us to pay.

I’ve previously mentioned the states who have their own approval process–and accompanying fees to pay–for continuing education providers. With the exception of Florida, who doesn’t charge you additional money if you are already an Approved Provider under the NCBTMB, these range from a couple of hundred dollars to “you don’t want to know.”  There’s a reason why I’m not teaching in those states…it isn’t worth it to me, at this stage of my career, to lay out hundreds or even thousands of dollars, and in some cases to complete a mountain of paperwork, to teach in a location that I may visit only once.

Another unfortunate trend is all the expense associated with presenting at trade shows, spa exhibitions, and conferences.  At many of these events, not only do you not get paid to teach; in some cases you actually have to pay for the privilege. Big companies who budget thousands of dollars into their advertising plan can afford to pay a big price for a booth. With a few of the heavy hitters being the exception, the average individual provider cannot. It’s a Catch-22 of spending the big bucks to get your name out there, and then rolling the dice to see if you’re going to be able to recoup that in sales–assuming you have anything to sell. Some teachers are just that–teachers–and they’re not necessarily textbook authors or purveyors of DVDs, home study courses, etc.

I’ve been an Approved Provider since 2000, and I have organizational approval. I have a classroom at my facility in Rutherfordton, NC, where I teach myself and host other instructors. During the recession of the past three years, I’ve had to cancel classes that some of the most well-known teachers in massage were scheduled to offer. Some of them didn’t receive as much as one inquiry about the class. In addition to mailing to licensees, advertising in a number of venues, my publicizing it to my email lists and social networks and them publicizing it to their own substantial lists, it just didn’t happen.  The classes that did happen have tended to be the ones taught by more local teachers, not as well-known, and not as expensive, as some of the big names.

Some perfectly competent, long-standing, and popular teachers have suffered to the point of drastically reducing the price of classes in order to fill seats and maintain their income. One of the most well-known teachers told me a few weeks ago that his teaching income was down $70,000 last year due to the recession. I know many who have never made that kind of money in any year, and their loss has been proportionate.

All the expense associated with teaching continuing education, in my opinion, is going to have some serious fallout. Some talented, but not necessarily famous, instructors will give it up because they just can’t afford to keep on doing it. By the time you provide handouts, pay your own travel expenses, advertise your class, ship whatever books or products you might have to offer, your profit has flown out the window along with the ridiculous price of your airline ticket.

True, some well-known providers have corporate sponsorship. Those are the exception; not the rule. Corporate sponsorship usually goes to those who are already at the top. They want someone with name recognition whose picture looks good in their advertising and helps sell their products. There are only so many big corporate sponsors. Small, but quality, companies often don’t have that money to spare.

It will be interesting to see how the CE environment changes when the FSMTB gets their program up and running. Their mission is public protection, and during her talk, Persinger addressed that fact. I don’t think the Federation intends to start approving Reiki classes, although I could be wrong. I believe their intent is to approve classes that have a direct bearing on public protection, such as ethics, contraindications and the like.

The lack of income is not just an issue for CE providers. Massage schools are notorious for low pay, and therein lies one of the problems in attracting quality teachers. They may deservedly feel they’re better off doing massage for $60 an hour than teaching for $20 an hour. Most of them don’t do it for the money. They do it because they love to teach.

That’s why I do it. I don’t have a corporate sponsor. I can’t afford to go everywhere I’d like to go. I fit in as many events as I can, and sometimes I have to pass one up. I know a lot of providers in the same position. I had many people say to me last week that they would have liked to attend the AFMTE conference but just couldn’t because of finances. Even when a conference is reasonably priced (as that one was), travel, hotel, meals, missing income when you’re gone from your office, or paying someone to be there covering your office when you’re not, adds up.

I’m hopeful that the education atmosphere is going up, along with income for those who provide it. It really doesn’t have anywhere else to go.