ELAP: Now that I’ve Read the Whole Thing…

I spent most of my spare time during the past week reading the Final Report and the Entry-Level Education Blueprint of the ELAP. Again, I will offer my appreciation for the collaboration of the Coalition and the team that actually performed the work on this. It was a big project and obviously, people took time away from their own pursuits to participate in it.

Now that I have read the whole thing in its entirety, I have a few observations on it. I quote from the Coalition statement:

We aspire to have this report influence several profession audiences:

• the Federation of State Massage Therapy Boards, which can use The Core as it builds guidelines for a model practice act;

My comment on that: The press release announcing that the FSMTB was going to create a Model Practice Act first appeared on April 1, 2011. In a letter I received dated Jan.31, 2014, FSMTB Executive Director Debra Persinger stated that the Task Force is currently completing the final revisions before releasing it for public comment.

It’s just my opinion that the ELAP will be a last-minute inclusion in that, if it does in fact get included.

• state licensing boards, which can use The Core in setting education requirements for licensees;

My comment on that: What is the Model Practice Act doing, if not that? It seems very possible that this is a duplication of efforts. While there are of course other things included in a practice act, one of them is spelling out the hours of required education. I don’t know any state board that goes much beyond setting the total number of required hours, and how that should be broken down in a general list of required subject matter. Not to mention changing a practice act requires legislative action.

the Alliance for Massage Therapy Education, which can refer to The Core in creating teacher training standards and curricula;

My comment on that: Aha! And therein lies the clincher and the biggest issue I have with it. Since I couldn’t say it any better myself, I am going to share the comment that Rick Rosen left on my FB page:

“The critical missing element that will prevent the ELAP Core Curriculum from being implemented on a wide scale is the lack of teacher training in our field.

I simply cannot fathom why the cash-rich organizations in our field (AMTA, ABMP, FSMTB) would spend significant sums of money on a curriculum development project, while they continue to turn their back on providing the financial support needed to carry forward the Alliance’s National Teacher Education Standards Project. Without this long-term investment in teacher development, educational outcomes and the quality of massage therapy services delivered will remain inconsistent at best.

My comment on Rosen’s comment: Nailed it on the head. And it would be another interesting research project to determine what the average training is of teachers in massage schools across the US.

I will repeat Rosen’s sentiments by saying I would like to see all the organizations give this kind of support to the Alliance for Massage Therapy Education and their National Teacher Standards Education Project. 

The Alliance is the youngest organization out there, and does not yet have the kind of cash reserves built up to move this project along at a better pace. The fact is these kinds of projects do require money in order to come to fruition. The Alliance membership is made up of educators and industry partners, and will never have the kind of membership numbers enjoyed by the other organizations by virtue of that fact. I can visualize the ELAP being very useful to the teacher training project–but they need the money to make it happen. I urge our other organizations and industry supporters to put your money into this project.

• the National Certification Board for Therapeutic Massage & Bodywork, which can use The Core as it identifies beginning vs. advanced knowledge and skills for its Board Certification credential;

My comment on that: The Board Certification exam is already out there and is still practically new. I don’t see any major revisions taking place on it any time soon. The NCBTMB is using their “old” certification exam for their entry-level licensing exams, and has been for years. As a certification exam and a licensing exam should require two different job task analysis surveys and one should not be interchangeable with the other, they are already in muddy water, and I don’t really see how this will clear it up. And, as is the case with the MBLEx, the exams that the NCB is using for entry-level licensing are geared to a 500-hour education requirement. Again, this would require major changes to that as well.

• professional membership organizations, which can use The Core in shaping membership criteria;

My comment on that: Pay the money, show proof that you are either a student or a licensee or a practitioner in an unregulated state, and boom! you’re a member. Within the past few months, myself and others made well-documented complaints about an unethical practitioner who was scamming fellow massage therapists and try as we might, we could not get her removed from the membership rolls of AMTA or the massage listing service. She has now finally been removed, after it was reported that she was also scamming her clients. Or she just didn’t pay her membership renewal fee. Either way, she’s no longer listed, but it took months to get any action on that front.

• the Commission on Massage Therapy Accreditation, which can use the Core in evaluating massage and bodywork curricula for programmatic accreditation;

My comment on that: COMTA has had their competencies spelled out for years. The basic difference I see is that ELAP is spelling out the number of hours to be spent in each subject matter area.

• other accrediting organizations, which can use The Core in shaping their accreditation criteria;

My comment on that: COMTA is the only accreditation organization devoted to massage therapy (and they now also include asthetic programs). The other accreditation programs I am aware of approve of all kinds of schools and programs and use the same evaluation criteria for a massage program as they would an engine repair program. I don’t realistically see it having impact on these types of accrediting agencies, although it would be nice if it did.

• school owners, administrators and faculty, who can use The Core to strengthen or validate curricula and to adopt consistent learning outcomes;

My comment on that: I wholeheartedly agree. I encourage all school owners, administrators and faculty to read this document…and I know the majority won’t take the time. I have seen the prevailing attitude of “I’m not going to let anyone tell me what to do at my school,” when I have tried to promote COMTA accreditation (disclosure: I have been a COMTA peer reviewer). It doesn’t matter if it would vastly improve their existing program. Stubbornness is hard to overcome.

• and potential massage therapy students, as they consider where to enroll.

My comment on that: I would be shocked to know that any potential student is ever going to read the 527- page document to help them choose a school. Just my opinion.

More of my unsolicited opinion: I am not critical of this document on the whole. I think it spells out a good foundational education for entry-level massage therapists as it was meant to do, and it requires 625 hours to do it in.

There are still 26 states here with a 500-hour minimum requirement. While it is very true that there are many schools that exceed their state’s hour requirement, there are also a large number of school owners that are determined they are not ever going to do more than the state requires. Neither do I see it having much effect, if at all, in states that already have higher requirements for education.

The ELAP report states that a 2012 survey showed schools are teaching an average of 697 hours. Still, if this were to be legally adopted, which I think is a long shot at best, it would undoubtedly put some schools in the position of “cooperate or close down,” which in the general scheme of things, might not be a bad thing, if their students are not truly well-prepared.

I am just of the opinion that being prepared to pass an entry-level examination, and being prepared for the real world of massage, are two very different things. It also isn’t about hours, per se, but about competencies–a statement, in fairness, made in the ELAP–but it does take a certain number of hours to teach those competencies, and this is what the work group decided on.

Bottom line: I like it, but I do think that in spite of the Coalition statement of support, that there has been some unnecessary duplication of efforts on some of their parts here, and that a good curriculum can only be effective with good, well-trained teachers. I’d like to see an equal amount of time, money, and effort spent on the National Teacher Standards Education Project. 

 

 

ELAP Final Report & Entry-Level Education Blueprint Released

The Entry-Level Analysis Project Final Report and the Entry-Level Education Blueprint were released today, and it’s a whopper…266 pages in the Report, and 527 pages in the blueprint. Obviously, I haven’t read that all this morning. I do want to take the time to express my appreciation for the collaboration among the Coalition (ABMP, AFMTE, AMTA, COMTA, FSMTB, MTF, and NCBTMB) and to Anne Williams of ABMP in particular, for spearheading the project. Both documents were co-authored by the ELAP workgroup, which included Pat Archer, Clint Chandler, Rick Garbowski, Tom Lochhaas, Jim O’Hara, Cynthia Ribeiro, and Anne Williams.

According to the Report, at the initial meeting of the Coalition in 2011, two pressing issues were identified: the inconsistent quality, depth, and focus of entry-level massage programs, and the lack of licensure portability from state to state.

The big recommendation is that 625 hours of education are needed just to give students the core basics that they need for entry-level competency. According to the report, currently 28 states only require 500 hours; 7 require between 570 and 600, and 10 states require more than 625 hours. In my opinion only, no matter how wonderful the Blueprint, those states that already have higher standards won’t be inclined to dumb it down for the rest. New York and Nebraska, for example, both have 1000-hour requirements. I don’t see portability happening there–ever–unless every other state decides to come up to that level. However, the Report does reference a 2012 study that states the average massage program in the US is 697 hours–so maybe even in the states with the 500-hour requirement, there is a tendency to do more than required–and that’s nice.

For those schools that are less than 625 hours, this recommendation would undoubtedly increase financial costs to the owner that would have to be passed along to the student.

The shocking news, to me, is the statement that 40-50% of graduates are leaving the field within two years of graduation! I would be interested to know exactly how those figures were arrived at.The Report cites unrealistic expectations about the physical demands of massage and compensation, and the evolving life circumstances of 20-somethings. I’m personally not sure how relevant the 20-somethings are; it’s been my own experience in the past 15 years that there are as many middle-aged people (whatever that is, nowadays) that take up massage as a second career as there are young people who jump in right out of high school.

The workgroup would like to encourage everyone to pay more attention to the core curriculum than the hours. According to the document, this can serve everyone:

  • The Federation can use it as a guideline for the Model Practice Act
  • The state boards can use it in setting hours for education
  • The AFMTE can use it in setting teacher standards
  • COMTA can use it in evaluating massage and bodywork criteria for accreditation
  • the NCBTMB can use it for identifying entry-level vs. advanced knowledge for Board Certification
  • Professional membership associations can use it in shaping membership criteria
  • School owners, administrators and faculty can use it in validating curricula and adopting consistent learning outcomes
  • Potential massage therapy students, as they are deciding where to enroll.

There is, within the document, the subtopics of Eastern bodywork, TCM, concepts of qi and all the accompaniments to that, with the caveat that schools may choose to integrate that according to their own philosophy. The focus is on the application of Shiatsu, tui na and Thai massage, which I will not argue the efficacy of, without personally buying into the theory behind them. I’m not going to have this argument here because it wears me out, and frankly, I’m outnumbered.

There is no doubt that a huge amount of work went into this project. Personally, I gave a lot of feedback on it during the calls for comments that happened some months ago, as did several other educators I know. I wasn’t crazy about this idea when it was initially introduced, and I was further distressed by the way the review and comment process was set up…I didn’t think it was good to have such a piecemeal approach to it, but in reality, I feel that the chance that many more people would have responded to the whole thing is probably relatively slim…it would have been just as long in any case. Anne Williams stated during one of the presentations on it that I attended last year that it isn’t perfect, but what is? I sincerely do commend everyone who gave of their time and effort on this huge undertaking. I plan to say more about it after I’ve read every page.

 

CE: No Approval is Better than Faux Approval

This is hardly the first time I’ve had gripes about the state of continuing education for massage therapists in the US. I’m not happy, and I haven’t been happy for a long time. I’m a CE provider myself, approved by the NCBTMB. That approval is accepted in many places, but there are some states that run their own CE approval processes. Sometimes, the cost and the amount of paperwork just can’t be justified to teach one class that may or may not fill. The CE environment, at least in my state of NC, is also very competitive. It seems there’s a provider on every corner here.

I’ve been distressed with the NCBTMB as an approval body for a long time, due to the total claptrap that they have approved. I also didn’t care much for the MOCC plan proposal from the FSMTB, which would have made all CE voluntary, except those classes that are about public protection, put forth by them on their website. I feel that has the potential to put a lot of good CE providers out of business.

I think it’s time to do away with two prevalent myths that have been used as the rationale for CE regulation: one, that the public is being seriously harmed by massage therapy, and two, that the current CE approval processes are able to provide quality assurance. It’s impossible to guarantee the competence of CE providers or the quality of their courses when it may not be there to begin with. Our field will never advance, and we will not be taken seriously by other health care professions if we continue to operate under these false pretenses.

I recently called for the other organizations to pool their resources to get the NCBTMB written out of the exam requirements in all states. North Carolina set an important precedent for that five years ago by choosing to accept only the MBLEx (except for a limited use by out-of-state applicants). This has simplified the testing process for schools, graduates and that board, and put the regulatory program on solid legal ground.

Rick Rosen has proposed a couple of alternative solutions for CE regulation, the first of which was a National Registry. He has now tweaked that into new template entitled Model Continuing Education Regulations: A Streamlined and Simplified Approach for State Boards.

I don’t agree with Rosen on everything, but I think this is a good plan. Ultimately, I would like to see states refuse acceptance of CE that is not science-based (other than classes such as marketing, ethics, etc.) one of the points Rosen and I disagree on. However, I’m being realistic when I say that probably is not going to happen in my lifetime.  

My main beef here is that  state boards need oversight of what they accept for CE, and they need to have control over entry-level examinations. As long as the NCBTMB is written into state statutes and rules, the regulatory boards are forced to blindly go along with whatever NCB does. As Rosen has pointed out many times in the past, that is an improper delegation of authority—and I definitely agree with that. FSMTB is not even following the advice of its own legal counsel in getting state boards out of this troubled relationship with NCB. Instead of hanging on to so-called “licensure” exams and a failed CE approval program, I would prefer to see the NCBTMB developing specialty certifications, which IMHO is what they should be doing.

It all boils down to this: no approval is better than faux approval. For all that it currently means, we could just do away with CE approvals altogether let the market deal with the good, bad and everything in between. As long as Flower Faerie Healing is acceptable for CE credit, that’s pretty much what we have anyway—except we’re paying for the privilege.

Here’s the Rub

A couple of different things are bugging me today, so here’s the rub: The NCBTMB referring to their licensing exams as certification exams. There was a period of time when the licensing exams were referred to as the NESL–National Exam for State Licensing.

National Certification, as it previously existed, was retired on Dec. 31, 2012. People who are currently Nationally Certified under the old paradigm have until 2016 to comply with the requirements for the new Board Certification, or lose their “old” certification. I’m not sure of the date that the NCBTMB decided to drop the term “NESL” which indicated a licensing exam as opposed to a certification exam, but now that they have dropped that and are just referring to it as the NCETM/NCTMB, to me it is confusing the issue of what certification is–and is not. I spoke my mind about this yesterday to Steve Kirin and Leena Guptha, and they promised to take this under consideration. As Leena pointed out, they have a lot of things that have gone wrong over the years, and they can’t all be rectified overnight. I do hope they change back to the NESL…in reality they are the same exams, but using the NCETM/NCETMB acronyms has lead people to believe they are Nationally Certified, when in fact they are not–they have simply passed a licensing exam given by that Board, but it is not a certification.

In another development, AMTA sent out a press release this week announcing their new policy of making chapter fees optional. Previously, each chapter has charged whatever they deemed fit for their members to pay. In my state of NC, that was $15…an amount that I found quite reasonable because our chapter rocks! We have a very active organization.

I heard through the grapevine a month or so ago that this had happened, so I went to the source. In a conference call I had with Bill Brown, Winona Bontrager, and Chris Voltarel, they confirmed that the Board of Directors had made this decision in an executive session at the annual convention held in Dallas/Fort Worth, which I personally felt was improper, but they stated to me that it was not improper because direct competitors were present in the open board meeting. I assume they meant representatives of ABMP. I accepted that explanation. The fact is, ABMP is trouncing AMTA when it comes to the membership numbers. AMTA has been around for 75 years. ABMP has only been around for 27 years, and according to their website, they have over 80,000 members. AMTA claims to have about 56,000, the last I heard, but I have heard rumors of lower numbers.

However, I did inform them that I had also heard that Chapter presidents were upset about it, and that a petition was rumored to be going around protesting the decision. The response was “we’ll cross that bridge when we come to it.” From my reports, the petition does exist but has not yet been sent to AMTA. Other than people grumbling about it on FB, there hasn’t been much said–maybe because most people just didn’t know. I made another phone call this week and complained because they hadn’t put out a press release, and that I thought the membership ought to be informed. Communications Director Ron Precht told me that members were being informed at renewal time, so they hadn’t put out anything about it, but apparently they changed their minds.

I posted the press release on my FB page a couple of days ago, and immediately got a few comments from people wondering if the chapters were going to suffer because of this move. I confess I am wondering myself. I hope not, but I have my doubts about the wisdom of this move. I reported on AMTA’s financial health a few weeks ago, and while they’re certainly not in any financial trouble as a national organization, I can’t speak to the financial health of the individual chapters.

One thing I can speak to is the fact that chapter money is used to pay lobbyists, among other things, and we need government representation now more than ever. The ACA stands to have an impact on the massage therapy profession. There are other things swirling from several fronts that could require legislative changes in many states, such as the Model Practice Act the FSMTB is working on, a continuing education paradigm shift that may or may not happen, and other things that government relations representation is clearly needed for. Although most chapters have a government relations representative, those folks are volunteers, and in all likelihood the vast majority does not have the same political savvy as someone who lobbies for a living. Here in NC, we were paying our lobbyist $20,000 a year the last time I looked. Experienced government relations people need to be on the scene anytime a sunset period is coming up, or anytime statutory changes are being considered. I don’t think the national office has the manpower to be everything to every state when it comes to that.

AMTA states in the press release that they will offer several new services to chapters, so they won’t be part of chapter expenses. And, if a chapter finds that it needs additional financial assistance to maintain necessary and high-caliber services to members, the National Board will look at providing funding. I hope they look hard at paying our lobbyists and not allowing crappy legislation to take over–particularly sunsetting a practice act.

One of the questions that arose on my FB page was what would happen to the huge donation AMTA makes to the Massage Therapy Foundation every year….usually that’s in the amount of $450,000. If they’re not taking it in, I don’t see how they can give it out. I certainly do not want to see the support for the Foundation fall by the wayside.

There are a number of people out there who aren’t going to pay any kind of fee that’s optional. On the whole, though, I think a lot of devoted AMTA members will continue to support their state chapters.

As a member, I have to say that I don’t think this was handled in the right manner. My own opinion is that instead of an executive decision that was made and then foisted upon us, the membership could have been surveyed, or at a minimum, the state chapter presidents polled. My guess is this we haven’t heard the last of this. I’ll take bets they’ll have to back up and punt.

Report from Seattle and Some Further Explanation

I was invited to Seattle by Dr. Ravensara Travillian to speak at a fund-raising dinner this past Monday night, to kick off her efforts to get a university-level certificate massage program started. Dr. Christopher Moyer was the other invited speaker, so I felt like I was, as we say in the South, “in high cotton.” I had a great time visiting with Ravensara and her husband Iain, and Christopher.

Most of our visit was spent discussing the project. Raven invited me on the basis of my knowledge of regulation and legislation, of what our massage organizations are up to, and the state of massage therapy education in the US. Prior to my going out there, I contacted some of our leaders to make sure I had up-to-date information on what’s going on with them. In fact, this week the Coalition (previously referred to as the Leadership Summit) is taking place in Florida…the CEOs/EDs and Chairs of the Boards of ABMP, AFMTE, AMTA, COMTA, FSMTB, NCBTMB, and the MTF are coming together to discuss the state of the union, so to speak.

I truly enjoyed seeing old friends and meeting some new ones that I had previously only met on FB, and some I didn’t know at all. I appreciate the fact that they came to hear more about this initiative. Good conversation was stimulated, good questions were asked. The speakers were videoed and that will be released in a day or two, so I’m not going to rehash everything that happened there; I’ll share the video when it comes out.

I particularly appreciated the presence of Bodhi Haraldsson, who is the Research Director at the Massage Therapists Association of British Columbia. Bodhi was appalled at my report on the financial status of MTs in the US, provided to me in the form of the Annual Report from the FSMTB. Their information was obtained by a survey of MTs in the member states, and compiled from surveys that were sent out by the AMTA and ABMP to their members, and the NCBTMB to their certificants. All in all, about 200,000 MTs were surveyed. The piece of news that shocked Bodhi was that 61% of MTs in the US say that they cannot support themselves/their families with their income from massage.  Only 2% of therapists surveyed stated that they make over $70,000. According to Bodhi, the five busiest therapists in his own clinic make more than that. Personally, I think that’s a direct reflection of the high standards of education and the devotion to research practiced by our neighbors in BC.

Ravensara’s plan to take massage education up another notch has been criticized by people who don’t understand what it’s about. No one is going to be forced into getting higher education. Since I said this was the report on Seattle and a little bit more, I’m going to seize the moment to repeat a little of what I said there and go a little in depth about the environment of massage. There seems to be a lot of confusion about many different things that are currently on the horizon. One of them is the Affordable Care Act, which contains the stipulation allowing massage therapists to direct bill insurance as long as they are licensed as health care providers in their state. I see the comments all the time that “I don’t want the government telling me what to do.” “I don’t want to get bogged down by the insurance companies.” The ACA does not mandate that anyone has to file insurance. If you want to run a cash practice, you can carry on as usual. Those who don’t want to participate in insurance billing should not interfere with those of us who do.

Another thing that seems to be confusing people is the ELAP (Entry Leval Analysis Project). As I have stated on my blog on several occasions, I had issues with the way that project was rolled out and the way it was presented. However, I do think it will turn out to provide valuable information, and we’ll all know on December 16, which Anne Williams of ABMP informed me will be the unveiling of the 776-page document.

I have seen school owners stating that they didn’t want more regulations telling them what to do and how to run their school. Again, this seems to be a point of confusion. The ELAP is a research project. Period. It is not regulatory in any way. No one will be forced to adopt whatever policy recommendations might come out of it, because they will be just that–recommendations.

AMTA, ABMP, and the AFMTE all have benefits and annual conferences for educators. They have projects going on to educate teachers in research literacy, as does the MTF. AMTA has teacher-track classes and research-track classes at the annual convention. ABMP has an upcoming class in teaching the teachers to write core curriculum. None of these organizations are regulatory. They can show you how to write your core curriculum, suggest what should be included in it, and show you how to teach research literacy. They can’t make you do it, or make you do it their way.

COMTA, which is a strictly voluntary accreditation body and the only one that was founded for the specific purpose of accrediting massage therapy, although they have now also taken in aesthetic accreditation, spells out standards for excellence in education. I hear from school owners that they don’t seek the accreditation because they don’t want anyone telling them how to run their school. The Standards are on COMTA’s website for anyone to see, and I think it would behoove any school owner to do their self-study report to see how you stack up. COMTA does not limit what you can teach to evidence-based modalities, which personally I find unfortunate, but if you’re using that for the argument against it, you’re wrong. If you are teaching belief-based energy work at your school, you’re free to carry on. They want to insure that you are teaching what you say you are teaching and that you are including the subject matter that matters to massage. They spell out standards for good record-keeping, good financial practices, insuring that teachers are competent to teach their subject matter, having and abiding by policies and procedures, and other such things, and they ask you to document it in writing. COMTA is not a regulatory organization. There are other accreditation bodies out there that take in massage therapy, among other things, and they are not regulatory, either. It’s a voluntary process that allows you to say “Here are the standards we have chosen to meet.”

Even the Federation of State Massage Therapy Boards is not regulatory, in and of itself. They are an association of the boards in regulated states. They are soon to unveil a Model Practice Act that they have worked on for the past few years, and they would like for the states to adopt. Notice I said “they would like for the states to adopt.” The purpose of that is to make practice acts uniform and facilitate reciprocity. It could require legislative changes in every state that already has a practice act, should the member states chose to adopt it. I don’t look for that to completely happen in my lifetime. I do imagine it will be discussed this week by the Coalition, along with the ELAP and other issues they are considering.

A couple of months ago, I sent the leaders of all the organizations my blog urging them to pool resources to get the NCBTMB written out of the statutes in every state. I am hopeful that topic will be discussed as well. The NCBTMB is not a regulatory organization–but their exams are written into the statutes in many states. That represents an improper delegation of authority; there is no government oversight and no public accountability there. This is not a vendetta against the NCBTMB; it is an attempt to rectify something that has been wrong all along.

Now I’m down to the function of state boards. I constantly get complaints from people about how long it is taking them to get their exam scores or get their license. There is no true reciprocity in the United States. The fact that you have a license in one state does not include any kind of guarantee that you’ll get one in a different state, regardless of how long you may have been practicing. Most state boards have it stated on their websites that processing out of state requests takes longer. My own experience in serving our state board for five years was that many times, a license is held up because the applicant failed to provide a piece of documentation. Sometimes, the holdup is that they have to check out your transcript to make sure your education in the state your are coming from stacks up to the education required in the state you are moving to. If it doesn’t, you can be denied a license. If you are lacking the documentation, you can be denied a license. They cannot take anyone’s word for it that “I have this, I have that.” If you don’t have the required paper trail of evidence, you’re not going to get it, period.

State boards are the ONLY regulating bodies in massage. They are the ONLY ones who can tell us what to do. The other organizations can suggest. The other organizations can lobby legislators to get laws passed or changed–and state boards can’t. State boards exist for one purpose: public protection. They are not here to serve the interests of massage therapists. They are not here to cater to us or to cater to schools. They exist to license therapists, to spell out the requirements for getting a license, to spell out what they expect from schools, and to deal with complaints from consumers.

I hope that clears up a few things for people. I see misinformation spread around on social media all the time, and all that does is perpetuate misinformation. If you are a massage therapist, you are obligated to know the law in your state. If you are planning to move somewhere, you need to learn the law in that state, prior to packing up and going there. I’ll go further and say that a board member recently said to me “I don’t know the bylaws and rules the way you do.” If you’re going to serve a board, then it’s your business to know them up one side and down the other. Ignorance is not bliss and it’s not an excuse, either. You can’t uphold the rules if you don’t know what they are. The burden is on you.

The Financial Health of Our Organizations: FSMTB

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 Federation of State Massage Therapy Boards is as usual, in excellent financial condition. For the fiscal year ending 06/30/2012, they are showing revenues of almost $5.2M, up about $857K from 2011. Their expenses were slightly over $3.3M, leaving their net revenue for the year at over $1.8M. They also have assets of over $3.8M. Not too shabby for an organization that isn’t even ten years old yet.

Unlike some of our other organizations, the Board of Directors of the Federation are not compensated, with the exception of being reimbursed for travel expenses. They’re all volunteers. The Executive Director, Debra Persinger, was paid reportable compensation of $231,472 and a little over $49K in other compensation. Non-profits have to report the salaries of the directors, trustees, and the highest-paid employees and there were no others listed. Other wages and salaries were less than $74K total.

Pearson-Vue was paid a little over $1.4M for delivery of the MBLEx. Exam processing and development accounted for another $1.4M. The exam revenues were over $5M so none of that seems out of line.Travel expenses amounted to slightly over $30K, conventions and  meetings were almost $69K, not an unreasonable figure since they have a presence at all national events and some state ones as well. Advertising expenses were less than $22K; office expenses were slightly over $18K.

There’s really no story, here, folks. The FSMTB seems to be in fine shape, not overextending themselves, and building up healthy cash reserves.

 

Calling All Massage Organizations: 911

I’ve seen some ups and downs since joining the massage profession about 15 years ago, but never, in all that time, have I been as disgusted and dismayed with one of our organizations as I am today. I feel as if I have a vested interest in all of them, so I have the right to complain—and to call on them for help.

The National Certification Board for Therapeutic Massage & Bodywork was the only path to licensing in many regulated states for a lot of years. Their exams are written into the statutes of about 40 states, as is the MBLEx, which has soared in popularity as the exam of choice in the past 5 years. The exam revenue at the NCBTMB has been steadily declining ever since the MBLEx debuted. The “National Certification Exams” as they formerly existed are the same exams being used for the NESL.

It used to be that taking one exam gave you the status of being Nationally Certified and being able to use that to get your license, but that’s no longer the case. There’s no attraction there anymore. The Federation has been in a position for several years to help solve this problem by buying out the NCBTMB’s entry-level exams; they certainly have the money and the infrastructure in place, but they have apparently preferred to stand by and watch the NCBTMB die a slow painful death rather than be in collaboration. Although I have favored the idea of such a deal in the past, at this point in time I am not going to blame the FSMTB for their refusal to play ball.

The majority of regulated states also have it written into their statutes that the continuing education required for maintaining licensure must be from a provider of CE that is approved by the NCBTMB.

As a provider of CE, I was not pleased when the Federation brought up their MOCC (Maintenance of Core Competencies) plan, which would have made all CE optional, with the exception of classes related to public protection, put forth online by them. My concern was that it would put a lot of CE providers, including me, out of business. In reality, based on some of the claptrap that is approved by the NCBTMB, there are a lot of CE providers that should be put out of business. The NCB’s response to my own repeated questioning of some of the things they have approved for CE has not been satisfactory to date.

According to FSMTB Executive Director Debra Persinger, they have let go of the MOCC plan, based on feedback from the profession and member boards. Instead, they have put forth a Standardized License Renewal Recommendation. In a nutshell, the language reads: 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.

Bear in mind, that has not been written into the law anywhere yet that I am aware of, and it is what it is—a recommendation.

In my conversation with Persinger this afternoon, she informed me that the online classes pertaining to public protection will roll out in 2014, and that states that require in-person classes will still be able to have that. She also stated that at the annual meeting of the FSMTB held earlier this month, the member states asked that the Federation form a new CE Task Force to look into the possibility of approving continuing education.

I can recall what I thought was the beginning of the downhill slide at the NCBTMB…and it was years ago. I’ve seen an egomaniac that was hell-bent on bankrupting the organization elected to the Chair position. I’ve seen lawsuits filed against them by two of their former executive directors that dragged on for years. I’ve seen the lawsuits they have filed against state boards for getting rid of their exams. Yes, they had the legal right to do that, but in the big picture, it didn’t win any friends for them. I’ve seen the ridiculous, totally un-credible, fantasy-land classes that they have approved for CE credit. I’ve seen the failed plan to turn into a membership organization, which cost them several years of being banished from AMTA conventions.

I’ve also seen the failed attempt at an “Advanced Certification,” and the morphing of that into “Board Certification.” The NCBTMB website states that those who are currently Nationally Certified must transition to Board Certification by their next renewal. Unfortunately, I have heard this past week from two prominent massage therapists, both of whom had let their national certification expire 6-7 years ago, that they received invitations to be grandfathered in on the new Board Certification. They declined for ethical reasons. Personally, that makes me feel as if my own certification is about as valuable as a used dinner napkin.

I’ve seen their attempts to present themselves to massage schools and certificants as if they are some sort of regulatory organization by using language that insinuated that. I’ve seen their attempts to replace lost exam income by gouging the hell out of CE providers. It was only when they were faced with a mass walk-out of prominent providers, who said they would give it up, rather than go along with the plan, that they had to back up and punt.

I’ve seen times when people could not get a phone call or e-mail to the organization answered, and times when it took months for certificates and approvals to arrive, if they arrived at all. I’ve seen an example, just yesterday as a matter of fact, of them blocking people, including me, from posting on their FB page because they had the nerve to complain—and that was after the new Chair encouraged people on my own FB page to make their comments there. I’ve seen well-respected, seasoned colleagues who are experts in massage organizations and government relations offer to help them and give them advice about how to pull themselves out of some of the messes they’ve made, and I’ve seen that help refused or ignored time and time again. I’ve seen their adamant refusals to own up to their mistakes. My distress with them is not new. It’s just been festering for a long time.

I think the NCBTMB has reached the tipping point. Some would even say they are long past it. I have, in the past, given them hell about some things, and I’ve also come to their defense many times, including some when they probably didn’t deserve it. I have stated many times that I wanted to see them survive and thrive, and I sincerely meant that.

I am sad to say I am no longer holding out that hope. I am sad to say that I think they have outlived their usefulness. I am sad to say that I think their credibility has been shot beyond repair. I am sad to say that although there are staff and volunteers there that I personally know and like, and believe have the best of intentions, things have gone too far. They’ve had years to turn this ship around, and it hasn’t happened.

Therefore, I am calling on AMTA, ABMP, AFMTE, and FSMTB to immediately pull out all the stops and use all their available resources to help get the NCBTMB out of all statutes and administrative rules, as it relates to approval of their exams and use of their Approved CE Provider program. There are only a handful of states that approve their own CE, and if the NCBTMB were to suddenly go out of business, confusion is going to reign in those states that still have the NCBTMB exams and CE provider requirements written into the law.

Removing them from all statutory language in the regulated states doesn’t necessarily mean the NCBTMB will go away. They may continue to limp along for a few more years. They may someday come to their senses and create some valid specialty certifications, and reestablish themselves as a viable entity, but at this point in time, I doubt if they have the financial resources to do so. They’ve wasted a whole lot of money on their previous missteps.

Lest anyone get the idea that I am happy about making this request of our other organizations, let me assure you, I am not. I am sad to see that one of our national organizations has fallen this far. It’s time for positive action, and since they’re obviously not going to take it, the other organizations are going to have to seize the moment. I would suggest orchestrating a hostile takeover, but one of my colleagues who knows much more about regulation than I do informs me that’s impossible due to their structure, so this is the next best thing.

The FSMTB is able to offer government relations support to their member states, and AMTA and ABMP can afford the lobbyists. As a young organization, they don’t have enough resources yet, but with financial aid from the other organizations, AFMTE could be a great alternative approval body for CE. COMTA could possibly step into that role as well, but again, they don’t have the financial resources that the other organizations have. I call on all of them to set it in motion immediately to get the NCBTMB out of all statutes. We all know how slow the government moves so it won’t happen overnight, but I believe it has to happen. The FSMTB has been working on a Model Practice Act, so the time is ripe.

I also suggest that anyone who is Certified, as I have been since 2000, examine what that really means to you. Personally, I will not be renewing mine. There was a time when I was proud to say I was Nationally Certified. That time has now come and gone.

Report from the AMTA National Convention

I arrived in Ft. Worth on Wednesday in time to attend the House of Delegates preliminary meeting, which was quite exciting. I was only an alternate this year so I did not get to participate in several spirited debates, one concerning the ACA, and another concerning delegates who arrive late for the meeting (they don’t get seated–something I am in total agreement with.) I spent the evening at the Lippincott author’s dinner, something I always look forward to. Authors and educators Ralph Stephens, Ruth Werner and her husband Curt, Pat Archer, Celia Bucci, Joe Muscolino, Diana Thompson, LWW Publisher Angus McDonald, Acquisitions Editor Jonathon Joyce, my wonderful editor Linda Francis were all present, and I’m probably forgetting someone! We dined at Reata, which served great Tex-Mex food, and the service was top notch.

Thursday morning, the opening ceremony was great. Doc Hendley was the keynote speaker. He is the founder of Wine to Water, and a fellow North Carolinian. He received a standing ovation and had some people in tears, including me. His life’s work is providing clean water to people all over the world who do without it, and it really makes you realize how much we all take for granted. President Winona Bontrager recognized long-standing members and handed out awards, including giving the President’s Award to Rick Rosen, co-owner of the Body Therapy Institute in Siler City, NC, and recognizing him for 30 years of service. Rick has contributed so much to this profession, I’ve actually written a previous blog about him. Congratulations to him for well-deserved recognition.

I had another chance to catch up with Joe Muscolino on Thursday when we shared a table at Starbucks. He is such a smart man who has been around this business for a long time. I’m hoping to attend his dissection class one of these days. Back to the House of Delegates on Thursday evening, where three position statements were considered.

Thursday night, the North Carolina Chapter went out to dinner together. Great to catch up with everybody. I walked back to the hotel with Joel Tull and we got slightly lost…which was okay…we took a good walk! Joel is a sweetheart and a gentleman, and he told me an Irish joke, which I won’t repeat here, but it was great to visit with him.

Friday I visited the Massamio booth for my appointment with Michael Reynolds. His task was to whip me into shape at using HootSuite, and he gave me some great advice. He and Allissa Haines were busy, busy, busy educating people about social media marketing. I hate I didn’t have more time to visit with both of them. That was the case with a lot of folks that I loved to see but just didn’t get to hang out with much.

Bruce Baltz saved me from a total meltdown by giving me a foot massage at the Bon Vital booth….shame on me for wearing a pair of flats all week, my feet were killing me! Note to self, don’t do that again!

On Friday I attended a presentation on the parasympathetic nervous system by Dr. Sandra Smith, Dr. Drew Riffe and Dr. Christopher Moyer. This was one of the research track classes and I was thrilled to see the room packed. The same thing happened on Saturday when Dr. Moyer taught a class on the effects of massage therapy on anxiety and depression. He’s a great teacher, and again, it was so wonderful to see the room filled with people who are interested in learning about and advancing massage therapy research.

Friday night I attended the reception for the Massage Therapy Foundation. I’m still trying to take it all in. AMTA’s annual donation to the MTF was $450,000. The Florida Chapter of AMTA made a $20,000 donation. The MA Chapter made a $10,000 donation. Massage Envy made a $10,000 donation. Then Massage Envy VP CG Funk made the offer that she would match up to $500 if someone passed the hat. Richard Wedegartner passed his cowboy hat around and in ten minutes collected over $800. He said next year he would wear a bigger hat. Biotone made a $15,000 donation, and Massage Warehouse made a $10,000 donation. Performance Health made a $2500 donation in honor of Diana Thompson, whom they honored for her many efforts on behalf on the profession. Outgoing President Ruth Werner also honored Diana, and I could not think of a more deserving person. I was really blown away by the generosity and dedication to massage therapy research that was on display. Thank you to every donor, whether your donation is big or small, it all helps!

Friday after the reception I spent some time catching up with Ariana Vincent. Ariana is dynamite in a small package! We actually roomed together Friday night and had a great chat.

After my class on Saturday I made a quick visit through the exhibit hall before heading to the airport. I missed the closing panel presentation on the ACA. According to Ariana, who took notes, the four panelists spoke knowledgeably about the health and legal ramifications. Therapists are encouraged to investigate thoroughly before jumping into the insurance waters, and reminded that you must be HIPAA compliant in order to accept insurance. The therapists in unregulated states will not be allowed to participate in insurance filing under the ACA. I’m sure there’s more but that’s the gist of it.

All in all, I had a great time. I always do! There is just something awesome about being with a couple of thousand people who do what you do! The Texas Chapter did a great job as hosts and we all appreciate it. Already looking forward to next year in Denver!

Report from the AFMTE 2013 Annual Meeting

I just returned from attending the fourth annual meeting of the Alliance for Massage Therapy Education, held this year in St. Charles, MO. I’m a founding member of this organization, and once again, it was a fabulous event. I would have to say that this was the best one in the history of the organization. Kudos to Nancy Dail and Cherie Sohnen-Moe, who spent the last year organizing the event, along with the other board members–all volunteers, I might add. This is the kind of thing that can’t be pulled off by just one person. Many people worked behind the scenes to make it happen.

I arrived on Wednesday night in time to visit with Ryan Hoyme (aka the MassageNerd), Greg Hurd, Allissa Haines, and Ralph Stephens. The Embassy Suites puts on a heck of a nice free happy hour, as well as a nice breakfast, and their staff was very efficient and attentive to our group. The meeting kicked off Thursday morning, and the next two days were filled with informative keynote speakers, great classes for educators, and plenty of visiting with friends, old and new.

During the annual reports, President Pete Whitridge reported that the organization now has over 300 members. About half were in attendance, and the rest missed out on a great time! Treasurer Sue Bibik reported that the organization is debt-free, which is quite an accomplishment since the Alliance is less than five years old.

Whitney Lowe’s keynote, Developing the 21st Century Teacher, really hit the nail on the head with the need to utilize technology and advance our own skills as educators. He is always a dynamic speaker. I had a visit with Jan Schwartz, who along with Whitney is one of the educators behind Education Training Solutions. Thursday evening, I missed the opening reception in order to go speak to Bloom, a networking group of massage therapists in St. Louis. The founder, Sara Newberry, took me out to a fabulous dinner at a rustic Mexican restaurant before the meeting, which was attended by about a dozen MTs. I really enjoyed my time with them.

Friday morning, Dr. Janet Kahn presented Massage in the Age of Healthcare Transformation: Our Opportunities and Responsibilities. Kahn has the inside track on the Affordable Care Act and how that stands to affect integrative health practitioners. After Kahn’s presentation, I ran into AMTA President Winona Bontrager, who assured me that AMTA was indeed going to take some action to support massage therapists as participants in the ACA, a move that she had just a few moments to explain during a panel presentation from the leadership of all 7 national massage organizations. She stated that they would be unveiling that very soon. It was very gratifying to me to see Karen Armstrong, VP of the FSMTB,  Sue Toscano, President of the NCBTMB, Anne Williams, Director of Education for ABMP, Winona Bontrager, President of AMTA, Ruth Werner, President of the Massage Therapy Foundation, and Kate Zulaski, Executive Director of COMTA, on the dais together. Later that afternoon, Kate and Dr. Tony Mirando of NACCAS, presented together on Coming to Agreement on Core Curriculum–another warm and fuzzy moment since these two organizations are competitors. It was a great presentation.

Friday was also the day for memorial tributes to our colleagues who have departed this life in the past year. One of the highlights of my trip was the tribute to Bob King, who just passed a couple of weeks ago. I joined David Lauterstein, one of the Educators of the Year and a primo guitarist, and Cherie Sohnen-Moe onstage to offer Bob a little musical tribute. Bob was a fan of “Blind Al” Wilson of Canned Heat, so I played a little harp and Cherie and I provided the backup vocals while David played and sang Canned Heat’s song, “On the Road Again.” I hope someone got a video of that!

Friday night, I attended the ELAP meeting facilitated by Anne Williams of ABMP and Cynthia Ribeiro, Immediate Past President of AMTA. Both of these ladies have a passion for education, and I acknowledge that wholeheartedly even though I have had plenty of concerns about the ELAP. About 20 or so of us piled into the room to hear about the ELAP and to get our questions answered. I was amused to see that their Power Point presentation referred to “angry bloggers,” and I assume that meant me and Sandy Fritz…we’ve both stirred the pot on that front, but in the end, I hope that some good information comes out of this. It was quite momentous in any case to hear that AMTA and ABMP, the two largest competing organizations in massage therapy, have shared some of their top-secret data with each other in the interest of the common good in order to facilitate this project.

Saturday, I attended the NCB CE Provider Update presented by Sue Toscano and Donna Sarvello of the NCBTMB. Their presentation was peppered with questions from the crowd regarding the new Board Certification and the (yet-again) revised version of the Approved Provider CE program. which they stated would be rolled out on November 1. I seized the opportunity to give them an earful about all the pseudo-science classes they have approved for CE, and also to inquire about how many people have earned the new Board Certification. The answer was over 1200, and that almost all of those have been grandfathered in from the ranks of those who were already Nationally Certified and met the new criteria. I gathered that it has been a very small number that have actually taken the new Board Certification exam. Toscano’s explanation was that due to the fact that the new exam just rolled out in January, and requires that people have 250 hours of work experience within six months (among other things), that newer graduates are just now starting to take it.

We also had our annual Author’s meet and greet organized by the lovely Nancy Dail–there were more than 20 textbook authors present.

Other highlights for me were having my blog and Sandy Fritz’s blog recognized for driving a lot of traffic to the AFMTE website, finally meeting longtime FB friend Emmanuel Bistas, and spending a few moments with Sandy Fritz, Bob Jantz, Gabriela Sonam, Benjamin McDonald, Sally Hacking, Allissa Haines and Greg Hurd, Stephanie and Brian Beck, and many more. Saturday morning I had breakfast with educator and author Elaine Stillerman, whom I had never met, and she is a ball of energy in spite of her recent back surgery. My plane was delayed both coming and going, and I visited with Linda Beach while we were waiting an inordinate amount of time to depart–actually got on the plane and then had to get back off an hour later. I had a little nap in the St Louis airport and woke up to find I was about to fall over on Dr. Janet Kahn–I hope I wasn’t snoring and drooling–and chatted with her for about an hour.

Every annual meeting of the AFMTE seems to get better and better. I urge all educators to join this organization and to PARTICIPATE. They have recently started a Human Energy Bank, so that those people who may not have time to take on a full-time volunteer position can volunteer to handle a specific task. There are many other benefits to belonging, which are detailed on the AFMTE website. As a founding member, I feel like I have definitely gotten my money’s worth every year. We are also looking for industry partners to join us. This is THE organization for schools, school educators, and CE providers. We’re doing more than just holding a meeting. The Alliance provides a comprehensive range of services to this community, and represents their interests in all domains. This advocacy comes into play in dealing with regulatory issues, accreditation, standard-setting initiatives such as the Alliance’s National Teacher Education Standards Project, as well as ongoing efforts to get massage therapy better recognized by and integrated into the health care delivery system. As Jan Schwartz said during one of our previous annual meetings, “if you’re not at the table, you’re on the menu.” Janet Kahn, during her presentation, said “you’re in the door, or in the dust.” Don’t be left out.

ELAP First Draft and Call for Comments Released

The first draft of the ELAP (Entry-Level Analysis Project) has finally been released. It’s been more than a year since I first blogged about it.

This research project proposal was introduced by ABMP and has come full circle from the first statements put out about it, which put me out quite a bit. The initial proposal stated: There is no step in this proposal to obtain input from the broader massage profession or from other health-care or bodywork organizations during this project. The reason is simple—the work group is simply performing a work task in writing learning outcomes and objectives for job tasks defined by surveys already conducted by FSMTB and NCBTMB. It doesn’t matter what stakeholders, or other groups think should be taught or shouldn’t be taught. The work group would be responding to what therapists report they do, on a day-to-day basis, in their massage-related environments as part of their jobs.

They had to back up and punt on that. The ELAP website now contains the following statements clarifying the purpose and scope of the project:

The Entry-Level Analysis Project (ELAP) is a research project that defines the minimum number of training hours necessary to acquire knowledge and skills essential for safe and competent practice as an entry-level massage therapist. The project was initiated through conversations between the Alliance for Massage Therapy Education, American Massage Therapy Association, Associated Bodywork & Massage Professionals, the Commission on Massage Therapy Accreditation, the Federation of State Massage Therapy Boards, the Massage Therapy Foundation, and the National Certification Board for Therapeutic Massage & Bodywork.

ELAP aims to obtain and use research data and analysis of findings from other massage profession projects to inform the creation of an entry-level curriculum map. The map will define the essential elements of an entry-level curriculum necessary for safe and competent practice in a massage career, as well as the number of hours deemed necessary to teach these learning objectives and outcomes. The project outputs will be used to inform the Federation of State Massage Therapy Boards (FSMTB) Model Practice Act designed to promote interstate portability of credentials in the massage profession. The recommendations of the ELAP project will be available to the massage profession as a resource to enhance consistency of entry-level curricula in massage and bodywork training programs.

The ELAP website now contains five webinars explaining the various facets of the project, and numerous surveys to complete. You do not have to complete all of them; the option is to pick and choose those areas that interest you the most.

I urge everyone to give feedback. It happens too often in our field that there is either no opportunity to give feedback, or the opportunity is presented and ignored….the MTBOK (Massage Therapy Body of Knowledge) was a prime example of that. Only a smattering of people responded to that, and then it came under all kinds of criticism when it was released. If you don’t take the opportunity to express your opinion, then don’t gripe when it comes out and you don’t like it. Visit the website and take advantage of your opportunity to participate.