Tag Archives: MBLEx

Board Certification: Just Do the Right Thing

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

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

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

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

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

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

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

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

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

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

 

 

Deal, or No Deal?

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

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

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

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

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

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

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

FSMTB Releases Model Practice Act

The Federation of State Massage Therapy Boards released the Model Practice Act a few days ago, just after the third anniversary of the announcement they had formed a Task Force of 8 state board members to work on it. I just had the time to read it in its entirety today, and as a former state board member and former delegate to the Federation myself, I appreciate the huge amount of time and effort that went into it.

I didn’t find much that surprised me. Last week when this was first released, I saw some rumblings from educators and school owners about the requirement for massage therapy programs to be 625 hours. As the publication says, it is consistent with the 625-hour recommendation of the recently-released ELAP (Entry-Level Analysis Project) that was a collaborative effort supported by all of the national massage organizations. Since there are currently more than two dozen states that still have 500 hours as their entry-level requirement, that’s going to require some major changes. Many smaller schools would probably go out of business rather than comply with the change.

The document does not state the name of the NCBTMB or any other entity’s exam in the context of eliminating them, but the definition of “examination” is given as a standardized test or examination of entry-level massage and bodywork knowledge, skills, and abilities that is developed and administered by the Federation of State Massage Therapy Boards. That means the MBLEx, period. About 40 states are currently accepting both the MBLEx and the NCB’s licensing exams. There are also a couple of states that have their own exam–and require much more than 625 hours. I don’t see that those states will want to back up and adopt this.

The MPA does seem to support portability in a good way. There are provisions for therapists participating in planned out-of-state events, temporary assignments such as with traveling sports teams, etc.,and emergency response disaster teams without requiring jumping through hoops. It would also seek to make the title of each state’s act the _____Massage Therapy Practice Act, leaving the term “bodywork” and any other terminology out of it. Licensees would be designated “LMT” (Licensed Massage Therapist) uniformly across the states.

One thing that I was not crazy about was the protocol for choosing board members. The MPA states that 7 members are to be appointed by the governor. I would prefer to see that power spread around a little. I wouldn’t want to see governors of any political party appointing only the people for their own party, for example. In my state, the appointees are made by the governor, the speaker of the house, and the senate pro tem. I think that or something similar is a little better balance of power, personally; even if they do randomly turn out to all have the same party affiliation.

I also wondered about the discrepancy in defining “clock hour” as 50 minutes of instruction and “contact hour” as 60 minutes of instruction. The NCBTMB has traditionally allowed 50 minutes of instruction as a contact hour for the purpose of continuing education.

The states are also still left with more autonomy than I expected. There’s plenty left in their hands, so to speak, with the usual statements about how the board may adopt, amend, and repeal rules. There is also a licensure by endorsement stipulation and a grandfathering accommodation.

There are only five states left without licensing. It would certainly be to their advantage to have this right out of the gate and avoid having to reinvent the wheel. As for the other 45 states that are already regulated, I don’t see that there will be a mad rush to adopt this, unless what they currently have isn’t working for some reason. We have to remember that the FSMTB is not a regulatory body in and of itself, but a coalition of regulated states. They can’t force the MPA on any state, nor are they trying to. It is a blueprint, a collection of suggestions for how to make the states more uniform in the regulation of massage. Too bad it didn’t exist a few decades ago before most of the states got on the bandwagon.

I don’t have any harsh criticisms of the document. Personally, I like the concept of raising the minimum requirement to 625 hours, but then again, I’m not a school owner that would be affected by such a thing. My final analysis: kudos to the people that worked on it. Things like this that are done by volunteers always come under a rash of criticism from people who disagree with the product.

 

 

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. 

 

 

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.

 

NCBTMB: Quit the Small Stuff and Take the Bold Step

Nearly two years ago, the Tennessee Board of Massage Licensure voted to change its rule pertaining to the examinations approved for licensure of massage therapists. They chose to adopt the Massage & Bodywork Licensing Examination offered by FSMTB as the only approved exam – and sunset the use of the National Certification Examination for Therapeutic Massage & Bodywork offered by NCBTMB.

That decision was entirely within the Board’s authority, and was based on the fact that the MBLEx is owned and administered by FSMTB, which consists of its Member Boards. This structure gives state regulatory boards direct ownership and supervision over this exam, which has never been the case with the use of NCBTMB’s private certification exams for state licensure purposes.

Rule changes can sometimes take a long time to make their way through the administrative process, and Tennessee’s exam rule just came up yesterday for final approval before a committee of the State Senate. This could and should have been a simple legislative rubber stamp of an agency decision, but NCBTMB threw a monkey wrench into the works by sending in a representative to oppose the rule change.

I was told last year by former NCBTMB CEO Paul Lindamood that they were swearing off the battle against the MBLEx, and would no longer challenge state massage board actions around exam approvals. He stated to me at the time that he knew they weren’t making any friends by doing so. The new CEO, Mike Williams, who came on board last September, apparently does not share that point of view.

At the committee hearing, the Senators stayed the decision on the rule change for another 30 days and sent the matter back to the Board for further consideration. According to my sources, the hearing went poorly, with legislators failing to understand the difference in the exams, state board members unable to answer the question about what the pass rate is on the exam, and general confusion leading to the stay instead of a decision.

I spoke to NCBTMB President Alexa Zaledonis today, who stated that “We didn’t go to Tennessee to fight, but to state our position. There are still people who want to take our exams and we support them having a choice. We never desire to create controversy in the states. We have quality licensing exams, a lot of people do like them and ask us to help keep them available in their states. No malicious intent, just a desire to let those people have a choice and so we try to stand up for them in an appropriate fashion.”

Earlier this year, there was an ugly ruckus in Ohio over a similar kind of rule change. It ended in a Massage Therapy Advisory Committee member being removed after he asked the NCBTMB during the hearing: “How much money will it take to make you go away?” It was deemed unprofessional conduct at best, and an offer of a bribe at worst.

While I hate the way the question was put forth, it has more than a little basis in reality. I personally would paraphrase that to: “How much money will it take for you to get out of the entry-level licensing exam business?” 38 states are still accepting the NCBTMB exams, but all you have to do is look at NCB’s financials (available on Guidestar.org) to see that they’ve had their butt kicked by the MBLEx. The MBLEx is a licensing exam used for licensing purposes. It’s the right tool for the job, and the marketplace has affirmed it by an overwhelming margin. The state boards themselves don’t derive income from the MBLEx; FSMTB is a non-profit organization (as is NCBTMB) and the Member Boards pay annual dues to the Federation.

If you’ve been reading my blog for long, you know that this is a relatively new opinion of mine –that the NCBTMB should get out of the entry-level exam market. I argued against that for a number of years. Rick Rosen, (a fellow North Carolinian and industry thought leader), has argued that point with me here on this blog and in other forums a number of times, as have others, and I resisted that change for a long time. However, I finally came around to Rosen’s point of view. A few months ago when NCBTMB announced the creation of a new post-graduate Board Certification credential and the ending of the current entry-level National Certification credential, I truly felt like it was the best move to be made.

The issue is that ever since the appearance of the MBLEx, the value of being Nationally Certified has largely gone by the wayside. I’ve heard many accusations that the MBLEx is an easier test than the National Certification Exam. This is not a valid argument, because these are two different tests created for entirely different purposes. The real point here is that National Certification no longer distinguishes therapists from the pack like it did back in the days when it was the only credentialing exam in the massage therapy field. I have personally been NCTMB for 12 years. I have always maintained my certification, even after the MBLEx appeared, but I know many therapists who have let it go because they’ve reached the belief that it doesn’t mean anything in the marketplace.

Under the new plan, Board Certification includes the requirements of 750 hours of education, passing a new higher-level exam, 250 hours of hands-on experience, keeping CPR certification current, and a criminal background check. Those who are already Nationally Certified will not have to take the new exam. In our conversation today, Zaledonis stated “Our Board Certification exam is created to test individuals who have achieved 750 hours of education and are at a level of expertise that exceeds an entry level graduate. Over 8000 individuals responded to our JTA, these answers (after psychometric interpretation) along with a panel of subject matter experts were used to differentiate between a entry level licensed practitioner and a certified practitioner. Our Certification test is different from a licensing exam in that it uses more cognitive thinking over just recall using innovative items over traditional. This test, coupled with the other requirements, are the start of a program that truly differentiates licensing from certification.”

I personally know many of the people on the staff and on the Board of the NCBTMB. I have no doubts about their dedication to the profession, and when it comes down to it, the organization isn’t an island. A CEO serves at the pleasure of the Board, and Board members have to reach a consensus. Apparently the members who are currently serving the NCBTMB have agreed to follow this path of continuing to challenge state boards, and that distresses me. I think it is a misguided effort, no matter how good their intentions. Even the name of the organization speaks to that: National Certification Board. It isn’t the National Licensing Board. There isn’t a National License. There is no portability, and the swirling sewer of argument and confusion around the exams is not helping the situation. I think the time is ripe for the NCBTMB to get out of the entry-level market altogether and focus 100% of their resources on the development and rollout of their new post-graduate credential. This IS something that our profession needs, and I urge the NCB leadership to let go of the past and turn towards the future.

I imagine that money is a primary factor in the organization hanging on to entry-level testing, and in the decision to continue challenging state boards that are ready to drop them. It doesn’t take a rocket scientist to figure out that states don’t want a private certification organization coming in and telling them how to run their business. State board members are normally unpaid volunteers who give up home, family and work time to serve a board….and to have an outside party come in and tell them they did the wrong thing doesn’t sit very well, (as I personally know). I don’t want to see the NCBTMB crippled to the vanishing point. Going around challenging state agencies is expensive, and it doesn’t win them any friends.

So here we are with a Catch-22. It’s time for NCBTMB to exit the entry-level testing business, but they don’t have the money to sustain them while the new Board Certification program is getting built. They need a bridge to help them get where we would like them to go.

There is a straightforward solution to this situation. Since the lion’s share of revenue from entry-level testing has shifted over to FSMTB, they now have a significant cash reserve. It is in the best interests of their Member Boards to bring a quick and painless end to the “exam wars” and to establish the MBLEx as the single standardized exam for state licensure. The profession as a whole will benefit, and portability for therapists will be improved.

What needs to happen is that NCBTMB declares that it will no longer offer any of its exams for state licensure purposes as of a certain date. In exchange, FSMTB will give NCBTMB a certain amount of money over a period of time to compensate it for this move. The mechanism for this process is called a Transfer Agreement, and there is a clear precedent we can look at.

For many years, the American Physical Therapy Association owned and operated the national exam used by state PT boards for licensure. APTA (like our own AMTA) is a private non-profit membership association, with no accountability to state PT boards. Because of the same inherent problems we’ve finally come to recognize, the Federation of State Boards of Physical Therapy entered into negotiations with APTA, and engineered a Transfer Agreement to take over that exam in the late ’80s. It’s worked like a charm ever since. Physical Therapy has 50-state licensure, and a lot more consistency in their state-to-state regulations than we have in the massage field.

Having one standardized national licensing exam is one of the hallmarks of a profession. We are at a critical juncture, where the opportunity to take a major step towards professional status is within our grasp. This will take the willingness and cooperation of the leaders of both NCBTMB and FSMTB to come together to work out the details of this agreement.

Let’s stop wasting time on the small stuff. Take the bold step, for the betterment of all.

 

 

 

Licensing Portability: Not in My Lifetime

I get at least two or three questions a week from massage therapists who intend to move to another state–or horrors–have already moved and found out that they can’t practice massage in their new destination. It’s a sad state of affairs. That’s particularly so when the person has been practicing 20 years or so, but they either a) don’t have the proper amount of education, b) haven’t taken the exam required in that state or c) both of the above. As a former state board member who served on the license standards committee, I also spent a lot of time reviewing those applications for “licensing by endorsement,” a procedure that we had in place to address that issue. Sometimes people get licensed; sometimes they don’t.

We have kind of  a weird situation in North Carolina. Our state no longer accepts the National Certification exams for entry-level licensing. We exclusively accept the MBLEx, unless you’re moving in from out of state and you’re already Nationally Certified. In that case, you don’t have to take the MBLEx, but you do still have to prove that you’ve had the proper amount of education. It’s strange to me that the NCBTMB exams are considered okay for citizens from out of state, but not our own citizens.

There are still many states that have the minimum 500-hour education requirement. My state does. However, we’re picky about how that’s broken down. If your 500 hours from out of state doesn’t match up to the breakdown of our 500 hours, you can be refused a license until you bring yourself into compliance by taking additional classes at a community college or through continuing education. While moving is a choice for most people, I feel particularly bad for those therapists who are moving with a military spouse and not able to get licensed in their new state without jumping through a lot of hoops and going to a lot of expense.

The Federation of State Massage Therapy Boards is working towards portability, whatever that means. They would like for all member states to adopt the MBLEx exclusively, and some have. Other states continue to give applicants a choice, and a few states have their own exam. There isn’t any consistency in the number of hours of education that’s required, nor in the breakdown of those hours.

I reposted both of Ralph Stephens’ editorials on “Challenging Sacred Cows” on my Facebook page, where they attracted a lot of comments. Ralph and I have sometimes disagreed and agreed to disagree, but I do agree with some of the statements he made in these articles…namely, that the education hours required for licensing are arbitrary and not any guarantee of competence. The examination system isn’t without flaws; nothing is. The fact is that some people are good at memorizing facts, and good at test-taking, and some people aren’t. Currently, though, it’s the only system we have, and one that is used in nearly every licensed profession.

Last year at the 2011 meeting of the FSMTB, a delegate posed the question, “Who thinks portability is a myth?” I would estimate there were 120 or so people in the room, and if memory serves, myself and one other person–who happened to be a member of the FSMTB Board of Directors, raised our hands. Everyone else was either holding on to the promise of future portability, or they just didn’t want to publicly state that it isn’t going to happen.

In order for portability to work on a nationwide basis, there has to be a nationwide agreement on what’s acceptable in the way of required education and required examinations. It’s as simple as that. In the meantime, massage therapists will continue to have a struggle to cross state lines.

It Was a Very Good Year

As I look back over 2011, it was a very good year. For the 8th year in a row, since I first opened my business, I am going to finish the year with a growth in sales and in my bottom line. That’s rather miraculous, considering the unemployment rate in my county has been between 14-16% for most of the year. Many businesses have closed. The foreclosure notices in the paper have far outweighed the job listings for the past couple of years. And still, we have thrived, and we had zero staff turnover. I’m very grateful to be blessed with such wonderful staff members and clients.

This year started out with a bang when we made a trip to Miami to participate in the Massage School Makeover organized by Angie Patrick of Massage Warehouse. What started as a little project of Angie’s snowballed into one of the most magnanimous displays of generosity throughout the massage world. The Educating Hands school ended up with over $80,000 worth of equipment and supplies donated by industry partners. As they were moving into a brand-new building at the time, it was just a fresh start for their well-respected school. It was a joy to participate in it and to see so many of my friends from the profession at the festivities. I also got to visit my youngest brother on that trip, and got to see a dear friend who used to live here in NC that I  hadn’t seen for several years. That one was bittersweet since her husband, who was also a friend and former business partner with Champ, had passed away suddenly a few months before, but it was a wonderful visit.

I was honored at the American Massage Conference this year as the Massage Therapist of the Year…and that wasn’t even the highlight of the conference. Getting up to play a few tunes with Errol N Schroeder at the dinner dance was the high point for me. I had a blast! Scott Dartnall and the rest of those Canadians came out of the gate running and made their first American event a resounding success.

Then the World Massage Festival came along and I was inducted into the Massage Therapy Hall of Fame, which I appreciated, but I was also awarded there for Government Relations, which I’d have to say meant even more to me. I’m no Sally Hacking–whom I greatly admire and who has been working in GR for several decades–I’m not able to go all over the country attending legislative sessions and even if I could, I certainly lack her expertise and experience; the award was for my efforts to keep the masses informed of what’s going on through my blog and social media. My politics aren’t popular with everyone, and that’s okay. I feel good about it if I am able to jolt even one person out of complacency to take up the fight against detrimental legislation. I got to play some music at that one, too. The Hinkles are just some of the nicest people in massage and I always enjoy the World Massage Festival, which I refer to as the Woodstock of massage. Leave your coat and tie at home, and just come and have a great time! The 2012 event will be in Las Vegas.

My annual trip to Ireland was one of the high points of the year. It always is. I enjoy teaching the students at the Obus School of Healing Therapies, hanging out with my Irish friends, visiting a few pubs 🙂 and in general, just breathing the Irish air.

I traveled a lot this year. I was invited by the NCBTMB to come to Chicago for a meeting with a lot of industry leaders to offer input on how they can improve the Approved Provider program. I in particular appreciated that meeting, because that’s where the seed was planted for the Massage Therapy Profession Leadership Summit that took place a few months ago, where for the first time, all of our national leaders came together for the common good. It was attended by the executive management and board chairs from the AFMTE, FSMTB, AMTA, ABMP, COMTA, NCBTMB, and the MTF. Speaking of the Massage Therapy Foundation, it was another red-letter day for me to be included on Rise and Shine, a CD of wonderful music donated by massage therapists to raise money for the Foundation. If you don’t have your copy yet, get on the ball! I am very honored to be in the company of such great musicians. It is truly a great compilation.

The Alliance for Massage Therapy Education meeting in Charleston was one of the best events I’ve ever attended. The annual national convention of AMTA in Portland was probably the best one I’ve ever attended, and I’ve been going to those for quite a few years. Kudos to the Oregon Chapter and to President Glenath Moyle for putting on a heck of a good time in such a lovely city. I also got to make my first trip to New Orleans on behalf of the North Carolina Board of Massage & Bodywork Therapy, and it was a blast. I completed five years of service to that board this year, and while I miss the wonderful staff and friends I made at the board, I don’t miss that five-hour haul to Raleigh or having to participate in disciplinary hearings. I got to make my first trip to Los Angeles to attend the Federation of State Massage Therapy Boards meeting, which was as usual, informative and a good time visiting with so many other board members from across the country.

Without dragging out my calendar, I can’t recall every place I got to teach in this year, but they were all fun and filled with beautiful people. One of the high points–literally–was the Take it to the Top Summit put on by Vivian Madison-Mahoney over in Gatlinburg, TN. The hotel was at the top of a mountain, we were on the 14th floor, and the view was just beautiful. That was one of the best education conferences ever, and Vivian and her husband John certainly know how to throw a great event. A lot of my buds were there–Lynda Solien-Wolfe, Michael McGillicuddy, Irene Diamond,  Mike Hinkle and his wife Cindy and a lot more, and a good time was just had by all. I got to play some music at that one, too. Vivian loaned me her limited edition Martin for the occasion since I came without a guitar. It was great.

I made my first site visit as a peer reviewer for COMTA a couple of months ago. I went to New Bedford, MA to review a community college massage program. It was a good learning experience for me, and the other reviewers were great companions. We had a good time. Our hotel was across from the harbor and a good seafood restaurant, so it was a good time.

I had some great classes at the office this year. Marjorie Brook came down from NY to teach a Scar Tissue Release seminar, and she was accompanied by my friend Allissa Haines. We had a good time visiting with them. Christine Courtney and her husband Colum came over from Ireland for Christine’s classes in Indian Head Massage and Traditional Chinese Medicine, and we always look forward to their visit as well.

On a personal level, lest I just sound like an effervescent fool who never has a bad moment, we’ve had some. My husband’s best friend Brent Stephens passed away this year…he was suffering, so it was a blessing for him to go, but it was still a great loss to both of us. Another dear friend died suddenly this year. Donna Metcalf was the picture of health when I saw her last, and three weeks later, she was gone…an unfortunate case of going to the hospital for a simple procedure that went very wrong. Donna was a force of nature, one of those women who dressed in sparkly clothes and a feather boa, and just lit up every room she ever entered. Her death was a shock. It was also a reinforcement that you ought to live every day like it’s your last. It just might be.

I’ve had some family trauma and drama this year…hasn’t everybody? But I’m pleased to say it seems to be on the upswing. My constant prayer is that those family members who need to forgive each other will just get on with it. One year at Christmas when there were some family divisions, my husband said “Well, we could have two dinners.” He was referring to the people who weren’t speaking to each other and the “I won’t be there if they’ll be there” situation, and my reply was “Hell no, we will not have two dinners. They can sit down and break bread with each other or they can go to McDonald’s.” My fond hope is that they’ll all come to the table. The people we resent feel good. Carrying around resentment is, as someone said, like drinking poison and waiting for the other person to die. It isn’t hurting anyone except the person carrying it around.

One of the last great things to happen this year was my husband Champ passing the MBLEx. He is currently waiting for his North Carolina massage license to arrive. Champ is a builder by trade, and the economy here has been a sudden death to his business. There are so many foreclosed properties here, no one needs to build anything. You can buy a house that was on the market three years ago for a million bucks for less than $200,000. You can buy a perfectly livable house for less than $30,000. In fact, if you only need a small one with one or two bedrooms,  you can find some for less than $20,000. Still, I feel optimistic that things are looking up. Facebook has recently built a new data center in our town, and a couple of other manufacturing businesses have come in on their coattails. Hopefully, the economy is going to turn around and the residents in my county will see their circumstances improve. I certainly hope so.

Another great thing this year was what I have been referring to as The Grand Purge. I have been on a mission the past couple of months to clean out my house and my office. I keep watching the old video clip on youtube of George Carlin and his rant about “Stuff.” I have too much Stuff. Or rather, I had too much Stuff. A lot of it is gone…I’ve donated things, sold things, thrown out some things, burned some things…I’m getting rid of my Stuff. Stuff is like an albatross around your neck. My attitude is if I haven’t used it in a year, I’m not going to use it in another year.  I figured if I was going to move, and wouldn’t want to take it with me, then I don’t really need it. So goodbye, Stuff. It’s been very liberating.

I’ll remember this year. A lot of good things happened. A few bad things happened. That’s the way life goes. But all in all, it was a very good year.

The Financial Health of Our Organizations: NCBTMB

Author’s note: This is the third year that I have reported on the financial state of the non-profit organizations of the massage therapy profession. The information I use to write these is obtained from www.guidestar.org, which is a clearinghouse of information on non-profits. If a non-profit does not provide their own Form 990 filing to Guidestar, it will be provided by the IRS, providing the organization meets the obligation of public disclosure. I am not an accountant or a financial expert. I merely offer this series as a source of information.

Just like last year, there’s good news, and there’s bad news for the organization. The National Certification Board for Therapeutic Massage & Bodywork could be the poster child for cutting expenses when revenue drops. They have done a bang-up job of tightening the belt without making services suffer….I say that because people complain to me about any of our organizations all the time, and I haven’t gotten many complaints about the service from the NCBTMB in the past year.

The bad news is that revenue has taken another million-dollar hit, almost the same as the decline last year. $800,000 of that can be mainly chalked up to the MBLEx taking away exam revenue. The good news is that in spite of that, the organization managed to get back in the black, nothing short of miraculous since they were $1.9 million in the hole just a year ago. They reported a net revenue of a little over $469,000. The Approved Provider revenue was actually up by almost $100K over last year. Their assets increased by almost $500K, and liabilities decreased by over $200K as well. I’m very happy to see them back in the positive column.

The belt-tightening that went on at the NCBTMB, to me, is also telling of their getting back on track and letting go of the battle with the FSMTB over the MBLEx. Legal expenses dived by $185,000, since they realized the futility of interfering with the states in choice of examinations.

Marketing was scaled back to the tune of over $260K, another sign of improvement to me…instead of wasting money on an agressive anti-MBLEx campaign, their advertising efforts in the past year have focused on their own positives, and that’s a good thing.

Salaries and compensation went down over $300,000.  CEO Paul Lindamood’s compensation was $228K, down slightly from last year. I’d have to say he deserves it for his pivotal role in cutting expenses and focusing on the good points of the NCBTMB instead of continuing down the path of destruction that led to legal and financial woes for the organization. The Board and volunteers are also to be commended. There were 8 less employees reported in 2010 than there were in 2009, and 10 less volunteers.

Bottom line: I applaud the NCBTMB for turning it around. Even though revenue on the whole was down, I will almost take bets that as I get through this series, I’ll find that the same has happened at some of our other organizations. The recession has affected organizations just like it has affected massage schools and individual practitioners. Kudos to the NCBTMB for adapting to the situation.

The Financial Health of Our Organizations: NCBTMB

This is the second year that I have written a series on the financial status of the non-profit organizations associated with the massage therapy profession. I am not an accountant or a financial expert. All the information in my blogs on this subject is available for public viewing on www.guidestar.org, which is a clearinghouse of information on non-profit organizations.

There’s good news, and there’s bad news. The bad news is that like some of our other non-profit organizations, the National Certification Board for Therapeutic Massage & Bodywork has taken a substantial financial hit during the past reporting year. In this particular instance, it can’t be blamed entirely on the recession; the MBLEx has taken a big chunk of change out of the exam revenues of the NCBTMB–over one million dollars in the past year alone.

Income from the sale of the mailing list decreased by over $30,000, which may also be indicative of the financial status of other businesses and organizations who have previously purchased the list. There’s always a trickle-down effect during a recession.

The good news is that recertification revenues actually rose by over $187,000; it’s good to know that I’m not the only one who values my National Certification enough to keep it up.

I also have to applaud the NCB for the way they have cut expenses. Their belt-tightening is nothing short of impressive. When revenues go down, expenses should go down (albeit not at the expense of customer service), and apparently not all our organizations get that concept, as I have pointed out on a previous blog or two. I think the general public relates well to that…when you earn less money, you have to spend less money.

Compensation to officers, directors, trustees and key employees was decreased by $418,000. Other salaries and wages were decreased by almost $160,000. Legal fees were down by more than $321,000. Advertising and promotional fees, office expenses, conference and convention expenses, printing expenses and other expenses decreased. Altogether, the NCBTMB cut expenses more than 2.4 million dollars from the previous year.

Paul Lindamood, CEO, drew a salary of $230k. Board members are also compensated at the NCBTMB; Chair Neal Delaporta is listed as devoting an average of 17 hours per week to the NCB and was compensated $55,000 for that service. Other Board members received anywhere from $3000 to over $13,000 for their part-time service. Former COO Laura Edgar Culver received more than $128,000.

Lindamood had personally stated to me earlier this year that the organization was doing everything possible to cut expenses, and I am happy to see that has in fact been done. Assets have increased and liabilities have decreased.

When the economy goes down, charitable contributions go down. I am particularly glad to report that in spite of the harsh financial hit the NCBTMB has taken, they still managed to donate $10,000 to the Massage Therapy Foundation. I think that shows commitment to the good of this profession. They could have easily said “we can’t afford it this year,” but they didn’t. Kudos to them.

I hope the recession is winding down for everyone, all the small business owners, all those who work in our profession and support industries, and our non-profit organizations as well.