CE Providers React to NCBTMB’s New Approval Plan

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

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

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

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

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

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

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

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

Let’s look at a few facts.

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

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

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

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

21 Replies to “CE Providers React to NCBTMB’s New Approval Plan”

  1. All valid points here Laura on organizational status!

    As an organization where I have a couple of instructors who teach their own material I don’t fall into the category of proprietary classes as does the Upledger Institute. However, I do have high standards for the people that represent my organization and won’t accept just anyone.

    As a CE provider, as you stated, every state is different. Some of us have to comply with state requirements as well and may even have to submit fees for that. Some states won’t allow us to teach hands on if we are not licensed in that state. So I can get an unqualified licensed assistant to teach the hands on – really?

    I, personally, am not happy with the additional fees I will have to pay for every course level I teach. Each of my instructors, as it stands now, will have to go on an individual basis. They may even chose to eliminate teaching, which is a shame because they offer quality education. Company names now will be confusing or unrecognized with individuals or vice versa.

    I also teach at AMTA conventions a shorter version of my classes and how will that change ?

    I have suggested to NCBTMB to have providers supply videos for many years to demonstrate our teaching abilities. Agreed, paperwork does not make us a qualified instructor.

    It is time we come together as a community of fellow practitioners and find a way to make this system work more effectively.

    I have had students ask about renewing their certification as well and are frustrated because they can’t get answers , phone calls responded to or emails answered.

    In the years NCBTMB has been in existence, honestly, there has been only 1 person (who is our CE contact person), who has ever gotten back to me in a timely manner with answers. I can honestly say I have had my share of frustration, misguided information etc., from this organization. Not complaining, just stating. I would love to report otherwise :).

    What “if” all current CE providers have to submit a video with specific teaching criteria demonstrated, along with student testimonials and back ground check they have included now in the application process.

    What “IF” all new providers have to demonstrate the above along with their lesson plans and we all have to submit updated videos for our new courses submitted upon our renewal applications.

    What “IF” we get a national agreement that all states accept our courses w/o further paperwork and approval state by state.

    I feel they are loosing support, especially on an individual basis because they have not been proving themselves as a worthy reason to continue paying for certification. Frankly, in my 25+ years in massage I worked along with many medical referrals and not 1 ever asked to see proof of certification. So that is why financially they are not stable either – what are they providing once we pass our exams and get licensed?

    As a CE provider, I hope they monitor individuals that ‘steal’ the work of others after taking a class or two. Whitney Lowe just posted his disappointment today that a colleague stole his material and is teaching it. How does this happen? While I understand nothing is really proprietary, there should be more precise monitoring system. I know of someone personally who has ‘stolen’ material not only from me but another colleague and seriously has obtained approval to teach this material when they only took 1 class. Anyone can lie on those forms. Where is the proof?

    I am happy to say the NCBTMB started a profile feature of educators so we can learn more about our colleagues and have our colleagues supported. Kudos!

    Bottom line, if you want more from us, what will you do for us?
    If you want better quality in education, more money is not going to get better classes for our MT’s. If someone has money they can buy anything they want – proven over and over in our system.

    I don’t have the answers and only suggestions.

    1. Create a system demonstrating a real purpose that will support our colleagues. Once our fees are paid and paperwork submitted what is the true purpose since states can vary.
    2. Validate through videos and/or webinar that the qualities of a true instructor exist and have a qualified individual(s) review, make suggestions etc.
    3. Provide Teacher training tools, classes etc, for us to continue to grow in our profession . Perhaps make all new instructors attend a workshop as part of their application fees.
    4. As a “National” Provider, get national approval . CE providers should not have to worry about traveling from state to state.
    5. Organizational status should allow for instructors to teach per a set of standards and review determined by a protocol. Not limited to teaching only certain course for the organization. It should allow for the freedom for a group to be able to offer their expertise under the umbrella.

    I am sure many of my colleagues are more skilled in this arena to set up a better system that will work for all of us.

    Thank you all ~ as we continue to grow ~ we continue to learn,

  2. When so many people balk at a new way of doing things, then the org that is making the change needs to stop and listen. However, there are some issues that Laura reports on that I’m not sure can be laid at the feet of NCBTMB. If I trained someone to teach my proprietary material and they take it as their own and teach it as their own, that is an ethical and perhaps legal issue, but hardly NCBTMB’s fault.

    Also, in terms of time it takes to get approval now vs the “new way” I think we’ve been somewhat spoiled. There was a time, and maybe it’s still true, that you could only test for your massage license twice a year in NY, (for example). It took me almost 6 months to get our courses approved in MS and it cost us $550. That’s just one state.

    I agree with Laura that we need to support NCBTMB–and that the organization needs to poll the providers. I can’t imagine having to get approval in every state, if states went in that direction. Talk about prohibitive costs!

    I guess what I’m saying here is that yes, NCBTMB needs to re-look at this plan, but we also need to be careful in terms of where and why we lay blame.

  3. You nailed it Laura! I am appalled at how easy it is to become a CE Provider with them, honestly. Although I do think that those listed under the “umbrella” of an approved CE organization ~should~ be listed in NCBTMB’s CE Provider lists (so that say, in my case, other people can see that I am an approved provider of Ashiatsu Oriental Bar Therapy as a part of Ruthie Hardee and Health & Bodyworks and am not just hiding behind the modalities number. Not that we each need our own #, but more so that we are simply listed as bullet points below our organization for validation to potential students.)
    A thorough process on checking the credentials and training of anyone and everyone representing NCBTMB and the massage profession should be foremost, with the integrity, safety, validity and credibility of the technique presented quadruple checked that it is not a repackaged copy of an existing version or complete bogus voodoo. It shouldn’t be about money, and the interests of the approved and documented techniques should be protected. Without the highest standards of quality training, where would NCBTMB be anyways? Beef it up and listen to your backbone. That’s what I think.

  4. Jan Schwartz is making a good point about the ethical/legal issue of people taking materials not being the fault of the NCBTMB—but that being said, there is a Code of Ethics at the organization that certificants and providers agree to abide by. That ought to include plagiarism and misrepresenting someone else’s work as your own.

    Perhaps we are spoiled in expecting timely service. Jan is right about the old times when some states only gave an exam once or twice a year.

    I’ve been dealing with the NCB for 13 years, and I have seen times when I got through on the phone and got a question answered immediately…and also times in the past when I couldn’t get a call returned. Donna Sarvello, the CE person currently at the NCB, has always been very diligent in responding to people, from my own personal experience with her and reports from other people.

  5. It’s time for a major reality check here. NCBTMB needs continuing education providers, schools and therapists a whole lot more than we all need NCB. I agree with Laura’s characterization of the problems with NCB’s new Board Approved CE Provider Program.

    NCB’s leadership is attempting to force this “upgrade” upon the community of individuals, institutions and organizations that have provided CE for many years — without even putting out these proposed changes for comment.

    Without the active support of the profession, NCB’s new Board Certification Program for therapists is unlikely to even get off the ground, let alone succeed. With their its revenues in a steady decline as more massage school grads take the MBLEx every month, NCB is desperate for a new and reliable revenue stream that will replace the millions lost from the use of its certification exams for state licensure.

    If NCB needs friends to survive, why is it acting in such a callous way with its most important constituents?

    Think about this: if we woke up tomorrow morning and the National Certification Board for Therapeutic Massage & Bodywork was gone from the landscape… doors shuttered, website down, phones unanswered… would CE stop in its tracks? Of course not. NEWS FLASH: The ongoing provision of continuing education does not need NCB to exist.

    How then did NCB get into the powerful role of being the primary approval agency for CE in the massage and bodywork field? Let’s go back to the beginning: NCB was launched in 1991 to provide a voluntary certification program. It chose to pursue accreditation status for its certification program with NCCA — the National Commission for Certifying Agencies. This was not a requirement. The NCCA Standards of Accreditation only mandate that certification programs require its certificants to recertify on a periodic basis. The particular criteria for recertification are set by the agency, and are not spelled out in the NCCA standards.

    Thus, NCB chose to create an approval process for continuing education providers, to give its own certification program more legitimacy. Following that, a significant number of state massage boards (including my own board here in North Carolina) decided to adopt the NCB Approved CE Provider program in place of creating a separate state approval process.

    From an workflow standpoint, that was a rational decision. However, because state boards have no control over how NCB runs its CE approval program, these agencies find themselves in the situation called “Improper Delegation of Authority”. As a general legal requirement, agencies of state governments cannot outsource legislatively-mandated functions to third-party entities unless there is an established mechanism for supervision and control of how that outside entity carries out the delegated function.

    As we have seen in so many instances over the years, NCB marches to the beat of its own drum, and has made major changes to its exam program, curriculum requirements and CE approval program without consulting with state boards, schools or CE providers. It is not a sound way to do business. What’s more, the lack of accountability that state boards have with the continued use of NCB’s certification exams and CE approval program is a serious legal and ethical issue that must be resolved to maintain the integrity of the profession.

    There are two critical questions that must be addressed at this juncture:
    1) Can ANY state or national CE approval program assure the quality of post-graduate education provided to therapists?
    2) Has the existence of CE approval programs in our field improved the protection of the public (i.e., fewer clients per year getting injured by massage therapists).

    On the first question, we must be honest about where massage education at this point in its development. As noted in a December 2010 white paper by the Alliance for Massage Therapy Education, the majority of those people teaching in this field (both in entry-level massage programs and CE) have not had formal training in the theory and methodology of teaching or curriculum design. This means the baseline quality of teaching in our profession is far below where it can and must be.

    AFMTE is attempting to address this deficit through a five-phase endeavor called the National Teacher Education Standards Project. But curiously enough, no other stakeholder organization in the field has yet to step up to provide institutional and financial support to this vital effort.

    To be sure, CE courses range in their effectiveness from the excellent to the abysmal. They probably follow the distribution of a standard bell curve, with most being about average. But the wide-scale lack of instructional competency and issues with program design means that a CE approval process that merely requires providers to submit paper documentation is insufficient. What’s more, you can’t assure quality when it may not be there to begin with. It’s public deception to put forth a “seal of approval” that is not a reliable guarantor of what the customer will receive.

    Speaking of the public, there is scant evidence to uphold the assertion that the unlicensed practice of massage and bodywork is harmful to the public. It’s a story line (some would say a mythology) that has been used as the justification for convincing state legislatures over the past 20 years that new license laws were needed.

    This strategy ran into a brick wall in Vermont two years ago, when AMTA and ABMP linked arms in an effort to get a massage law passed in that state. The Vermont Office of Professional Regulation carefully weighed the evidence provided by these two membership associations and ruled that licensure would not be adopted because: “The applicants (AMTA and ABMP) have not demonstrated that the unregulated practice of massage therapy can clearly harm or endanger the health, safety or welfare of the public. The potential for harm is remote and speculative.”

    So have CE approval programs made massage safer for the public? Since the incidence of client harm is miniscule to begin with, it’s impossible to say whether or not this is true. Given the relatively low amount of education required to become a licensed massage therapist, I believe that CE should be retained as a requirement for license renewal. Professional advancement at the individual level will continue to improve our profession overall, but that is separate from that which is necessary for public protection. I want to see therapists get better at what they do, which is more important and relevant than trying to prevent harm that rarely occurs.

    If the situation with NCBTMB wasn’t bad enough, we now have FSMTB gearing up a new internal committee to create its own new CE approval program for use by state boards. Now, such a program would solve the problem of Improper Delegation of Authority (cited above). However, FSMTB has refused to work with NCB in any way, so we could wind up with two competing national CE approval programs on the landscape, along with the holdouts from states with their own approval programs that refuse to go along with either organization. From the perspective of CE providers, this would be adding insult to injury.

    If neither FSMTB nor NCB are willing to work together to establish a unified CE approval program — and if CE approval itself is fundamentally unable to assure the quality of courses that are offered — then where does this leave us?

    Dear colleagues… ponder what I have presented here, and then stay tuned for a novel out-of-the box solution in the New Year.

    Rick Rosen, MA, LMBT
    Founder & Director, Body Therapy Institute
    Founding Chair, NC Board of Massage & Bodywork Therapy
    Past Executive Director, AFMTE and FSMTB

  6. I’m not an educator and have never lived in a state that required continiiuing educational credits in order to work as a massage therapist.. I’ve worked outside the system so to speark for nearly thirty years now. And feel I have benifited greatly because of it. Every time in the past that I have looked at it from my 3rd person perspective. I’ve seen dysfunction. But now, I see disorder within the dysfunction.

  7. Rick Rosen stated above, “If NCB needs friends to survive, why is it acting in such a callous way with its most important constituents?”
    I have been tooting this horn for some time now. Thank you, Rick, for stating it so eloquently. I don’t think most of us need this organization anymore. The way they treat their customers, whether you are a school, an individual MT or a CE provider, will naturally provide for their rapid death and disappearance. And, as Rick states, “NEWS FLASH: The ongoing provision of continuing education does not need NCB to exist.” I also love the way he outlines the scam that the AMTA and ABMP have pulled over the eyes of many state legislatures that there has been any appreciable harm to the public by unregulated massage. He gives the truth when he says that the real reason for CE is to raise the effectiveness of massage work. It is a shame that the lie has to be told about harm to get to the truth that CE is woefully needed. My curiosity is piqued about his last statement. I’m tuned in, Rick!

  8. You’ve all made some excellent points and provided a lot of things to think about. Thanks to Laura and everyone for your comments.

    While I am appalled that anyone would steal from another and call the work their own, I do not agree that it is the NCBTMB’s duty to police this activity. Copyright and Trademark enforcement is the responsibility of the creator of the work. I do not want the NCBTMB to squirm their way into the role of copyright enforcement for the simple reasons that a) I don’t believe that they are capable of determining who is the original author and b) I think they would always find in favor of whomever was paying them for certification. It’s not their role.

    The loss of the organizational approval troubles me because it completely undermines any collaborative work. I developed one CE class with another MT and I paid for the organization number so that we could both teach the same class. We both put in the effort, did the research, developed the curriculum and are both equally qualified. It is exactly the same material. Why should it be covered under 2 individual approvals?

    I teach primarily in WA state, which does not require NCBTMB approved providers, or any certification or approval for that matter. Taking renewal as a business decision, I am trying to decide whether to spend the money and renew, or save myself the money and hassle and just take down the approval number and stick with teaching in this state.

    It seems a shame to me that the NCBTMB is going to such lengths to alienate its customers. If that is their business strategy, then I do hope that Rick Rosen has an out of the box solution, because NCBTMB can’t survive without paying customers.

  9. Im an MT in an unregulated State.. I’ve been working full time as a massage therapist for 30 years.. I study all the time.. I dont have to take any tests to proove myself. But I study all the time.. Ive got thousands of dolllars of books and DVDs.. Im paying money to CE providers and smart people for all their work.. But Im free to study as I please.. and not forced to take some class that Im not interested in just too meet some ones requierments. I am not under pressure.. and I can freely study.. I have a lot of everybodies DVDs.. I like DVDs.. I can push the re-wind button. But I notice there is hardly any CE credit to DVD study.. Im highly skilled now, because Im free to study.. Im not forced to study…and I save money buying books and dvds. I dont need a live seminar to learn… Ive touched bodies for years.. I dont want to be regulated.. ever.. Its just to my advantage not to be. Id rather pay a good massage organization money to provide access to information to use as I please instead of being required or forced to attend live seminars.

  10. I moved from CT to TX, the guidelines for CE providers here is that anyone licensed for 1 year as a MT can apply for an Instructor license and they a CE certificate. When I first moved here I went to take a CE course and the person teaching the course was uneducated and charging $20 a cerdit hour (6 hr). I look for NCB providers for all of my CE’s I would hate to lose this.

    How do I voice my concerns to NCB (I have my NCBTMB since 2005).

  11. Its all about money, not talent… Ive sat thru sooo many bad classes, I want to see an Instructor class for massage teachers not just time in ther field, you can be a great massage therapist, it does not mean it makes you a good teacher …. CE providers also need a governing body, I dont think the NCB is that org, may perhaps its time to create one…..in light liz

  12. Rick, please help me understand “NCB’s leadership is attempting to force this “upgrade” upon the community of individuals, institutions and organizations that have provided CE for many years — without even putting out these proposed changes for comment”
    Did I mis understand your paper on “the optimal role of NCBTMB”? where you state:
    “NCBTMB has an excellent opportunity to upgrade and repurpose what has been called “national certification” to a graduate-level credential. Decoupling certification from licensure would bring NCBTMB back to its original mission as the provider of a truly voluntary program that allows experienced practitioners to distinguish themselves through testing and demonstration of continued competence. That’s what certification was designed for.”

    Also, could you clarify this statement:
    “If NCB needs friends to survive, why is it acting in such a callous way with its most important constituents? ”
    Do we want our professional credentialing entity to depend on it’s friends or work to develop best practices for the profession?
    I do believe there is much work to be done with our profession and the organizations that support and develop it. I hope that we take the personal out of it and look at the larger picture, how can it develop the profession for the future.

    Emmanuel Bistas has great points in the linkedin post: “If NCB wants to make the new credential meaningful, they will need new criteria, they will need to scrutinize applicants, they will basically need to ensure that a board certified practitioner is one who has gone the extra mile, who has invested in education, who has taken courses along a meaningful path, etc……”

    I appreciate Gloria’s post stating “I don’t have the answers and only suggestions….”
    Nothing is perfect, but I have learned that change happens more effectively when people try to collaborate and point out the positive things people (organizations) are accomplishing and suggestions on how to improve. It’s a journey we’ve all been on for awhile and will most likely be on for a long time to come.

  13. Would it make sense to vet instructors for their ability to teach while vetting classes for content and learning objectives?
    A good teacher should be able to teach most subjects?
    Good programs should be able to be taught by good teachers?

  14. Great article Laura, that association NCBTMB should end. They care just about the money, I requested them a refund after taking almost 2 months proccessing my application on 12/2012, they pretenteded to refund me only $75 out of $225. So I complained to the BBB. Finally the NCBTMC, CEO authorized the refund of 150.00 which was better instead of $75.

  15. Massage therapy laws have been reinforced in the State of Arizona in order to safeguard the profession and combat prostitution. However, what many or most therapist think is that this was made for economical purposes instead of protecting the profession. Massage schools, associations, and the Arizona therapy board are beneficiating in monetary means.
    It is very challenging for out of state applicants to become licensed in Arizona. Most of state requires only an average of 500 hours of education, except NY with 1000 hours. However Arizona Board request 700 hours of education. For an out of state applicant like me with 600 hours, would need to take 100 hours in a School, pay up to $1000, to be able to be licensed. Furthermore, it would take two more months in making those Hours. Plus, most of schools like Anthem College or Carrington College let therapist enroll only for the whole program of 1000 hours. In other words more money.
    The reciprocity rules for out of state applicants are very demanding. For example you need to be licensed for 5 years to qualify as an out of state licensed applicant license and 500 hours or education. Five years is a long time, due that 6 months or a year of practice in enough to perform safely.
    There are two test for licensing, the MBLEX and NCBTMB, the first one is only a test and the second one is a certification through testing which is accepted with only 500 hours for out of state applicants. As I took the MBLEX, 600 hours of education is not enough. I need hundred more. That means pay to a school to take those classes.
    Fees to keep license active are high. As seen in the AZ board website, is $219 for applying, $ 225 for testing with the NCBTMB, $8 dollars for fingerprinting. Also, requires to renew the NCBTMB with authorized Continuing education courses with elevated prices of $150 and up every two years, plus $95 license renewal. The NCBTMB increases and makes harder to applicants due to the unnecessary requirements such as 250 practice hours from schools.
    Private Schools play an important role in this industry, especially the ones that accept financial aid. With exorbitant tuition fees of $24000 of a 1000 hours course for massage. The fafsa covers only $5000, leaving the student with a loan of 17000. That has to be repaid 6 months after graduation. Not even securing the license because it depends on the test pass or failure grade.
    In conclusion, it is a good cause to safeguard professions but it is also important to provide some flexibility to competent applicants from other states that would like to work in Arizona. Instead of making subjective excuses of citing prostitution as a reason. Just to make money from the people that would like a career change or continue their art in a new state. Is a vicious circle where only schools, unscrupulous associations and the board get most of the whole pie.

    AJ Martinez
    LMT Florida
    CMT California

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