Final Draft of Model Practice Act Released

The Model Practice Act was released in its final draft this week, after more than three years of work on it and two periods of public comment. The introduction does state that it will be an evolving document as changing times and circumstances dictate, but as of now, it still has many of the school owners on my social media pages up in arms.

The language requiring accreditation from previous drafts (Section 103(B) ) was modified to say “Approved Massage Therapy Education Program means a school or educational program that meets the criteria established in rule by the Board, at a minimum includes 625 Clock Hours, and is both authorized in the jurisdiction in which it is located and that reflects a curriculum acceptable to an accrediting body recognized by the U.S. Department of Education…” While the requirement has been downgraded to a suggestion, the comment section makes it clear that the eventual goal is required accreditation for one and all.

Personally, I have some mixed feelings on this. Accreditation is a process of quality control–to a point. (Disclosure: I am a peer reviewer for COMTA). Obtaining accreditation is not cheap, it’s rigorous and it’s time-consuming. It sends the message that you have voluntarily gone over and above what the state requires. Other health care professions require it. And therein lies the clincher.

There are no other health professions that I am aware of accrediting programs that teach psuedoscience, and many massage school programs, including those accredited by COMTA and other accrediting bodies–and in the case of community colleges, even the regional accrediting bodies–do. So what does that really mean? Is it really a hallmark of excellence when we accredit things that have no basis in fact, just because it’s tradition, and been around for a long time, even though it’s been shot down by science?

I am not a school owner, but if I was, I wouldn’t be hitting the panic button just yet. The FSMTB has no power of legislation and they can’t lobby. In order for accreditation to become the law of the land, that’s what will have to happen: it will have to become the law of the land, literally, through legislative changes. There may be some FSMTB member states who are gung-ho to see it happen, but remember, state boards can’t lobby, either. That is the domain of the professional associations. In my state, our AMTA chapter has paid a lobbyist for many years. Since the chapter fees are now optional, I have heard that he volunteered to continue working at a lesser fee, but I bet some of the state chapters have lost their lobbyist altogether, if they had one to start with. The wheels of government don’t turn that quickly unless they’re greased.

The MPA is a template for the states. It isn’t the law and it may never be. For the few unregulated states, should they finally get out of the Dark Ages and decide to regulate, this will be very time-saving for them. It isn’t perfect; nothing is. Obviously a lot of work went into it. Only time will tell what effect it is really going to have.

5 Replies to “Final Draft of Model Practice Act Released”

  1. Laura,
    The publication of this Model Practice Act should be a cause for celebration, as it’s one of the hallmarks of a profession. However, we cannot celebrate a document that contains so many serious flaws. I, along with numerous others, provided comments to the MPA Task Force, and it appears that most of them were ignored.

    The problem with the school standards in Section 103(B) is not a question of science vs. pseudoscience (as you pointed out), it’s the fact that about half the massage schools in the country could not qualify for accreditation even if they wanted it. Universal accreditation in our field is not possible, unless the smaller massage schools were wiped off the map.

    And the phrase in the schools definition: “reflects a curriculum acceptable to an accrediting body recognized by the U.S. Department of Education” is technically WRONG. Other than COMTA, which has competency-based curriculum standards, none of the other six vocational accreditors, and none of the seven regional higher-education accreditors have any kind of curriculum standards for massage therapy programs. How could such a glaring error make it into the final document?

    Rightly, this is a MASSAGE THERAPY practice act. However, FSMTB has chosen to lump “bodywork” under this act, and has claimed title protection over the terms “bodywork” and “bodywork therapist” without ever defining these terms. As we’ve seen in NC and other states, the small associations of modality practitioners in asian bodywork, polarity therapy, structural integration and somatic movement therapy, are not happy about this. It’s not possible to have it both ways; the MPA should have left out “bodywork”, and included exemption language for the “bodywork” and “somatic” groups. There is no other practical solution, given the divide on our landscape.

    The philosopher George Santayana said, “Those who cannot remember the past are condemned to repeat it.” In this Model Practice Act, FSMTB has made the same grievous mistake already committed by NCBTMB — by putting itself and the MBLEx in the statutes that deal with exam requirements. This same trick gave NCB a 15-year dominance in the field, because they guaranteed themselves exam business by getting their test written into state massage laws.

    The CORRECT — and more neutral — exam language (found in the practice acts of NC and some other states), should have read, “Has passed a competency-assessment examination that meets generally accepted psychometric principles and standards, and that has been approved by the Board.” Then, each state board’s administrative rules would name the specific exam that meets that standard.

    It’s ironic that at the recent FSMTB Annual Meeting in Tucson, the MPA was rolled out right after the announcement that NCB and FSMTB had reached an agreement whereby NCB would cease to offer its certification exams for state licensure purposes after November 1, 2014. The long-suffering entanglement of licensure and certification is finally being put to rest, and yet FSMTB couldn’t resist giving itself top-dog status in the exam language of the MPA. Tsk tsk!

    FSMTB also chose to bypass a critical opportunity to expand the scope of practice definition of massage therapy. You were gracious to include the full text of my proposed new scope definition in your blog dated June 15, 2014, but this was not utilized in the MPA. What we’re stuck with is just more of the same kind of limited scope definition found in existing state massage laws. We are more than just soft tissue manipulators, and we need language that describes that. If we don’t claim our true and rightful scope, we will continue to be restricted by other health care entities.

    While I appreciate and honor the efforts made by the MPA Task Force over the past three years, I am disappointed by the outcome. I hope this document will be revisited sooner than later, and brought up to the level it needs to be to guide the development of optimal regulation of our field.

  2. Valid points, Rick. I’m curious about why you say half the massage schools wouldn’t qualify’ for accreditation even if they wanted it.

  3. Jan,
    Many, if not most of the smaller proprietary massage schools operate on very limited budgets and don’t have the resources to meet the financial responsibility standards of accrediting agencies. As you know, these standards require the institution to maintain a ratio of current assets to current liabilities of at least 1:1.

    In addition to being under-capitalized, most smaller schools cannot afford the actual costs of accreditation. These costs include initial application fees for accreditation and expenses for the on-site team visit, as well as annual sustaining fees and staff hours to maintain the level of operations required under standards of accreditation. Add to that the cost of annual CPA financial reviews or audits, and it creates a bar that is too high for these schools.

    Because we have such a large number of our massage schools in this category, I recently proposed to COMTA that they establish a programmatic REVIEW option. This would be offered to schools that are unable to qualify for accreditation, or schools that don’t need accreditation because they are not planning to administer Federal Student Aid. A Program Review option would focus on a school’s curriculum and faculty, and it would be outside of the scope of the U.S. Department of Education’s oversight of COMTA.

    Having this option would position COMTA to become a centralized agency to maintain standards for the entire massage education community. That’s the only way to get a consistent baseline in our entry-level programs. Schools that already have institutional accreditation through one of the other six vocational accreditors — or one of the seven regional higher ed accreditors — would be required to seek programmatic accreditation from COMTA.

    FSMTB passed up an opportunity to include this framework in the Model Practice Act. As it stands, the MPA strongly recommends use of the curriculum standards in the ELAP, but state massage boards should not be in the business of legislating the fine-grained details of massage school curricula. In every other health care profession, this crucial function is handled by a single specialized accrediting agency (except for nursing, which has two of them; one for baccalaureate and graduate-level programs, and the other for associate-level programs).

    Along with the consistency that comes with having all institutions working from the same fundamental model, the specialized accreditation agency can amend education standards over time, without each state board having to seek changes to its laws or rules.

    If we ever hope to become a profession, the leaders of the massage therapy field are going to have to solve these root-level problems.

Comments are closed.