Intersate Practice for Massage Therapists Takes a Step Forward

The massage field is a step closer to the ability to practice in more than one state under one license.

The Federation of State Massage Therapy Boards (FSMTB) announced March 17 that the U.S. Department of Defense (DOD) has selected the massage therapy profession to receive technical assistance from The Council of State Governments to develop an interstate compact for occupational licensing portability.

What this means for massage therapists is one could, upon completion of this new project, practice in more than one state with just one state license.

The scope of the assistance includes the drafting of model interstate compact legislation, developing a legislative resource kit, and convening a national meeting of state policymakers to introduce the compact.  

Details related to an interstate compact that would allow massage therapists to practice in any state were discussed at an International Spa Association (ISPA) town hall meeting held online in September. (See the section below, “Questions About the Massage Interstate Compact, Answered.”)

Transcend State Boundaries

Interstate occupational licensure compacts allow professionals in licensed occupations to transcend state boundaries by creating uniform licensure requirements, FSMTB  Executive Director Debra Persinger, PhD, told MASSAGE Magazine.

Although the Department of Defense couched this development in language related to spouses of military personnel, “The compact will create streamlined pathways for interstate practice for all members of the profession, not just those with a military affiliation,” Persinger said.

The FSMTB, with support from the Commission on Massage Therapy Accreditation and Associated Bodywork and Massage Professionals, submitted an application for assistance with establishing the compact, according to an FSMTB press release. Established in 2005, the Federation of State Massage Therapy Boards (FSMTB) is an autonomous, 501(c)(3) not-for-profit organization comprising state regulatory boards and agencies that regulate the massage therapy profession.

When will the development of interstate compacts for licensure portability begin? In a sense it has already begun, said Persinger, because it is a natural step in the trajectory FSMTB set long ago.

“Since the inception of the FSMTB, a primary goal has been to support efforts among member boards and agencies to establish compatible requirements and cooperative procedures for the legal regulation of massage therapists,” she said. “The purpose of this goal is to facilitate professional mobility and to simplify and standardize the licensing process.”

Questions About the Massage Interstate Compact, Answered

ISPA Chair Patrick Huey moderated a discussion among people involved in developing compacts for the massage and cosmetology fields: Debra Persinger, executive director of the Federation of State Massage Therapy Boards; Leslie Roste, director of education for Barbicide/BlueCo Brands; Deirdre Strunk, vice president of spa, fitness and beauty, Canyon Ranch; and Matthew Schafer of the National Center for Interstate Compacts–the Council of State Governments.

Here is a selection of questions and responses from Schafer (edited for clarity) from the ISPA town hall related to interstate compact development:

Q: How did the Department of Defense (DOD) get involved in this?

A: From DOD’s perspective, this issue comes down to wanting to take care of their military spouses and military families. If you think about a family member or a spouse in the military who works in a licensed profession, they may be having to move every year, every two years, maybe three years. The DOD entered into this cooperative agreement with the Council of State Governments, basically saying, “Hey, we really like what you’re doing with these compacts. Let’s make more.” And that’s where this whole project emerged in developing new compacts for these particular professions that we’re talking about today.

Q: Do we know what states have already said, “We’re going to work to have this passed as legislation in our states and join this compact?”

A: We’re just a little bit too early in the process to be able to say these states are signing on and these states aren’t. It will take 12 to 18 months to develop the model legislation because it’s a long negotiation process with all the stakeholders in the profession to come to an agreement on what’s going to end up in that document. In the end, you have something that is permanent and lasting in the profession and something that’s viable and has a significant amount of buy-in

Q: Will the language of the bill be the same by the state or will each state adopt a different language around the bill?

A: This is a contract, and so you can’t have many states passing different versions. They all have to be passing, essentially, the same thing. There can be very minor tweaks, but the language will be about 98% the same.

Q: This legislation is not just for military spouses, it’s for any person within the state who’s holding the licensure, correct?

A: Correct. The Department of Defense recognized that through developing a compact for the entire profession, their military spouses would benefit. They didn’t want to only create something for military spouses, but they recognized the benefit that they could provide these professions at large. So all licensees would be able to benefit, not just military spouses.

Q: Will the bill require a database that people would have to register to be a part of to move between states?

A: All of the other licensure compacts that already exist all have data systems that the compact commission, which is the governing structure, uses to track who is utilizing the compact. It would be nearly impossible to implement a compact where you could see who is practicing in your state without that kind of IT infrastructure available to you.

Q: Will there have to be a governing body of this compact, and who’s going to sit on that governing body?

A: The Interstate Commission is the body that oversees compact activities. Every state that is a member of the compact gets to elect one person to sit on that interstate commission. The only thing that the commission has the authority to do is implement the compact.

Q: Do we already have sponsors for the bill?

A: Not yet, but the Council of State Governments has a network of legislative champions who we can rely on for these compacts. They trust the Council of State Governments. They trust our compact development process.

To learn more, watch this video recording of the Massage Therapy Compact Kickoff Meeting, featuring information on interstate licensure compacts from Elizabeth Whitehouse, chief public policy officer for the Council of State Governments; Patricia Barron, deputy assistant secretary of defense for Military Community and Family planning; and Marcus Beauregard, director, Defense-State Liaison Office, Department of Defense.

FSMTB: Removing Obstacles

The FSMTB has long been working toward making things easier and more uniform for massage therapists so that they can practice and move around the country without unnecessary obstacles, Persinger said, citing such examples as:

2007: National licensing exam (MBLEx) – introduced to bring uniformity to entry-level examination and for states to govern competency assessment. The MBLEx replaced prior inconsistent use of state exams and various certification exams.

2013: Entry-Level Education Analysis Project (ELAP) – defines knowledge and skill components of entry-level education and recommends the minimum number of hours (625) schools should teach to prepare graduates for safe and competent practice in the massage profession. This ELAP initiative was initiated and supported by the seven national massage organizations. 

2014: Model Massage Therapy Practice Act – a comprehensive resource for FSMTB Member Boards and Agencies and to assist regulators with statutory language based upon collective input from the Massage Therapy regulatory community and the profession. FSMTB promotes licensure uniformity for portability where appropriate and the Model Practice Act enhances this mission.

2020: Continuing Education Standards – the regulatory community introduced CE standards to bring uniformity to education requirements for licensure renewal.

2021: Massage Therapy Licensing Database (MTLD) – most recent initiative to provide a comprehensive view of regulated massage therapists to facilitate the role of public protection among state licensing boards and agencies and to facilitate license portability.

“We are thrilled that our goals parallel that of the Department of Defense in this regard and we are appreciate of their funding to help the massage therapy profession establish a compact in conjunction with the Council of State Governments,” said Persinger.

In addition to massage therapists, the DOD stated, the professions of teaching, social work, cosmetology and dentistry/dental hygiene were also selected to work with the Council of State Governments to develop model interstate occupational license compact legislation.

Intersate, massage, Practice, Step, Takes, Therapists ⋆ Intersate Practice for Massage Therapists Takes a Step Forward

Karen Menehan is MASSAGE Magazine’s editor in chief—print and digital. Her recent articles for the magazine include “As Spa Industry Rebounds from COVID-19, Staffing Shortage Looms” and “This is How Diversity, Equity & Inclusion Practices Make Business Better.”


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