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Massage Therapists’ Information Guide to Massage Organizations, Advocacy and Government

14 Dec 2021 4:17 PM | Marybeth Berney (Administrator)

Written by Stephanie Dickey, Edited by Marybeth Berney

As a practicing LMT for over a decade now, I have the honor of being a former member and chair of the Board of Massage (BOM) in Washington and am a current volunteer for the Washington State Massage Therapy Association (WSMTA). In that time, I have witnessed a great deal of confusion from LMTs about what the various state agencies and organizations are, as well as the differences in what they do. I have had questions where LMTs have been confused about how and where to go for information, requests or procedures. With good reason! There are many acronyms to keep track of and each entity does very different things. The truth is that there are many ways we can be a part of our profession and be a voice or advocate for the things we believe in, if we know the right place to go.

LMTs are often not sure what each agency/organization’s focus is or the subtle differences within them. Unless you are volunteering your time in one of these groups or you are interested in government, regulation and massage, you are likely not thinking about how the rules that govern your profession came to be…until you need to be that is! My hope here is that this information can assist in helping you find your way.   

Many of the laws/rules that govern us in massage are created in two ways: legislative acts (Revised Code of Washington, RCWs) and Board of Massage rulemaking (Washington Administrative Code, WACs). These are entities that are part of the State and are tasked with the primary goal of protecting the public and creating laws and regulations that allow a profession to operate without infringement on financial gain, while not harming the public while doing so. They also define what our scope of practice is and how we can operate within that scope.

Each one of these branches of government are only able to create or define certain actions or language in our profession. For instance, the Board of Massage (BOM) cannot create a new scope of practice. For example, if we wanted to increase our scope to use Cold Laser Therapy, the House and Senate health committees and Washington State legislators would first have to take up this scope of practice request as a bill and vote to approve the new scope of practice thus creating a new RCW or expanding an already existing RCW. Then the BOM would create rules, also known as WACs, to give detail to this new law regarding our scope. This can also happen in other ways. A recent example was a law that passed in Washington requiring LMTs to have their valid government issued photo ID and their massage license present while they are working. This law was passed by the legislature and then adopted as law with no need for the BOM’s input. It is also possible sometimes that a court case can cause a need to change rules or laws and when this happens, both the legislature and the BOM may need to take action to line up with the court findings.

The Board of Massage does not set your rates for licensure and state legislators are only a little bit involved in this. Existing laws and regulations require that all healthcare boards be financially self-sufficient. The cost of licensure is based on all the costs of support staff and their responsibilities for licensure, complaints, etc. associated for each profession. This means if the Department of Health receives lots of complaints about our profession, or many LMTs are not fulfilling their CE requirements or other requirements, the cost of investigating and potentially adjudicating cases increases costs to the Board.  Every year, these fees are reviewed and the rates rise and fall based on the budget’s bottom line for the Board of Massage.

The Office of Insurance Commission (OIC) is also a part of this governmental dance in our rules for practice, as they oversee the laws that are created by legislation for health carriers and thus healthcare providers. They also monitor how those laws and rules are administered.

The following is a brief summary of each of the Governmental entities.

House Health Care and Wellness Committee/Senate Health and Long Term Care Committee

These two legislative committees consider a broad range of issues relating to the provision of physical and behavioral healthcare services; long-term care; and strategies to promote better health. Healthcare service issues include the licensing and regulation of healthcare facilities and the credentialing of healthcare providers. The committee also regulates pharmacies and pharmaceutical drugs and has oversight and regulatory responsibility for state public health programs. The committee also considers issues relating to the accessibility and affordability of healthcare in both the private health insurance market and public health programs such as Medicaid and the state health exchange.

Department of Health (DOH)

The Department of Health is a branch of Washington State's regulatory entities and within the DOH is the Health Systems Quality Assurance (HSQA), this division oversees all boards and commissions that represent and regulate healthcare providers. The DOH is involved in creating regulatory guidance for all healthcare providers, such as the protocols and rules recently established for COVID-19. They also credential licensees and review continuing education completion. They are guided by, and answer to, the Secretary of Health. The BOM is one of many  boards governed by the Department of Health's Health Systems Quality Assurance division.

Department of Health - Board of Massage (BOM)

The mandate of the Board of Massage is to protect the public’s health and safety and to promote the welfare of the state by regulating the competency and quality of professional healthcare providers under its jurisdiction. The Board accomplishes this mandate through a variety of activities working with the Department of Health, Health Systems Quality Assurance division. 

The Washington State Board of Massage was created by the legislature. The Board consists of four professional members who are appointed by the governor for a term of four years each. Members must be residents of this state and shall have not less than three years’ experience in the practice of massage immediately preceding their appointment and must be licensed  and actively engaged in the practice of massage during their incumbency.

In addition to the professional members, the governor shall appoint a consumer member of the board, who also serves for a term of four years. The consumer member of the board must be an individual who does not derive his or her livelihood by providing healthcare services or massage therapy and is not a licensed health professional. The consumer member must not be an employee of the state nor a present or former member of another licensing board.

Powers and Duties of the Board of Massage

1) In addition to any other authority provided by law, the board of massage may:

(a) Adopt rules in accordance with chapter34.05 RCW necessary to implement massage practitioner licensure under this chapter, subject to the approval of the secretary;

(b) Define, evaluate, approve, and designate those massage schools, massage programs, transfer programs, and massage apprenticeship programs including all current and proposed curriculum, faculty, and health, sanitation, and facility standards from which graduation will be accepted as proof of an applicant's eligibility to take the massage licensing examination;

(c) Review approved massage schools and programs periodically;

(d) Prepare, grade, administer, and supervise the grading and administration of, examinations for applicants for massage licensure;

(e) Establish and administer requirements for continuing education, which shall be a prerequisite to renewing a massage practitioner license under this chapter; and

(f) Determine which states have educational and licensing requirements for massage practitioners equivalent to those of this state.

(2) The board shall establish by rule the standards and procedures for approving courses of study in massage therapy and may contract with individuals or organizations having expertise in the profession or in education to assist in evaluating courses of study. The standards and procedures set shall apply equally to schools and training within the United States of America and those in foreign jurisdictions.

Office of the Insurance Commissioner (OIC)

“We protect consumers, the public interest and our state’s economy through fair and efficient regulation of the insurance industry”.  With 242 employees (and 400 volunteers), we are one of the smaller state agencies, but we cover a lot of ground:

  • Holding down costs to consumers by reviewing insurers' proposed rates.

  • Answering questions and investigating problems from more than 100,000 consumers each year.

  • Recovering millions of dollars a year for consumers with insurance disputes or delays.

  • Licensing and auditing the 37 insurers based in Washington -- and monitoring the other 2,135 that do business here.

  • Testing, licensing and monitoring the more than 158,000 individuals and businesses that sell insurance here.

  • Collecting more than $1.1 billion a biennium for the state’s general operating budget.

  • Maintaining a statewide network of volunteers who advise thousands of consumers on health care issues.

This is done with virtually no state general-fund dollars. Most of their budget comes from assessments charged to the insurers regulated.

Where Do YOU Come Into This Equation?

In many ways, you are already a part of this process. You are licensed and working in the field of massage and learned the techniques and laws in our profession to become an LMT. You also have the opportunity to be part of a larger body of voices, both in our state and across the country through massage organizations. They are not governmental entities and many of them are nonprofit organizations, they often influence and work closely with the massage boards and legislators in states to influence and help create language for our profession. In fact, much of the laws that change and the rules that are written are created by the organizations and then presented and lobbied for. This is where so much of the groundwork is laid for making changes in our profession.

The following is a list of the organizations that work with the state and that make changes across the country while advocating, suggesting and supporting the profession of massage and what they do.

Washington State Massage Therapy Association-WSMTA (Non-profit)

“The Mission of the Washington State Massage Therapy Association is to Advocate for Massage Therapy as a Recognized and Respected Healthcare Profession.”  The WSMTA was formed in 2015.

  • WSMTA is completely independent of any national massage therapy association and as such can focus its attention on challenges and opportunities that are unique to Washington LMTs.

  • Until WSMTA, massage was the only healthcare provider group in WA that was not represented by a State Association.

  • WSMTA is not supported or influenced by massage corporations and large chain lobbyist activity.

  • WSMTA promotes and ensures the accessibility and financial viability of massage therapy as a reimbursed healthcare service through advocacy and communication with government entities (agencies), third-party insurance payers and allied healthcare organizations.

  • WSMTA provides necessary resources for practitioners of massage therapy, including advanced education in manual therapy and healthcare business development as well as advanced credentialing avenues.

Associated Bodywork and Massage Professionals - ABMP (For-profit)

Professional liability insurance, discounts on massage products, massage business services, free website builder, Find a Therapist database of members…are just a few of the benefits.

This organization has a Government Relations position that keeps updated on all the states current laws and changes state by state. They send a representative to board meetings to support or reject changes to language and to advocate. They also work on larger broader issues that affect all massage therapists across all states. 

 American Massage Therapy Association - AMTA (Non-profit)

“The mission of the American Massage Therapy Association is to serve AMTA members while advancing the art, science and practice of massage therapy.”

AMTA offers professional liability insurance, member discounts and offers online educational CE for massage.

  • AMTA’s president and the executive director are the only persons with inherent authority to speak for or on behalf of the AMTA or to bind AMTA to any agreement.

  • AMTA seeks cordial relations with all professional massage organizations and it requires chapters and local AMTA groups to develop joint political efforts with compatible non-AMTA groups.

  • AMTA and its chapters should not create or be affiliated in any way with political action committees (PAC).

  • The purpose of AMTA Chapters shall be to hold meetings and conduct the business of the Chapter; provide professional and social networking opportunities; organize educational, legislative, public relations, and membership programs on the state and local levels; provide various means of communication such as publications; and support the activities and programs of the National Association for the benefit of its members. The Washington Chapter is called AMTA-WA.

National Certification Board for Therapeutic Massage and Bodywork (NCBTMB)

NCMTMB maintains that Board Certification is the highest voluntary credential attainable in the massage therapy and bodywork profession with a distinct level of achievement beyond entry-level licensure—including completing more education, hands-on experience, and a background check—that will give meaning to your career (and your clients!) with credentials that matter. Formerly the top content creator for testing of LMT’s in all states, NCBTMB is more focused now on continuing education and competency.

That’s why they created the Board Certification credential for the profession. It is more than just another credential—it’s a lifelong commitment to raising the standards of our esteemed profession. Even more, Board Certification now aligns the massage therapy and bodywork profession with other allied health and medical professions, enhancing value and credibility to what we do best.

A Specialty Certificate symbolizes advanced education and training in a particular modality or when working with a specific population—requirements both massage therapy leaders and healthcare organizations agree are necessary to:

  • Further elevate the standards of massage therapy

  • Further massage therapy’s role in integrative healthcare

  • Provide therapists access to high-quality, advanced programs for specific modalities and populations

  • Ensure patients receive the best possible care

The creation of NCBTMB’s Specialty Certificate Program furthers its mission of defining and advancing standards by creating yet another career pathway for massage therapists. By partnering with major healthcare organizations and academic programs across the country, Specialty Certificates empower current and future massage therapists with the top-notch education and experience necessary to succeed in various environments or when working with specific populations. NCBTMB’s Specialty Certificate Program provides the credentials to prove such training, as well as continues to tier the profession—an evolution NCBTMB is proud to be a part of with Board Certification, and now with Specialty Certificates.

Federation of State Massage Therapy Boards  (FSMTB)   

The mission of the FSMTB is to support its member state massage boards (42) in their work to ensure that the practice of massage therapy is provided to the public in a safe and effective manner. In carrying out this mission, the FSMTB shall:

  • Support efforts among member boards to establish compatible requirements and cooperative procedures for the legal regulation of massage therapists, in order to facilitate professional mobility and to simplify and standardize the licensing process

  • Ensure the provision of a valid, reliable licensing examination to determine entry-level competence

  • Improve the standards of massage therapy education, licensure, and practice through cooperation with entities that share this objective, including other massage therapy organizations, accrediting agencies, governmental bodies, and groups whose areas of interest may coincide with those of member boards

  • Represent the interests of its member boards in matters consistent with the scope of the bylaws

  • Is offering CE required course content to some states and encouraging others states to join.

FSMTB History

In early 2005, the Associated Bodywork and Massage Professionals (ABMP) convened a meeting of massage regulators and educators to re-energize a former “Alliance” of the massage regulatory community. Attended by representatives from seven regulated states, along with educators from around the country, this group recognized the need to establish an organization that could bring the regulatory community together in its mission of public protection. Importantly, the concerns of most significance were the need for the provision of a valid and reliable licensing exam and the desire to bring commonality in licensing requirements to assist with professional mobility. The commitment to re-energize this former alliance came to fruition with the formation of an interim organization. The Federation of State Massage Therapy Boards (FSMTB) formed an interim board consisting of all the regulators in attendance. This interim board was charged with conducting research into other similar organizations, reaching out to the community for feedback, drafting bylaws and planning a meeting to formally establish the organization. In September 2005, the FSMTB held its formalizing meeting in Albuquerque, New Mexico prior to the annual American Massage Therapy Association (AMTA) convention. The meeting was attended by 22 states and the District of Columbia. During this landmark event, bylaws were unanimously adopted, and the first formal board was elected. Additionally, dialogue arising from the meeting suggested that three key issues were of utmost concern for the massage therapy regulatory community:

  • The need for consistent scopes of practice and entry level standards across the country

  • The need for a valid and reliable licensing exam that would be accepted by all jurisdictions

  • The need for a common database with licensing and disciplinary information and the ability to store critical documents

Since the formational meeting in September 2005, the volunteer Board of Directors and committee members have continued to diligently work to establish a foundation upon which to build and advance the organization to carry out the desires of the member states.

How to Become Involved

Most states now have legislation and licensing for massage. Whether you are a LMT, LMP, RMT,CMT or something else, there is likely a website for your regulatory agency. Organizations create a voice for us and help to maintain regulation and scope of practice, as well as many other things. During the last two years, many of these organizations provided guidelines and information to give LMTs a way to successfully navigate COVID- 19. Some groups such as the WSMTA, AMTA-WA, and ABMP monitor, attend, and provide feedback for government entities. They also monitor insurance providers’ changes to contracts and provide LMTs important information that may impact their practices.

One of the most effective ways to understand how we all work together is to get involved with your local massage groups and organizations. There is one sure way to help make change or support the massage profession: leave the therapy room for just a short amount of time and get to know your Board of Massage and other massage organizations. Attend a meeting or volunteer a bit of time to work on one of the many things that the organizations are working on. It is important to network with others and talk to people in our field. Groups such as the WSMTA, ABMP, ATMA, NCBTMB and FSMTB all have places where you can get involved and have a voice in your profession.

We know this all seems like a lot for someone to take in.  We know that you are trying to balance a career, life, and potentially all sorts of other things, but it will be handy information for you at some point . The best thing to do is find one place to start getting connected and the rest will usually flow. You do have a voice. Go throw that pebble in the pond and watch the waves!

Contact us at WSMTA if you are interested in volunteering time and becoming a part of our organization or explore some of these other links for information as well.

To learn more about these organizations and Government entities please visit the websites below. 

Washington State Massage Therapy Association (WSMTA) - https://www.mywsmta.org

Associated Bodywork and Massage Professionals (ABMP) - https://www.abmp.com

American Massage Therapy Association (AMTA) - https://www.amtamassage.org

Washington Chapter, American Massage Therapy Association (AMTA-WA) - https://wa.wp.amtamassage.org

National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) - https://www.ncbtmb.org

Federation of State Massage Therapy Boards (FSMTB)  -  https://www.fsmtb.org

Department of Health - https://www.doh.wa.gov/

Dept. of Health - Board of Massage  (BOM) - https://www.doh.wa.gov/LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/MassageTherapist

House Health Care and Wellness Committee/Senate Health and Long Term Care Committee - https://leg.wa.gov/House/Committees/HCW/Pages/default.aspx

Office of the Insurance Commissioner (OIC) - https://www.insurance.wa.gov


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