This is the continuation of the Interstate Massage Compact -- Mobility and Structural Issues (Part 1) blog.  If you have not read the Mobility section, please read it first by clicking the above link.  Part 2 continues the discussion on Structural Issues of the Interstate Massage Compact.

Creation of the Interstate Massage Compact based on the Nurse Licensure Compact (NLC): There were 14 organizations in addition to the Federation of State Massage Therapy Boards (FSMTB) and the Council of State Governments (CSG) that worked together to develop the Interstate Massage Compact. WSMTA does not know why the Nurse Licensure Compact was chosen to be the Compact model to base the Interstate Massage Compact on.  But they did.  If it had been WSMTA’s choice, we would have chosen the Compact Model the Physical Therapists have.

Due to our Compact being based on the NLC, WSMTA feels that massage therapists holding a license through the Interstate Massage Compact will potentially:

About the Nurse Licensure Compact (NLC):  The original Nurse Licensure Compact was created in 2000.  The original Compact was dissolved and shortly after the dissolution, the current Nurse Licensure Compact (NLC) was created in 2018.  The NLC was developed for RNs and LPN/VNs.

Until 2023, Washington had remained out of the NLC, the nurses choosing not to join.  However, employer interests (hospitals and large medical clinics, etc.) had stronger lobbyists and were able to convince Washington State Legislators to have our state join the NLC against the nurses' will.  More about this is stated in the Similarity of issues between the Nurse Licensure Compact (NLC) and the Interstate Massage Compact: section on WSMTA’s Compact webpage.

Here are characteristics of the NLC:

Differences between nurses and massage therapists:  There are some very large structural differences between the employment of nurses and massage therapists:

These structural differences mean that while nurses have the freedom to move from state to state, they will more than likely have employers who make sure they are on-boarded and follow the laws and regulations in the state they are working in because these laws and regulations are more likely to be built into the fabric of their employment as nurses.  Whereas massage therapists often work on their own or may work for employers who may not know the laws and regulations as they pertain to massage therapists because their places of employment might not also be owned or managed by massage therapists or other allied healthcare professionals.

About the Physical Therapy (PT) Compact:  Because of the employment differences between nurses and massage therapists, WSMTA would have preferred to have had the Physical Therapy Compact Model used for the basis of the Interstate Massage Compact instead of the NLC.  Structurally, our profession is more similar to physical therapists.  While more PTs are employees than massage therapists, generally there are more similarities between how we work, what we do and where we work versus between nurses and LMTs.

The Physical Therapy (PT) Compact, Occupational Therapists (OT) Compact and 4 other Healthcare Compacts all require Compact Licensees to obtain"CompactPrivilege" for each state they choose to work in. This means that for every Compact Member State that a PT wants to work in, they must contact their Compact, request Compact Privilege for that state by paying a small fee, and then take a jurisprudence exam (if the state requires it).Like the Nurse Licensure Compact and the Interstate Massage Compact, the PT Compact Compact helps Multistate Licensees to work in Compact Member States, it does not help them to move from one Compact Member State to another.

The benefits of Compact Privilege:

While the Nurse Licensure Compact relies on larger employers to notify nurses of laws, regulations and practice acts in the state they are working, Compact Privilege is a more reliable substitute for employers, and it also helps the state regulatory agencies know who could be practicing in their state.  The state regulatory agencies for nurses do not know which Multistate nurses work in their state because nurses are not required to notify either their Compact or state regulatory agencies where they work.

Issues created by the Compact Model selected for massage therapists:  WSMTA believes that the Interstate Massage Compact would remove too much regulatory authority from the Member States and the Compact Commission and it would give too much freedom of movement to the Multistate Licensee (the massage therapist).  Without controls built in to ensure the safety of the public and the Multistate Licensee, it will create extra expense and liability for Member States, Multistate Licensees and the Compact in the following ways:

Conclusion: WSMTA is a big supporter of greater portability in the massage profession. We wholeheartedly endorse the idea of greater standardization in the regulation of the massage profession. But let's make sure that it benefits and uplifts the professionalism of massage as both wellness and treatment.

Let’s also make sure that it doesn’t increase expenses to in-state massage therapists as well as create greater liability and financial risk for the Multistate Licensees, Member States and Compact.

This was a quick overview of how the Compact would create mobility for massage therapists and an outline of the issues created by the structural differences between nurses and massage therapists. For a more in-depth dive please take a look at our Compact web page.

Next week, we will be discussing the Compact options available to our state and then shortly after that we will be sending out a poll to find out what your thoughts are about the Compact and if the Compact would personally help you in your situation and how it would help you. This information will then be passed on to Washington Legislators.

Thank you in advance for your time and dedication to educating yourself about the issues.