It is important for all massage therapists in our state to learn about the Interstate Massage Compact.  As Washington nurses experienced in 2023, it's not always a profession's choice to enter a compact.  Washington nurses were entered into their Nurse Licensure Compact against their will because the lobbyists for large employers of nurses (e.g. hospitals and large clinics) had greater influence and money than their own.  WSMTA believes that what happened to the nurses in Washington in 2023 could happen to massage therapists as well.  We would like LMTs in our state to know what the details of the Interstate Massage Compact are as well as the issues, so you can make informed decisions.

Current system in Washington: The system that is currently in place for licensed massage therapists wanting to move from other states to Washington is called, “Licensing By Endorsement for Out-of-State Applicants”. WAC 246-830-035 provides for licensed massage therapists from other states that have substantially equivalent requirements to be granted a license in Washington. If the massage therapist comes from a state that does not have substantially equivalent requirements there is WAC 246-830-037 Transfer Programs, that will guide the massage therapist in getting the additional education they need to qualify for a Washington massage license. If an out of state massage therapist wanted to work temporarily (180 days) in Washington they could use RCW .130.075 Temporary Practice Permits. Almost all states have a “licensing by endorsement” process to admit qualified out-of-state LMTs to their state.

Why do we have Occupational Licensure Compacts? Through licensure compacts, states establish uniform standards to lower barriers to multi-state practice.  A state still maintains their own laws and regulations regarding its professions, but by joining a licensure compact, multistate compact licensees are allowed to practice within other compact member states. States that meet the eligibility criteria join interstate compacts by agreeing to the uniform provisions through the legislative process. Essentially, the goal is to create a more streamlined process for licensed professionals to work in multiple states without having to obtain a license in each state that they want to work in. Washington state currently participates in five Healthcare Compacts: Nurse Licensure Compact, Interstate Medical Licensure Compact, Physical Therapy Compact, Psychology Interjurisdictional Compact and Occupational Therapy Compact.

One of the most misunderstood things about all Professional Compacts is that a Compact License, also known as a Multi-State License does NOT help you to move, it only helps you to temporarily work in another Compact Member State. You must continue to maintain a residence and a single state license (your current state massage license) from your Home State at all times.

Massage Licensure Compact:  The Interstate Massage Compact was created via a partnership between the Department of Defense (DoD), Council of State Governments (CSG) and the Federation of State Massage Therapy Boards (FSMTB). This Compact does not become effective until seven states pass legislation to enter into the Compact agreement. At the time of this writing, two states passed Massage Compact legislation, (Nevada and Ohio) and nine states have pending legislation, (Montana, Virginia, Arkansas, Connecticut, Illinois, Georgia, New York, Maine and Alabama). Currently, there is no Massage Compact legislation pending in Washington.

Issues related to joining the Compact:

• Healthcare provider vs personal service provider: In Washington, massage therapists are somewhat unique in that they are classified as healthcare providers. In most states, massage therapists are personal service providers. 

• • WSMTA has learned from Washington massage schools that have transfer programs, that massage therapists coming to work in Washington from another state where they were trained as a personal service provider often have some very large gaps in their educational background and their understanding of the regulatory minefield of being a healthcare provider. 

• Lowering the educational standards of Multi-State Licensees while raising Washington’s own educational standards: Washington currently requires 625 hours of education, with a very specific breakdown of subject matter, from a Board approved massage school to qualify to receive a massage license. The Board of Massage is currently in discussion about increasing this minimum requirement to 750 hours due to the fact that massage therapists are healthcare providers. A Multi-State licensee must have 625 hours of education, but they are allowed to cobble together these hours from a massage program and continuing education hours. 

• Multi-State Licensees more than likely will not be aware of all of Washington's massage laws and regulations:  The Compact’s legislative language does not require that a Multi-State licensee take a Jurisprudence exam. So, it is highly probable that a Multi-State licensee will NOT be familiar with Washington massage regulation. The Compact language also allows for a Multi-State licensee to work in Washington and not report that they are here to the Department of Health. So, if there are regulatory changes they would never receive any notification of the changes.

• Costs for joining the compact that will impact state licensing fees: There will be expenses to the Department of Health and Board of Massage to join the Compact, such as the expenses to implement the requirements of the Compact, and an annual fee levied by the Compact for being a member state (as stated in the Compact’s legislative language).  In addition, our state would be responsible for disciplinary costs to manage complaints against Compact licensees while temporarily working in our state. In Washington, the Board of Massage, by law, must be self-supporting. So, if its expenses go up, licensing fees go up for Washington massage therapists.

WSMTA’s biggest concerns relate to public safety as well as the impact to our profession in our state.  Would  massage therapists working in our state through the Massage Compact work and conduct themselves in a way that could undermine the decades that many of us in Washington have dedicated to raising the professionalism of massage therapy as healthcare? In Washington, we have finally won the respect of other healthcare providers and massage consumers. We have shown that we can help people to relax and unwind and we can successfully treat their musculoskeletal issues too!

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.

WSMTA has published a wealth of information about the Massage Compact. All that information can be found on our website.https://www.mywsmta.org/page-1075510 and https://www.mywsmta.org/Interstate-Compact-Blog-Entry

Be on the look out for a second Interstate Massage Compact 2025 Update in the coming weeks. This Update will discuss some of the known structural issues of the Nurses Compact (which is the Compact that the Massage Compact is based on), that have been problematic for nurses as well as some other potential issues to be aware of.