BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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                              UNFINISHED BUSINESS


          Bill No:  SB 731
          Author:   Oropeza (D)
          Amended:  8/8/08
          Vote:     21

           
           SEN. BUSINESS, PROFESSIONS & ECON. DEV. CMTEE  :  6-2,  
            4/23/07
          AYES:  Ridley-Thomas, Corbett, Denham, Florez, Simitian,  
            Yee
          NOES:  Aanestad, Harman

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           SENATE FLOOR  :  29-4, 5/31/07
          AYES:  Aanestad, Ackerman, Alquist, Calderon, Cedillo,  
            Corbett, Correa, Denham, Ducheny, Dutton, Florez, Kehoe,  
            Kuehl, Lowenthal, Machado, Maldonado, Migden, Negrete  
            McLeod, Oropeza, Padilla, Perata, Ridley-Thomas, Romero,  
            Runner, Scott, Steinberg, Torlakson, Vincent, Yee
          NOES:  Cox, Harman, McClintock, Wyland
          NO VOTE RECORDED:  Ashburn, Battin, Cogdill, Hollingsworth,  
            Margett, Simitian, Wiggins

           ASSEMBLY FLOOR  :  64-7, 8/13/08 - See last page for vote


           SUBJECT  :    Massage therapy

           SOURCE  :     American Massage Therapist Association,  
          California Chapter


                                                           CONTINUED





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           DIGEST  :    This bill creates the Massage Therapist  
          Organization (MTO) and provides for the certification of  
          massage therapists and massage practitioners by the MTO.  

           Assembly Amendments  added one member appointed by the  
          California Community College Chancellor's Office to the  
          Board of Directors of the MTO, specified that the meetings  
          of the MTO are subject to the rules of the Bagley-Keene  
          Open Meetings Act, specified that new massage practitioner  
          certificates issued pursuant to this bill shall not be  
          issued after December 31, 2015, specified that any  
          certificate applicant denial or certificate holder  
          discipline shall be done in good faith and in a fair and  
          reasonable manner, extended the sunset date from January 1,  
          2014 to January 1, 2016, and added intent language.

           ANALYSIS  :    

          Existing law:

          1. Provides for the regulation and licensing of various  
             health arts professionals, including physicians and  
             surgeons, chiropractors, physical therapists, and  
             acupuncturists.

          2. Authorizes a city or county to adopt an ordinance which  
             provides for the licensing for regulation of the  
             business of massage when carried on within the city or  
             county. 

          3. Specifies that the ordinance may require reasonable  
             standards which may include, but need not be limited to,  
             the age and education and experience of massage  
             personnel, passage of a practical examination of  
             competence, sanitary conditions of the establishment,  
             hours of operation of the business, prohibition of the  
             sale or serving of food or drink, or conducting  
             non-massage business on the premises.  

          4. Permits local agencies to deny massage licenses to  
             persons who have been convicted of crimes such as  
             pandering, prostitution, or sales of narcotics, and to  
             persons who are required to register as sex offenders.
          







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          This bill:

          1. Creates the MTO and specifies that the MTO is a  
             nonprofit organization and is to be governed by a board  
             of directors (board) and may immediately begin issuing  
             certificates after adopting the necessary bylaws or  
             rules, but in no case may it issue certificates prior to  
             September 1, 2009. 

          2. Provides that the board shall include specified members,  
             should each entity, as specified, choose to exercise its  
             right to be represented on the board: 

          3. Specifies that the meetings of the MTO shall be subject  
             to the rules of the Bagley-Keene Open Meetings Act, as  
             specified. 

          4. Provides that the board shall establish certification  
             fees that are reasonably related to the cost of  
             providing services and carrying out its ongoing  
             responsibilities and duties and authorizes the board to  
             establish initial and renewal fees annually. 

          5. Requires the MTO to issue a "massage practitioner"  
             certificate after December 31, 2015, to an applicant who  
             submits a written application and provides satisfactory  
             evidence that he/she meets specified requirements: 

          6. Specifies that new massage practitioner certificates  
             issued pursuant to the requirements of this bill shall  
             not be issued after December 31, 2015. 

          7. Requires the MTO to issue a "massage therapist"  
             certificate to an applicant who submits a written  
             application and provides satisfactory evidence that  
             he/she meets all specified requirements: 

          8. Authorizes the MTO to issue a certificate to an  
             applicant who meets certain qualifications, as  
             specified, and holds a current and valid registration,  
             certification, or license from any other state whose  
             licensure requirements meet or exceed those defined  
             within this bill, and authorizes the MTO the discretion  
             to give credit for comparable academic work completed by  







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             an applicant in a program outside of California.

          9. Provides that any certification issued shall be subject  
             to renewal every two years in a manner prescribed by the  
             MTO and shall expire unless renewed in that manner. 

          10.Provides that the MTO shall determine whether or not a  
             school provides education that meets the requirements of  
             certification and requires the MTO to investigate, if  
             necessary, whether or not an applicant has actually  
             completed the education he or she claims in his or her  
             application, prior to issuing a certificate. 

          11.Provides that prior to issuing a certificate to the  
             applicant or designating a custodian of records the MTO  
             shall obtain fingerprints from an applicant for  
             certification as a massage therapist or massage  
             practitioner for the purpose of conducting a criminal  
             background check, and specifies that the Department of  
             Justice (DOJ) shall provide the MTO with the specified  
             information relating to an applicant's criminal history.  


          12.Provides that the MTO shall request subsequent arrest  
             notification service from the DOJ to conduct a search  
             for state and federal level criminal offender record  
             information. 

          13.Provides that the MTO may discipline a certificate  
             holder by any, or a combination of, the following  
             methods:  (a) probation, (b) certificate suspension, (c)  
             certificate revocation, (d) conditional certificate  
             suspension, and (e) any other appropriate action. 

          14.Requires the MTO to immediately suspend on an interim  
             basis a certificate if the holder has been arrested and  
             charged with any sexually related or  
             prostitution-related crime and to notify the holder and  
             his/her employer within 10 days of the suspension, and  
             if the charges result in a conviction, the MTO shall  
             permanently revoke the certification, however, if the  
             holder is acquitted of the charges, the MTO shall  
             re-instate the certification within 10 days. 








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          15.Requires the MTO to provide specified information  
             regarding certificate holders to any local law  
             enforcement or other agency that regulates massage  
             therapy, and likewise the MTO shall accept and review  
             any information pertaining to a certificate holder  
             provided by local law enforcement or other agency that  
             regulates massage therapy. 

          16.Provides for various grounds for discipline against a  
             certificate holder or for denial of a certificate to an  
             applicant, including:  unprofessional conduct,  
             procurement of a certificate by fraud, violating any  
             provisions of this bill or the MTO's bylaws, as  
             specified, conviction of a felony or misdemeanor  
             substantially related to their qualifications, functions  
             or duties, impersonating an applicant or acting as a  
             proxy for an applicant in any examination, impersonating  
             a certified practitioner, committing any fraudulent,  
             dishonest, or corrupt act that is substantially related,  
             or committing any act punishable as a sexually related  
             crime. 

          17.Specifies that any certificate applicant denial or  
             certificate holder discipline shall be done in good  
             faith and in a fair and reasonable manner, as specified.  


          18.Authorizes the MTO, prior to January 1, 2012, to issue a  
             "massage practitioner" certificate to an individual who  
             provides sufficient documentation demonstrating he/she  
             meets specified requirements.

          19.Authorizes the MTO, on or before January 1, 2012, to  
             issue a "conditional certificate" to a massage  
             practitioner who has completed at least a 100-hour  
             course in massage, but who has not completed the  
             required number of practice hours specified; however,  
             the applicant must complete at least 30 hours of  
             additional education per year within five years from  
             approved or registered schools until he/she has  
             completed a total of 250 hours of education, as  
             specified. 

          20.Provides that it is an unfair business practice for any  







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             certified massage therapist or certified massage  
             practitioner to state or advertise or put out any sign  
             or card or other device, or to represent to the public  
             through any print or electronic media, that he/she is  
             state-certified, registered, or licensed by a  
             governmental agency to perform the functions of a  
             massage therapist or massage practitioner. 

          21.Provides that it is an unfair business practice for any  
             person to hold himself/herself out or use the title of  
             "certified massage therapist" or "certified massage  
             practitioner" or any other term, such as "licensed,"  
             "registered," or "CMT," that implies or suggests that  
             the person is certified as a massage therapist or  
             practitioner without meeting the requirements for  
             certification. 

          22.Provides that the superior court in and for the county  
             in which any person acts as a massage practitioner or  
             massage therapist in violation of any of the provisions  
             of this bill may upon petition from any person issue an  
             injunction or appropriate order restraining such  
             conduct. 

          23.Provides that the holder of a certificate issued by the  
             MTO shall be able to practice massage in any city,  
             county, or city and county, and shall not be subject to  
             any ordinance enacted by any local government that  
             regulates individuals practicing massage. 

          24.Provides that local government shall not enact an  
             ordinance that requires a license, permit or other  
             authorization to practice massage by an individual who  
             is certified under this bill and no provision of any  
             ordinance enacted by local government that is in effect  
             before the effective date of this bill, and that  
             requires a license, permit, or other authorization to  
             practice massage, may be enforced against an individual  
             who is certified pursuant to this bill. 

          25.Provides that nothing in this bill shall be interpreted  
             to prevent local government from adopting or enforcing  
             any local ordinance governing zoning, business  
             licensing, and reasonable health and safety requirements  







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             for massage establishments or businesses. 

          26.Provides that building code or physical facility  
             requirements applicable to massage establishments or  
             businesses shall not require additional restroom,  
             shower, or other facilities that are not uniformly  
             applicable to other professional or personal service  
             businesses, or other requirements, as specified. 

          27.Provides that local government may adopt reasonable  
             health and safety requirements with respect to massage  
             establishments or businesses as specified, but may not  
             impose additional qualifications, such as medical  
             examinations, background checks, or other criteria upon  
             any person certified by the MTO. 

          28.Provides that nothing in this bill shall restrict a  
             local government from regulating an individual not  
             certified by the MTO. 

          29.Provides that nothing in this bill is intended to affect  
             the practice rights of any person licensed by this state  
             or to grant any individual certified by the MTO any  
             additional practice rights not enumerated in this bill. 

          30.Subjects the MTO to the "sunset review process"  
             conducted by the Joint Committee on Boards, Commissions,  
             and Consumer Protection (Joint Committee). 

          31.Sunsets these provisions on January 1, 2016. 

           Background  

          Massage has grown into the third most requested  
          Complementary and Alternative Practice.  Only chiropractic  
          and relaxation techniques are more popular, according to  
          the bill's sponsors, the American Massage Therapy  
          Association, California Chapter (AMTA-CA).  Massage is used  
          for managing stress, enhancing self-awareness, maintaining  
          health, increasing athletic performance, rehabilitating  
          from injuries, and as an adjunct to medical treatment for a  
          wide variety of conditions. 

          Estimates based on surveys, professional affiliations, and  







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          liability insurance show that up to 25,000 massage  
          therapists are currently practicing in California.  Exact  
          numbers are hard to pinpoint given the high turnover rate  
          of the profession.  Some massage therapists are independent  
          practitioners while a large number of others are employees  
          of spas and chiropractors.

          According to the AMTA-CA, 220 schools in California are now  
          approved to offer instruction in massage, with programs  
          ranging from 100 hours to 1,000 hours.  In addition to the  
          large number of proprietary schools approved by the BPPVE  
          or nationally accredited, massage as a vocation is now  
          taught in cosmetology schools, trade schools, and several  
          community colleges.   

          Titles used in California by the massage profession include  
          massage therapist, massage practitioner, certified massage  
          therapist, massage technician, bodyworker, masseur,  
          masseuse, myotherapist, and Nationally Certified in  
          Therapeutic Massage and Bodywork.  Where no local  
          regulations exist, any title can be used.  

          The National Certification Board for Therapeutic Massage  
          and Bodywork (NCBTMB) certifies massage therapists and  
          bodyworkers on behalf of the profession.  NCBTMB developed  
          and administers the National Certification Examination for  
          Therapeutic Massage and Bodywork.  There is also a  
          nationally recognized certification exam for practitioners  
          for certification in Asian bodywork therapies.  This is  
          administered by the National Certification Commission for  
          Acupuncture and Oriental Medicine.  

          According to the AMTA-CA, consumers do not know the  
          difference between a purchased certification and a  
          certification that requires a specific amount of training.   
          Different jurisdictions have different standards which  
          would indicate that there is no local government agreement  
          about what standards are necessary and sufficient.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          SUPPORT  :   (Verified  7/3/08) (Unable to reverify)








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          American Massage Therapist Association, California Chapter  
          (source)
          Associated Bodywork & Massage Professionals
          California Chiropractic Association
          California Peace Officers Association
          City of Campbell

           OPPOSITION  :    (Verified  7/3/08) (Unable to reverify)

          California Physical Therapy Association
          City of Vista
          McKinnon Institute of Massage

           ARGUMENTS IN SUPPORT  :    According to the author's office,  
          cities and counties currently set up their own requirements  
          for the field of massage and use similar practices as any  
          small business.  There is no statewide regulation of the  
          massage therapy field, therefore any person engaging in the  
          profession of massage in several different cities may be  
          subject to several different types of regulation.  Also, as  
          indicated by the author's office, since there is no  
          statewide certification of the massage therapy field,  
          consumers are left with virtually no recourse if they are  
          harmed in the process of receiving a massage.  There are no  
          statewide uniform requirements for massage businesses and  
          no statewide checks for an individual's criminal history  
          which may adversely affect a consumer's decision to choose  
          a massage therapist.  As argued by the author's office, the  
          current patchwork regulatory scheme throughout the state  
          does not protect the consumer.  Additionally, it does not  
          protect the "professional" massage therapist who does not  
          wish to be subject to individuals who view the massage  
          industry as an entrance into the sex trade.  

           ARGUMENTS IN OPPOSITION  :    The California Physical Therapy  
          Association (CPTA) opposes this bill, in its present form,  
          for the following reasons:

            "The regulatory scheme proposed by the bill is  
            unnecessary and inconsistent.  CPTA does not disagree  
            with the need for a bill that is trying to move away from  
            inconsistent local regulations aimed at massage  
            businesses.  However, SB 731 goes further than that by  
            assuming that all persons performing massage services are  







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            providing health care services.  This does not account  
            for all of those persons providing what are clearly  
            recreational services at day spas throughout the state.   
            Additionally, if all massage service providers are indeed  
            health care providers, then the scheme in this bill would  
            make them the only health care providers in the State  
            regulated by a nonprofit entity and not a State-run  
            licensing board.

            "This bill adds confusion for the general public.  The  
            bill would create three different types of massage  
            service providers, with no clear distinction as to a  
            difference in function or quality level of services  
            provided.  The first would be a 'massage practitioner,'  
            reserved for those who have 250 hours of curricula.  The  
            second is the category of 'massage therapist' for those  
            with 500 hours.  The third would [be] the category of  
            providers who choose not to submit an application to this  
            newly recognized body.  There would be no essential  
            difference in the types of services that any of these  
            could perform."  
           

           ASSEMBLY FLOOR  : 
          AYES:  Adams, Aghazarian, Arambula, Beall, Benoit, Berg,  
            Berryhill, Brownley, Caballero, Charles Calderon, Carter,  
            Cook, Coto, De Leon, DeSaulnier, Dymally, Eng, Evans,  
            Feuer, Fuentes, Fuller, Furutani, Galgiani, Garcia,  
            Garrick, Hancock, Hayashi, Hernandez, Horton, Houston,  
            Huff, Huffman, Jeffries, Jones, Karnette, Keene, La  
            Malfa, Laird, Leno, Levine, Lieber, Mendoza, Mullin,  
            Nakanishi, Nava, Niello, Nunez, Parra, Plescia,  
            Portantino, Price, Ruskin, Salas, Saldana, Silva, Smyth,  
            Solorio, Strickland, Swanson, Torrico, Tran, Villines,  
            Wolk, Bass
          NOES:  Anderson, De La Torre, Emmerson, Gaines, Ma, Maze,  
            Spitzer
          NO VOTE RECORDED:  Blakeslee, Davis, DeVore, Duvall,  
            Krekorian, Lieu, Sharon Runner, Soto, Walters


          JJA:mw  8/16/08   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE







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