BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1147
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          Date of Hearing:   May 7, 2013

              ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER  
                                     PROTECTION
                              Richard S. Gordon, Chair
                      AB 1147 (Gomez) - As Amended:  May 1, 2013
           
          SUBJECT  :   Massage therapy.

           SUMMARY  :   Revises the qualifications for certification as a  
          massage practitioner and massage therapist, and allows a city,  
          county, or city and county to require the owner of a massage  
          business to obtain a revocable certificate of registration, as  
          specified.  Specifically,  this bill  :  

          1)Requires an applicant for certification as a massage  
            practitioner to pass a massage and bodywork competency  
            assessment examination that meets generally recognized  
            psychometric principles and standards and is approved by the  
            California Massage Therapy Council (CAMTC). 

          2)Provides that the successful completion of the competency  
            examination may have been accomplished prior to the date CAMTC  
            was authorized to issue certificates.

          3)Eliminates a specific 100 hour coursework requirement in  
            anatomy and physiology, contraindications, health and hygiene,  
            and business and ethics, in favor of a more general  
            requirement to complete 500 hours of hours in massage and  
            related subjects.

          4)States that nothing in this chapter precludes a city, county,  
            or city and county from including a provision in a local  
            ordinance requiring the owner or owners of a massage  
            establishment or business apply for and receive a revocable  
            certificate of registration.

          5)Permits a city, county, or city and county, to require the  
            following as part of the application for a certificate of  
            registration:

             a)   The full and true legal name under which the massage  
               establishment or business will be conducted;

             b)   The present or proposed address where the massage  








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               establishment or business will be conducted;

             c)   The full true legal name and mailing address of the  
               owner or owners of the massage establishment or business;

             d)   A copy of a certificate, or any other evidence of  
               certification, issued to each person who will be providing  
               massage services at the massage establishment or business;

             e)   A copy of a photographic government-issued  
               identification card of the owner or owners of the massage  
               establishment or business; 

             f)   A statement that the business will only employ or use  
               certified persons to provide massage services, and that  
               failure to comply may result in the suspension or  
               revocation of, imposition of conditions upon, or action  
               against the certificate of registration;

             g)   A statement that the applicant will provide written  
               notification of any changes to the original application  
               within 10 days of the change occurring;

             h)   Authorization for the city, county, or city and county  
               to investigate the truth of the information contained in  
               the application; and,

             i)   The payment of a fee to conduct a background check if  
               the owner or owners of the massage establishment or  
               business applying for the certificate of registration are  
               not certified and own five percent or more of the massage  
               establishment or business. 

          6)Authorizes a city, county, or city and county to require a  
            massage establishment or business to comply with any  
            applicable local ordinance, regulation, rule, requirement, or  
            restriction as a condition of granting or maintaining a  
            revocable certificate of registration including, but not  
            limited to, those provisions pertaining to health and safety.

          7)Authorizes a city, county, or city and county to exempt  
            certain classes of persons or businesses from compliance with  
            the requirements for a certificate of registration.

          8)Authorizes a city, county, or city and county to make the  








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            certificate or registration nontransferable.

          9)Authorizes a city, county, or city and county at its sole  
            discretion to suspend, revoke, impose conditions upon, or  
            otherwise act against a certificate of registration for cause.

          10)Makes other technical and clarifying changes.

           EXISTING LAW  : 

          1)Establishes the CAMTC and defines the responsibilities and  
            duties of the CAMTC.  (Business and Professions Code (BPC)  
            Section 4600.5)

          2)Defines massage therapist, body worker, or bodywork therapist,  
            massage and body work therapist, massage practitioner, body  
            work practitioner or massage and body work practitioner to  
            mean "a person who is certified by the CAMTC as specified."   
            (BPC 4600)

          3)Requires the CAMTC to issue a "massage therapist"  
            certificate to an applicant, who submits a written  
            application and provides satisfactory evidence that he or  
            she meets all of the specified education, experience or  
            examination requirements.  (BCP 4601)

          4)Requires the CAMTC to issue a "massage practitioner"  
            certificate to an applicant who submits a written application  
            and provides with satisfactory evidence that he or she meets  
            all of the specified education, experience or examination  
            requirements.  
          (BCP 4601)

          5)Provides that the holder of a certificate issued by the  
            CAMTC shall be able to practice massage in any city,  
            county, or city and county, consistent with the law and  
            the qualifications established by his or her  
            certification, and shall not be required to obtain any  
            other license, permit, or other authorization, except as  
            provided in current law.  (BPC 4612)

          6)Provides that nothing in existing law shall prevent a  
            city, county, or city and county 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 that employs or  
            uses persons who are not certified by the CAMTC.
          (BPC 4612) 

          7)Provides that a local government may subject any massage  
            business or establishment to reasonable inspections to  
            verify conformance with local ordinances and fire,  
            health, and safety requirements, and may also require the  
            operator of a massage business to notify it of any change  
            in business name, management, or transfer of ownership to  
            another person.  (BPC 4612)

           FISCAL EFFECT  :   None.  This bill is keyed non-fiscal by the  
          Legislative Counsel.

           COMMENTS  :   

           1)Purpose of this bill  .  This bill would impose stronger  
            regulations on massage therapy businesses by authorizing local  
            governments to require revocable certificates of registration  
            for massage businesses.  These revocable certificates would  
            give local governments more information about massage therapy  
            businesses, and more power to discipline or shut down  
            unscrupulous massage businesses.  Additionally, this bill  
            requires individuals applying for certification as a certified  
            massage practitioner (CMP) to pass an examination and  
            eliminates specified coursework requirements for individuals  
            applying for certification as a Certified Massage Therapist  
            (CMT).  This bill is sponsored by the author.

           2)Author's statement  .  According to the author, "Several years  
            ago the Legislature pre-empted local control over land use  
            issues surrounding massage parlors.  As a result of the  
            preemption numerous communities [complain] about what they  
            regard as an explosion of these places.  It is not the intent  
            [of this bill] to disrupt legitimate owners, but a number of  
            communities are experiencing a real concentration of these  
            [massage] parlors."
                
            3)The profession of massage therapy  .  Massage therapists treat  
            clients by using touch to manipulate the soft-tissue muscles  
            of the body. Massage therapy may be used to relieve pain,  
            rehabilitate injuries, reduce stress, increase relaxation, and  
            aid in the general wellness of clients.  In 2010, massage  
            therapists held approximately 153,700 jobs nationally and the  








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            massage therapy profession is continuing to grow.  Massage  
            therapists work in a variety of settings, such as private  
            offices, spas, hospitals, fitness centers, and shopping malls.  
             

            SB 731 (Oropeza), Chapter 384, Statutes of 2008, established  
            the voluntary statewide certification of massage therapists by  
            the Massage Therapy Organization (MTO), which was renamed the  
            CAMTC in 2011.  The goal of the CAMTC is to standardize the  
            process of certification throughout the state.  The  
            certification allows for massage professionals to work in  
            multiple California locations without the need for multiple  
            permits or fees.

            Massage professionals can obtain one of two certification  
            levels: Certified Massage Practitioners (CMPs) are required to  
            complete at least 250 hours of education and training, while  
            Certified Massage Therapists (CMTs) are required to complete  
            at least 500 hours of massage education and training at an  
            approved massage therapy school, or complete 250 hours of  
            education and training and pass an examination.  CMPs and CMTs  
            must also undergo background checks, including fingerprinting  
            and other identification verification procedures.  The CMP and  
            CMT licenses are renewed biannually and licensees are not  
            required to obtain continuing education in order to renew a  
            license.  Titles commonly used in California by the massage  
            profession may include:  massage therapist, massage  
            practitioner, certified massage therapist, massage technician,  
            bodyworker, masseur, and masseuse.  However, current law makes  
            it an unfair business practice for anyone not certified by  
            CAMTC to use the titles CMP or CMT.

            Currently, applicants for certification as a CMT must pass an  
            examination which is administered by the National  
            Certification Board for Therapeutic Massage and Bodywork  
            (NCBTMB).  The NCBTMB is a nationally recognized entity which  
            certifies massage therapists and bodyworkers on behalf of the  
            profession.  NCBTMB developed and administers the National  
            Certification Examination for Therapeutic Massage and  
            Bodywork.

            This bill would require both CMT and CMP applicants to pass an  
            examination, and CMT applicants would now need to complete 500  
            hours of education in order to be certified.       









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           4)California Massage Therapy Council  .  The CAMTC was created to  
            implement a statewide certification process with clear  
            standards of preparation and education.  The provisions  
            related to regulation of massage therapy and CAMTC will sunset  
            on January 1, 2015.  

          The CAMTC is led by a volunteer Board of Directors comprised of  
            professionals from California's massage community, including  
            massage associations, schools, and businesses.  Two  
            representatives are selected by each professional society,  
            association or other entity whose membership is comprised of  
            massage therapists and that choose to participate in the  
            CAMTC.  One member is selected by each statewide association  
            of private postsecondary schools incorporated on or after  
            January 1, 2010 whose member schools have had 1000 graduates  
            in each of the previous three years.  Additionally, the League  
            of Cities, California State Association of Counties, Director  
            of the Department Consumer Affairs, and the Chancellor of the  
            California Community Colleges may appoint a member to the  
            CAMTC board if they choose.  Currently, the CAMTC is comprised  
            of 20 members.  
             
             While CAMTC does not accredit or approve schools, it does have  
            the responsibility to determine if the curriculum of schools  
            meets the legal requirements for applicants to obtain  
            certification.  Schools must either be nationally accredited  
            or approved by the California Bureau for Private Postsecondary  
            Education (BPPE) or a California community college.    The  
            CAMTC regulates approximately 38,000 certified CMPs and CMTs.

            If a certificate holder violates the terms of certification,  
            CAMTC can suspend or revoke their certification, but it has no  
            "cite and fine" authority.  The CAMTC may deny, discipline or  
            revoke the certification of a CMP or CMT for a variety of  
            reasons, including: failure to obtain a clear fingerprint  
            check; reports of unprofessional conduct in another state; any  
            attempt to obtain a certificate through misrepresentation or  
            fraud; or, committing any act punishable as a sexually-related  
            crime.  All of the relative disciplinary procedures are  
            carried out by an employee of the CAMTC known as the Division  
            Director of Professional Standards.  Since 2010, there have  
            been approximately 130 certificate suspensions or revocations.
             
          5)City ordinances regulating massage therapy  .  As provided by SB  
            731, cities and counties may enact ordinances related to the  








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            operation of a massage business including, but not limited to,  
            requiring evidence for review by local authorities  
            demonstrating that persons providing massage therapy services  
            are certified, charging specified licensing fees, and filling  
            out an application that provides relevant information about  
            the business.  However, cities and counties may not enact  
            ordinances related to land use regulations, permits or zoning  
            requirements specifically for massage businesses if those same  
            requirements are not uniformly applied to all other businesses  
            providing professional services.  Additionally, local cities  
            and counties cannot require any other specified permit or  
            requirement other than for reasonable health and safety  
            requirements.  The original intent behind these restrictions  
            was to prevent discrimination against legitimate massage  
            businesses.  

            Under current law, the power of cities and counties to  
            regulate massage businesses depends on the certification  
            status of the owner and the individuals working in the  
            business.  If a business chooses not to hire CMTs or CMPs, or  
            if the owner is not certified, then a city or county ordinance  
            may condition the issuance of a license upon proof that the  
            business meets reasonable standards, such as minimum age,  
            education and experience of personnel; passage of a practice  
            examination of competence by massage personnel; sanitary  
            conditions for the establishment; hours of operation; a  
            prohibition on the sale or serving of food or beverages; and a  
            prohibition on conducting non-massage-related business on the  
            premises.  

            AB 1147 would expand the ability of cities and counties to  
            regulate massage businesses by explicitly making their  
            certification revocable.  An application for the revocable  
            certification could include: a request for the full name and  
            address of the business and the legal name and mailing address  
            of the owners, a copy or other evidence of certification for  
            each person providing massage services, a statement that the  
            business will only employ certified individuals, and a  
            statement that an applicant for certification will provide  
            notification of any changes to the original application.  This  
            bill also allows a city or county to charge an application fee  
            for a background check if the owner of a business is not  
            certified.  Additionally, AB 1147 provides local governments  
            with the option to revoke, suspend, impose conditions upon or  
            otherwise act against the certification for violations.  








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           6)Recent issues in the news  .  Recent news stories have  
            highlighted the concern in some communities about a rise in  
            the number of massage businesses, as well as the fear that  
            some of those businesses are operating as a front for  
            prostitution or other illegal activities.  

          A news story by the independent public television station in Los  
            Angeles KCET, reported on March 25, 2013: "In case you haven't  
            noticed, massage parlors are springing up all over Southern  
            California, maybe even in your neighborhood.  They seem to be  
            everywhere-from Simi Valley to Beverly Hills.  Huntington  
            Beach has seen a 600% increase in just three years.  Some  
            blame a new state law for rules that allow this to growing  
            industry to regulate itself."  

          According to the Bureau of Labor Statistics, the employment of  
            massage therapists is expected to increase by 20% nationwide  
            between 2010 and 2020.  

           7)Arguments in support  .  The American Massage Therapy  
            Association-California Chapter writes in support, "We  
            recognize cities must have the tools necessary to regulate  
            massage establishments effectively to reach our mutual goals  
            of eradicating human trafficking and have a healthy massage  
            industry in each city.  To meet this end, we support the  
            changes in [this bill] which will allow cities to provide a  
            revocable certification of registration to [CMTs and CMPs].  
            This will go a long way in providing cities another tool to  
            keep bad actors from the massage industry and ensure consumer  
            protection." 

           8)Arguments in opposition  .  The League of California Cities is  
            opposed unless amended and writes in opposition, "While cities  
            have seen some benefits as a result of the 2008 [SB 731  
            Oropeza] legislation, there have been some unintended  
            consequences and issues that need to be addressed.   
            Illegitimate businesses have found ways to work within the  
            confines of SB 731 by requiring one or two persons in their  
            establishment to have a certification (as a cost of doing  
            business) because they know they cannot be regulated if they  
            are CAMTC certified.  If law enforcement enters an  
            establishment that is CAMTC certified, only the massage  
            therapists are required to have certification."









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           9)Questions for the Committee  .  The Committee may wish to  
            inquire of the author and interested parties as to whether or  
            not there are any available data that can evidence the extent  
            of nuisance or illegality caused by massage businesses in  
            California. 

          Furthermore, to the extent that advocates for local government  
            contend that cities and counties should have expanded  
            authority to specifically regulate other elements of massage  
            businesses, such as the density or total number of businesses  
            in a geographic area, the Committee may wish to discuss how  
            best to balance local governments' need for greater control  
            over potentially unscrupulous businesses against the rights of  
            legitimate massage businesses to practice their profession  
            without undue restriction.  
           
           10)Technical amendment  .  The Committee recommends a technical  
            amendment to revise a deleted section related to coursework  
            requirements for CMT certification.  

               On Page 4, line 1, after "schools." insert:

               "Included in the 250 hours from approved schools shall be  
               instruction addressing anatomy and physiology,  
               contraindications, health and hygiene, and business and  
               ethics, with at least 100 hours of the required minimum 250  
               hours from approved schools devoted to these curriculum  
               areas."  

           11)Previous legislation  .  AB 619 (Halderman), Chapter 162,  
            Statutes of 2011, changed the name of the MTO to the CAMTC and  
            makes a number of clarifying, conforming and technical changes  
            to the Massage Therapy Act.

            SB 1238 (Price), Chapter 655, Statutes of 2012, made a number  
            of substantive, clarifying, conforming and technical changes  
            regarding the approval of school credit hours and examination  
            and training requirements for purposes of certification; the  
            grounds for suspension, denial or revocation of certification  
            of the certificate holder; the sharing of information between  
            local law enforcement and the CAMTC; the responsibility of  
            owner/operators of massage businesses for conduct of employees  
            or their independent contractors and background checks of  
            owner/operators; and the ability for cities to restrict the  
            operation of massage businesses involved in prior criminal  








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            activity.

            SB 285 (Correa) Chapter 149, Statutes of 2011, provided that  
            any person who provides a certificate, diploma or other  
            document, or otherwise affirms that a person has received  
            instruction in massage therapy, knowing that the person has  
            not received such training, is guilty of a misdemeanor,  
            punishable by a fine of $2,500, or imprisonment in county jail  
            for up to one year, or both.  

            AB 1822 (Swanson) of 2010, would have added two additional  
            members to the MTO's board of directors, each one selected by  
            the California Police Chiefs Association and the California  
            State Sheriffs' Association, respectively, unless those  
            entities choose not to do so.  AB 1822 was vetoed by the  
            Governor. 

            SB 731 (Oropeza) Chapter 384, Statutes of 2008, created the  
            MTO and provided for the voluntary certification of massage  
            therapists and massage practitioners by the MTO.

            SB 412 (Figueroa) of 2005 would have established the MTO and  
            would have provided for the certification of massage therapist  
            and massage practitioners by the MTO.  SB 412 was held on the  
            Assembly floor.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          American Massage Therapy-Association
          California Massage Therapy Council
                    One private individual

           Opposition 
           
          City of Huntington Beach
          City of Thousand Oaks
          League of California Cities
           
          Analysis Prepared by  :    Elissa Silva / B.,P. & C.P. / (916)  
          319-3301 











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