BILL ANALYSIS                                                                                                                                                                                                    �



                                                                AB 1147
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        (  Without Reference to File  )

        CONCURRENCE IN SENATE AMENDMENTS
        AB 1147 (Bonilla, et al.)
        As Amended  August 22, 2014
        Majority vote
         
         ---------------------------------------------------------------------- 
        |ASSEMBLY: |68-1 |(January 27,    |SENATE: |34-0 |(August 26, 2014)    |
        |          |     |2014)           |        |     |                     |
         ---------------------------------------------------------------------- 
         

         ------------------------------------------------------------------------ 
        |COMMITTEE VOTE:  |12-1 |(August 28, 2014)   |RECOMMENDATION: |concur    |
        |(B., P. & C.P.)  |     |                    |                |          |
         ------------------------------------------------------------------------ 

        Original Committee Reference:    B., P. & C.P.  

         SUMMARY  :  Substantially revises existing law regulating certified  
        massage therapy professionals, including the deletion of the  
        preemption of local massage-related ordinances as they relate to  
        land use, a two-year extension of the sunset date of the California  
        Massage Therapy Council (CAMTC) which regulates certified massage  
        therapists, reconstitution of CAMTC's board of directors (Board),  
        the increase of educational standards for certified massage  
        professionals, and the creation of new protections for consumers of  
        massage services.   

         The Senate amendments  delete the Assembly version of this bill, and  
        instead:

        1)Clarify that a city or county may not prevent an individual  
          licensed or otherwise authorized under the Business and  
          Professions Code from engaging in their regulated profession.

        2)Establish the Massage Therapy Act (Act).

        3)Define the terms "approved school," "certificate,"  
          "compensation," "Council," "massage," "massage practitioner,"  
          "massage therapist," as specified.  

        4)Define a "massage establishment" or "establishment" to mean " a  
          fixed location where massage is performed for compensation,  








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          excluding those locations where massage is only provided on an  
          out-call basis."

        5)Define a "sole provider" to mean "a massage business where the  
          owner owns 100% of the business, is the only person who provides  
          massage services for compensation for that business pursuant to a  
          valid and active certificate, as specified, and has no other  
          employees."

        6)Establish CAMTC to carry out the responsibilities and duties of  
          the Act, and authorize CAMTC to develop rules and bylaws in  
          addition to policies and procedures to carry out the duties of  
          the Act. 

        7)Authorize CAMTC to require background checks for all employees,  
          contractors, volunteers, and board members as a condition of  
          their employment, formation of a contractual relationship, or  
          participation in CAMTC activities.

        8)Authorize CAMTC to determine whether information provided to them  
          in relation to certification of an applicant is true and correct  
          and meets the specified requirements, and if CAMTC has any reason  
          to question whether the information provided is true or correct  
          or meets the specified requirements, CAMTC may make any  
          investigation it deems necessary to establish that the  
          information received is accurate and specifies that the applicant  
          has the burden to prove that he or she is entitled to  
          certification.

        9)Repeal the authority, structure and composition of CAMTC's Board  
          on September 15, 2015.

        10)Specify that the terms of 13 new members of the Board will begin  
          on September 15, 2015, with new Board members, each of whom shall  
          serve a term of four years, being chosen in the following manner:

           a)   One member shall be a representative of the League of  
             California Cities;

           b)   One member shall be a representative of the California  
             Police Chiefs Association;

           c)   One member shall be a representative of the California  
             State Association of Counties;









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           d)   One member shall be a representative of an anti-human  
             trafficking organization, to be determined by CAMTC;

           e)   One member shall be appointed by the Office of the  
             Chancellor of the Community Colleges.

           f)   One public member shall be appointed by the director of  
             Department of Consumer Affairs;

           g)   One member appointed by the California Association of  
             Private Postsecondary Schools;

           h)   One member shall be appointed by the American Massage  
             Therapy Association, California Chapter, who is a  
             California-certified massage therapist or practitioner, is a  
             California resident, and has been practicing massage for at  
             least three years;

           i)   One member shall be a public health official representing a  
             city, county or city and county health department;

           j)   One member who shall be a certified massage therapist (CMT)  
             or a certified massage practitioner (CMP) who is a California  
             resident who has practiced massage for at least three years  
             prior to the appointment, selected by a professional society,  
             association, or other entity, as specified;

           aa)  Three additional members appointed by the Board at a duly  
             held Board meeting in accordance with the Board's bylaws, one  
             of whom shall be an attorney who represents a city in the  
             state, and one of whom shall represent a massage business  
             entity that has been operating in the state for at least three  
             years, as specified.

        11)Require the Board to establish fees reasonably related to the  
          cost of providing services and carrying out its ongoing  
          responsibilities and duties, as specified. 

        12)Provide that the fee for certification or renewal may be no  
          higher than $300.

        13)Authorize the Board to adopt additional policies and procedures  
          that provide greater transparency to certificate holders and the  
          public than required by the Bagley-Keene Open Meeting Act.









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        14)State that prior to holding a meeting to vote upon a proposal to  
          increase the certification fees, CAMTC shall provide at least 90  
          days' notice of the meeting, as specified, and require CAMTC to  
          update its Internet Web site and notify all certificate holders  
          and affected applicants by email within 14 days if CAMTC  
          increases certification fees.

        15)State that the protection of the public is the highest priority  
          for CAMTC in exercising its certification and disciplinary  
          authority, and any other functions, and whenever the protection  
          of the public is inconsistent with other interests sought to be  
          promoted, the protection of the public is paramount.

        16)Revise and recast the educational requirements for certification  
          to require all applicants to complete curricula in massage and  
          related subjects totaling a minimum of 500 hours from CAMTC  
          approved schools, and specify that of those 500 hours, a minimum  
          of 100 hours must address anatomy and physiology,  
          contraindications, health and hygiene, and business ethics.

        17)Require all applicants for certification to take and pass a  
          massage and bodywork competency assessment and examination, as  
          specified.

        18)Require an applicant for certification to successfully pass a  
          background investigation, as specified, and pay the required  
          fees.

        19)Permit CAMTC to issue a certificate to an applicant who meets  
          specified qualifications, if the applicant holds a valid  
          registration, certification, or license from any other state  
          whose licensure requirements meet or exceed those established by  
          the Act, as specified.

        20)Require a certificate holder to surrender his or her certificate  
          and any identification card issued by CAMTC if his or her  
          certificate is suspended or revoked by CAMTC. 

        21)Prohibit CAMTC from accepting applications to practice as a CMP  
          on or after January 1, 2015, clarifies that applications accepted  
          prior to January 1, 2015, to practice as a CMP may be renewed  
          without any additional educational requirements, and permits a  
          person who was issued a conditional certificate to practice as a  
          massage practitioner, as specified.









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        22)Provide that a certificate issued by CAMTC is subject to renewal  
          every two years, and authorizes CAMTC to provide for the late  
          renewal of a certificate or registration. 

        23)Require CAMTC, prior to issuing a certificate to an applicant or  
          designating a custodian of records, to require the applicant or  
          custodian of records to submit fingerprint images, as specified.

        24)Establish the process for obtaining the record of state and  
          federal level convictions and of state and federal level arrests,  
          as specified.

        25)Permit CAMTC to receive arrest notifications and other  
          background material about applicants and certificate holders from  
          a city, county, or city and county.

        26)Specify that CAMTC may discipline an owner or operator of a  
          massage business or establishment who is certified by CAMTC for  
          the conduct of all individuals providing massage for compensation  
          on the business premises. 

        27)Require a certificate holder to:

           a)   Display his or her original certificate wherever he or she  
             provides massage for compensation and have his or her  
             identification card in his or her possession while providing  
             massage for compensation;

           b)   Provide his or her full name and certificate number upon  
             request at the location where he or she is providing massage  
             for compensation; 

           c)   Include the name under which he or she is certified and his  
             or her certificate number in any and all advertising of  
             massage for compensation; and, 

           d)   Notify CAMTC of his or her primary email address, if any,  
             and notify CAMTC within 30 days of a change of the primary  
             email address, except as specified.

        28)Expand the definition of unprofessional conduct to include:

           a)   Engaging in sexually suggestive advertising;

           b)   Engaging in any form of sexual activity on the premises of  








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             a massage establishment where massage is provided for  
             compensation, excluding a residence;

           c)   Engaging in sexual activity while providing massage  
             services for compensation;

           d)   Practicing massage on a suspended certificate or practicing  
             outside of the conditions of a restricted certificate;

           e)   Providing massage of the genitals or anal region;

           f)   Providing massage of female breasts without the written  
             consent of the person receiving the massage and a referral  
             from a licensed California health care provider;

           g)   Procuring or attempting to procure a certificate by fraud,  
             misrepresentation, or mistake;

           h)   Failing to fully disclose all information requested on the  
             application; and,

           i)   Dressing while engaged in the practice of massage for  
             compensation, or while visible to clients, in a massage  
             establishment in any of the following:

             i)     Attire that is transparent or see-through, or that  
               substantially exposes the certificate holder's  
               undergarments;

             ii)    Swim attire, if not providing a water-based massage  
               modality approved by CAMTC;

             iii)   In a manner that exposes the certificate holder's  
               breasts, buttocks, or genitals;

             iv)    In a manner that constitutes a violation of the Penal  
               Code, as specified; or,

             v)     In a manner that is otherwise deemed by CAMTC to  
               constitute unprofessional attire based on the custom and  
               practice of the profession in California.

        29)Permit CAMTC to deny an application for a certificate for the  
          commission of any specified criminal acts.









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        30)Enhance CAMTC's authority to discipline a certificate holder to  
          include the imposition of probation, which may include  
          limitations or conditions on practice.

        31)Require CAMTC to deny an application for a certificate, or  
          revoke the certificate of a certificate holder, if the individual  
          is required to register as a sex offender, as specified.

        32)State that any denial or discipline must be decided upon and  
          imposed in good faith and in a fair and reasonable manner, and  
          that any procedure that conforms to specified requirements is  
          fair and reasonable, but a court may also find other procedures  
          to be fair and reasonable.

        33)Specify that a procedure is fair and reasonable if specified  
          procedures are followed or if all of the following apply:

           a)   Denial or discipline is based on a preponderance of the  
             evidence;

           b)   The provisions of the procedure are publically available on  
             CAMTC's Internet Web site; 

           c)   CAMTC provides 15 calendar days prior notice of the denial  
             or discipline and the reasons for the denial or discipline;  
             and,

           d)   CAMTC provides an opportunity for the applicant or  
             certificate holder to be heard, orally or in writing, as  
             specified.

        34)Require CAMTC, upon receiving notice that a certificate holder  
          has been arrested and charges have been filed, to:

           a)   Notify the certificate holder, at the address last filed  
             with CAMTC, that the certificate has been suspended and the  
             reason for the suspension within 10 business days;

           b)   Provide notification of the suspension by email to the  
             clerk or other designated contact of the city, county or city  
             and county in which the certificate holder lives or works,  
             pursuant to CAMTC's records within 10 business days; and,

           c)   Provide notification of the suspension by email, to any  
             establishment or employer, whether public or private, that  








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             CAMTC has in its records as employing the certificate holder,  
             within 10 business days.

        35)Permit an applicant or certificate holder to challenge a denial  
          or discipline decision, as specified.

        36)Provide the procedures and process for CAMTC to immediately  
          suspend the certificate of a certificate holder, if CAMTC  
          determines that a certificate holder committed any act punishable  
          as a sexually related crime or a felony that is substantially  
          related to the qualifications, functions or duties of a  
          certificate holder, as specified.

        37)Prohibit a city, county, or city and country from enacting an  
          ordinance that conflicts with the provisions of this Act or  
          specified provisions of the Government Code.  
         
        38)Clarify that nothing shall prevent a city, county, or city and  
          county from licensing, regulating, prohibiting, or issuing a  
          permit to an individual who provides massage for compensation  
          without a valid certificate.

        39)Require CAMTC, upon the request of any law enforcement agency or  
          any other representative of a local government agency with  
          responsibility for regulating or administering a local ordinance  
          relating to massage, to provide information concerning an  
          applicant or certificate holder, as specified.

        40)Require CAMTC to accept information provided by any law  
          enforcement agency or any other representative of a local  
          government agency with responsibility for regulating or  
          administering a local ordinance relating to massage and review  
          that information in a timely manner, and clarifies that CAMTC has  
          the responsibility to take any actions that are authorized or  
          warranted, as specified.

        41)State that upon request of CAMTC, any law enforcement agency or  
          any other representative of a local government agency with  
          responsibility for regulating or administering a local ordinance  
          relating to massage or massage establishments is authorized to  
          provide information to CAMTC concerning an applicant or  
          certificate holder, as specified.

        42)Require CAMTC to determine whether the school from which an  
          applicant has obtained his or her education meets applicable  








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          requirements, as specified, and require CAMTC to investigate the  
          facts prior to issuing a certificate, including oral interviews  
          or any other investigation deemed necessary to receive factual  
          information, as specified. 

        43)Require CAMTC to develop policies, procedures, rules or bylaws  
          governing the requirement and process for the approval and  
          unapproval of schools including any corrective action required to  
          return a school to approved status, as specified.

        44)Authorize CAMTC to approve and unapprove schools and specify  
          corrective action in keeping with the purposes of protecting the  
          public, as specified.

        45)Authorize CAMTC to charge a reasonable fee for the inspection or  
          approval of schools, provided the fees do not exceed the  
          reasonable cost of the inspection or approval process.

        46)Provide that CAMTC may only be sued in the county of its  
          principal office, which is Sacramento, unless otherwise  
          designated by CAMTC. 

        47)State that the superior court of a county or competent  
          jurisdiction may, upon petition by any person, issue an  
          injunction or any other relief the court deems appropriate for a  
          violation, as specified.

        48)State that the provisions of this chapter are severable.

        49)Require CAMTC, on or before June 1, 2016, to provide a report to  
          the Legislature for the time period beginning January 1, 2015,  
          that addresses all of the following topics:

           a)   A feasibility study of licensure for the massage  
             profession, including a proposed scope of practice, legitimate  
             techniques of massage, and related statutory recommendations;

           b)   CAMTC's compensation guidelines and current salary levels;

           c)   The status of CAMTC's progress towards revising the school  
             approval process; and,

           d)   Performance metrics, including, but not limited to, total  
             application denials, discipline against certificates,  
             inspections of schools, and complaints, as specified. 








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        50)Extend the sunset date of CAMTC by two years, until January 1,  
          2017, and subject CAMTC to review by the appropriate policy  
          committees of the Legislature.

        51)Prohibit a city, county, or city and county from doing any of  
          the following:

           a)   Defining a massage establishment as an adult entertainment  
             business, or otherwise regulating a massage establishment as  
             adult entertainment;

           b)   Requiring a massage establishment to have windows or walls  
             that do not extend from the floor to the ceiling, or have  
             other internal physical structures including windows, that  
             interfere with a client's reasonable expectation of privacy;

           c)   Imposing client draping requirements that extend beyond the  
             covering of genitalia and female breasts, or otherwise require  
             that the client wear special clothing;

           d)   Prohibiting a massage establishment from locking its  
             external doors when there is only one individual working on  
             the premise as specified;

           e)   Require a massage establishment to post any notice in an  
             area that may be viewed by clients that contains explicit  
             language describing sexual acts, mentions genitalia, or  
             contraception devices;

           f)   Impose a requirement that a certificate holder take or pass  
             any test, medical examination or background check, or comply  
             with educational requirements beyond what is required;

           g)   Impose a dress code requirement in excess of that already  
             required of certificate holders;

           h)   Impose a requirement that an individual holding a  
             certificate issued in accordance with the Act obtain any other  
             license, permit, certificate, or other authorization to  
             provide massage for compensation; provided, however, that a  
             city, county, or city and county is not prohibited from  
             requiring by ordinance that a massage business or  
             establishment obtain a license, permit, certificate or  
             authorization in order to operate lawfully within a  








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             jurisdiction; and, 

           i)   Prohibit an individual holding a certificate from  
             performing massage for compensation on the gluteal muscles,  
             prohibit specific massage techniques, recognized by CAMTC as  
             legitimate, or impose any other restriction on the practice of  
             massage beyond what is specified under the provisions of the  
             Act.

        52)State that is the intent of the Legislature that land use  
          authority be returned to local governments while professional  
          regulation remains the province of CAMTC and the state, and that  
          fees and regulations imposed by local governments on massage  
          businesses and establishments be necessary and reasonable. 

        53)State that the Legislature finds and declares that the  
          regulation of the profession of massage therapy is a matter of  
          statewide concern and not a municipal affair, and that this Act  
          applies to all cities, counties, and cities and counties,  
          including charter cities and charter counties.

        54)Make numerous other technical and clarifying changes to the Act.  


         FISCAL EFFECT  :  According to the Senate Appropriations Committee,  
        pursuant to Senate Rule 28.8, negligible state costs. 

         COMMENTS  :   

        1)Purpose of the bill.  This bill substantially revises the  
          existing massage therapy law, incorporating changes which were  
          recommended as a result of the 2014 sunset review process.  This  
          bill would revise, recast, and update multiple provisions of  
          current law to give local governments greater authority to  
          regulate massage establishments and businesses while creating a  
          more robust statewide regulatory system for massage  
          professionals.  Among its major provisions, this bill would  
          return land use authority over massage establishments and  
          businesses to cities and counties; reconstitute CAMTC's governing  
          Board and enhance its disciplinary authority; raise professional  
          standards for massage professionals; and create new  
          consumer-oriented protections for individuals seeking massage  
          services.  This bill is intended to address the concerns raised  
          by local governments battling illegal businesses engaged in  
                                                                                     prostitution and human trafficking while protecting the  








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          legitimate massage therapy profession.  This bill is  
          author-sponsored.   

         2)Authors' statement.  According to Assembly Member Bonilla, "in an  
          effort to enhance consumer protection and local control, this  
          bill makes major changes to the current regulatory system for  
          massage therapy.  AB 1147 will restore the ability of cities to  
          better control massage establishments while raising certification  
          standards and creating a stronger regulatory system for massage  
          professionals.  It will also reconstitute the Board of the  
          California Massage Therapy Counsel to make it more inclusive by  
          incorporating a broader range of stakeholders who care about the  
          massage industry in California, including a city attorney and a  
          member of an anti-human trafficking organization.  It also  
          clarifies the rights of the profession, and sets out certain  
          protections for consumers of massage.  

          "Unfortunately, the current massage therapy law (SB 731  
          (Oropeza), Chapter 384, Statutes of 2008) had serious unintended  
          consequences; with bad actors masquerading as legitimate massage  
          professionals exploiting loopholes in current law to insulate  
          themselves against the ability of local governments and law  
          enforcement to shut them down.  This bill will give that power  
          back to the cities and counties, which will go a long way towards  
          eliminating the brothel owners and human traffickers who are  
          hurting women, hurting neighborhoods, hurting the profession, and  
          hurting California." 

          Assembly Member Gomez writes, "It's time we take back control of  
          our neighborhoods with this reform measure.  Legitimate massage  
          therapists have a role in our communities.  But the current law  
          has allowed criminal elements to hide behind the law and disrupt  
          our communities.  The most critical piece of the reform measure  
          is that the bill will return land use authority to cities and  
          counties.  The broad pre-emption of local land use authority for  
          'certified-only' massage professionals has been removed,  
          returning local land use control back to the cities and counties.  
           Now our communities will once again have a voice in the  
          process."

          Assembly Member Holden writes, "This bill frees cities and law  
          enforcement to do what they do best: guard the best interests of  
          its citizens and resident businesses and protect their community  
          from criminals.  This bill allows good massage therapists to be  
          recognized and bad actors to be put out of business.  AB 1147  








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          removes the most detrimental parts of the law and ensures that  
          control over planning of our communities is handed back to the  
          people, not business owners with bad intentions."

        3)The profession of massage therapy.  Massage professionals treat  
          clients by using touch to manipulate the soft-tissue and muscles  
          of the body.  Massage therapy is a healing art used to relieve  
          pain, rehabilitate injuries, reduce stress, increase relaxation,  
          and increase the general wellness of clients.  Massage  
          professionals work in a variety of settings, including private  
          offices, spas, hospitals, fitness centers and shopping malls.   
          According to the Bureau of Labor Statistics, employment of  
          massage professionals is projected to grow 23% from 2012 to 2022,  
          much faster than the average for all occupations.   

          Titles commonly used in California by the massage profession may  
          include:  massage therapist, massage practitioner, CMT, CMP,  
          massage technician, bodyworker, masseur, and masseuse.  Current  
          law makes it an unfair business practice for anyone not certified  
          by CAMTC to use the title of CMP or CMT.

        4)Regulation of massage therapy.  SB 731 established a system for  
          the voluntary statewide certification of massage professionals by  
          a Massage Therapy Organization, which was renamed CAMTC in 2011.   
          The goal of establishing what would become CAMTC was to  
          standardize the process for certification throughout the state.   
          Certification allows massage professionals to work in multiple  
          California locations without the need for duplicative local  
          certifications.  CAMTC is led by a volunteer Board comprised of  
          professionals from California's massage community, including  
          massage associations, schools, and businesses.  CAMTC's authority  
          in statute is set to expire on January 1, 2015, unless that  
          authority is extended by legislative action.    

           Currently, massage professionals in California can obtain one of  
          two certification levels: CMPs are required to complete at least  
          250 hours of education and training, while CMTs are required to  
          complete at least 500 hours of massage education and training 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 certificates are renewed biannually,  
          and certificate holders are not required to obtain continuing  
          education.  Of the 250 hours of educational requirements for  
          CMPs, 100 hours must be in the instruction of anatomy,  








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          physiology, contraindications, health and hygiene, and business  
          ethics.  The current law permitting the certification of CMPs is  
          scheduled to be repealed on December 31, 2015.  CAMTC regulates  
          over 45,000 CMPs and CMTs in California.   
           
        5)CAMTC's Board of Directors (Board).  The current Board is largely  
          comprised of professionals from California's massage community,  
          including massage associations, schools, and businesses.  CAMTC's  
          bylaws provide for a total of 20 members, although it has only 19  
          members at the moment.  In addition to the power to issue  
          certificates, CAMTC also has the authority to discipline  
          certificate holders and unapprove massage schools.   

           a)   Discipline.  If a certificate holder violates the terms of  
             certification, CAMTC may suspend or revoke his or her  
             certification, but it cannot exercise cite and fine authority.  
              CAMTC may deny, revoke or impose probationary conditions on  
             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  
             CAMTC's Division of Professional Standards.  According to  
             CAMTC, there have been approximately 248 certificate  
             suspensions or revocations since 2010.
            
           b)   Schools.  While CAMTC does not accredit or affirmatively  
             approve massage schools, it does have the responsibility to  
             determine if the curriculum of a school meets the legal  
             requirements for applicants to obtain CAMTC certification.  In  
             practice, this means that schools are generally treated as  
             approved unless and until CAMTC takes action to "unapproved"  
             them.  Schools must meet certain requirements such as be  
             nationally accredited, approved by the California Bureau for  
             Private Postsecondary Education (BPPE), be a public  
             institution, or a California community college in order to be  
             approved for CAMTC's purposes.

        6)Oversight hearings and sunset review.  In March and April of  
          2014, the Assembly Business, Professions and Consumer Protection  
          (BPCP) Committee and the Senate Business, Professions and  
          Economic Development (BPED) Committee conducted joint oversight  
          hearings to review nine regulatory entities, including CAMTC.   
          The BPCP and BPED Committees began their review of these entities  








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          over three days of public hearings in March.  This bill, like  
          other sunset bills, is intended to implement the legislative  
          changes recommended in the background reports authored by the  
          Senate BPED and Assembly BPCP Committees.

        7)Issues raised during CAMTC's sunset review.  This was the first  
          sunset review for CAMTC, which highlighted numerous issues about  
          the operations of the organization and the impact of the massage  
          therapy law - particularly its land use preemption provisions -  
          on local governments.  This bill represents an effort to address  
          concerns raised by the BPCP and BPED Committees, massage  
          professionals, local governments, and other interested parties.   
          The major provisions of this bill reflect those issues raised  
          during the sunset review process, of which many are noted in the  
          BPCP sunset review report.   

           a)   Limitations on fees.  Under current law, the Board is  
             permitted to establish fees reasonably related to the cost of  
             providing services and carrying out its ongoing duties and  
             responsibilities, including fees for certification and  
             recertification.  Currently, the Board is required, under its  
             bylaws, to assess the certification and recertification fees  
             annually.  Although the certification and recertification fees  
             have not been raised since the inception of CAMTC, the BPCP  
             Committee recommended capping the fees in statute to ensure  
             greater certainty for massage professionals in the future.   
             The fee cap established in this bill will allow the Board to  
             raise fees up to $300, if an annual assessment by the Board  
             determines an increase of the fees, as authorized by CAMTC's  
             bylaws, is warranted.  Additional prior notice provisions for  
             fee increases were incorporated as well. 

           b)   Certification tiers.  The legislation that authorized CAMTC  
             also created the two-tier certification system (CMT and CMP)  
             in order to provide a pathway to certification for many  
             massage professionals who had been practicing in California  
             prior to a statewide voluntary certification program.  In  
             order to raise the standards of the profession as a whole in  
             California, the BPCP sunset report recommended the elimination  
             of the lower certification tier, the CMP.   

           This bill will sunset the existing CMP certification tier for  
             new applicants, beginning January 1, 2015, instead of December  
             31, 2015, under current law, and will require all applicants  
             for CMT certification to obtain the required 500 hours of  








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             education from an approved school and pass an examination.   
              
              This bill would also revise the educational requirements for  
             the CMT certification by requiring applicants to complete all  
             of the 500 hours of required education from a school approved  
             by CAMTC, and specifies that 100 of the 500 hours required for  
             certification must be in the subjects of anatomy, physiology,  
             contraindications, health and hygiene, and business ethics.  

           c)   Certification revocation, suspension or denial.  According  
             to CAMTC's procedures for discipline, revocation, or denial, a  
             certificate may be denied or revoked for a wide variety of  
             reasons reasonably related to protecting public safety,  
             including failure to meet statutory requirements, violations  
             of law, and certain dishonest acts.   

             In order to increase public confidence that CAMTC certificate  
             holders are operating appropriately, this bill expands the  
             definition of unprofessional conduct to prohibit certain  
             behaviors and practices of concern to local governments.   
             Those new standards include engaging in sexually suggestive  
             advertising, engaging in any form of sexual activity on the  
             premises of a massage establishment, or practicing massage on  
             a suspended certificate or outside the of the conditions on a  
             restricted certificate.  These additions will improve CAMTC's  
             ability to discipline certificate holders who engage in  
             inappropriate or unprofessional behavior while providing  
             massage services. 

           d)   School approval.  The 2014 sunset review report raised the  
             issue of CAMTC's current "reactive" school approval process.   
             According to CAMTC, it currently does not proactively approve  
             schools, but rather "unapproves" a school if it finds that a  
             school does not meet the minimum standards for training and  
             curriculum or operates inappropriately.  Schools may be  
             unapproved for selling or offering to sell transcripts,  
             failing to require students to attend the classes listed on  
             the transcript, failure to require students to attend all of  
             the hours listed on the transcript, or engaging in fraudulent  
             practices.  

           While CAMTC may unapprove a school for a number of reasons, the  
             most common reason is transcript discrepancies, meaning the  
             transcript does not accurately reflect the education actually  
             received by the applicant.  In November of 2013, CAMTC  








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             reported that it had unapproved approximately 46 schools and  
             placed seven on its "inadequate education list," which means  
             that applicants who have taken courses at those schools must  
             submit additional proof of education beyond a transcript and  
             diploma.  
              
              The sunset review report recommended that CAMTC take proactive  
             steps to improve their current complaint-driven unapproval  
             process, and instead find a more proactive-based approval  
             process.  In response, this bill authorizes CAMTC to take an  
             affirmative role in establishing an approval process for  
             schools by requiring that CAMTC develop policies, procedures,  
             rules or bylaws governing the requirements and process for the  
             approval and unapproval of schools, including any corrective  
             action to return a school to approved status.  This bill also  
             provides CAMTC with explicit authority to establish a  
             reasonable fee for the inspection or approval of schools.  
         
            e)   Board composition.  CAMTC is led by a volunteer Board  
             primarily comprised of professionals from across California's  
             massage community, including massage associations, schools,  
             and businesses.  CAMTC currently has 19 members with one  
             vacancy.       

           In order to make the Board more responsive based on feedback  
             from stakeholders, the BPCP sunset review report recommended  
             that the number of board members be reduced to 15 or less,  
             that local government or local law enforcement representation  
             be increased, and a California residency requirement be  
             imposed.  This bill reconstitutes CAMTC's Board to reduce the  
             total number of authorized board members from 20 to 13,  
             increases the diversity of the Board by making the seats  
             available to a broader array of stakeholders, including public  
             health and anti-human trafficking advocates, and requires all  
             appointees to be residents of California.  
              
            f)   Increased accountability of CAMTC.  As a voluntary,  
             nonprofit organization CAMTC has discretion in many of its  
             administrative practices and procedures.  While this structure  
             is in place to provide the organization with the flexibility  
             it needs to fulfill its statutory mission while operating as  
             an independent non-profit entity, the BPCP sunset review  
             report highlighted a number of areas where administrative  
             accountability can be improved, including obtaining additional  
             customer service information from stakeholders, providing  








                                                                AB 1147
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             better enforcement data, enhancing communication with local  
             governments and law enforcement representatives, and sharing  
             salary data, contract awards and hiring standards.  

           To that end, this bill mandates expanded data sharing with law  
             enforcement and local governments, and requires CAMTC to  
             provide specified reports on the above-mentioned topics to the  
             appropriate policy committees of the Legislature beginning  
             January 1, 2016.   

           g)   Local control.  SB 731 was originally intended to provide  
             uniform standards for the education, training and background  
             investigations for massage practitioners to help  
             professionalize the massage industry in California.  Moreover,  
             it also attempted to create a brighter distinction between  
             legitimate massage professionals and the illegal sex trade by  
             creating a reliable certification system for professionals and  
             eliminating discriminatory business regulations on legitimate  
             healing arts professionals.  As many of the professionals  
             involved in massage therapy are sole practitioners who work  
             from their home, travel to a client's home or contract to work  
             at spas in various cities and counties, the concept of a  
             statewide certification program was designed to help alleviate  
             the need for duplicative certification standards which varied  
             from city to city.  From a consumer protection perspective, a  
             voluntary statewide certification meant that a "certified  
             professional" has meet educational, training and background  
             standards sufficient to give consumers some reassurance that  
             the massage professional providing services was properly  
             educated, trained and obtained the appropriate background  
             clearance.  
             Because the legitimate massage profession in California had  
             often been unfairly linked to illegal practices, particularly  
             prostitution and human trafficking, some cities and counties  
             established massage ordinances that appeared to presume that  
             massage professionals and clients may be engaging in  
             prostitution, which led to a host of problems for real massage  
             therapists, many of whom operate part-time or as sole  
             practitioners.  

             For example, the Riverside Municipal Code requires massage  
             professionals to wear special attire in an attempt to dissuade  
             potential prostitution, but also marking the profession as  
             suspect.  The Temecula Municipal Code requires massage  
             establishments to post a notice to patrons that "massage rooms  








                                                                AB 1147
                                                                Page  19

             do not provide complete privacy and are subject to inspection  
             by the Temecula Police Department without prior notice," which  
             is off-putting to some clients.  As another example, the  
             Westminster Municipal Code requires massage technician  
             applicants to complete a medical examination that tests for  
             the HIV Virus, Syphilis, Gonorrhea, Tuberculosis, and  
             Hepatitis 30 days prior to submitting an application as a  
             massage technician - tests which are required of no other  
             healing arts professional and imply a likelihood of engaging  
             in prostitution.  

             This bill attempts to balance local governments' real need to  
             regulate businesses throughout their jurisdictions with the  
             need to protect certificated massage professionals by giving  
             local governments back their land use authority to regulate  
             massage establishments and businesses while imposing  
             narrowly-tailored protections to ensure that the profession  
             will continue to be regulated consistently across the state.  

           h)   Practice protection for massage professionals.  Because  
             massage as a profession is not formally licensed by the state,  
             a voluntary certification was designed as a mechanism to  
             create uniform education and practice standards as opposed to  
             multiple, duplicative local ordinances which vary in the  
             requirements needed to practice massage.  The voluntary  
             certification allows massage professionals to work in multiple  
             jurisdictions without a need to obtain multiple costly city  
             licenses to practice.  

           However, as some local governments may have ordinances now or in  
             the future that could impinge on the practice rights of  
             certified massage professionals; this bill enumerates a number  
             of new protections for certificated individuals.  Local  
             governments will not be permitted to impose a requirement that  
             certified massage professionals be required to take any test,  
             medical examination, or background check, or otherwise comply  
             with any additional educational requirements beyond what is  
             already required.  Nor may a city or county impose a  
             requirement that certified massage professionals obtain any  
             other license, permit, certificate or authorization to provide  
             massage for compensation, excluding those normally required to  
             operate a business.  This bill also prohibits the imposition  
             of a dress code requirement in excess of what is already  
             considered unprofessional conduct by CAMTC, and protects  
             certified massage professionals from interference in their  








                                                                AB 1147
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             performance of legitimate massage techniques approved by  
             CAMTC.   

           i)   Continuation of CAMTC and a voluntary certification  
             program.  The 2014 sunset review report found overall that the  
             health, safety and welfare of consumers is protected through  
             the voluntary certification of massage professionals, which  
             ensures greater consistency and quality amongst professionals  
             while giving local governments the tools to more easily  
             identify trustworthy practitioners.  The current regulatory  
             system operated by CAMTC combines education, training, and  
             background standards into a systematic formal review process  
             whereby only those individuals who have met the standards can  
             represent themselves as massage professionals.    

             However, the BPCP sunset review report also found that CAMTC  
             faces many challenges in fulfilling its mission:  there is a  
             need for greater oversight of educational institutions; a need  
             for stronger administrative controls; questions regarding  
             proper board composition; and a strong desire from local  
             governments to regain their land use authority over  
             establishments using certified professionals. 

             If CAMTC were to be allowed to sunset, consumers would lose  
             any hope of making useful distinctions in quality between  
                                                                            massage practitioners, practitioners would be again subject to  
             a patchwork of licensing regimes, and local governments would  
             be forced to develop expensive new regulatory processes from  
             scratch.  

             In response, this bill provides for only two-year extension of  
             CAMTC's sunset date, which will maintain a voluntary  
             certification process for massage professionals while  
             simultaneously giving back to local governments the proper  
             authority they need to regulate massage businesses and  
             establishments.  CAMTC will need to be proactive in addressing  
             these underlying issues in order to fulfill its mandate and  
             earn the trust of its many stakeholders before its next sunset  
             review in 2016.  In order to provide more guidance in that  
             endeavor, this bill also clarifies CAMTC's mission by  
             specifying that the highest priority for CAMTC is the  
             protection of the public, and whenever other interests of  
             CAMTC conflict, the protection of the public shall be the  
             prevailing priority 
                








                                                               AB 1147
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         8)Practice rights for licensed, permitted or certificated  
          professions.  Under current law, a city or county is generally  
          restricted from prohibiting a person or group of persons  
          authorized by DCA via a license, certificate or other such means  
          to engage in a particular profession, from engaging in that  
          occupation, while allowing a city or county to adopt or enforce  
          any local ordinance governing zoning, business licensing, or  
          reasonable health and safety requirements.  This bill would put  
          CAMTC and its certificate holders under that protection as well,  
          while clarifying that local jurisdictions have full authority to  
          adopt local ordinances governing the zoning, business licensing,  
          and reasonable health and safety requirements of the individual  
          communities.  In this way, regulation of the profession and the  
          individuals practicing it remains the sole purview of the state  
          and CAMTC, but land use decision-making over massage  
          establishments and businesses returns to the local governments  
          themselves.  

        9)Prohibitions.  In an effort to standardize massage industry  
          practices while providing local jurisdictions with the ability to  
          properly regulate massage businesses and establishments, this  
          bill establishes a small number of narrow prohibitions on local  
          regulations that would be discriminatory against individual  
          professionals and massage businesses and establishments. It also  
          enacts changes protective of the massage consumer as well. 

          Those protections would prohibit local jurisdictions from  
          enacting ordinances which:  require massage businesses or  
          establishments to be zoned as adult entertainment; require an  
          establishment or business to have windows or short walls that  
          interfere with a consumers expectation of privacy; impose  
          unnecessary draping or covering requirements on consumers;  
          require a business with one employee from locking its door,  
          thereby jeopardizing employee and customer safety; or posting any  
          signs or any notice in a business that may be viewed by clients  
          that contains graphic language describing sexual acts, genitalia,  
          or contraceptives.  This bill also explicitly prohibits the  
          imposition of medical testing, duplicative education standards  
          and examinations, and dress code requirements on individuals who  
          are CAMTC certified.   
                
         10)Previous version.  As passed by the BPCP Committee on January  
          21, 2014, with a vote of 11-0, and the Assembly floor on January  
          27, 2014, with a vote of 68-1, this bill required an applicant  
          for certification as a massage practitioner to pass a massage and  








                                                                AB 1147
                                                                Page  22

          bodywork competency examination that meets specified standards  
          and is approved by CAMTC. 

        However, most of the provisions of this bill were completed and  
          amended into this bill while in the Senate, and the provisions  
          regarding the massage examination provision were deleted.  As a  
          result, the language of this bill in its current form has not yet  
          been heard in an Assembly Policy Committee.    

         
        Analysis Prepared by  :    Elissa Silva / B., P. & C.P. / (916)  
        319-3301 


                                                                FN: 0005565