Legislature(2017 - 2018)BARNES 124
02/17/2017 03:15 PM LABOR & COMMERCE
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HB 110-MASSAGE THERAPY LICENSING; EXEMPTIONS 3:17:56 PM CHAIR KITO announced that the only order of business would be HOUSE BILL NO. 110, "An Act relating to the practice of massage therapy; relating to the Board of Massage Therapists; and providing for an effective date." 3:18:18 PM CRYSTAL KOENEMAN, Staff, Representative Sam Kito, Alaska State Legislature, presented HB 110 on behalf of Representative Kito, prime sponsor. She stated that the bill would add language allowing the Board of Massage Therapists to adopt regulations governing massage therapy establishments. The proposed legislation would: increase the number of hours for in-class supervised instruction and clinical work at an approved massage school from 500 to 625 hours; reduce the number of hours of blood-borne pathogen education from four hours to two hours; and allow the board to issue exemptions from the licensing requirements for practitioners of certain professions who submit an application, pay a registration fee, and submit proof that they meet the exemptions. She noted that HB 110 does not extend any regulatory or statutory authority of other professions to the board, but it would ensure that the department knows who is practicing. 3:19:57 PM CHAIR KITO opened public testimony on HB 110. 3:20:10 PM MARK HUTTON, Rolfer, testified in opposition to HB 110. He referred to a letter he wrote to the committee [included in the committee packet], which he stated is truthful, verifiable, and consistent with the common good. He expressed that those proposing the bill have said that the bill is not about regulating the Rolfing and structural integration community but is merely a registry required to combat rampant human and sex trafficking. He offered his opinion that such comments are misleading and untrue. He directed attention to one of the proposed duties of the Board of Massage Therapists proposed under HB 110, paragraph (3), on page 4, lines 1 and 2, which read as follows: (3) establish by regulation standards and requirements for persons applying for an exemption under this section. MR. HUTTON stated that he opposes paragraph (3). He characterized human and sex trafficking as sick behaviors that do great harm to the public and need to be policed. He noted that the most recent criminal charge against a Rolfer was in Minnesota in 2010, and the Rolfer thereafter lost his certification. The most recent among a long list of criminal charges against massage therapists was on January 18, 2017. He remarked, What bothers me is it seems unconscionable that you would use this kind of puritan, red, white, and blue, all American banner, which everyone agrees with, to slip in a clause or a phrase that in essence and in truth places regulation on my industry under another unrelated industry. MR. HUTTON stated that the current registry is effective. He urged the committee not to adopt a registry that serves no purpose. He commented that the state needs fiscal accountability and a needs-based assessment before changing current law. He opined that the committee deserves accurate information and truthful testimony. He noted that the legislative process allows for spirited debate of issues and points of view but there is no place for misleading information. He urged the committee to read a letter from the chair of the International Association of Structural Integrators (IASI) Law and Regulation Committee [included in the committee packet] to find correct information. MR. HUTTON informed the committee that his client received a response from a committee member's office that said [the member] respects the client's opinion but would proceed on his/her current trajectory, the client was misinformed, and the bill would give Rolfers a professional status. He assessed that the member's response was preconceived and showed that the end result was valued more than the search for truth; he advised that public hearings should weigh opinions and information. He asked the committee to dismiss untrue and unsubstantiated claims and produce legislation that would actually target the risks of sex trafficking in the massage industry. 3:24:35 PM LAURA EMBERTON, Director, Government Relations, Associated Bodyworks & Massage Professionals (ABMP), testified in opposition to HB 110. She stated that ABMP is one of the largest professional associations for massage therapists and bodyworkers in the country with over 80,000 members nationwide and more than 300 members in Alaska. She stated that ABMP believes that human trafficking often goes through the massage industry. She recommended addressing the problem by increasing criminal punishments, providing counseling for victims, and allowing local governments to conduct inspections to determine whether all businesses have the licenses necessary. She opined that local governments should have the authority to inspect all businesses. She expressed that establishment licensing creates an unfair financial and logistical burden on people doing things legally. She assessed that the bill would only affect those acting legally, not those performing illegal actions. MS. EMBERTON stated that ABMP is in favor of moving to 625 hours, but asked for a grandfathering clause for those currently enrolled in a 500-hour school. She added that changing the requirement would create an issue for someone with a license coming from another state. She suggested that the issue could be solved with an endorsement of out-of-state licenses, hours of practice, and an individual's lack of disciplinary actions. She claimed that ABMP's main opposition to HB 110 is with the registry for exempt modalities, which she compared to a person having to register and pay to not have a license. She remarked: If a practice is not regulated, those practitioners should not be required to register and pay an arbitrary fee not to have a license. To require a person to apply, pay a fee, and submit proof satisfactory to the board is subjective and opens the process up to ... potential abuse. In most regulated states, bodywork professionals are not required to obtain a license or to register to practice their profession. MS. EMBERTON acknowledged that there are bad actors in the body work profession, but stated that requiring licensing is not the solution. She asked the committee to get rid of the section in HB 110 regarding the registry, to adjust the 625-hour requirement to account for those operating under the current statute, and to "get rid of the massage ... therapy establishments." 3:28:41 PM RYAN RICE, Rolfing Student, testified in opposition to HB 110. He stated that he is in training to become a Rolfer, which involves extensive time on the subjects of therapeutic relationships and sex trafficking. He recommended that HB 110 be dropped or reconsidered. 3:29:54 PM AMANDA NOSICH testified in support of HB 110. She drew on her experience as the former chair of the Board of Massage Therapists. She stated that at board meetings, the [Federal Bureau of Investigations] (FBI) and other state agencies requested to have massage establishments regulated, and the board felt it was necessary because of human and sex trafficking. The registration of exemptions would prevent illicit businesses from reopening under a different exempted modality after being shut down. She mentioned that the board's intention is to stop human and sex trafficking, not just move it to another business. MS. NOSICH noted that the 625-hour requirement would have a two- year leniency to allow people currently enrolled in a 500-hour program to finish. The board has previously spoken about adding a regulation to allow licensure of out-of-state licensees who have graduated with 500 hours and have written documentation and notary of education or clinical experience totaling 125 hours. She expressed that the board is not seeking to overregulate Rolfers or any other exempted modality. She acknowledged that the modalities are different; the board is looking to stop moving the human and sex trafficking to other businesses. 3:32:43 PM EDWARD TOAL, Rolfer, testified in opposition to HB 110. He contradicted previous testimony which informed the committee that current statute allows anyone to hang a shingle and claim an exemption from a massage license requirement by stating he/she is a Rolfer or structural integrator without the authorities' knowledge of his/her professional legitimacy. He drew attention to the requirements listed in AS 08.61.080, which read as follows: (10) person engaged only in the practice of structural integration for restoring postural balance and functional ease by integrating the body in gravity using a system of fascial manipulation and awareness who has graduated from a program or is a current member of an organization recognized by the International Association of Structural Integrators, including the Rolf Institute of Structural Integration; MR. TOAL emphasized that a person must be a graduate of a particular group of trainings and be monitored by IASI to claim the exemption. He expressed that although previous testimony denied it, HB 110 would attempt to regulate exempt practitioners. He referenced HB 110, page 4, lines 1 and 2, which read as follows: "establish by regulation standards and requirements for persons applying for an exemption under this section." He explained that under HB 110, his profession's exception would be moved out of protected statutory language and placed under the authority of the Board of Massage Therapists, which is not qualified to regulate the exemption. 3:35:03 PM BARBARA MAIER, Certified Advanced Rolfer, testified in opposition to HB 110. She stated that she has had a Rolfing practice in Anchorage for 35 years. She referenced emails she sent to committee members [included in the committee packet]. She expressed that she supports legislation addressing human and sex trafficking in Alaska, and she offered her opinion that HB 110 would not achieve that desired end. She drew attention to HB 110, Section 5, line 14, which would repeal four categories of statutory [exceptions] but would leave nine intact. She opined that singling out structural integration is punitive. She stated that no evidence of problems within the structural integration profession has been brought to the board, the FBI, or the Department of Public Safety. MS. MAIER mentioned documents from IASI [included in the committee packet] that explain the scope of practice and ethical standards of structural integration, and she said the documents argue that structural integration is a distinct and separate profession. She stated her opposition to Section 5 of HB 110, which she said would give complete jurisdiction to the board to control policy and procedure. The proposed bill calls for a registry of exempted persons and establishes regulations and requirements for exemptions, which she expressed is "unacceptable and intolerable." MS. MAIER noted that under HB 110, structural integrators would be controlled by a board with no knowledge or appreciation of the profession. She said that structural integrators do not want to be associated with the massage industry and its problems. She remarked, "We are not part of their problems, and we are not a part of their solution." She stated that it is ridiculous to suggest that registering exemptions would solve the sex trafficking issue. She added that she has not had any kind or productive encounters with the board. She offered her impression that the board has harassed structural integrators for three years by withholding information and has done so under the guise of [preventing] sex trafficking. She opined that the proposed legislation is an attempt of one industry to control another. She asked the committee to vote down HB 110 or at least strike pages 3 and 4 of the bill. 3:40:30 PM GAIL BOERWINKLES, Rolfer, testified in opposition to HB 110. She referenced the previously cited language in HB 110, on page 4, line 1 and analyzed that that language would give the board complete decision-making authority on regulations although there is no representation for structural integrators on the board. She noted that the board's authority would not be based on standards or input from structural integrators, and she characterized the authority as severe overreach. She stated that while she respects the effort to stop sex trafficking, she sees no correlation between Rolfers and the massage therapy establishments that have "bad people doing bad things." She expressed that finding herself put on a prostitute watch list feels awful. She urged the committee to stop HB 110. She suggested that the board tweak the hours required of massage therapists if needed. 3:42:44 PM JEN LANDRY, American Organization for Bodywork Therapies of Asia, testified in opposition to HB 110. She stated that since 2004, she has been a practicing bodywork professional and has been certified with the American Organization for Bodywork Therapies of Asia (AOBTA) and the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). She offered her understanding that her practices and expertise are exempt from current statute; her eastern approach is focused on meridians and pressure points, not muscle tissue. She noted that the statutory language is vague for professions other than Rolfers. She urged that all proposed legislation in this realm have more specific language for other bodywork professionals. She stated that current statute and HB 110 are biased against practitioners making a living in rural areas with a small population base. She expressed that the fees imposed by the HB 110 would likely be beyond what she could absorb as a part-time professional and would be an undue burden. She aired that she does not find HB 110 to be in the best interest of the community or industry professionals. 3:44:53 PM MARY REIMANN, President, Alaska Reflexology Association (AKRA), testified in opposition to HB 110. She stated that she considers the proposed bill to be horribly written and considers it extreme to change things every two years. She noted that she does not want the Board of Massage Therapists to set standards for her as a reflexologist. She stated that she has much more training in her profession than the board members. She acknowledged that human trafficking is a concern, but it is not related to the professions [reclassified in HB 110]. She explained that massage practices involve removal of clothing, while reflexology clients only remove shoes and socks. She listed other professions where touch over clothing is involved such as yoga instructors, shoe shiners, and personal trainers. She expressed that these professions are not in the same category [as massage]. She noted that Rolfers and reflexologists have been singled out in the wording of HB 110. She urged the committee to vote against HB 110. 3:48:01 PM DAYLE SHERBA testified in opposition to HB 110. She offered her opinion that the bill is a solution looking for a problem. She stated that she is opposed to human trafficking. She expressed that the modalities [reclassified in HB 110] are very different from massage. She noted that she disagrees with Mr. [Edwards- Smith]'s testimony in a prior meeting regarding a task analysis which concluded that the other modalities are similar to massage. She restated that the modalities are very different. 3:49:11 PM SONJA WAY, Government Relations Specialist, Federation of State Massage Therapy Boards (FSMTB), testified in support of HB 110. She remarked: The federation is a 501(c)(3) non-profit governed by massage therapy state licensing boards and agencies in the United States. Our mission is to support our 43 member boards, including the Alaska Board of Massage Therapists, in their work to ensure that the practice of massage therapy is provided ... to the public in a safe and effective manner. In support of the Alaska Board of Massage Therapists, FSMTB wishes to offer information on regulation of the practice of massage and bodywork therapy. The first school of massage therapy in the United States was established in 1916 and the profession has grown and evolved in many different ways, both formal and informal, since then. Today, massage therapists are frequently working with other professions as a part of a team of healthcare providers. Massage therapists are often a first point of contact for the consumer in prevention, identification, assessment, treatment, and rehabilitation of many pathologies and conditions. Therefore, uniform regulation is needed to protect the public. MS. WAY stated that the FSMTB developed a Model Practice Act (MPA) to provide a comprehensive resource to assist regulators with statutory language based upon the collective wisdom of the massage therapy regulatory community. The MPA contained a recommended definition of the practice of massage therapy and used broad descriptions reflecting practice rather than identifying the therapeutic approach by name. She noted that FSMTB encourages the broad language in order to recognize the authority of the board to interpret the services and activities defined in the scope through rulemaking and administrative operations. MS. WAY explained that FSMTB conducted a job task analysis in 2007 and 2013 to assess the necessary skills and knowledge of entry level practitioners. The analysis concluded that massage therapists, bodywork therapists, and somatic therapists have a nearly perfect alignment of frequency and importance of tasks performed. She reiterated that FSMTB supports the public protection of citizens through HB 110. 3:52:27 PM MARY O'REILLY, Director of Examinations, Federation of State Massage Therapy Boards (FSMTB), said that she concurred with Ms. Way's testimony. 3:52:45 PM IRIS AHARONOVICH, Chair, Legislation and Education Committee, Reflexology Association of America, testified in opposition to HB 110. She stated her support of Christine Issel's written testimony [included in the committee packet]. She explained that she started working in reflexology 20 years ago in Israel, where reflexology is very different from massage and is recognized as a therapeutic method. In Israel, reflexology is considered medical care and is paid for by insurance companies and the government. It is a health service that citizens can receive in hospitals and medical centers. Doctors refer patients to reflexologists. She analyzed that reflexology is very different from massage; they are two different and unrelated techniques and methods. She explained that reflexology deals with nerves and organs; massage deals with muscles. 3:54:28 PM LAUREN PAAP, President, American Organization for Bodywork Therapies of Asia (AOBTA), testified in opposition to HB 110. She explained that FSMTB has been working with state boards across the nation to expand the scope of authority with the claimed intent to solve human trafficking. She stated that the federation's claim is a guise. She said AOBTA attempted to work collaboratively with FSMTB to define scopes of authority, but FSMTB defined the scope without AOBTA's input or support. She explained that FSMTB has treated the verb "massage" as a noun synonymous with an industry. She remarked, "They tried to say that anyone who touches the body, therefore, is massage." She stated that although it maybe be true in the sense of the verb, it is not true in the sense of the scope of authority. She expressed that FSMTB does not want to define what a massage therapist is so that people can self-identify; this is happening in many states, and it works to expand the scope of authority of massage. She stated that a clear exemption is needed for practitioners of bodywork with certified professional memberships. She concluded that AOBTA is not opposed to people checking on bodywork professionals, but is opposed to HB 110. 3:58:07 PM JILL MOTZ testified in support of HB 110. She stated that she doesn't believe asking bodyworkers to prove themselves to be who they claim to be is burdensome or unreasonable. She explained that HB 110 would not require exempted practitioners to apply for a license or to comply with massage therapists' regulations. She expressed that the proposed legislation is not an attempt to compare massage therapists and the other modalities or increase competition, but the bill asks the practitioners of other modalities to provide their credentials. An exemption would last for approximately 10 years. She remarked, "We're asking for an exemption, not a full application." She expressed that the registration fee is not likely to be high and the board is not trying to oversee anyone. She stated her understanding that the bill is an attempt to solve a problem with which law enforcement has asked for help. She noted that many massage therapists also practice structural integration. 4:00:42 PM GRETCHEN GRAEFF, Massage Therapist and Rolfer, testified in opposition to HB 110. She stated that the board appears to have put in tremendous effort to expand its regulation jurisdiction, and doing so has distracted the board from its current jurisdiction. She expressed that she has concern about criminals interfacing with the massage profession, but the board's focus should be on the interface between the profession and clients. She said that she finds HB 110 questionable and of great concern. She pointed out that universal precautions for infections are outdated; they were developed to protect health care workers from getting infections from exposure to blood. Since then, the [Centers for Disease Control] (CDC) has expanded its recommendations for infection control. She stated that she opposes the idea of being required to continue education in an outdated mode. She opined that the board's role is an odd combination of oversight and "undersight." She suggested that a solution to the problem would be to add "standard" precautions to universal precautions. She agreed that human traffickers exploit her profession, but she does not believe HB 110 is the solution. 4:04:54 PM DEVRON HELLINGS testified in opposition to HB 110. She noted that she has been a Rolfing, acupuncture, and therapeutic massage client. She stated that she is aware of the different levels of education, training, and peer review required for Rolfers and acupuncturists. The professions require diplomas or certifications, adhere to industry standards and national protocols, and do not belong under the jurisdiction of the Board of Massage Therapists. She said that she does not intend to be critical of massage therapists, but she opined that their training lacks the sophistication and financial commitment required of Rolfers and acupuncturists. Rolfers and acupuncturists do not relocate their practices at a whim; they establish long-term business practices. She acknowledged that there is concern of human trafficking in Alaska. She said she had heard reports from the FBI Human Trafficking Task Force while attending conventions of the Association of Village Council Presidents and the Alaska Federation of Natives. MS. HELLINGS remarked, "The massage board and its industry concerns over human trafficking is simply a charade. Its true objective is to impugn and diminish the profession of Rolfing and structural integration by subjugating them to its power and control." She said HB 110 affiliates Rolfing and structural integration professionals with the massage industry although the professions are distinctly different. She opined that HB 110 is bureaucratic overreach and would unnecessarily govern and regulate the Rolfing, acupuncture, and reflexology industries. She offered her belief that including Rolfers and structural integration practitioners with the massage industry is a travesty. She aired that HB 110 is an attack from the board on the integrity and reputation of the Rolfing industry. She urged the committee to vote against HB 110. 4:07:27 PM KAY BROWN testified in opposition to HB 110. She stated that she supports the previous testimonies of members of the Rolfing community. She noted that despite prior contrary testimony, the bill gives power to the board to regulate Rolfers and other modalities. She drew attention to HB 110, page 3, line 28 to page 4, line 2, which directs the board to adopt regulations, standards, and requirements for the exempted groups. She remarked, "This is in contradiction to what has been stated as the intent of the bill." She urged the committee to remove the aforementioned lines, leave the exemptions in place, and find another solution to address the registry issue. 4:09:47 PM SHARON LEE, Feldenkrais Practitioner, testified in opposition to HB 110. She requested that her profession's current exception remain in place. She stated that HB 110 should be limited to regulating only massage therapists, which is the only profession that falls within the scope of practice of the board. Each discipline currently exempted in statute has a specific set of skills, education, scope of practice, and professional conduct, and thus should remain separate from the Board of Massage Therapists. MS. LEE explained that the Feldenkrais Method is a method of learning shown to have therapeutic benefits. It uses movement and directed attention to increase awareness and function. Feldenkrais students become aware of existing patterns of action and the method guides a discovery of additional possibilities of action. She noted that the Feldenkrais Method facilitates recovery of movement, improves skills, and enhances learning. Touch is one element of the learning process that may or may not be used in Feldenkrais lessons. In lessons that do involve touch, the student is fully clothed and the intent of touch is to promote learning, and touch is gentle, non-invasive, and non- corrective. She explained that certified Feldenkrais teachers complete 800 hours of specialized training over a three- to four-year period. Massage therapists complete 500 hours of training in a shorter amount of time. She remarked: The Feldenkrais Guild has developed and enforced accreditation and certification standards for the Feldenkrais Method profession since 1977, and teachers must graduate from an accredited Feldenkrais program, be certified, fulfill the requirements for annual certification renewal, continue education, and adhere to the strict code of professional conduct, ... ethics, and standards of practice. MS. LEE informed that Feldenkrais.com provides a way to find all certified Feldenkrais practitioners in Alaska, which is much less expensive than creating legislation for a registry. She offered her opinion that there should be no change to the existing exemptions. 4:13:14 PM CHRISTINE ISSEL, American Reflexology Certification Board (ARCB) testified in opposition to HB 110. She stated that ARCB agrees with the structural integrators and others who have testified against the bill. She requested that the committee vote against HB 110. 4:14:10 PM TRACI GILMOUR, Massage Therapist, testified in support of HB 110. She commented that massage therapists want to deliver the best massage possible in a safe environment. She remarked: We're all body workers with different training. None of our therapies stands out as superior, we just deliver a different product, and in the end we all manipulate soft tissue and work to decrease your pain and help you feel better. We complement each other, support each other, encourage, and share clients. We refer to all other modalities or therapies. We work under the clouded stigma that our profession was and in some cases is known for offering sexual favors. We know that our profession is a haven for sex trafficking. MS. GILMOUR explained that the exemptions are different because practitioners of the exempted professions generally practice only one therapy. Bodyworkers who have become licensed massage therapists are able to bill insurance companies. She offered her opinion that licensing requirements have added credibility and respect to the massage profession. She indicated that working cooperatively with all investigative agencies would decrease the prevalence of human and sex trafficking. She stated that closing loopholes would offer protection to everyone, and increasing education requirements would improve the knowledge of therapists. MS. GILMOUR noted that other testifiers have mentioned their concerns with the portion of the bill requiring exemptions to prove their certification. She expressed that HB 110 would increase the ability for investigators to enter studios of exempted practitioners and would allow investigations to focus on establishments suspected to be illegally practicing massage. She offered her understanding that HB 110 may look and feel like government overreach and that it may be a burden to some. She stated her desire to have the state and industry be a "brick wall" for human traffickers and to no longer be a safe haven to conduct illegal activities. She encouraged the passage of HB 110. 4:17:22 PM REPRESENTATIVE JOSEPHSON referred to the recommendation of a previous testifier [Ms. Graeff] to add "standard" precautions to universal precautions in the requirements proposed under HB 110. He asked Ms. Gilmour to comment. MS. GILMOUR stated that the recommendation has been suggested in previous board meetings. 4:18:14 PM CHAIR KITO announced that HB 110 was held over.