HB 328-BOARD/LICENSING OF MASSAGE THERAPISTS  4:48:38 PM CHAIR OLSON announced that the next order of business would be HOUSE BILL NO. 328 "An Act establishing the Board of Massage Therapists; relating to the licensing of massage therapists; and providing for an effective date." 4:48:40 PM REPRESENTATIVE BENJAMIN NAGEAK, Alaska State Legislature, introduced himself and his staff, Mary Schlosser. 4:49:28 PM MARY SCHLOSSER, Staff, Representative Benjamin Nageak, Alaska State Legislature, stated that Alaska is one of six states that does not regulate massage therapists. She stated the standard of practice or regulation allows consumers to self-educate the expected standard of care and an appropriate therapy for their individual care. This bill endorses business development by allowing massage therapists to become an in-network provider, giving them the ability to bill insurance directly versus going through chiropractors, physical therapists, or physicians' offices. This may be especially important in light of the roll out of the Affordable Care Act. She surmised that physical therapists may see an increase in demand. Regulation may be a nuisance but it is expected. MS. SCHLOSSER related that in the fall of 2013, Forbes graded states in terms of their legal and regulatory framework. She reported that Alaska ranked 37th in business friendliness. Part of the standing ranks the states' regulatory environment and Alaska is ranked 44th of 50 states. She said that this bill encourages greater professional opportunities for therapists. The massage therapy profession is growing at a rate of approximately 120 therapists per year in the state. The time has come to bring clear industry standards for the health and safety of Alaskans. She reported that 84 percent of respondents in the field support state licensure. The sponsor requests the committee to support this bill and raise the massage therapy standard in the state. 4:51:59 PM REPRESENTATIVE JOSEPHSON said he was familiar with massage therapist rates, which range from $60 to $120, depending on the time. He surmised that providers that massage therapists work under receive a portion of the fees. He asked whether this would change that in massage therapists' favor. MS. SCHLOSSER deferred to the professionals to answer. 4:52:55 PM AMANDA UNSER, Chair, Alaska Massage Therapy Licensure Coalition (ANTLC), stated the ANTLC represents 600 members. She also serves as the first vice-president of the American Massage Therapy Association, Alaska Chapter, in charge of legislation. She has practiced massage therapy for 12 years. She has previously been licensed in the State of Washington and maintains that license. The majority of massage therapists are employed by chiropractors. She referred to a letter of support from the chiropractors in members' packets. She explained that the Alaska Massage Therapy Licensure Coalition formed in 2012 and houses two major groups that represent massage therapists nationwide: the [Associated Bodywork & Massage Professionals] ABMP and the [American Massage Therapy Association] AMTA, and massage therapists throughout Alaska. The intentions were to assess whether massage therapists were ready for licensure and to get feedback on bill provisions, such as grandfathering or transition provisions, education, cardiopulmonary resuscitation (CPR) requirements, exemptions, and how the licensing board would be formed. The result was overwhelming support from massage therapists throughout the state. After two years of research and much deliberation, the result was HB 328. She urged members to pass HB 328 out of the committee. 4:55:28 PM DON HABEGER, Director, Division of Corporations, Business, and Professional Licensing (DCBPL), Department of Commerce, Community, & Economic Development (DCCED), stated that bring up one issue. He referred to page 3, line 24, related to qualifications of a license. He read [beginning on page 3, line 22]:"[Sec.08.61.030. Qualification for license.] The board shall issue a license to practice massage therapy to a person who (1) applies on a form provided by the board; ...." He stated that the division is happy to allow the board to do that work but typically it is delegated to the department. The same issue occurs on page 4, line 18. He stated that this language requires the boar to supply the form, but often this is something that the department does. He offered his neutrality on this issue, but if the board wants to delegate this activity, the department will take the responsibility. In response to a question, he directed attention to page 4, line 18. 4:57:52 PM REPRESENTATIVE JOSEPHSON asked for assurances that fees won't rise above $500. He further asked what assurances that the biennial fees would be predictable and massage therapists will not see marked increases. MR. HABEGER responded that predictability is one of the issues the department and the legislature have been discussing recently. He said there are no assurances that it will be $500 year after year. He explained that the license fees are a cost and fee relationship. The centralized licensing in AS 08.01 basically requires costs incurred by the program results in fees adjusted accordingly. Licensees are required to pay for the activities of the program; however, fees don't tend to fluctuate but are concentrated more on small programs. 4:59:33 PM CHAIR OLSON offered his belief that a bill before the House Finance [Standing Committee] would attempt to level out the fees. MR. HABEGER answered yes. 4:59:41 PM REPRESENTATIVE HERRON said he has read the bill and asked whether this bill provides a typical, normal setup for any new licensed profession. MR. HABEGER answered that this program looks similar to an existing program, and the fiscal note is based on the Board of Social Work Examiners, consisting of five board members, likely with a shared licensing examiner based on the time spent working on the program. REPRESENTATIVE HERRON asked whether the state has a position on the bill. MR. HABEGER answered no. 5:00:53 PM REPRESENTATIVE HERRON asked if there is a need for this bill. MR. HABEGER stated that the division has not received any calls prior to advocates requesting the program about a year ago. REPRESENTATIVE HERRON noted one letter in opposition to the bill. He asked whether he has read the letter. MR. HABEGER answered no. CHAIR OLSON asked whether the suggested changes would provide more comfort to the division. MR. HABEGER answered the two changes are merely suggestions that may make it easier for the board. 5:02:06 PM REPRESENTATIVE HERRON asked him to read the letter in opposition to the bill. MR. HABEGER agreed to do so. 5:02:18 PM TRACI GILMOUR, Massage Therapist, stated she has waited 19 years for licensure. She is a fourth generation Juneauite and has been practicing massage since 1994 in Juneau. She attended an 800-hour massage program in Seattle, and has held a license from Washington for her entire career. She owns a massage business and has practiced under the supervision of a chiropractor for 17 years. She practices medical massage as a majority of her business and passing this bill will allow her to be recognized as a health care provider. She has been required through her license and national membership to receive continuing education annually. She has not felt burdened by her Washington licensing fees and the American Massage Therapy Association (AMTA) not the costs associated with her initial and continuing education. She indicated that she holds a business license, pays sales tax, and charges $60 per hour. She did not believe her fees would increase due to costs incurred with licensure. She takes great pride in the diverse knowledge she has about the body and welcomes the opportunity to discuss massage and how she can help her clients. This bill will assist nearly 600 massage therapists become current with their education, knowledge of the body and the many ways they can help or harm their clients. She urged members to pass the bill from the committee. 5:04:00 PM REPRESENTATIVE SADDLER asked how many people who are practicing massage therapy will be barred from doing so under the bill. MS. GILMORE answered that the grandfathering provisions would permit anyone practicing massage therapy right now and can properly prove it. There are seven ways in which they can prove they have been currently working in the industry. 5:04:47 PM REPRESENTATIVE SADDLER understood that no one would be barred. MS. GILMORE agreed so long as they have been working in the industry for fees. In response to a question, she deferred to Ms. Unser to reference the specific provisions. MS. UNSER referred to page 10, line 3, to the transition provision in HB 328. She specified the bill allows six different ways to transition in, which can date back to five years prior to the [effective date of the bill]. 5:05:57 PM CARL KANCIR, Massage Therapist, Northern Comfort Massage Therapy, stated that he received his training at the University of Alaska Anchorage (UAA). He started in approximately 2000 or 2001 to get state licensure for massage therapists. He strongly supports state licensure for massage therapists, but he does have some questions and comments on the bill. He referred to page 3, line 27, to the number minimum of hours of in-class supervised instruction, which he felt should be 1,000 hours. A number of other states require a minimum of 750 to 1,000 hours. He offered his belief that increasing the number of hours would lend credibility for massage therapists, in particular, to gain knowledge on healing and yet still stay within their scope of practice and not "run afoul of doctors, chiropractors and other health care professionals." Again, he suggested it would be more credible to raise the minimum to 1,000 hours for the minimum hours for a course of study. 5:08:16 PM MR. KANCIR referred to page 2, line 26, to the one public member, which seemed confusing. The language read, as follows: "(2) one public member; the governor may not appoint as a public member (A) a licensed health care provider; ...." Additionally, he expressed concern about requirements for submitting the person's Form W-2, which he believes is private and personal to obtain licensure as a massage license. Instead, he thinks that this provision should be limited to those applicants without education. He indicated that his accredited studies required 1,250 hours, although he wished he had obtained more hours. He suggested that provision may need further clarification. He related he has obtained numerous hours of continuing education costing several thousand dollars. He just finished a February 1-2 course that cost $400, which illustrates his commitment to his profession. 5:11:06 PM REPRESENTATIVE HERRON referred to the transition language. He asked whether the committee should base the minimum requirements on the length of time a person has practiced massage therapy. MR. KANCIR answered yes. He pointed out that the current massage therapists can't go backwards to gain more hours. He reiterated his belief that from this point forward the minimum number of hours for massage therapists should be increased. He knows many massage therapists, some of whom worked on the issue of licensure for massage therapists who also objected to being required to submit federal income tax forms. He said, "It just doesn't make sense." He acknowledged that he not a lawyer and suggested the bill language could be stated in "plainer language" so it could better be understood. 5:13:02 PM CHAIR OLSON asked whether it is common to require applicants to submit federal income tax documents and records. MR. HABEGER answered that he could not think of any program that requires it. MS. SCHLOSSER responded that the transition language offers numerous options and the signed federal income tax is only one of many options applicants can use to prove they have met the education and examination requirements. She referred to page 10 to [paragraph (2)(A)-(F)] that lists the options. 5:14:22 PM CHERI ZEP, Massage Therapist, Chez Sante, stated that she was raised in Southeast Alaska and has been practicing massage therapy for 10 years. She stated she is self-employed and owns and operates Chez Sante in Juneau. She said she provides employment for six other massage therapists. The hourly rate for massage is $60 plus tax and she does not anticipate raising rates since she currently engages in continuing education and associated costs. She supports massage therapy licensure in the state to provide public safety for clients and the massage therapists. The bill sets a standard of education to ensure massage therapists are trained in contraindications as well as the body systems and the effect of massage on the body. She acknowledged that if massage therapists are not properly educated they can cause harm. It protects clients from potential sex offenders and human traffickers. Currently, anyone can call themselves massage therapist since the person doesn't need to submit to background checks or fingerprinting. Thus it is possible to have sex offenders and sexual predators working on innocent people without their knowledge. She chooses respect and asked members to pass HB 328. 5:15:51 PM REPRESENTATIVE JOSEPHSON asked whether she pays for malpractice insurance. MS. ZEP answered that she pays for liability or malpractice insurance. REPRESENTATIVE JOSEPHSON asked about the cost of the insurance. MS. ZEP answered she pays $195 per year for a $2 million policy. REPRESENTATIVE JOSEPHSON remarked that is a bargain. 5:16:24 PM REPRESENTATIVE HERRON asked whether some massage therapists "won't make the cut" if HB 328 passes. MS. ZEP answered that she didn't know. She suggested that those who cannot meet the standards are those currently "hiding behind the curtains" without a business license and not paying sales taxes. She offered her belief that there are lots of people in Juneau that do not want the bill to pass. 5:17:11 PM REPRESENTATIVE HERRON asked if there are inappropriate people in the business. He asked whether this activity is prevalent. MS. ZEPP said she has heard about some issues in larger cities. She said, "It's not happening here in our town so I don't think it's going on right now...." She said that it could happen. [HB 328 was held over.]