Massage Therapy Body of Knowledge

Comment

Comment by Mike Hinkle on October 30, 2009 at 3:23am

How are nurses controlled in CA that are also massage therapists? Are there any different rules for them or the hospitals?

Comment by Keith Eric Grant on October 30, 2009 at 3:18am

Mike,

You're not listening. At the beginning of 2005 there was two-tier licensing bill language that ABMP, CAMBS, and AMTA-CA were willing to proceed with. That was squelched by the legislature itself. Not a political feasibility to pass a licensing bill. An occupational regulation bill without the approval of the the Joint Leg committee is dead. Things may change, but now is now.

The only way the CCA will allow a massage bill to pass with a scope of practice is if passive stretching is removed from that scope. The CCA has far more clout than the massage profession in CA. They effectively killed SB 412 is a single day of lobbying and the end of a legislative session. Put the scope of practice in, either lose passive stretching or watch the bill die. That simple. It's a pure exercise in turf and clout that gets hidden behind false statements of potential harm -- statements that in many instances massage organizations have laid the ground for in believability. Most would rather take the exemption from local regulation and go with it, than risk the whole ball of wax.

It could come to pass, in any case, that city and police chief factions that don't like losing control to the state preemption will introduce legislation to gut SB 731. In this case one can expect the chiropractic and PT associations to also step in. Remains to be seen, but it's a serious consideration.

Comment by Mike Hinkle on October 30, 2009 at 3:16am

All valid points. So what do the CA therapists want?

I understand why the state doesn't want to license. And that explains why the Associations are trying to help therapists have some form of structure.

Wow, I feel for your Agency. I can't imagine the varibles across the state, especially, basically using rules set for just Northern CA. But more and more townships seem to be coming under your agencies umbrella, right? That's a good start.

I still think if there isn't that much difference and if that is what therapists want, a way can be found. So it comes to funding the board... always does.....and the problem with that is the money could/would be grabbed for the budget. You have a pickle. But I don't give up. Still don't like tiers, but that's just me.

Comment by Mike Hinkle on October 30, 2009 at 2:51am

Keith,
I'm not trying to be mean here, but that's difficult to navigate. I could help you with that website. Actually almost every page dealing with these links you've given need work. It must be confusing for beginning therapists. I could not find a definitive reason for lack of scope of practice. A state usually determines that or allows the profession to and then they accept that statement.

Most of the information at your blog is based in 2006, I could not find the latest update of SB 412. But, if they leave in the 250 hour tier, would your board be able to put a scope of practice back in or are you afraid to open it because they may want to tag something else or are you just going to wait for review time?

It seems most therapists have at least 500 hours in the state; there is common ground here. This would be another reason to license, to have a State Massage Board to go head to head with their Board of Chiropractic Examiners.

Comment by Keith Eric Grant on October 30, 2009 at 2:49am

Mike,

The state did not license massage with SB 731. In fact the law specifically forbids claiming state licensure. The state created and exemption from local licensure for those certified by CAMTC, the creation of which they specifically authorized.

The only inherent difference between certification and licensure is the effect on the unlicensed/uncertified. Thus it is not unusual that those being certified would go through exactly the same steps as for licensure.

State licensure requires the agreement of both the legislature and the governor that licensure is the appropriate level of regulation. That agreement is traditionally difficult to obtain in California. During the term of Governor Schwartzenegger there has also been both the unwillingness of the legislature to go that route and the certainty that it would be vetoed if they did. It is also, at the current time, far better to be separate from the state budget than to be part of it. A governor who want to eliminate boards is not likely to allow a new one.

The current regime of title protection is also likely to be a better match for the more isolated northern reaches of California. California is far from being a state of uniform demographics or of uniform needs.

Comment by Keith Eric Grant on October 30, 2009 at 2:18am

One can gain a bit of historical perspective on why a scope of practice definition is NOT in the CA regulations by scrolling down my blog posts on SB 412, the predecessor to SB731 that DID include a scope of practice. Initially, even the removal of a scope of practice was not sufficient for the CCA. They wanted removal of passive stretching from our scope of practice. What may have made it acceptable to them, was that the Board of Chiropractic Examiners came under extensive scrutiny by the legislature and Sacramento Bee during spring 2007 for interfering in a criminal investigation and blowing off the Bagley-Keene Open Meeting Act. In short, their profession had other fish to fry during the hearings on SB 731 and they decided to be in favor of SB 731 without the scope of practice statement. The blog also contains several links to the document I had put together (with help from friends), rebutting CCA contentions that passive movement was outside of our normal scope or represented a danger.

Comment by Mike Hinkle on October 30, 2009 at 2:12am

Keith, they are not swipes. I was talking to Carl, not you and you are taking offense or/and trying to protect him. I have said on this and other forums that you and the folks that have put this together have done the best you could, given the circumstances given you. The state actually licensed massage to be able to take control from local control and have agreed to allow a private non-profit agency to certify therapists. That is not the norm. The state controls licensure. Your therapists are doing the same things that they would have to do if they were licensed, including background checks. There really is not that much difference. As you pointed out in an earlier discussion. Why are you resisting licensure?

CE's are tied to almost every health care related field there is. People get to chose the CE's they take. So where are they being made to where what they would learn is facade? After school, we choose what we take.

So now, you too, are willing to set "your list" of mandatory courses. Your words, not a swipe.

The ABMP, AMTA, Council of Schools, FSMTB and Massage Therapy Foundation, NCBTMB chose the MTBOK. If you or others were not choosen for these positions, I am sorry. But these stackholders are the ones making these decisions and we as a profession should support them, not blindly but hopefully.

They deserve it and Keith, if you were on that board, I would be just as solid behind you.

Comment by Keith Eric Grant on October 30, 2009 at 1:33am

Sorry, gave the link to a prior comment in the same discussion -- on why is licensing a state function. This (hopefully) is the comment on CA regulation.

Comment by Keith Eric Grant on October 30, 2009 at 1:30am

For an answer to a number of Mike's questions on the form of California regulation, see my comment to another of Mike's swipes at the result of some hard work and hard compromises.

As to CE requirements, those might be added when we identify infrequently used but critical knowledge or skills that require currency and/or identify specific knowledge and skills that are identified as necessary and rapidly evolving.

When I was employed at a national laboratory, I witnessed just this efficient means of competency management. Every year we filled out a training questionnaire outlining our areas of job tasks and responsibilities. Based on that questionnaire, required update courses were entered, with due dates, into our individual training profiles some annual; some biannual. The longest ones, as an employee with a security clearance, were on classified document handling and use of classified computer systems and those were annual. Requirements did change and evolve. Others included disaster first aide (I was an alternate on a search team), blood borne diseases, integrated safety management (hazards control), and awareness of beryllium placarding and disease. The upshot is that you can learn a lot about CEs and competency management when the subject matter is deemed of of critical importance. You also then recognize, by the lack of specificity, when the requirement is just a facade.

I would be supportive, for example, to requiring taking a web-course covering cervical arterial dissections, signs of stroke, and deep vein thrombosis at the time of each certification renewal. Probably some other material such as universal precautions and blood borne pathogens (essentially the course I used to have on my list) could also be added.

I am now on the CAMTC as the representative from IMSAC. We've talked about creating some resources for the IMSAC member schools, and I certainly could envision creating some web-based material such as what I just mentioned.

Comment by Mike Hinkle on October 30, 2009 at 12:41am

Carl, I hope so for you too.

Carl? If you go to college? (2 year college, 4 year, Masters, PhD?) If you can get the courses? Carl, we can't wait. We have been waiting for decades.

You really want therapists to go to school this long? No wonder you don't want to talk hours. I thought you wanted the BOK to set less rules. Poor Rev he just wants to be left alone. In CA, there are not even CE requirements to recertify. And you are going to go to the other extreme?

The same procedures that you now are requiring of therapists to certify, "mirror" licensure. I don't understand your state's reluctance to license. Your own therapists continue to say they are state certified. They are not. You have a private non-profit agency that is organizing and applying the same rules as licensure, to include titles. But there is no scope of practice and I find it strange you are not fighting that. How can any competency or standards be determined when you haven't even taken this first step?

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