a community of practitioners

Update on NH House Bill 446 (deregulation of massage)

From Vickie Branch, Government Relations, AMTA-NH

Dear Friends and Colleagues,

As many of you are aware, House Bill 446 – an act to repeal regulation for certain professions, was introduced to the Executive Departments and Administrations Committee (EDA) this past February. The reasons for this bill are not completely understood, but I understand that it may be more about eliminating government from our day to day lives and not so much about “picking on” the professions named in the bill. The sponsors of the bill feel that the consumer ought to be able to hire whomever they wish regardless of the individuals’ credentials. With that said, the primary sponsor of the bill, Representative Spec Bowers from Sunapee, added an amendment to make licensing voluntary.

A subcommittee met several times this summer to study the merits of the bill. Although testimony from the public was not guaranteed, the subcommittee members allowed persons from each profession to state their reasoning’s for or against the bill. Unfortunately the subcommittee voted 3-2 in favor of the amendment and it now goes to the full committee for a vote. The ED&A committee will hold its first meeting on Thursday October 27th at 10am in room 306 of the Legislative Office Building (LOB). National AMTA has been working tirelessly with NH AMTA drafting letters to committee members. It is our hope that the committee will vote to omit Massage Therapy from this bill.

I have included some of the information written to the committee why we believe that Massage Therapy should be omitted. As AMTA members and Licensed Massage Professionals, you are also encouraged to write to the committee members. You may also write to your local representative, but the committee members will be our first stumbling block. They need to hear from you. I have included a draft of a letter you may use if you don’t want to write something yourself. I have also included a draft you are welcome to give to your clients to encourage them to write also. This bill affects all of us. You and your clients are also invited to attend the ED&A meeting on the 27th. A show of support speaks volumes.

If you have any questions please do not hesitate to contact me.

Best

Vickie

Links:

1. Contact the ED&A committee: http://gencourt.state.nh.us/house/committees/committeedetails.aspx?...

In the right hand corner you can click on “email committee members” and you can email all members at the same time.

2. AMTA reasons for licensure

3. AMTA White Paper to ED&A Committee Members

4. Sample letter you may use to send to committee members

5. Sample letter your clients may use to send to committee members

Replies to This Discussion

Permalink Reply by Michael Huber on November 4, 2011 at 10:34am

Hi Kevin, I have sent an email blast out to my graduates in hopes they will contact their rep's and make their displeasure known. Thanks for the update though, that could be good news.

Permalink Reply by Mark Rebillard on November 17, 2011 at 9:53pm

Hi,

I've started an online petition. Please sign it and pass it along via email, facebook, twitter and whatever else there is.

Stop the deregulation of massage therapy in NH.

Also reluctantly willing to ask for a meeting with state legislators. Anyone have advice?

Thanks!

Mark

Permalink Reply by Michael Huber on November 18, 2011 at 4:52am

Hi Mark

I have only emailed, and heard back from a few of them. Larry Gagne seems open, his main point was he was waiting to hear what the rest of his district was thinking, but as of emailing him, I was the only one he heard had from. Will Infantine is against HB 446. Spec Bowers is very much for it, I posted his reply below.

"Frankly, I think this bill will enhance your reputation as health professionals. People will quickly realize that there is a difference between a Licensed Massage Therapist and a massage therapist. Those consumers who want to relieve pain, who want the best and safest therapy, will visit only Licensed establishments. Those who just want something to help them relax and feel better, may visit unlicensed therapists. Right now, people don't realize that there is a difference between the two kinds of massage. This bill will result in people paying more attention to the significance of "licensed" vs. "unlicensed".

Wanted to post their opinions in case you meet with anyone of them in particular. Vicki Branch is spearheading the AMTA push back, she can be a great resource, I do not know who is doing it for the ABMP, but as they have practice with this I would look to connect with them, and depending upon when the meeting is I am happy to go and add my support.

Permalink Reply by Kevin Clark on November 18, 2011 at 1:19pm

Representative Paul Mirski is also in favor of the bill, as far as I can tell. He wrote the following on the Enfield Listserv:

Some final thoughts on the subject of licensing:

Most individuals who are convinced that licensing is a good thing have never evaluated the performance of either licensed professionals statewide or have they ever evaluated the extent to which state licensing boards actually work to insure and enforce a high level of performance on the part of those the state licenses.

I have.

I've reviewed published enforcement surveys of licensed professions in Massachusetts, and I've personally initiated at least two statewide legislative surveys in NH - one last term. Every survey reveals that only a minimalist effort is made to appraise performance [and in the majority of cases none at all] which means that virtually no serious evaluation, inspection, or systematic enforcement of licensed professions takes place. Licensing boards rely on those they license to self-report and also to report the egregious behavior of others in their professions. Since licensed professionals and licensed tradesmen are loathe to rat out colleagues in their field knowing that when considering “what goes around comes around” they could just as easily become a victim of a critical report. When claims against a licensee are proved baseless its usually too late to revive a ruined reputation or business.

Recognizing the limited value of licensing when it comes to consumer protection, no responsible hospital relies on state licensing when they go about hiring medical personnel. Responsible hospitals and responsible medical practices individually and carefully review the performance history of whomever they seek to hire. They know that the state’s not responsible for the performance of those they license and they know that the state has no way to judge what would or would not be considered appropriate performance in any given profession at any given point in time. It will be the medical practice or hospital that will bear the blame and the cost of medical malpractice by the new hire, not the state.

The only conclusion any rational person can reach from reviewing the history of the public oversight of professional practice and the practice of licensed tradesmen is that the "public safety" and "consumer protection" rationale for state licensing has been a failure. In other words, regardless of the faith individuals like those pro-licensing folks on this list-serve may have in the promotion of licensing and regulation, the system and approach does not work to serve consumer interests.

So whose interest does licensing serve?

The sad truth of state licensing is that licensing requires a fair sized political constituency to lobby for the idea of licensing in the first place and since excellence is a rare commodity in the marketplace of services and trades, in order to assemble a sufficient and politically motivated critical mass of tradesmen and or professionals to cause the interested constituency to become a licensed constituency, advocates must enlist the broad support of many average and less than average performers in order to impress those in politics of the 'need.' The effect of this is that, state licensing “qualifies” many more mediocre and average performers than the number of excellent and outstanding performers - probably on a ratio of 10 to one, bad to good. The effect that licensing actually has is that it gulls the public into hiring less than stellar performers at the expense of promoting the best of tradesmen and professionals.

I've been a licensed architect for 42 years and not once has anyone ever has any client asked if I were licensed or asked if any of my employees were licensed. I' ve also been a licensed real estate broker for nearly the same period but have never listed shown or sold a piece of property. Zero state evaluations. Zero state enforcement. Zero value of licensing in either case.

Over the years, the quality of architectural design has declined in inverse proportion to the growth in the number of licensed architects in the world. If you climb to the highest point in town or to the highest point in your neighborhood and survey the surrounding town-scape, I bet you’ll find that the overwhelming number of buildings you would consider to be attractive or beautiful were constructed before there ever was any such thing such architectural licensing. I’d also wager that the vast majority of those that you find to be the ugliest were constructed after architectural licensing became the norm. Licensing has been the bane of good design.

Tim Linehan asked, "Should we allow anyone to hang up a sign that they are a whatever? Tim Lenihan Expert Architect? Paul Mirski Dermatologist?" My answer is yes, absolutely yes because liability laws and word of mouth puts poor performers out of business far more quickly and effectively than state licensing boards ever will.

I’ve never, in business, ever hired a tradesman or consultant because they were licensed. I've always made it a point to try to hire the best where performance was critical - and I've rarely been disappointed with this approach whether it involved getting a great haircut or hiring engineers for complicated projects. Further, I couldn't afford the liability associated with hiring a poor performer. Hiring a 'professional" or "tradesman" out of the yellow pages because they advertise that they're licensed, is a fools exercise.

Finally, I agree with Kevin Ellicot who pointed out that that in today's world, licensing represents an across the board effort at the reimplementation of the medieval guild syste whose principal purpose was meant to limit competition and restrain trade. Ellicott also correctly pointed out that the difference between medieval guilds and present licensing is that medieval guilds were obsessed with producing the very best tradesmen [and the banishing bad performers] whereas contemporary licensing's purpose is to validate a vast number of poor performers.

For you excellent performers out there, from licensed cosmetologist to licensed engineer, take a minute sometime to count those of your peers who can match your performance and skills. Then ask yourself how the state's practice of admitting lesser qualified practitioners into the system reflects upon you and your chosen profession. Generally the answer will be "not very well."

I favor professional certification by private professional organizations over state licensing in all cases - as with certified public accountants for example. From a consumer protection point of view, I’d only have the state issue generic and readily available business licenses for tax purposes primarily but perhaps in a way would also provide a means for pulling business licenses where malpractice had been proven.

Paul Mirski

He desperately needs to hear from his constituents on this matter. He is a Representative of District 10 comprising the towns of Canaan, Dorchester, Enfield, Grafton, Orange.

Permalink Reply by Kevin Clark on November 18, 2011 at 1:40pm

Re. ABMP

I am unaware of any organized effort by ABMP members. However, ABMP is opposed to HB 446. Jean Robinson, Government Relations Director, is the go-to person at ABMP. She can be reached at 800-458-2267 ext. 645 or jean@abmp.com.

From the ABMP website:

New Hampshire Bill Would Repeal Massage Therapy Regulation

Thursday, February 17th, 2011

House Bill 446 FN, sponsored by Representative Spec Bowers (Phone: (603)763-2369 Email: spec.bowers@leg.state.nh.us ) of Sunapee, would repeal the professional regulation of several occupations in New Hampshire, including massage therapists, reflexologists, structural integrators, and Asian bodywork therapists...

ABMP is opposed to this bill and encourages you to ... voice your opposition.

The profession has been regulated in New Hampshire since 1980. The current licensing law sets entry-level standards for education and provides an avenue for consumer complaint. While ABMP would not be opposed to lowering the 700 hour entry-level education requirement to 500 hours to be more consistent with the rest of the country, there is no reason to repeal the regulation altogether.

Representative Bowers claims that he and his co-sponsors believe the “consumer is king and they should be able to hire the provider of their choice without interference from the state.” We agree and believe this is already the case even with regulation. Representative Bowers is also concerned that regulation discourages entrepreneurs from bringing businesses and jobs to the state. Setting entry-level education standards for a health profession is not discouraging entrepreneurs, it’s protecting the public.