Since 1998, reflexology has been removed
from massage regulation in the states of Washington, Texas,
Tennessee, New Mexico, North Carolina, Maryland, Arizona, and the
city of Chicago. Should pending massage licensing legislation be
enacted this year in Idaho, Montana, and Pennsylvania, reflexology
will be excluded in the resulting laws. Massage licensing requirements continue
for reflexologists in the states of Oregon, Delaware, Hawaii,
Alabama, Nebraska, New York, and Florida as well as under
anti-prostitution ordinances in the cities of Los Angeles, Denver,
and Colorado Springs. The San Diego City Council will vote to
establish separate licensing for reflexologists (March
2003). Reflexology is clearly different from
massage in its origins, technique applications, safety issues, and
assessment. The modern-day practice of reflexology is a direct
descendant of medical research into the reflex at the end of the
nineteenth century in Europe. A variety of therapeutic methods was
created to influence the body through the reflexes. One resulting
therapy was the work of Dr. William Fitzgerald of Connecticut who
created zone therapy, application of pressure to all parts of the
body, following a visit to England. His work was gradually developed
by Dr. Riley and Eunice Ingham into the foot work known today in
America as reflexology. An established standard of practice has
been accepted by the reflexology profession as represented by the
professionals organizations, Reflexology Association of America and
the American Reflexology Certification Board. It is: "Reflexology is
the physical act of applying pressure to feet and hands with specific
thumb, finger, and hand techniques that do not utilize cream, lotion
of oil, assessed on the basis of zones and reiterative areas with the
premise that such work effects a physical change in the
body." Massage laws are arbitrary and
unconstitutional, failing to demonstrate that restraining
reflexologists from entry into their profession is rationally related
to legitimate public health and safety objectives. While the national standard of the
reflexology profession is 200 hours of education, no reflexology
education is required of massage licensees. Over-regulation becomes
no regulation as massage licensees with little or no reflexology
training provide reflexology services. As a result, consumers are
mislead as to the competency of state-approved reflexologists. In
addition, reflexologists are required to obtain education that is not
relevant to their profession. As noted in case law: "California law used
to require that African hair braiders spend 1,600 hours in classes,
costing at least $5,000, at state-approved cosmetology schools and
pass a licensing examination in order to legally practice their
craft. California's cosmetology schools teach hair-straightening and
chemical use but absolutely nothing about braiding. …The federal
court held in Cornwell v. California Board of Barbering and
Cosmetology that the licensing law was arbitrary and
unconstitutional. This was an important victory for economic liberty
&emdash; the right to earn an honest living free from excessive
government regulation." Massage laws and their enforcement are
arbitrary and prejudicial. Of the many alternative health practices
where pressure is applied, not all are required to obtain massage
licensing. Existing laws are not enforced for other
professionals. "Massage" is offered by clerks selling make-up at
counters in department stores with no penalty. Licensed massage
therapists offer services tantamount to the practice of medicine with
impunity. For example, providing reflexology services and selling
herbs in a single session to a client, raises the issue of diagnosing
a problem with reflexology and then prescribing an herbal
remedy. Public safety issues are met by the
assurance that, when licensed, practitioners practice within the
legally defined, legislatively-mandated and licensed scope of
practice, "confining their work to those (activities) that they are
trained to do." Fair Practice Acts in each state maintain
that the consumer receive goods or services as promised. No massage
law, ordinance or rules includes a definition or scope of practice
for reflexology. Consumers cannot be assured of what services are to
be received or if reflexology services provided are within
professional boundaries. The Constitutional, First Amendment Rights
of reflexologists have been abridged by massage regulation of their
profession. Under such laws, individuals are not allowed to provide
or receive health services or their belief choice. In order for such
abridgement to take place, it must be shown that there is an
over-riding public safety issue. The
legal situation for reflexologist's in 1998 could only be described
as grim. A reflexologist in Tennessee and another in Florida were
issued cease and desist orders, requiring that they cease business
because they did not possess their state's massage licensing. At that
time, some 33% of the American population was mandated by law to
receive reflexology services from massage licensed individuals.
Reflexologists have expressed concern about the appropriateness of
regulation by massage licensing because: (1) the focus of massage
licensing is to discourage prostitution due to professional problems
not shared by reflexologists, (2) the consumer is not protected in
the purchase of reflexology services since no reflexology training is
required, and (3) reflexology is an idea and profession separate from
massage. What
a difference four years have made. Reflexologists rallied and have
contested licensing, winning in state after state. With the most
recent success, Chicago, reflexologists have changed legal
requirements for providing services to 35.5 million Americans.
Reflexologists in three states and one city are no longer required to
obtain massage licensing. Officials in Texas (population, 21 million)
removed reflexology from massage licensing following participation by
reflexologists at public hearings. An exemption in law was signed
into law in Washington (population, 6 million) in March 2002. The
state of Tennessee (population 5 million) now has a legislatively
mandated registration system for reflexologists. Chicago residents (3
million) will have (August 2003) access to reflexology services from
non-massage licensed individuals thanks to the enactment of a new
Illinois state massage law that exempts
reflexologists. In
other states, newly enacted massage licensing brought response by
reflexologists. Reflexologists in North Carolina.were granted an
exclusion from massage licensing by the state's newly created Board
of Massage. Reflexologists in Maryland obtained an exemption in law
from massage licensing. Reflexologists in Pennsylvania, Idaho,
Montana and Arizona will be granted exemptions should legislation be
enacted to license massage in those states. In addition,
reflexologists in New Mexico obtained an exemption in law following a
change in the state's massage licensing. (May 2003 up-date: Arizona
massge licensing signed into law with massage defined as services not
primarily applied to the head, hands and feet thus excluding
reflexologists. Montana massage licensing sttempt
failed.) Massage
licensing (but no reflexology training) is still required of
reflexology service providers to some 20% of the American population
including those in: New York, Florida, Oregon, Delaware, Hawaii,
Alabama, Nebraska, Denver, Colorado Springs, Los Angeles, San Diego
and a few other cities. A change in state regulation is under study
by New York state officials. (March 2003 up-date: San Diego City
Council will soon vote to create reflexology licensing thus ending
massage liccenisng requirements for reflexologists.) The year 2001 marks the year
that reflexologists turned the tide of regulation in their favor.
Three years ago reflexologists faced massage licensing requirements
in states and cities representing one-third of the American
population. Today, culminating years of efforts and active
participation in legislative and regulatory processes, reflexologists
are changing laws, ordinances, and regulations effecting millions and
in place for ten and twenty years. The regulatory systems have been
reviled by reflexologists for belittling the practice and the
practitioner. Current Chicago regulations, for example, require
massage training of reflexologists, no reflexology training, and
subject reflexology practitioners to anti-prostitution regulations
such as VD and AIDS testing. Reflexologists are now free to practice
in some areas, control their own destiny in others, and have
potential for freedom in still further areas. Reflexologists
have learned how to create change by working within the regulatory
process. Reflexologists have learned that: Millions
of Americans are impacted by the changed regulations: Texas and its
population of 20 million, San Diego and a population of 3 million. If
the Illinois massage therapy licensing law is enacted, the long-time
Chicago city massage ordinance will fall, freeing reflexologists to
practice in the city of 5 million. (Effective date of change: August
2003.) The
roles of individual reflexologists cannot be understated in this
achievement. Not all efforts succeed but those who work for the good
of reflexology while spending their own time, money and effort in the
sometimes mind-numbing boredom of the governmental process are to be
congratulated for their contributions to the future of
reflexology. Reflexologists
have learned that professionals faces a clear and present danger with
the enactment of state massage therapy laws. Legislation passed in
recent years in Alabama, Tennessee, New Mexico, and Maryland included
no mention of reflexology. Subsequent findings by attorneys general,
and decisions by newly created Massage Therapy Boards, however, have
raised the issue of requiring massage licensing of reflexologists in
these states. These laws are seen to be "practice" laws. Thus, the
Boards are legally entitled to define "massage" as including
reflexology (and other) practices and to require massage licensing.
(The issue has been resolved in New Mexico and discussion continues
in Tennessee.) Reflexologists in Maryland were unaware that massage
legislation was working its way through the legislature.
Reflexologists in New Mexico were told the legislation was a "title"
law, impacting only massage therapists, at the time it was passed.
(It is not clear whether language in the original law was not
appropriate to a "title" law or whether changes in the law over the
years changed the Massage Practice Act to a "practices"
act.) Beginning
in the 1970's city officials attempted to stem the use of the word
massge as a cover for prostitution. Especially noticeable were massge
paror ads under the heading of "Masage" in the "Yellow Pages" of
telephone books. Since anyone in a bodywork profession was required
by the phone company to list under "Massage," the heading icluded
lisstings from an array of body wokers beyond the troubvled massge
designation. In
respoinse to the situatioon, many cities adopted so-called "touching"
ordinances requirein that anyone who "touched" another for money
under any job title would puchase a massage license. Even
though reflexologists sought and were granted a "Reflexologist"
heading to avoid the confusion of their business with prostitutioon,
the profession was ensnared by the cities' simples solutioon to the
problem of prostitutioon and massage. House
Bill 90, exempting reflexologists from the states massage practices
act, has failed. A previous attempt two years ago
failed. Reflexologists
find themselves living in the eleventh state to require massage
licensing of reflexologists as the legislative session in Alabama
ended before any change was made in the recently enacted massage
law. • A packet of information
about reflexology will be hand-delivered to state legislators by
reflexologists in Alabama. The reflexologists are seeking an
exemption from the state's massage law. It requires massage licensing
of reflexologists. (Alabama Reflexology Association, P. O. Box 4715,
Huntsville, AL 35815, Barbara Musso, 205-650-0447) A
packet of information about reflexology will be hand-delivered to
state legislators by reflexologists in Alabama. The reflexologists
are seeking an exemption from the state's massage law. It requires
massage licensing of reflexologists. (Alabama Reflexology
Association, P. O. Box 4715, Huntsville, AL 35815, Barbara Musso,
205-650-0447) Massage
therapy licensing became law in Arizona after a bill passed in the
legislature and was signed by the governor on May 12, 2003. It
defines massage therapy as "The manual application of compression,
stretch, vibration or mobilization of the organs and tissues beneath
the dermis, including the components of the musculoskeletal system,
peripheral vessels of the circulatory system and fascis, when applied
primarily to parts of the body other than the hands, feet and head."
Arizona reflexologists achieved their goal of avoiding licensing as
massage therapist (http://www.azleg.state.az.us/legtext/46leg/1r/bills/sb1103o%2Easp) A
coalition of hands-on practitioners is meeting next on July 29 to
consider legislation that would create licensing. Los Angeles area reflexologist Cheryl
Matthews was recently denied a license to practice by the city of Los
Angeles because her education was not obtained from a massage school
on the city's list. The city of Glendale has volunteered to issue a
"Bath and Massage Technician" license with the inclusion of
"Reflexologist" on it if Matthews submits five reference letters, a
doctor's statement of no communicable diseases, TB test and fees. She
had completed a 210 hour program in reflexology taught at an
accredited university. For the first time in twenty
years, long-time practitioner Jim Ingram of Mission Hills, California
was refused the Los Angles city massage license required of
reflexologists in March. Orange County south of Los Angeles is moving
to implement a county-wide massage ordinance to replace the existing
hodge-podge of local licenses. "Practitioners who present to the Police
Chief proof of satisfactory completion of two hundred hours of
reflexology classroom instruction in reflexology related subjects
dealing with feet, hands or ears and reflexology practice from a
reputable school of reflexology. The practitioner must submit proof
of attendance, including certified transcripts or other documents
acceptable to the Police Chief." Sacramento,
California reflexologists were once subject to the city's "adult
entertainment" licensing requirement. Aside from the $5,000 per year
fee, few areas of the city were zoned appropriately for such zoning
requirements. A particular distance from schools, residences and
schools was required. It was virtually impossible to rent office
space that qualified as meeting zoning requirements. Reflexologists
lobbied with other hands-on professionals to create an improved
licensing and zoning arrangement. Following
two years of negotiation and a unanimous vote by the City Council,
reflexologists and others in the city of Sacramento may now apply for
a "somatic practitioners" license. For years practitioners in the
city had practiced underground to avoid the $4,000 business licensing
fee as an "adult business" required of them and businesses such as
pornographic bookstores. Such licensing also confined practitioners
to a few limited commerically zoned areas of the city. Now,
"therapists must provide proof to city police that they have a
diploma from an accredited massage therapy school, and that they have
120 hour of classroom instruction (That increases to 250 hour on Jan.
1.)... "They also must be a member of a national professional massage
organization, and must receive 12 hours of continuing education each
year." (Bizjak, Tony, "Massage therapists freed from 'adult business'
label," Sacramento Bee, May 20, 1998, p. B8) (Thanks to Adrienne
Elliott for the article.) Legitimate
massage practitioners and a coalition of "healing-arts" professionals
are seeking a new ordinance in the city of Sacramento. They are
campaigning for an ordinance that would separate health professionals
from other masseuses. Currently massage practitioners are licensed as
"adult entertainers" and massage establishments are zoned to one
small part of the city with other "adult related" businesses. Permits
cost $4000. The proposed ordinance would require a $260 initial fee
and $100 annual fee with the right to practice anywhere in the city
where business zoning is permitted. The "somatic practitioner"
classification would require of practitioners a minimum of 250 hours
of professional education and a personal background check. Some
practitioners complained about the requirement of membership in a
professional association for certification of competency. (Thanks to
Adrienne Elliott for contributing "Coalition seeks separate law for
certified massage therapists" by Ted Bell, Sacramento
Bee) Sacramento Bee, p. 1,
"Massage-parlor sex sneaks back into capital" by Marje Lundstrom and
Chris Bowman, Reflexology is used as a dodge by prostitutes to avoid
the city's strict massage law. Bobbi Warren is one step
closer to seeing her dream come true - seeing reflexology out from
under the massage licensing ordinance in the city of San Diego. At a
public hearing on March 26, 2003, a sub-committee of the San Diego
City Council recommended that reflexology be regulated separately
from massage. The full City Council will vote on the
measure. In October 2000, the City
Council held a public hearing to review its massage licensing
ordinance. At that time, the city required of reflexologists and
others regulation by the San Diego Police Department (SDPD) Vice
Squad with two levels of licensing: (1)110 hours of training of those
receiving a massage technician license; (2) 500 hours for a massage
license. Those with 1000 hours of training practiced as a holistic
health practitioner (HHP), unregulated by the SDPD. From 1989 to
2000, 27 individuals with HHP status were arrested for prostitution.
Following the public hearing, the San Diego City Council appointed a
task force consisting of alternative health practitioners to explore
the issue. The task force deadlocked by a 6 to 6 vote on its
recommendation to include reflexology in massage licensing
requirements - 500 hours of massage education with no reflexology
training. At the March 2003 hearing,
a Kunz and Kunz legal argument and strategy faxed to Bobbi caught the
attention of Councilors: (1) A recent Federal court case found that
hair braiders should not be subject to cosmetology licensing because
required educational hours had nothing to do with their craft and (2)
Under its plan the city would license individuals, guaranteeing
safety and competency to the public to practice many alternative
modalities, following 500 hours of massage training. In point of
fact, meeting educational requirements established by each of the
professions would require thousands of hours of
training. Before 1998, some 33% of
the American population was covered by such licensing mandates. If
the measure makes it through the full City Council, the 3 million
residents of San Diego will join some 35.5 million other Americans
who are now free to purchase reflexology services from someone other
than a licensed massage therapist who has received no mandated
reflexology education. Thanks to efforts of reflexologists since
1998, residents of Texas, Tennessee, Washington, Maryland, North
Carolina, New Mexico, and Chicago have seen changes in laws and
Massage Board Rules removing reflexologists from massage educational
requirements. Lesson learned over the
years: City councilors, state legislators, and state officials take a
common sense view of licensing requirements for reflexologists that
include no reflexology education. Massage Board members (who are
frequently massage school owners) and others with such economic
interests will vote with their economic concerns to maintain or
establish massage education requirements for
reflexologists. Massage licensing is
currently required of reflexology service providers to some 20% of
the American population including those in: New York, Florida,
Oregon, Delaware, Hawaii, Alabama, Nebraska, Denver, Colorado
Springs, Los Angeles, and a few smaller cities. A change in state
regulation is under study by New York state officials. A public hearing will be
held to receive public comment about changes in the city's Massage
and Holistic Health Ordinance. The Public Safety and Neighborhood
Services Committee of the City Council will be held March 26 at 2 pm
at the Council Committee Room on the 12th floor of the City
Administration Building loacted at 202 C Street in Dan
Diego. Reflexologist
Bobbi Warren is continuing work as a task force member to designate
reflexology as separate from 1000-hour massage education requirements
and anti-prostitution regulatory system in the city's soon-to-be
changed massage ordinance. The city council held a public hearing to
consider changes in the massage ordinance. Under the current
ordinance, twenty-eight individuals had been arrested for
prostitution while holding massage licenses over a ten-year period.
Chair massage practitioner were the only other hands-on practitioners
to request differentiation from the massage requirements.
Reflexologists will be required to obtain licensing but in terms of
reflexology standards, 200 hours of training rather than 1,000.
Licensing will be separate from the anti-prostitution massage
ordinance. San
Diego-area reflexologist Bobbi Warren continues work toward the goal
of avoiding the placement of reflexology under Massage licensing
requirements in the city of San Diego. A Task Force named by the City
Council was unable to agree on a recommendation for Council action. A
sub-committee of the City Council meets next to consider the issue.
If included in massage licensing, reflexologists would be required to
obtain a 1,000-hour massage education in order to practice in the
city. Reflexologist
Muff Warren found a powerful ally in her presentation to the San
Diego City Council - the mayor. In response to Muff's remarks about
the inclusion of reflexologists in massage therapy licensing by the
city, Mayor Golding noted that she had received reflexology services
and "everyone knows" reflexology is not massage. The San Diego City
Council then decided to exclude reflexology from the massage
ordinance it has been subject to since 1989. The
Council held a public hearing on October 23 to receive comment about
the city's massage ordinance. In the past, the city has required
regulation by the San Diego Police Department (SDPD) Vice Squad with
two levels of licensing: (1)110 hours of training of those receiving
a massage technician license; (2) 500 hours for a massage license.
Those with 1000 hours of training practiced as a holistic health
practitioner (HHP), unregulated by the SDPD. Since 1989, 27
individuals with HHP status have been arrested for prostitution. City
reflexologists had been concerned that the new 500-hour education
standard would be applied to reflexologists. A task force has now
been created to consider solutions ranging from total exemption for
reflexologists to licensing requiring fewer than 500 hours of
education Modesto,
CA The
Executive Director of the Florida Massage Therapy Board has requested
examples of exemptions and exclusions from Dwight Byers,
International Institute of Reflexology in St. Petersburg. Kunz and
Kunz track such information and supplied the examples. The
state Board of Massage Therapy has deleted language mentioning
reflexology from its Rules and Regulations. Previously it had been
stated that "The following acts shall constitute gross negligence in
the practice of massage for which the disciplinary penalties
contained in Sections 455.227 and 480.046, Florida Statutes may be
imposed: ... (e) engaging in the practice of reflexology without a
current massage license." While the significance of the deletion to
reflexologists is unclear, the change may spell the end of a
long-standing controversy in Florida. Some reflexologists had been
issued cease and desist orders and continued reflexology practice
only after action had been taken by their attorneys. In an
on-going effort to regulate reflexology as massage, the state of
Florida has acted to enforce a state Massage Board decision requiring
that "reflexologists" obtain massage licensing. During a January
meeting of the Florida state Massage Board, reflexologist Diane
Breeding made a public statement during the meeting on behalf of the
eighteen reflexologists present. Following the statement, she was
asked by a Florida assistant attorney general if she was a
reflexologist. Diane replied, yes. She was served a cease and desist
order by an enforcement officer from the Department of Health in
March. At one point, a charge of practicing medicine without a
license, a felony, was under consideration. Her husband Paul was
subsequently issued a cease and desist order. Attorneys for the
couple have responded to the state's order. During a series of
interviews by Kevin Kunz with massage officials it was noted that
reflexologists who can show two hundred hours of education and have
them approved by a massage school as meeting educational standards
can be issued a state massage license. Reflexologists
were almost licensed in the state of Florida but Governor Chiles
vetoed the bill at the eleventh hour. The legislation had been passed
by both houses of the Florida legislature and would have become law
at midnight on June 19, 1995. The governor vetoed the bill at ten
minutes to midnight. Florida
reflexologists had worked for years to bring the legislation to the
governor's desk. The St. Petersburg-based International Institute of
Reflexology, owners Dwight and Nancy Byers, reflexologists Diane and
Paul Breeding, and reflexologists Harold and Gayle Charleston had
donated time, money, and effort to the goal of creating a separate
licensing for reflexologists. The reflexologists had hoped to
establish themselves as a profession separate from
massage. If
passed, the law would have created a reflexology license, regulated
under the Massage Board. The requirements of licensing would have
included certification by the American Reflexology Certification
Board (ARCB). ARCB requirements include 100 hours of classroom
instruction, work on a certain number of feet, testing, and practice
within a particular scope of practice. Diane
Breeding notes, "A Florida Licensed Massage Therapist may practice
reflexology and never (have) taken a course or read a book. This
would not have changed if the new law had passed. However, only a
licensed reflexologist would be able to teach if the new law was in
effect." As a
result of the governor's veto, the established law continues.
According to the Florida state Massage Board, reflexologists are
required to be regulated by the Massage Board. Reflexologists in
Florida contest this interpretation of the state's law. (See "At
Issue in Florida") The net result has been a 10-year stand-off
between the Board and reflexologists. In
1985, the Florida state Department of Business and Professional
Regulation (DBPR) received a query regarding reflexology. It was
forwarded to the state attorney general's office which issued a
finding that the practice of reflexology was a part of massage
practice therefore it should be regulated under the Massage
Board In
1987, cease and desist orders were being prepared against several
reflexologists by the attorney general's office. The International
Institute asked that its practicing reflexologist, Diane Breeding be
issued a cease and desist order as a representative of the
group. At
meetings with the DPR and the IIR, both sides agreed that it was an
injustice. Subsequently the DPR asked the Massage Board why
reflexology should be regulated especially without a
grandfathering-in provision. Several
years of legal limbo followed, when reflexologists were not
challenged legally. Unable to be separately licensed under the
Massage Board, Florida reflexologists looked to other Boards in the
state to take them in. Any such move would have required an exemption
from the Massage Board and the Massage Board would not grant the
exemption. In
1991, a cease and desist order was executed against reflexologists
Diane and Paul Breeding. IIR attorneys raised the issue of the
vagueness and, therefore, the constitutionality of the law. See "At
Issue in Florida." In
1993, the IIR hired a lobbyist. The first year the lobbyist
acquainted legislators with the reflexologists and their situation.
In 1994, legislation was introduced but failed to. In
1995, the legislation passed the House creating separate licensing
for reflexology under the Massage Board. No sponsor was found in the
Senate until one sponsor tacked it onto another bill. The bill
involved construction workers and unions. Governor Chiles vetoed the
bill because of his opinions about this portion of the bill. Questions
about the Florida Massage Practice Act center around the claim of
domaine over the practice of reflexology by the Florida State Massage
Board. Does the Florida Board of Massage really have the legal right
to regulate reflexology? Issue
1: Massage is defined as the manipulation of "superficial tissue" in
the Florida state law. Reflexologists raise the question of why their
practice should fall under this definition. No known dictionary
includes "superficial tissue" as a term. The two words appear to be
joined for the convenience of Florida state massage legislation. It
represents no apparent body of knowledge including
massage. Issue
2: "Reflexology" is not included in the Florida sate massage law.
Reflexology is included, however, in the regulations of the Florida
Board of Massage. At issue is vagueness and constitutionality of the
law. Specifically: If the state of Florida has seen it necessary to
regulate a profession, such as reflexology, why is it not in the
statute? Or is the Florida Department of Professional Regulation
interpreting the state statute to create its own meaning? (Raymond
Beck, "Commentary: An Interpretation of Florida's Massage Law,"
Massage, May/June, 1995, pp. 116-7.) Issue
3: Attorney/reflexologist Ray Beck argues that the Florida law is a
hybrid act - both a "title" act and a "practice" act. The law states
that those who use the title "massage therapist" or who manipulate
superficial tissue or apply to the body any herbal or chemical
preparation are required to be licensed for massage therapy by the
state. At issue: If a reflexologist does not claim to practice
"massage therapy," does not apply preparations to the body, and does
not work with the intent to manipulate superficial tissue, can he or
she be regulated by the Board of Massage? Reflexologists
working to be exempted when and if massge licensing is enacted.
(February 2003) Chicago
For the first time in mote than a generation, Chicago reflexologists
will be free to practice without massage licensing. The state of
Illinois has enacted a state-wide massage law that exempts
reflexology. It supersedes the city's long-time ordinance requiring
massage licensing of reflexologists. The law impacts Chicago in
August 2003. The
exemption states: "Exempt bodywork methods include those that involve
energy techniques only without intentional soft tissue manipulation
of any kind, movement education and re-education, and somatic
education, addressing awareness, posture and action by verbally and
physically guiding the student in the discovery of existing and
alternative postures and actions. Specific modalities included in
this exemption are Zen Therapy, Rolfing, Alexander Technique, Reiki,
Polarity, Feldenkrais, Trager, Therapeutic Touch, OrthoBionomy,
Reflexology and approved Asian bodywork modalities." The
Chicago city massage ordinance was an anti-prostitution measure. 500
hours of massage training from a state-approved school were required
of license holders as well as membership in a major professional
association, such as the AMTA. Further requirements included VD and
TB tests. The licensed individual was required to work for an
establishment with a massage establishment license. Facilities were
required to include separate facilities of showers and changing rooms
for males and females. Board of Health, Building Inspector, and Fire
Department representatives paid surprise periodic visits to the
establishment. The total cost of licensing was $600 per year. (Nurses
in Illinois pay $10 per year for licensing.) Illinois
legislators sought to license massage therapy throughout the state
during the spring session for the purpose of unifying the many
municipal ordinances regulating the massage profession as separate
from prostitution. House Bill 2211 was tabled by the Rules Committee
of the Illinois Legislature. Had it passed and received the
governor's signature, reflexologists in that state would have been
required to obtain licensing under a Massage and Somatic Practices
Act. While reflexology is not specifically mentioned, massage
licensing has eventually been required of reflexologists in other
states under similar circumstances. Ironically,
a long list of modalities would have been specifically exempted in
the bill but not reflexology. This is the exact opposite of the
situation in New Mexico where reflexology was the only modality
exempted in law and other modalities are subject to the massage
therapy practices act (but excluded under Rules and Regulations
adopted by the Board of Massage Therapy). Legislation will be
presented in the next legislative session to license massage
therapy. Years of efforts
spear-headed by Pat Barrants has resulted in a temporary exemption in
Iowa. The Iowa Department of Public Health will conduct a one-year
study to determine if reflexologists (and practitioners of other
modalities) should be requirred to obtain massage therapy licensing.
"The Iowa department of public health, with input from the (massage
therapy) board, shall conduct a study regarding the modalities
associated with the practice of massage therapy. The study shall be
conducted with the input of licensed massage therapists,
reflexologists, and unlicensed persons practicing modalities related
to massage therapy. The objective of the study shall be to determine
which modalities shall be included under the definition of massage
therapy and require licensure, and shall include, but not be limited
to, a recommendation regarding the licensure of reflexologists. The
study shall focus on the health, safety, and welfare of the public
regarding each of the modalities reviewed. The department shall
submit a report summarizing the results of the study and making
recommendations regarding modality inclusion to the general assembly
by January 15, 2003.… "The bill provides that an individual who
is engaged exclusively in the practice of reflexology or an
unlicensed individual who is practicing a modality related to massage
therapy, but whose professional practice does not incorporate aspects
that constitute massage therapy as defined in Code section 152C.1,
shall not be subject to the licensure provisions of this chapter for
a one-year period beginning July 1, 2002, and ending June 30, 2003.
Beginning July 1, 2003, these individuals shall be subject to
licensure unless permanently exempted based on the results of the
modalities study."
(http://www.legis.state.ia.us/GA/79GA/Legislation/HF/02300/HF02390/Current.html) Reflexologists
are once again seeking legislation to be exempted from the state's
massage licensing law. In the previous legislative session an
exemption bill was defeated in legislative committee. Legislators
were swayed by a legislator who was also an osteopath. He
successively argued that reflexology was not a therapy and should not
be included with licensed massage therapy. An
exemption from state massage licensing for reflexologists failed in
Senate committee after passing a House of Representatives committee
and the House (by a vote of 92-0). The Bill sought to exempt
reflexologists for two years during which time the Department of
Health would study the issue and decide whether or not reflexology is
indeed a part of massage and thus subject to regulation by the
massage board. An Osteopath testifying before the Senate committee
stated that reflexology is not a therapy and, thus, should not be
considered for regulation as a massage therapy. Ironically,
reflexologists had originally sought total exemption from the massage
practices act. The Bill as presented was a compromise measure sought
by the massage board. Defeated along with the reflexologists'
exemption was a provision sought by the massage board creating a
limited-time grandfathering-in for massage
practitioners. An
exemption from state massage licensing for reflexologists failed in
Senate committee after passing a House of Representatives committee
and the House (by a vote of 92-0). The Bill sought to exempt
reflexologists for two years during which time the Department of
Health would study the issue and decide whether or not reflexology is
indeed a part of massage and thus subject to regulation by the
massage board. An Osteopath testifying before the Senate committee
stated that reflexology is not a therapy and, thus, should not be
considered for regulation as a massage therapy. Ironically,
reflexologists had originally sought total exemption from the massage
practices act. The Bill as presented was a compromise measure sought
by the massage board. Defeated along with the reflexologists'
exemption was a provision sought by the massage board creating a
limited-time grandfathering-in for massage
practitioners. Exemption
from massage licensing for reflexologists met with unexpected
complications in the Iowa legislature. Sponsoring legislator Jeff
Elgin had suggested an informal review of the massage law by a member
of the Attorney General's staff. The assistant attorney general
informally noted that reflexology was indeed a part of massage as
defined in the Iowa law. The Iowa law, defining massage as "soft
tissue manipulation," is typical of state massage laws - written with
a definition vague enough to exclude possible acts of prostitution.
If it passes, the exemption for reflexologists currently will include
a two-year exemption for reflexologists. During the time period, the
Iowa Department of Health will study the issue and determine if
reflexology and other alternative health modalities are in point of
fact a part of massage. Quick
action by Patricia Barrance of Marion, Iowa and others provided
prompt relief from the possibility of massage regulation of
reflexology. When minutes from a recent state Board of Massage showed
that Board members considered changes that would require the state's
reflexologists to meet massage licensing qualifications to practice
reflexology, reflexologists got on the agenda to present their
objections at the September 4 Board meeting. Kunz and Kunz have
provided what-to-do information gleaned from successful encounters in
New Mexico and Texas. An agreement was reached and reflexology will
not be included in massage regulation. Legislative action for a
reflexology exemption in law at the January, 2002 session is under
consideration. Letter
to the Editor "Thank you so much for the information about our
Massage Therapy Board. I will be putting the form letters to good use
this week. I plan on attending the meeting on the 4th along with
Patricia Barrance. I have to thank you for all of your hard work you
have done for all of us. Just got off the phone with Kay Thomas and
she had talked with you earlier. She mentioned that you have been
fighting for our rights for over 20 years. THANK YOU, THANK YOU,
THANK YOU. Without your help we would not be doing our work this
well. Sincerely, Marcia Lenning, Humboldt, Iowa" Following
more than a year of efforts by members of the Maryland Reflexology
Association and members of a coalition of other impacted
practitioners, an exemption for reflexologists and other
practitioners has been signed into law by Governor Glendenning.
Senate Bill 194 had passed the Senate by a vote of 46 to 1 and the
House of Delegates by a vote of 138 to 70. It states "Massage Therapy
DOES NOT include the laying on of and consisting of pressure or
movement on a full clothed individual to specifically effect the
electromagnetic energy or energetic field of the human
body." Reflexologists
in Maryland are lobbying the state legislature to provide an
exemption to the Massage Practices Act for
reflexologists. A
coalition of bodywork practitioners has formed to question state
massage licensing requirements. Under a
law that took effect October 1, 1999, reflexologists and others who
"knead, stretch, tap, rub, stroke, or compress soft tissue in any
manner or degree" are subject to certification or registration as a
massage therapist or practitioner. The requirements for a waiver
available until 2002 include (1) proof of three hundred paid hours of
massage, (2) proof of passing the National Certification Board for
Therapeutic Massage and Bodywork examination, and (3) completion of
the Maryland Jurisprudence Examination. After 2002, requirements will
include completion of a 500-hour course of study at a state-approved
and COMTA accredited school or accredited by a certification society
approved by the U.S. Department of Education or a school program
equivalent to that approved by COMTA. State investigators will refer
alleged violators to the state attorney general's office. Violators
are subject to a $5,000 fine and a year in jail. Reflexologists
are attempting to hold in legislative committee a massage therapy
bill until an exemption for reflexologists is
included. Janice
L. Lucht of Worcester, Massachsett's is the first and only
reflexologist granted a business license separate from other
modalities by the city's Department of Public Health. In Lucht's own
words: "I was told I needed to have 500 hours of massage school to
get a license to practice reflexology. I told them I was not a
massage therapist and wanted a license to practice reflexology and
that I was prepared to fight for it. I sent a large packet of
information, a long cover letter and a legislative packet from ARCB
(American Reflexology Certification Board) and about a month and a
half later, I received a call saying that I would be issued a license
to practice reflexology. I said so I've paved the way for other
reflexologists and he said yes, you have!" Massage
therapists in Massachusetts had hoped that a state massage law would
provide for relief from a hodge-podge of local ordinances. Passage of
a legislative bill establishing a state massage ordinance was
defeated in late July. A group of physical therapists helped lobby
against it. The
bill had been considered by some to be an example of enlightened
legislation. It included a provision to create a separate board of
massage therapist and somatic practitioners. A
common complaint about the typical massage law is that many other
therapies are encompassed by laws with no specific educational
requirements or clear definition. The holder of a massage license is
thus legally allowed to practice any of a number of alternative
practices with no training or experience. At the same time, an
alternative practitioner with training and experience in a single
therapy such as reflexology cannot practice without meeting licensing
requirements for the profession of massage. Massage
therapists complain about the difficulties of practicing in
Massachusetts under current laws. Local ordinances vary widely. Many
are based on "regulations that come from an era when massage was
considered akin to prostitution." One town requires a window in
massage rooms. One requires an open window in a massage room. One
requires testing for syphilis. "In Revere, massage therapy is listed
in the municipal code under `offenses against public decency.' Cross
gender massage is prohibited." Physical
therapists defended their position, stating that massage therapists
do not have sufficient training to be health care providers and
therefore pose a serious risk to the public. Others contend that
physical therapists compete with massage therapists for
business. The
bill will be reintroduced later this year. ("Mass. Laws Irk
Massagers," Associated Press, AOL News Profiles @aol.net, Sept. 9,
1996) A
legislative conference committee is working out differences between
House of Representatives and Senates bills for the "Complementary and
Alternative Health Care Freedom of Access Act." The law would
"establish an office in the state Health Department to investigate
complaints and disseminate facts about alternative treatment. ... The
bill under consideration would not attempt to license or set training
standards for alternative practitioner, but rather to oversee their
work when necessary." While reflexology is not specifically mentioned
in the bill, reflexologists would be included. The
bill creates an office to investigate complaints against "unlicensed
complementary and alternative heath care practitioner," disciplining
them and providing information on complementary and alternative
health care practices. The bill requires the reporting of "certain
conduct" of the "unlicensed complementary and alternative heath care
practitioner" by governmental entities, health care institutions,
professional societies, health care professionals, insurers who
provide professional liability insurance, court
administrators. The
client must be made aware of the "alternative health care client bill
of rights." The bill includes a full and fair disclosure system with
informed consent making the client aware of theoretical approach
utilized by the practitioner and his or her educational background.
Also included are (1) a description of the procedure for filing
complaints, (2) client rights to information concerning
practitioner's assessment, recommended course of treatment, including
duration of treatment, (3) client confidentiality, and other
provisions. "Current
law fives the state's medical practice board authority over anyone
who practices medicine without a clinics. That would still be
illegal, but most alternative health practices would no be construed
as `practicing medicine' in the same way as physicians do." ... Dr.
Paul Sanders, chief executive officer of the Minnesota Medical
Association, said the proposal is `something we can live with, given
the clamor to do something.'" The
Minnesota legislature will be presented with a bill from a coalition
that believes no licensing is needed for alternative practitioners.
According to "Working long draft 21A," the bill will propose a system
of informed consent: "`Informed
consent' means that an individual has been informed of the nature of
the health care practice including: 1. The
contents and methods of treatments; 2. The
anticipated benefits of said treatment; and 3. Any
reasonably foreseeable side effect that may result from such
treatment." "Prior
to the provision of any service the client or the client's legal
representative, must sign a written statement attesting that the
client has received a written statement of the complementary and
alternative practitioner's education, experience, and credentials
relating to the complementary or alternative health care practice
offered to them by the practitioner ..." The
practitioner is also required to provide to each client in
writing: 1. "a
statement in capital letters which reads as follows: `THE STATE OF
MINNESOTA HAS NOT ADOPTED UNIFORM EDUCATIONAL QUALIFICATIONS
STANDARDS FOR ALL COMPLEMEENTARY AND ALTERNATIVE HEALTH CARE
PRACTITIONER. THIS STATEMENT OF CREDENTIALS IS FOR INORMATIONAL
PURPOSES ONLY." 2. "a
statement in capital letters which reads as follows: TO PROVIDE
COMPLEMENTARY OR ALTERNATIVE HEALTH CARE PRACTICES DOES NOT INVOLVE
THE OFFERING OF A MEDICAL DIAGNOSIS FOR YOUR
CONDITION." 3.
"Information regarding the fee schedule and billing
practices" 4.
"Notice of their right to complete and current disclosure concerning
the practitioner's assessment and recommended course of
treatment" 5.
"Notice that the records of the client and transaction with the
practitioner are confidential, unless release of these records is
authorized in writing by the individual or their legal
representative." Attempt to license massage
therapy fails. Reflexologists in Montana are
working to include an exemption for reflexologists written into
massage therapy licensing under consideration during the
legislature's 2003 session. Nevada
reflexologist Hoss Wylie notes that a June 12, 1992 letter from the
Office of the Attorney General has actually been standardly issued to
anyone inquiring about reflexology since 1976. In the letter to the
City Attorney of Boulder City, the Office of the Attorney General,
State of Nevada, advises the city about issuing a business license to
a reflexologist. Assistant Attorney General Page Underwood states
that "The practice of reflexology, if it involves the treatment of
human illnesses and ailments, would constitute the practice of
medicine as defined in Chapter 630 of Nevada Revised
Statutes.Therefore, in accordance with Boulder City's Municipal Code,
a prerequisite to the issuance of a city business license would be a
medical license by the Nevada Board of Medical Examiners. "... It
must be pointed out that a medical license would not be required and
a business license could be issued for an individual who is simply
offering massage, which may represent an aspect of the practice of
reflexology, but the individual would be required to confine himself
to that scope of practice. However, a medical license would be
required if an individual exceeds that scope of practice and
undertakes to diagnose or treat diseases." The
Nevada Reflexology Organization, lead by Billie Scott, president, is
actively involved in defending their right to practice in the state.
As originally introduced, a proposed Nevada state massage law was to
include reflexologists among those required to obtain 500 hours of
massage training and testing to practice. Action taken by members of
the N. R. O. has created questions about the inclusion of
reflexologists in the bill. Billie Scott reports that the group wrote
to the legislative sponsor of the bill and the massage lobbyist.
Members of the group have also contacted their own assemblymen and
senators as well as attending sub-committee meetings. This activity
helped convince those involved with the bill to take a second and a
third look. The bill is currently being rewritten by its sponsors. It
has yet to win committee approval or to pass either house of the
legislature. If it
is true that politics makes strange bedfellows, then the proposed
Nevada law certainly qualifies. Two massage therapists "testified
massage practitioners have an image problem caused by people who
mistakenly believe they are prostitutes. Telephone companies
exacerbate the problem by taking advertisements from masseuses who
are actually prostitutes. ... At the same time, George Flint,
lobbyist for the Nevada Brothel Association, expressed support for
the bill because it might weed out illegal prostitution that exists
in places that advertise themselves as `massage parlors.' Flint wants
legal brothels to be exempted from the massage licensing bill as long
as the acts they perform are confined to licensed brothels."
("Massage bill leaves Las Vegas assemblyman tense" by Ed Vogel,
Las Vegas Review Journal, March 12, 1991) (Ed's.
note: In one version of the bill, legal prostitutes were exempted
from the proposed law while reflexologists were not. Reflexologists,
lead by R. R. P., fought for and won a "Yellow Pages" listing for
reflexologists in 1981 specifically to avoid telephone book
advertisements with prostitutes.) Members of the New Jersey Reflexology
Association are preparing to meet a new legislative effort to
regulate reflexology and other modalities through massage. Assembly
Bill #A843 has been introduced for the new session. (Reflexology
Association of New Jersey, c/o 187 Whitehead Avenue, South River, NJ
08882. Debra Hinlicky: 732-238-3927) Attempts
to create licensing for the "massage, bodywork and somatic therapist"
in New Jersey ended when the House of Representatives of the State
Assembly failed to pass the Bill. A reintroduction of legislation is
anticipated in the future. The
Bill would not have denied the right to practice reflexology to any
individual. It would, however, have created credentialling terms to
be used only by those who were state licensed. State-licensed
individuals would have been at an advantage in gaining jobs in
conventional medicine for the practice of any bodywork modality
including reflexology. Conventional medical institutions require that
alternative practitioners meet any state licensing
laws. Issues
about the legislation included: 1. The
creation of the profession of "massage, bodywork, and somatic
therapist" without the educational requirements standard to bodywork
professions (including all other state massage laws) -- completion of
a course of study in the professional practice. Completion of hours
of study in various modalities were accepted as adequate to certify
the competency of the "massage, bodywork, and somatic
therapist." 2. A
declaration that "massage, bodywork and somatic therapy practices are
designed to effect the energetic system of the body for the purpose
of promoting and maintaining the health and well-being of the
client." A
Massage, Bodywork and Somatic Therapist Act, Senate Bill 1866, was
introduced to the New Jersey state legislature on March 10,
1997. A copy
of the legislation is available by calling the state legislative
office at 609-292-4840. Our thanks to Alex Menard for this
information. District 18 State Senator Sinagra, sponsor of the Bill,
can be telephoned at 908-819-7551 and faxed at
908-819-7974. The Bill
creates the licensing of a "massage, bodywork and somatic therapist."
The license holder is required to successfully complete five hundred
hours of class study in the field of massage, bodywork and somatic
therapies or the successful completion of the written examination
offered by The National Certification Board for Therapeutic Massage
and Bodywork. No one
is prohibited from providing massage, bodywork and somatic services.
Individuals are prohibited, however, from using the titles granted to
license holders: "massage, bodywork and somatic therapist,"
"registered massage, bodywork and somatic therapist," "licensed
massage bodywork and somatic therapist," or the abbreviations "MBT,"
RMBT," LMBT," LOBT," or "LMY". Many
reflexologists reacted with alarm to the New Jersey Bill. Concerns
include: 1. The
law creates a new profession -- massage, bodywork and somatic
therapist -- without regard to the standards of bodywork professions.
A 1996 Reflexology Association of America Education Committee Report
found that certifiers of competency in bodywork professions require
the completion of a course of study in a specific curriculum of those
who are certified as competent. Thirty-one of thirty-two professional
organizations and state boards were in agreement on the issue.
Nineteen state laws were included in the assessment. The
proposed New Jersey law requires class study and not completion of a
course of study in an approved curriculum. 2.
Safety to the public issues are not considered in the proposed
legislation. The proposed legislation does not require that licensed
individual complete a course of study in his or her future profession
including the safety concerns inherent to any
profession. Practitioners
of reflexology and meridian-based therapies are aware of the
potential public safety issues involved in the mixing of their
practices with others. While the Bill states that massage, bodywork
and somatic therapies co not include the diagnosis of illness, courts
have found that the mixing of bodywork modalities in one client
session or the mixing of bodywork services with the sale of
ingestible substances has been considered the diagnosis of and
prescription for a disease. The Bill creates a system that encourages
the mixing of modalities by failing to clearly define each
one. 3. The
proposed legislation certifies the competency of the licensed to
provide any number of bodywork services. The potential is that the
licensed individual is given carte blanche to practice any therapy
with no actual education or experience in the bodywork service. The
question is thus raised whether or not the state of New Jersey is
sponsoring a state-mandated paper mill, creating a situation where
certification of competency is granted to individuals who are not
qualified. By
contrast, it is rumored that the state of California has recently
cracked down on paper mills, organizations that issue certificates to
the undeserving. The state evidently now requires that any
certification system be tied to a state-approved
school. 4. The
Bill states that "Massage, bodywork and somatic therapy practices are
designed to effect the energetic system of the body for the purpose
of promoting and maintaining the health and well-being of the
client." The meaning of the statement is unclear. Is the state
mandating an energy belief system? Will the New Jersey Bill
circumvent efforts to scientifically test alternative
therapies? 5. In
the state of Washington, the legislature required that insurance
companies make available alternative therapy practitioners to policy
holders as a benefit. Only state-licensed alternative health
practitioners are eligible to receive insurance
payments. As
alternative therapies grow in popularity, residents of New Jersey
face the future possibility of a state-sanctioned monopoly of
licensed alternative health practitioners, eligible to receive
insurance payments but untrained in providing the service sought. He
or she could not seek insurance payments for the services of a
trained and experienced but unlicensed practitioner. 5. Will
the Bill live up to its stated purpose -- to identify those
individuals who are best qualified to practice massage, bodywork and
somatic therapies? A typical response to such laws is a rise in the
price of services, a decline in the quality of services, and an
increase in the danger to the public. Competition is removed from the
marketplace and the Board assumes enormous powers. 6. As
alternative therapies struggle to professionalize, the New Jersey
Bill serves as an example of the possible granting of official
sanctioning credentials without adequate research. The failure to
separately license individual therapies will serve only to create
confusion in the marketplace. New
Jersey reflexologists choose not to be included among modalities
regulated under the state's newly enacted "Massage, Bodywork and
Somatic Therapist Certification Act." The law, however, does not
specifically exclude reflexologists. A Massage, Bodywork and Somatic
Therapy Examining Committee has been established within the Division
of Consumer Affairs in the Department of Law and Public Safety under
the New Jersey Board of Nursing. To be
eligible for certification and licensing an individual must complete
a minimum of 500 hours of class study in the field of massage,
bodywork and somatic therapies approved by the committee or
successfully complete the written examination of The National
Certification Board for Therapeutic Massage and Bodywork or
equivalent exam. Any
state resident may continue his or her alternative practice but only
those who meet state certification requirements may use the titles of
"therapist" or "licensed." Massage
licensing will again be proposed before the next session of the New
Jersey Assembly. Under the proposed umbrella law, reflexologists will
be allowed to continue practice but not at a therapeutic
level. Members
of the New Jersey Reflexology Association are preparing to meet a new
legislative effort to regulate reflexology and other modalities
through massage. Assembly Bill #A843 has been introduced for the new
session. (Reflexology Association of New Jersey, c/o 187 Whitehead
Avenue, South River, NJ 08882. Debra Hinlicky:
732-238-3927) Attempts
to create licensing for the "massage, bodywork and somatic therapist"
in New Jersey ended when the House of Representatives of the State
Assembly failed to pass the Bill. A reintroduction of legislation is
anticipated in the future. The
Bill would not have denied the right to practice reflexology to any
individual. It would, however, have created credentialling terms to
be used only by those who were state licensed. State-licensed
individuals would have been at an advantage in gaining jobs in
conventional medicine for the practice of any bodywork modality
including reflexology. Conventional medical institutions require that
alternative practitioners meet any state licensing
laws. Issues
about the legislation included: 1. The
creation of the profession of "massage, bodywork, and somatic
therapist" without the educational requirements standard to bodywork
professions (including all other state massage laws) -- completion of
a course of study in the professional practice. Completion of hours
of study in various modalities were accepted as adequate to certify
the competency of the "massage, bodywork, and somatic
therapist." 2. A
declaration that "massage, bodywork and somatic therapy practices are
designed to effect the energetic system of the body for the purpose
of promoting and maintaining the health and well-being of the
client." A reflexologist reports that a state massage board member
has commented that massage licensing is not required of
reflexologists in that state. The reflexologist has since obtained a part-time
position at a health spa and is continuing her reflexology work.
A reflexologist had been previously informed by a state official that massage
licensing was required. A bill
to exempt reflexology and health professionals from the massage
practices was signed into law by Governor Gary Johnson in April. The
bill passed the state House by a vote of 62-0 and the Senate by a
vote of 25-0. A bill
to exempt reflexology and health professionals from the massage
practices act awaits the signature of Governor Gary Johnson. The bill
passed the state House by a vote of 62-0 and the Senate by a vote of
25-0. Reflexologists Diane Phillips, Debra Pirtle, and Christine
Dawson attended legislative committee hearings and provided
reflexology services to legislators between sessions. At one point
Christine waited outside the Senate Public Affairs Committee room
from 2 p. m. to midnight to testify in favor of the exemption. The
Board of Massage Therapy initially proposed the exemption legislation
but without the clause for reflexologists. Kevin Kunz worked with the
state's former American Massage Therapy Association lobbyist to
insert the clause. While
reflexologists had worked in 1998 and 1999 to obtain an exclusion
under the Board of Massage Therapy Rules and Regulations, exemption
in law will remove the issue from future change by the Board. Kunz
and Kunz attended thirty-one meetings over a 15 month period. Debra
Pirtle and Erma Sylvester were also active
participants. Kevin
and Barbara Kunz worked to oppose another Bill before the 2001
legislature, spending 15 hours over three days researching and
waiting to testify. The Bill was sponsored by an out-of-state
naturopathic association. It was not supported by any New Mexico
resident except for a paid lobbyist. The Bill was a modification of
the Alternative and Complementary Practitioners Law enacted in
Minnesota in 2000. The Minnesota law creates a full and fair
disclosure system and an exemption from the Medical Practices Act for
practitioners but does not allow diagnosis or prescription of
regulated drugs. A $10, 000 fine is levied against those who stray.
The New Mexico version did not include full and fair disclosure of
the theory of the practitioner's work. It created the same exemption
with a $100 fine and it created a registration system with the state
with no educational requirements mandated. Consumer protection
measures occupying two-thirds of the Minnesota law were not included
in the New Mexico proposal. The
measure initially gained the approval of legislators on the basis of
its title alone - Alternative Medicine Clients Bill of Rights. The
Bill's sponsoring Senator had agreed to insert language exempting
massage therapists from the registration system. Had the Bill become
law, all alternative practitioners in the state except for massage
therapists would have been exempt from the Medical Practices Act. The
proposed change in the Medical Practices Act was not mentioned during
the Senate Public Affairs Committee hearing. The measure failed in
committee when two Hispanic Senators asked about the inclusion of
curenderas, traditional Hispanic healers, in the registration system.
(Bernard Balow, a Las Cruces reflexologist, had previously spoken
with his Senator, one of the two, voicing his opposition.) Republican
Senators then commented on the expansion of government for no real
purpose. Lobbyists for the New Mexico Medical Society, Oriental
Medical Doctors Association and Association of Physical Therapists
spoke against the measure. Lessons
learned: (1) Read and decipher every part of a proposed Bill. The
section changing the Medical Practices Act did not mention the
Medical Practices Act but referred to its number in law. (2) Find out
who is behind the legislation. Kunz and Kunz found out who was paying
the lobbyist (registering such information is required by law and
available through the Legislative Council). Kunz and Kunz then went
to the Internet to find information about the
Association. Proponents
of the legislation are evidently to introduce the Bill in other
states. The proposed New Mexico Bill and a re-examination of the
Minnesota law has sparked questions about the value of the Minnesota
law. While the full and fair disclosure system is of value (and under
consideration by San Diego officials), the issue arises whether or
not the law is good for alternative health practices. The law allows
practitioners to mix and match practices and does not require defined
practice of any modality. Such anti-professionalism removes future
hopes of alternative practitioners for receiving insurance payments
for their practices. Insurance companies require licensing. Licensing
creates demands for establishment of a legal scope of
practice. Attempts
to correct a typographical error and return an exemption for
reflexology to the Massage Practice Act died with the 2000
legislative session. A last-day filibuster by Senate Republicans
prevented voting on a number of bills including the reflexology
exemption. The bill had passed the House of Representatives by a vote
of 68 - 0. Reflexologists are excluded under Rules and Regulations
passed by the Board of Massage Therapy in November
1999. At its
November 1999 meeting, the New Mexico Board of Massage Therapy voted
to exclude reflexologists and other bodywork practitioners from its
definition of massage therapy as a part of its Rules and Regulations.
The vote followed a two-year process of meetings and formal hearings
conducted by the Board to up-date its Rules and Regulations. Kevin
and Barbara Kunz developed an educational network, letter writing
campaigns, and common strategies with reflexologists, Polarity
Therapists, Feldenkrais practitioners, and others to address the
issue. The two attended 30 hearings, meetings, and meetings about
meetings in a 14-month period. Legislation
exempting reflexology in law was passed during the 1999 session of
the New Mexico Legislature. At the August Board meeting, however, it
was revealed that the exemption for reflexology and other practices
is invalid because the bill included a repeal of the exemption
clause. Reflexologists are working with legislators to reintroduce
the exemption clause to the Massage Therapy Practices Act during the
January 2000 legislative session. An exemption in law is being sought
by reflexologists since Rules and Regulations can be changed by
future Boards. The
nation's first exemption in law for reflexology became a reality with
the flick of a Bic on April 7, 1999. Governor Gary Johnson of New
Mexico held the fate of state reflexologists in his hands. He had
until April 9 to sign into law House Bill 423 that includes an
exemption for reflexology. HB423 was passed by both the state Senate
and House of Representatives. The legislative session ended March 20
and the governor had 20 days after the session to sign any
legislation into law, veto it or fail to take any
action. House
Bill 423, "Relating to Licensing, Amending and Repealing Sections of
the Massage Therapy Practice Act," "Section 61-12C-6 Exemptions"
states "Nothing in the Massage Therapy Practice Act shall be
construed to prevent: ... D. sobradores, Hispanic traditional
healers, Native American healers, reflexology which is limited to
hand, feet, and ears or other healers who do not manipulate the soft
tissues for therapeutic purposes from practicing those
skills." The
exemption culminated six months of work by New Mexico reflexologists
Kevin and Barbara Kunz, Eva Giggliello, Debra Pirtle, Erma Sylvester,
and Representative Lisa Lutz. Reflexologists met, attended Board of
Massage Therapy meetings and legislative committee meetings as well
as lobbied state legislators. The
designation of "reflexology" and not "reflexologist" was determined
to be an important issue by reflexologists and one which they fought
to be included in the law. An exemption for "reflexologists" would
have provided an exemption for individuals and not the practice of
reflexology. Reflexologists were concerned that without such
designation some licensed massage therapists would continue the
questionable practice of advertising possession of state licensing
for reflexology in the "Yellow Pages" of the telephone book, on
business cards and brochures. Reflexologists' were conscious of being
put at an economic disadvantage as the consumer perceived these
individuals as certified competent in reflexology by the state when
no such licensing existed. The massage therapy educated individual in
New Mexico typically receives 13 to 33 hours of reflexology
instruction at massage therapy schools. "Body
reflexology" proved to be a problem. Owners of registered massage
therapy schools had previously argued in Board of Massage Therapy
meetings that a designation of "reflexology" would be construed as a
right to practice "body reflexology." Lisa
Lutz, long-time reflexology enthusiast, student reflexologist, and
member of the New Mexico state House of Representatives, emerged as a
savvy, hard-working legislative representative of reflexologists'
interests. (Lisa fondly recalls childhood memories of her
grandmother's reflexology work on her feet.) The
Board of Massage Therapy was in a position of immanent demise during
the legislative session. Like seventeen other state boards, the Board
faced "sunsetting" or extinction without legislation to continue it
in 1999. Lutz was placed in the position of sponsoring the Board's
legislation when no other legislator stepped forward before the
beginning of the legislative session. Great confusion arose when the
American Massage Therapy Association's (A. M. T. A.) New Mexico
lobbyist Lucille Torres also found a sponsor for massage legislation
that was described as "having the support of the Board." The A. M. T.
A. bill, as it was called, met with an outcry of protests from the
state's alternative health community. The Bill called for the
licensing of massage therapy and "bodywork" practices. Torres'
legislative sponsor later amended her bill to delete references to
bodywork and come within three sentences of Lutz's
bill. A
dramatic moment was created during a hearing for the bills before the
House Business and Industry Committee. Co-sponsor with Lisa,
Representative James Taylor, both members of the committee, asked
Lutz if her bill had the support of the Board as indicated by her.
Since Torres' bill was also being presented to the Committee with the
support of the Board, the issue was under question. Lisa produced a
FAX from the Board to her pre-dating the legislative session
detailing the Board's proposed legislation. AMTA lobbyist Torres
mis-spoke herself and stated that her bill had been voted on by the
Board. New Mexico law requires that regulatory boards hold open
meetings. No vote in support of Torres" bill was ever taken at a
Board of Massage Therapy meeting. Torres also mistakenly reported
that 3200 individuals are licensed to practice massage therapy in the
state. The actual number is 2300. The two bills were eventually
merged in committee. Ironically,
with Governor Johnson signature, the Board of Massage Therapy is the
only one of eighteen state boards to escape sunsetting during the
1999 legislative session. The Democratically controlled legislature
tied the extension of life for all eighteen regulatory boards to a
collective bargaining bill that the Republican governor has vowed to
veto. (HB423 included sunrising as well as sunsetting language so
it.) The move is seen as purely political, however. All boards will
not cease to exist for eighteen months and can be given renewal by
the governor at the next legislative session in January
2000. One
portion of the exemption clause in the existing New Mexico Massage
Therapy Practice Act is unique among state massage therapy laws.
Unlike any other states in the union, New Mexico has a population
that consists of more than 50% minority members. The clause in the
previous law specifically recognized the rights of Native American
healers and sobradores (traditional Hispanic massage practitioners)
to practice hands-on work. The exemption clause will now also come to
include Hispanic traditional healers, reflexology which is limited to
hand, feet, and ears or other healers who do not manipulate the soft
tissues for therapeutic purposes from practicing those
skills. The
exemption for sobradores and Native American healers was added to the
original Massage Therapy Practice Act in 1991 when Kevin Kunz called
his state senator Tito Chavez from the Senate floor during discussion
of the bill to ask if sobradores and Native American healers would be
included. The result was a specific exemption for them. In 1991, A.
M. T. A. lobbyist Torres had assured the alternative health community
that the Massage Practices Act was a "title" bill affecting only
those who practiced professions titled "massage." The statement was
inaccurate. Reflexologists and other practitioners spent 1998
attending Board of Massage Therapy meetings to defend their practices
as outside of massage following a ruling by an assistant attorney
general in January 1998 that the law was a "practices"
law. In
spite of hard work and long hours, New Mexico reflexologists are not
resting on their laurels. They have joined a coalition of somatic
practitioners who will seek state licensing at the legislative
session in January, 2001. (While the legislature meets in January,
2000, only fiscal matters are considered and not issues concerning
professions.) Reflexologists, Polarity therapists, Feldenkrais
practitioners, and Rolfers are already meeting to write a Somatic
Practitioners Act. New
Mexico reflexologists have been joined by others to voice their
concerns about the licensing of massage therapy in the state in an
organization titled Citizens Concerned about Massage Therapy (CCAMT).
CCAMT members presented information at a December 9 New Mexico Board
of Massage Therapy preliminary hearing to determine what practices
would be exempted from massage licensing under the state Massage
Practices Act. Practitioners of reflexology, polarity therapy,
Tragerwork, and Feldenkrais therapy were granted exemptions in the
"Rules and Regulations" of the Board of Massage Therapy. Shiatsu and
acupressure practitioners were not. CCAMT
members include polarity therapists, chair massage specialists, and
Feldenkrais therapists. Reflexologist members include Eva Giggliello,
Barbara Kunz, Kevin Kunz, Lisa Lutz, Debra Pirtle, and Erma
Sylvester. Student reflexologist Lisa is a member of the state's
House of Representatives. The New
Mexico Massage Practices Act was originally intended to be a "title"
act, licensing those individuals who provided massage titled
practices. The Act has been interpreted as a massage "practices" act,
however, raising on-going questions about what is a massage practice
and what is not. For example, the Board has issued 30 letters in
reference to acupressure over the years -- 14 noted massage licensing
requirements and 16 did not. One
specific provision of the Act has contributed to the confusion.
Massage-licensed individuals are required to complete 650 hours of
education. 300 hours are required in massage therapy practice and 350
hours in other practices, such as reflexology, decided by owners of
registered massage schools. While the owners claim that the practices
included in the 350 hours of instruction are "informational,"
nonetheless schools issue certification of competency over the
practices and massage therapists commonly advertise that they are
state-licensed for these practices. Without a change in the Massage
Practices Act great confusion among consumers, massage therapy
students, licensed massage therapists, and owners of registered
massage therapy schools will continue. Members
of CCAMT debated requesting a specific exemption for their practices
to be written into the massage legislation versus requesting broad
changes in the Massage Practices Act itself. In the end, it was
decided to do both. (See page 3.) Specific exemptions are problematic
in legislation and difficult to obtain. Also, with only an exemption,
members' concerns about being placed at an economic disadvantage in
the marketplace would not be answered. For
example, Albuquerque reflexologist Erma Sylvester was recently denied
the right to be a provider of reflexology services by the state's
largest HMO. The HMO is willing to pay for reflexology services --
provided by either one of two HMO-approved massage therapists. While
state law does not certify the competence of massage therapists to
provide reflexology services, the HMO evidently views the massage
therapist, with undetermined reflexology credentials, as more
qualified than a certified reflexologist. Polarity
therapists and Feldenkrais practitioners have also voiced concerns
about being placed in similar positions of economic
disadvantage. The
concern of chair massage specialists is the requirement of massage
therapy training for their profession. It is perceived as costly
over-education for those who practice a a clothed service provided to
the upper back, shoulders, and arms. Reflexologists
attended Board of Massage Therapy meetings in October, November, and
December.At the October Board meeting, Dan Hill, the chairman of the
Board and a civilian Board member, emphasized that the state's
massage law is not an anti-prostitution measure. He was unaware until
told during public testimony by reflexologists that the state's law
was preceded by a city of Albuquerque massage ordinance that included
a paragraph listing sexual activities that could not be practiced in
a massage establishment. He was particularly struck by a provision
that did not allow dogs in a massage establishment. At the time the
state law became effective in 1992, the Albuquerque City Council
allowed its ordinance to be superseded by the state law only when it
had no choice. (By law, state laws supersede those of
cities.) After
the "preliminary rules hearing" in October, reflexologists fulfilled
a request by the Board's administrator Geraldine Mascarenas to
provide a reflexology curriculum showing that reflexology education
is different from that of massage. An exemption was granted for the
practice of "foot and hand reflexology without the use of creams,
lotions and oils" at a December 9 preliminary hearing. A "formal
rules hearing" will also be held in 1999. Members
of the CCAMT intend to pursue licensing of their professions. Members
of a profession seeking to become licensed in the state of New Mexico
must first go through the process of the "Sunrise Program." The
program requires application in writing by answering a 61-question
form, submission of a $1,000 fee, review by the Legislative Finance
Committee, a public hearing, and a legislative
process. Learning
about state government worked to the advantage of New Mexico
reflexologists. Using a multi-pronged strategy to obtain an
exemption, they brought their concerns about massage regulation to
the notice of all segments of the state government from legislators
to the governor's office to the state's attorney
general. The New
Mexico State Massage Board is seeking to include acupressure and
shiatsu in state regulation. Reflexology regulation is possible in
the future. The Board is concerned about (1) the increasing liability
to massage therapists for practices outside of Swedish massage and
(2) consumer safety issues involved in each of the ever-growing
number of bodywork professions. Among
issues: how does the consumer know what type of session he or she
will receive when purchasing bodywork services? Even when purchasing
massage services, he or she could receive one of several different
styles of massage practice such as Swedish, Esalen, deep tissue work,
or connective tissue work. The consumer is now faced with the choice
of more and more bodywork services. The challenge to a regulatory
body is to safeguard the interests of the consumer while fairly
over-seeing professionals' practice. Kunz and Kunz have been asked to
submit a regulatory proposal. While
New Mexico with some 2 million residents may not be among the most
populated of states, recent discussion within a special committee of
the state's Massage Board sheds some light on the future
relationships between massage and reflexology
regulation. The
Massage Board created a special committee to consider changes in the
state's massage law with an eye towards proposing changes to the 1995
state legislature. Individuals from disciplines aside from massage,
such as reflexologist Kevin Kunz, were invited to join the special
committee. Currently the state law is a "title" law, regulating those
who use the word "massage" to describe their work. The concern of the
Massage Board was to include under its jurisdiction individuals who
are actually provide massage services but label them otherwise. It
was the additional intention of the Board to expand its scope to
become an "umbrella" board for body work practices with legislation
to be proposed before the 1997 state legislature. During
the course of discussions at a series of meetings throughout the late
summer and fall, it became clear that an "umbrella" board for the
various body works was feasible, but that the label of "massage" was
perceived as problematic. The past history of "massage" ordinances
being used by cities and states to regulate prostitution was seen to
create an unfavorable climate for "umbrella"ing under a "massage"
board. In addition, it was noted that many massage therapists
themselves now practice something other that traditional Swedish
Massage. It was commonly agreed that all participants actually
practiced forms of structured touch. "Touch therapies" seemed to be a
term neutral enough not to provoke negative response yet broad enough
to describe the many varied forms of body work. In reference to the
potential for all "touch therapy" practitioners to be regulated at
some time in the future, it became obvious that all will be required
to obtain some sort of minimal educational hours in their specialty
to provide a credible professional image. A 200-hour training period
to begin with was considered as a minimal standard of
education. The
suggestions of the special committee were presented to the full Board
at a late September meeting. It was decided that the chief concern of
Board members would be to concentrate on the interpretation and
implementation of the current law. No change in legislation will be
suggested for the 1995 legislative session. Concerns were expressed
that state employees who actually implement the law are doing so
incorrectly and giving out invalid information. Because the Board
felt that they hands were full trying to implement the present law,
the suggestions were tabled. Despite
the tabling of its findings by the Board, it was perceived by the
special committee that progress had been achieved in building a
consensus. The special committee members agreed to work towards a
future change in the stOverview
Fact Sheet: Massage Regulation of
Reflexology (May 2003)
Reflexology is Clearly Different than
Massage
Ramifications of Massage Regulation of
Reflexology
• Abridgment of Reflexologist's
Fourteenth Amendment Rights
• Prejudicial
treatment
• Public Safety
• Fair Practices Act
• Abridgment of Consumers' and
Reflexologists' First Amendment Rights
Ocotber
2002, Reflexions, Barbara & Kevin Kunz
Legal
Practice in the US
Winter
2001, Reflexions, Barbara & Kevin Kunz
Regulatory
Turn Around
· Rules regulating licensed professions are reviewed and changed
periodically. Reflexologists in Texas attended hearings and wrote
letters pursuant to Rules changes in October 2000. Following review
of their comments, Rules requiring reflexologists to obtain massage
registration were changed in February.
· City ordinances are reviewed and changed. Muff and Bobbi
Warren participated in a hearing and contributed comments to improve
reflexologist's licensing requirements in San Diego.
· Participation in the legislative process can change, create or
modify law. Reflexologists in New Mexico obtained an exemption
through legislation (pending signature of the governor).
Reflexologists in Tennessee are creating a reflexology registration
law through legislation (pending completion of legislative process).
Reflexologists in Illinois became part of the exemption clause in a
proposed Illinois state massage licensing law (pending in the
legislature).
· Other alternative health practitioners and, in some instances
massage therapists favor regulatory change. Coalitions of
reflexologists, alternative health practitioners and/or massage
therapists created change in Texas, New Mexico, Tennessee and,
potentially, Pennsylvania.Winter
2000, Reflexions, Barbara & Kevin Kunz
Winter
1990, Reflexions, Barbara & Kevin Kunz
Alabama
Spring
2000, Reflexions, Barbara & Kevin Kunz
Spring/Summer
1998, Reflexions, Barbara & Kevin Kunz
Winter/Spring 1998,
Reflexions, Barbara & Kevin Kunz
Reflexologists in Pursuit of
Legislation: Work in four states
Winter/Spring
1998, Reflexions, Barbara & Kevin Kunz
Arizona
May
2003, Reflexions, Barbara & Kevin Kunz
Spring
2000, Reflexions, Barbara & Kevin Kunz
California
Spring/Summer 1999, Reflexions,
Barbara & Kevin Kunz
Spring/Summer
1998, Reflexions, Barbara & Kevin Kunz
Modesto
Sacramento
Spring/Summer
1999, Reflexions, Barbara & Kevin Kunz
May
1998, Reflexions, Barbara & Kevin Kunz
Spring/Summer
1998, Reflexions, Barbara & Kevin Kunz
Aug.
27, 1989
San
Diego
April 2003,
Reflexions, Barbara & Kevin Kunz
March 2003,
Reflexions, Barbara & Kevin Kunz
Winter
2002, Reflexions, Barbara & Kevin Kunz
Summer
2001, Reflexions, Barbara & Kevin Kunz
Fall
2000, Reflexions, Barbara & Kevin Kunz
Winter 2001
The city has enacted a reflexology licensing procedure:
"Practitioners who present to the Police Chief proof of satisfactory
completion of two hundred hours of reflexology classroom instruction
in reflexology related subjects dealing with feet, hands or ears and
reflexology practice from a reputable school of reflexology. The
practitioner must submit proof of attendance, including certified
transcripts. or other documents acceptable to the Police
Chief."Delaware
Florida
Summer
2001, Reflexions, Barbara & Kevin Kunz
Summer
2000, Reflexions, Barbara & Kevin Kunz
Spring/Summer
1998, Reflexions, Barbara & Kevin Kunz
Spring/Summer
1995, Reflexions, Barbara & Kevin Kunz
History
of the Legislation
At Issue in FloridaIdaho
Illinois
October
2002, Reflexions, Barbara & Kevin Kunz
Spring/Summer
1999, Reflexions, Barbara & Kevin Kunz
Iowa
June 2003,
Reflexions, Barbara & Kevin Kunz
Oct.
2002, Reflexions, Barbara & Kevin Kunz
Jul.
2002, Reflexions, Barbara & Kevin Kunz
June
2002, Reflexions, Barbara & Kevin Kunz
March
2002, Reflexions, Barbara & Kevin Kunz
Attorney generals in Texas and New Mexico had previously issued
official findings stating that it was up to the Department of Health
(Texas) and the Board of Massage (New Mexico) to make such "findings
in fact." After examining the issues, both neither body found that
reflexology was a part of massage.Summer
2001, Reflexions, Barbara & Kevin Kunz
Maryland
Fall
2001, Reflexions, Barbara & Kevin Kunz
Winter
2001, Reflexions, Barbara & Kevin Kunz
Fall
2000, Reflexions, Barbara & Kevin Kunz
Winter
2000, Reflexions, Barbara & Kevin Kunz
Massachusetts
Spring
2000, Reflexions, Barbara & Kevin Kunz
Spring/Summer
1999, Reflexions, Barbara & Kevin Kunz
Summer/Fall
1996, Reflexions, Barbara & Kevin Kunz
Minnesota
Spring
2000, Reflexions, Barbara & Kevin Kunz
(O'Connor, Debra, "Bill focuses on alternative medicine: Massage,
acupuncture among targeted treatments," Minneapolis-St. Paul
Pioneer Press, April 26, 2000)Fall/Winter
1998, Reflexions, Barbara & Kevin Kunz
Montana
March
2003, Reflexions, Barbara & Kevin Kunz
January
2003, Reflexions, Barbara & Kevin Kunz
Nevada
Spring/Summer
1992, Reflexions, Barbara & Kevin Kunz
March
1991, Reflexions, Barbara & Kevin Kunz
New
Jersey
Winter/Spring 1998,
Reflexions, Barbara & Kevin Kunz
Reflexologists in Pursuit of
Legislation: Work in four states
Fall
/ Winter 1997, Reflexions, Barbara & Kevin
Kunz
Precedent-Setting
Legislation in New Jersey
Concerns
about law
Winter
/Spring 1999, Reflexions, Barbara & Kevin
Kunz
Spring/Summer
1998, Reflexions, Barbara & Kevin Kunz
Winter/Spring
1998, Reflexions, Barbara & Kevin Kunz
Fall/Winter
1997, Reflexions, Barbara & Kevin Kunz
New
Hampshire
New
Mexico
Summer
2001, Reflexions, Barbara & Kevin Kunz
Winter
2001, Reflexions, Barbara & Kevin Kunz
Spring
2000, Reflexions, Barbara & Kevin Kunz
Winter
2000, Reflexions, Barbara & Kevin Kunz
Winter/Spring
1999, Reflexions, Barbara & Kevin Kunz
"Reflexology"
vs. "Reflexologist"
Woman
of the hour
Unique
exemption
Charting
the future
Fall/Winter
1998, Reflexions, Barbara & Kevin Kunz
The New Mexico state Board of Massage Therapy will be sunsetted
(cease to exist) unless new legislation enabling it to continue is
passed during the 60-day legislative session that begins January 19,
1999. The Board is asking that the legislature renew the existing
Massage Practices Act. CCAMT members are seeking changes in the Act.
Speaker of the House of Representatives Raymond Sanchez has expressed
interest in supporting the changes.Confusion
in the law
Exemption
vs. sweeping change in law
Months
and months of meetings
Licensing
in the future
Learning
experience
Spring/Summer
1998, Reflexions, Barbara & Kevin Kunz
Summer/Fall
1994, Reflexions, Barbara & Kevin Kunz