Massage Licensing: Moving to other states could get easier and more expensive.

A new interstate compact is being developed by the The Council of State Governments (CSG) who is partnering with the Department of Defense (DoD) and the Federation of State Massage Therapy Boards (FSMTB) to help people in the military move more easily and practice massage therapy in different states. License Portability has been something that the massage profession has been looking into for years and years. Right now you have to get a massage license in each state that you want to work in and each state has such different requirements for the number of hours of education and most require that a massage therapist attend a state approved massage school. That makes it difficult to move from one state to another. Currently, the massage license has to be transfered to the next state which can be a long, drawn out process and many often are unable to practice without going back to massage school.

What is an Interstate Compact?

Think of your drivers license… Every state has their own rules of the road that one must know to obtain a license to drive in that state. It allows you to drive in other states but you also do have to know the rules in other states and abide by them—speed limits, turning rules, passing rules etc.

The same sort of thing would apply to people with a compact massage license, except the first hurdle is getting a law passed in each state that would make it so that state could become a member of the compact. The bill/law must match the Interstate Compact as close as possible in order to qualify. If your state passes a bill to join the compact that does not mean that you can automatically move to the other states. You will have to apply to the Compact Commission for a license to move around.

An Interstate Commission that will be created to implement and administer the Interstate Massage Compact (IMpact ). The Interstate Massage Compact outlines the details of the establishment and operations of the IMpact. Each member state will have “one delegate selected by that member state’s licensing authority. The delegate shall be the primary administrative officer of the State Licensing Authority or their designee.”

It will take a minimum of 7 states who pass bills to become a member of the compact to start the compact. (Actually, I need to confirm the number of states needed.) If you are in a state that approves the compact, you will be able to practice in any other state that also approves the compact.

Other professions have compacts:

History of the IMpact

March 17, 2021 Press Release from the Federation of Massage State Boards. FSMTB Secures Assistance for Interstate Compact

Massage Therapy Compact Kickoff Presentation: May 18, 2021 Youtube presentation

Nov 16, 2021 Council of State Governments (CSG) invites professions to apply for assistance with the development of an interstate compact to improve occupational licensing portability. Youtube

INTERSTATE MASSAGE THERAPY COMPACT First Draft (PDF)

There was a stakeholder review and survey done.

Jun 15, 2022 International Spa Association presentation (Youtube): ISPA Town Hall session, Matt Shafer with the Council of State Governments helped educate ISPA members

AMTA sent an email to their members and posted a statement concerning the number of hours education being required in the IMpact.
“One key issue is the requirement of at least six hundred and twenty-five (625) clock hours of massage therapy education for therapists to participate, when nearly half of the licensed states in the country have a 500-hour requirement. While we support standards for the profession, this 625-hour requirement specific to the Interstate Compact could potentially exclude massage therapists practicing in the 500-hour states, or those that were grandfathered in years’ ago, from being eligible to participate.”

https://www.fsmtb.org/media/2804/why-625.pdf The 625 hour requirement is very confusing.

In a Facebook Post on EdNet (closed group), Craig Knowles, the President of FSTMB clairified: “the 625 hours of education did not have to be all entry level education. The 625 is total minimum education. That gives the Compact Commission leeway if someone’s entry level transcript is 500 hours, the Commission can accept other forms of education to make the difference.”

December 12, 2022 A MOVE TO TRANSCEND STATE BOUNDARIES: UPDATES ON THE INTERSTATE COMPACT FOR MASSAGE THERAPISTS from Massage Magazine

Current Questions

The only exam mentioned is the MBlex exam making it lucrative for the FSTMB and futher hurting the NCBTMB and their Board Certification. Article 3. Member State Requirements: “148 3. Accept passage of a National Licensing Examination as a criterion for Massage Therapy licensure in that State;”
That is the FSTMB MBLex Exam.
The number of required hours. The IMpact says (ARTICLE 4- MULTISTATE LICENSE REQUIREMENTS) : “2. Have completed at least six hundred and twenty-five (625) clock hours of Massage Therapy education or the substantial equivalent which the Commission may approve by Rule.
The 625 hours can be made up of initial massage school education PLUS CE classes. What would this mean for states that require 625 hours or more and other states require 500 hours? People could just take any CE to make up the difference? CE is a nightmare really across the US with so many various requirements. You can take free online classes, read a book, attend a board meeting and use various things to fulfill the CE requirements. States with higher educational requirements may then get massage therapists who are less qualified to practice which is very concerning. The few states that require evem more then 625 hours of education would really not want that.
I emailed the Compact about this and the answer they gave was this:

“The logistics of how CE classes will be counted or reviewed will be decided on by the compact commission, which will have a representative from each state that joins the compact. These specifics, including the process and how CE will fit into the hours requirement, are not in the compact legislation so there are not clear answers as of yet. Once the compact commission is set up and puts the process in place there will be clearer answers to these questions.”
Who would be paying for this? YOU WILL ! States will raise their licensing fees to pay for this. That means you will pay for it even if you never plan on moving.
Section G line 509:
The Commission may levy on and collect an annual assessment from each Member State and impose fees on Licensees of Member States to whom it grants a Multistate License to cover the cost of the operations and activities of the Commission and its staff, which must be in a total amount sufficient to cover its annual budget as approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount for Member States shall be allocated based upon a formula that the Commission shall promulgate by Rule.”
What does this mean exactly? It seems like state boards would be giving up their autonomy and this whole thing could move toward being a true national licensing board. Do we want that at this point?
ARTICLE 14. CONSISTENT EFFECT AND CONFLICT WITH OTHER STATE LAWS
“Nothing herein shall prevent or inhibit the enforcement of any other law of a Member State that is not inconsistent with the Compact.
Any laws, statutes, regulations, or other legal requirements in a Member State in conflict
with the Compact are superseded to the extent of the conflict.
All permissible agreements between the Commission and the Member States are binding in accordance with their terms.”
The intent of the IMpact was to allow members of the military who move around state to state to be able to practice more easily. How many members of the military have spouces/partners who practice massage therapy? This would also apply to anyone with a massage license so it is a step toward license portability. Could there be other ways to create portability or to allow MT to more easily transfer their massage licenses to other states?
If a state passes a bill to join the compact and then don’t want to be in it for some reason, another bill has to be passed to get out of the compact.
Have the other compacts been studied to see the effects of it? What is the language used in other compacts? Do physical therapy schools and nursing programs have better standards of education that make it easier to compare training and education so when they work in other states, employers know what skills and eduation they have?
Healthcare provider or not a HCP? If you are licensed and considered to be a healthcare provider in your licensed state, this will not allow you to be considered a healthcare in other states that you are moving to that may not be considered to be healthcare providers. You will have to abide by all laws in the new state you want to be licensed in.
State practice laws vary greatly by state. You will have to know the laws in that state to practice legally. Some states have jurisprudence exams that are open book or easy to pass but will not be required under the IMpact bill. I am not sure if that can be added in each state that wants it.
States that require more education hours like Nebraska and New York (1000) and some of the others at 750 hours (New Hampsire, North Dakota, Connecticut) and possibly Arizona at 700 hours of education, would not want to have someone with only 625 hours of education move to their state.

Update: 01/04/2022 – I emailed the compact before the holidays asking for more info and they just replied saying that a new website is being created to explain everything.

02/03/2023 – New Website up for the Massage Compact.

WA State Compact Bill HB 1437 – 2023-24 Concerning the interstate massage compact. Started by Kloba from the 1st District who was a massage therapist for 20 years. Jan 25, there was a hearing on the bill in the House Postsecondary Education & Workforce committee. There was a person from the Association of Day Spas in attendace who supported the bill. (Joran Klowers or something like that). He mentioned that ID and OR were working on bills in their states. Matt Shafer from the Council of State Governments spoke in support of the bill. Ashley Hernandez, the GR person for the FSTMB spoke in support of the bill. Tammy Perot (not sure of name or who she represents) also spoke in support of the bill. You can read the bill and watch the testimonies in this link: bill presentation at 1:00:00 approx and 1:51;35 for testimonies. Bill documents with bill analysis here: https://app.leg.wa.gov/committeeschedules/Home/Documents/30466

Nebraska Compact Bill – LB280 – Adopt the Interstate Massage Compact shut down by AMTA-NB and FSTMB. The NE bill was shut down for now they say. AMTA-NE testified against it (even though AMTA has told their members to be neutral on the bill.)

Georgia HB 153 Interstate Massage: Georgia State Massage Licensing requirments are 500 hours of massage school. The rest would be made up in CE but we do not know how the CE will be monitored and approved.

Call to Action: Contact your state legislators and have them start looking into this. Ask them to ask the health care committee in your state to start looking into this and start doing research on the impact of the IMpact.

What else can be done?

License portability has been a dream of the massage profession for many years. I once was involved in a task force for ABMP that was looking into state laws to see what could be done. The result was that nothing could be done because state scope of practice laws vary so much and also education requirements and CE requirements vary so much, you just don’t know what kind of skills a massage therapists from other states have.

AMTA has always been the moving force with licensing and legislation. The Federation of Massage State Boards did create a model massage therapy practice act back in 2014 after more than three years of work on it and two periods of public comment. (See Laura Allen’s Blog Post on this) and other posts from her blog at that time.