By Forrest Satterfield in Alabama — 28 Feb 2025

SB37: Streamlining Massage Therapy Across State Lines

This compact seeks to establish a multistate licensing program, ensuring uniformity in licensing requirements and interstate practice. The implications of this bill are far-reaching, impacting not only massage therapists but also consumers seeking these services and the regulatory bodies overseeing the profession.

SB37's primary aim is to reduce the burdens on state governments while simultaneously improving public access to safe and competent massage therapy. It proposes a regulatory framework that offers increased value and mobility to licensed practitioners, thereby enhancing the profession's overall standards. This blog post will delve into the key aspects of SB37, exploring its objectives, the requirements for member states and multistate licenses, the role of the Interstate Massage Compact Commission, and the potential impact on both therapists and the public. We'll also examine the provisions for adverse actions, military personnel, data management, and dispute resolution, providing a comprehensive overview of this transformative legislation.

The Core Objectives of the Interstate Massage Compact

At the heart of SB37 lies a set of clear objectives designed to modernize and streamline the practice of massage therapy across state lines. The bill explicitly states its intentions, emphasizing increased public access, enhanced public safety, and robust regulatory cooperation. These objectives serve as guiding principles for the compact, shaping its structure and ensuring its relevance to both practitioners and consumers.

One of the primary objectives is to increase public access to massage therapy services by providing for a multistate licensing pathway. This means that therapists holding a multistate license can practice in any member state without needing to obtain separate licenses for each, thereby expanding the availability of these services to a wider population. As stated in the bill, "Through this compact, the member states seek to establish a regulatory framework that provides for a new multistate licensing program."

Furthermore, the compact aims to enhance the member states' ability to protect the public's health and safety. By establishing uniform standards and facilitating the exchange of information between states, the compact seeks to ensure that only qualified and competent therapists are practicing, reducing the risk of harm to consumers. This is closely linked to the objective of enhancing the member states' ability to prevent human trafficking and licensure fraud. The shared database and reporting system mandated by the compact allows states to quickly identify and address any issues related to fraudulent practices or potential exploitation.

The compact also aims to encourage the cooperation of member states in regulating the multistate practice of massage therapy. By creating an interstate commission, the bill facilitates communication, coordination, and collaboration among the member states, fostering a more cohesive and effective regulatory environment. This cooperation extends to supporting relocating military members and their spouses, providing them with a streamlined pathway to continue their massage therapy practice in new locations. The bill recognizes that the needs of licensed massage therapists and the public receiving their services will be met through this compact and the objectives that support it. The cooperation will facilitate and enhance the exchange of licensure, investigative, and disciplinary information between the member states, streamlining regulation and ensuring a collaborative approach to maintaining high standards of practice.

Requirements for Member States Joining the Compact

To ensure the integrity and effectiveness of the Interstate Massage Compact, SB37 outlines specific requirements that states must meet to be eligible for membership and maintain their standing within the compact. These requirements encompass licensing and regulatory practices, complaint mechanisms, examination standards, educational qualifications, and participation in a comprehensive data system.

Firstly, a state must license and regulate the practice of massage therapy, demonstrating a commitment to overseeing and governing the profession within its borders. Additionally, the state must have a mechanism or entity in place to receive and investigate complaints from the public, regulatory or law enforcement agencies, or the commission about licensees practicing in that state. This ensures accountability and provides a channel for addressing concerns related to the quality of services or ethical conduct.

Acceptance of a national licensing examination is another crucial requirement. As the bill indicates, member states must "accept passage of a national licensing examination as a criterion for massage therapy licensure in that state." This promotes uniformity in testing standards and helps ensure that all licensed therapists possess a baseline level of competence. Furthermore, states must require that licensees satisfy educational requirements prior to being licensed to provide massage therapy services to the public. These educational requirements ensure that therapists have the necessary knowledge and skills to practice safely and effectively.

Perhaps one of the most significant requirements is the implementation of procedures for requiring background checks of applicants for a multistate license. This includes obtaining and submitting fingerprint or other biometric-based information to the Federal Bureau of Investigation for background checks and considering the results of such checks in making licensure decisions. This is a critical step in safeguarding public safety and preventing individuals with a history of criminal activity from obtaining a multistate license. Finally, member states must have continuing competence requirements as a condition for license renewal and participate in the data system, including through the use of unique identifying numbers. The bill's text states that participating states must "notify the commission and other member states, in compliance with the terms of the compact and rules of the commission, of any disciplinary action taken by the state against a licensee practicing under a multistate license in that state, or of the existence of investigative information or current significant investigative information regarding a licensee practicing in that state pursuant to a multistate license." These are foundational requirements for those states looking to participate in the interstate compact.

Multistate License Eligibility and Scope of Practice

SB37 sets forth specific criteria that applicants must meet to qualify for a multistate license under the Interstate Massage Compact. These requirements are designed to ensure that only qualified and competent individuals are granted the privilege of practicing massage therapy across state lines. The eligibility criteria encompass holding an active single-state license, completing a minimum level of education, passing a national licensing examination, undergoing a background check, and maintaining a clean criminal and disciplinary record.

To begin, applicants must hold an active single-state license to practice massage therapy in their home state. This ensures that they have already met the basic requirements for licensure in their primary state of residence. Additionally, applicants must have completed at least 625 clock hours of massage therapy education or the substantial equivalent approved by the commission. This educational requirement reflects the importance of formal training in developing the necessary skills and knowledge for safe and effective practice.

Passing a national licensing examination or its equivalent is another essential criterion. This examination serves as a standardized measure of competence, ensuring that all multistate licensees have demonstrated a baseline level of proficiency. In addition to educational and examination requirements, applicants must submit to a background check to screen for any criminal history that may disqualify them from holding a multistate license. The bill specifically outlines disqualifying events, including convictions for felonies or misdemeanors related to the practice of massage therapy, as well as offenses related to kidnapping, human trafficking, sexual battery, or other similar crimes.

Furthermore, applicants must not have previously held a massage therapy license that was revoked or surrendered in lieu of discipline and must have no history of adverse action on any occupational or professional license within two years prior to their application. This demonstrates a commitment to ethical conduct and professional responsibility. Finally, applicants must pay all required fees to cover the costs of processing their application and maintaining their multistate license. It's important to understand that a licensee practicing in a member state is subject to all scope of practice laws governing massage therapy services in that state. Therefore, the practice of massage therapy under a multistate license will subject the licensee to the jurisdiction of the licensing authority, the courts, and the laws of the member state in which the massage therapy services are provided.

The Interstate Massage Compact Commission: Powers and Functions

SB37 establishes the Interstate Massage Compact Commission, a joint governmental agency comprising all member states that have enacted the compact. The commission serves as the central administrative body responsible for implementing and administering the compact, ensuring its effective operation and promoting uniformity in the regulation of massage therapy across state lines. The commission's powers and functions are extensive, encompassing rulemaking, data management, dispute resolution, and enforcement.

One of the commission's primary responsibilities is to adopt reasonable rules to effectively and efficiently implement and administer the purposes and provisions of the compact. These rules have the force of law in each member state, providing a consistent framework for the regulation of massage therapy. The commission also maintains a coordinated database and reporting system, assigning each applicant for a multistate license a unique identifier. This data system facilitates the exchange of information between member states, enabling them to track licensees' credentials, disciplinary actions, and investigative information.

The commission is empowered to resolve disputes related to the compact that arise among member states and between member and non-member states. It also has the authority to enforce the provisions of the compact and its rules, initiating legal action against member states in default if necessary. Financially, the commission pays the reasonable expenses of its establishment, organization, and ongoing activities. It also has the capability to "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." The members, officers, executive director, employees, and representatives of the commission shall be immune from suit and liability, both personally and in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability.

The Interstate Massage Compact Commission is critical to the success of this interstate agreement. All states participating in the compact will be working alongside the commission, making the commission vital to the uniformity and consistent application of the compact across state lines.

Adverse Actions and Disciplinary Procedures

SB37 addresses the critical issue of adverse actions and disciplinary procedures, outlining the authority of both home states and remote states to take action against licensees who violate the scope of practice laws or engage in misconduct. The bill carefully balances the need for consistent enforcement with the recognition of each state's unique regulatory environment.

A licensee's home state has exclusive power to impose an adverse action against a licensee's multistate license issued by the home state. This means that the state where the licensee holds their primary license is primarily responsible for overseeing their conduct and taking disciplinary action if necessary. However, a home state may take adverse action on a multistate license based on the investigative information, current significant investigative information, or adverse action of a remote state. This ensures that states can rely on information from other jurisdictions when making disciplinary decisions.

Remote states, or states where a licensee is practicing under a multistate license but is not their home state, also have significant authority. A remote state has the authority to take adverse actions against a licensee's authorization to practice in that state, issue cease and desist orders or impose an encumbrance on a licensee's authorization to practice in that state, and issue subpoenas for both hearings and investigations. "If an adverse action is taken by the home state against a licensee's multistate license or single-state license to practice in the home state, the licensee's authorization to practice in all other member states shall be deactivated until all encumbrances have been removed from such license." This ensures the licensee cannot simply move to a new state to escape any disciplinary measures.

These provisions ensure that massage therapists are held accountable for their actions and are subject to disciplinary measures if they violate the law. By establishing clear lines of authority and promoting cooperation between states, SB37 seeks to maintain high standards of practice and protect the public from harm.

A key component of SB37 is the establishment of a comprehensive data system that facilitates the sharing of information between member states. This data system serves as a central repository for information about licensees who hold multistate licenses, including license status, investigative information, and adverse actions. The goal is to promote transparency, enhance regulatory oversight, and protect the public from unqualified or unethical practitioners.

The commission assigns each applicant for a multistate license a unique identifier, which is used to track their records within the data system. This unique identifier ensures that information is accurately attributed to the correct individual, even if they move between states or change their name. Member states are required to submit a uniform data set to the data system on all individuals to whom this compact is applicable. This includes identifying information, licensure data, adverse actions against a license, nonconfidential information related to alternative program participation, any denial of application for licensure, the existence of investigative information, and the existence or presence of current significant investigative information.

The records and information provided to a member state pursuant to this compact or through the data system, when certified by the commission or its agent, constitute the authenticated business records of the commission and are entitled to any associated hearsay exception in any relevant judicial, quasi-judicial, or administrative proceedings in a member state. This provision ensures that the information shared through the data system is considered reliable and admissible in legal proceedings. However, member states contributing information to the data system may designate information that may not be shared with the public without the express permission of the contributing state, which may be relevant in more sensitive cases.

This system ensures greater accountability and improves public safety by preventing practitioners with a history of misconduct from obtaining licenses in other states without proper scrutiny.

Conclusion: The Future of Interstate Massage Therapy

SB37 represents a significant step forward in modernizing and streamlining the practice of massage therapy across state lines. By adopting the Interstate Massage Compact, Alabama has the opportunity to join a growing number of states committed to enhancing professional mobility, increasing public access to services, and strengthening regulatory oversight. The bill's provisions for member state requirements, multistate license eligibility, the Interstate Massage Compact Commission, adverse actions, data management, and dispute resolution collectively create a robust framework for interstate cooperation.

The implications of SB37 extend beyond the immediate benefits for massage therapists seeking to practice in multiple states. The compact has the potential to foster greater standardization of training and licensing requirements, leading to improved quality of services and enhanced consumer protection. By facilitating the exchange of information between states, the compact can also help to prevent fraud and misconduct, ensuring that only qualified and ethical practitioners are licensed. As more states join the Interstate Massage Compact, the vision of a truly national marketplace for massage therapy services will become a reality.

The successful implementation of SB37 will require ongoing collaboration and commitment from all stakeholders, including state legislatures, regulatory boards, massage therapy professionals, and the public. By working together, these stakeholders can ensure that the compact achieves its objectives and delivers its intended benefits. The potential for improved service delivery, heightened public safety, and more efficient regulatory practices makes SB37 a key development in the evolution of the massage therapy profession, promising a future where practitioners can more easily serve communities across state lines and the public can be assured of safe, competent care.