Massage therapists don’t want to be seen as sex workers. Chiropractors want to defend their sovereignty over human joints. And the Governor doesn’t want to add any new boards or commissions to state government.
It all adds up to an unusual case of an industry trying to force the state to regulate it–and having to walk through a political minefield to get there.
SB 731 would establish a private, nonprofit called the Massage Therapy Organization (MTO) to enforce uniform licensing and regulations on the approximately 36,000 massage therapists working in California. The MTO would include a six member board, with two massage therapist outnumbered by city and state representatives and a member from the Department of Consumer Affairs (DCA).
Currently, they’re governed by a patchwork of city and county ordinances, according to Bob Benson, chairman of the Association of Bodywork & Massage Professionals, which is sponsoring the bill.
“Massage is already regulated in California, but in about as disjointed and dysfunctional a way as one could imagine,” Benson said.
At least thirty-three states have uniform codes and governing bodies for massage therapy. Massage is also the only one of the top 20 largest health care-related fields in California without statewide board. The lack of recognition and standardization has an effect every time a potential massage client opens the yellow pages to find a provider, Benson said.
“You’re going to find a history of legitimate massage services being confused with escort services trying to appropriate the term ‘massage,'” Benson said.
However, this seemingly simple effort has been complicated by turf wars reminiscent of the 1980s war over the ankles between podiatrists and orthopedic surgeons. In 2003, then-Assemblywoman Christine Kehoe introduced AB 1388, which would have created a Massage Therapy and Bodyworks Commission under the Department of Consumer Affairs. The bill died in Assembly Business and Professions Committee. Benson said this effort was partially due a campaign statement from Schwarzenegger saying he did not want to add any new boards or commissions to state government.
In 2005, then-Senator Liz Figueroa carried SB 412, a very similar bill to SB 731. It went down in Assembly vote on the closing days of session last year. Part of the reason came from opposition from the California Chiropractic Association, who objected to the definition of massage in both bills. On April 19, SB 731’s author, Senator Jenny Oropeza, D-Carson, took an amendment to remove the definition from the bill.
In particular, Oropeza removed references to the word “joint.” The chiropractors did not want language in print that specifically put joints under the massage therapists scope of practice; massage therapists, in turn, did not want to specifically excluded from working on joints, because that would mean they would run afoul of the law every time they helped a patient stretch. Instead, a massage therapist or bodyworker will now be defined by the MTO, when and if it’s established.
“It wasn’t just working on some muscles, it was moving joints,” said Christine Shultz, director of government affairs at the California Chiropractic Association. Any time the state makes a definition for a professional, she said, people read that as an endorsement. With the change, she said, her Association now supports the bill.
However, the California Physical Therapy Association (CPTA) and California Association of Private Postsecondary Schools (CAPPS) still object to SB 731. The CPTA brought up numerous issues in an opposition letter, including the lack of distinction between therapeutic and recreational massage, according to an analysis by consultant Bill Gage in the Senate Business and Professions Committee. CAPPS has argued that the bill, as written, could weaken educational standards.
Critics have also objected to massage therapists being governed by a board outside of the direct control of state government. Benson countered that massage therapists would be happy to have a board under state government, but that the Schwarzenegger administration has signaled that they don’t want to create new state bureaucracies.
However, in his analysis, Gage noted two professions successfully administered by non-governmental boards: the California Tax Education Council for tax preparers, and the California Council for Interior Design Certification. The MTO would be modeled on these bodies, he said.
While the effort to establish a governing body for massage therapists has been going on for years, Benson and others said that there has been a renewed urgency due to recent events out of the California Board of Chiropractic Examiners. There, a board of Schwarzenegger appointees has been in open war with the Board’s now-demoted executive director and allied staff.
One key problem cited with the Chiropractic Board has been the lack of oversight via the state’s annual sunset review process. A 2000 sunset review of the Chiropractic Board by Figueroa called for numerous changes, but she had no way to enforce them. According to Gage’s analysis, despite existing outside the official walls of government, the Massage Therapy Organization would be subject to sunset review.