American Association of Masseurs and Masseuses (AAMM) 1983 Name changed to the American Massage Therapy Association (AMTA).

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1 History of Massage in WA 1943 American Association of Masseurs and Masseuses (AAMM) 1958 Name changed to American Massage & Therapy Association (AM&TA) 1983 Name changed to the American Massage Therapy Association (AMTA). 1960's Washington State had three massage schools: Atomic School of Massage in Tri-Cities, Broadmoor in Seattle and one school in Spokane CHAPTER 280 [House Bill No. 774] MASSAGE BUSINESS AN ACT Relating to the operation of massage businesses; adding a new chapter to Title 18 RCW; and prescribing penalties. Be it enacted by the Legislature of the State of Washington: NEW SECTION. Section 1. There is added to Title 18 RCW a new section to read as follows: In this chapter, unless the context otherwise requires, the following meanings shall apply: (1) "Board" means the state massage examining board; (2) "Massage" means the treatment of the superficial parts of the body, with or without the aid of soaps, oils, or lotions, by rubbing, touching, stroking, tapping, and kneading, provided no attempt be made to adjust or manipulate the articulations of the spine; (3) "Massage operator" means a person engaged in the practice of massage; (4) "Director" means the director of the department of motor vehicles. (5) Massage business means the operation of a business where massages are given. NEW SECTION. Sec. 2. There is added to Title 18 RCW a new section to. read as follows: The state massage examining board is hereby created. Passed the House June 8, Passed the Senate June 8, Approved by the Governor July 2, 1975 with the exception of section 8 which * is vetoed. Filed in Office of Secretary of State July 2, Note: Governor's explanation of partial veto is as follows: Gov. Dan Evans "I am returning herewith without my approval as to one section House Bill No. 774 entitled: "AN ACT Relating to the operation of massage businesses." This bill provides for the regulation and licensing, at the state level, of massage businesses and operators. Section 8 contains a "grandfather clause" allowing any person engaged in the massage business for one year or more to qualify for

2 the massage operator's license without taking-the examination prescribed elsewhere in the bill. I have long stated my objection to grandfather clauses in business licensing acts for the reason that I do not believe it is either in the best interest of the public or the particular business involved to license all persons previously engaged in a business for a set period of time regardless of the competency of such person. in addition, I cannot ignore the reports by law enforcement agencies detailing the proliferation in certain areas of our state of purported massage parlors which actually engage in a number of illicit and criminal activities. Approval of the grandfather clause in this bill would effectively grant licenses to persons engaged in such activities at those establishments. With the exception of section 8 which I have vetoed for the reasons stated, Director of Motor Vehicle Licensing until 1979 Director of Licensing ( DOL) Washington State required passage of State Massage Exam to practice. Ruth Williams was among the first to be licensed; also Heida Brenneke, Cheryl Hockett, Susan Rosen, William Prelle, Daisy and Cohen Kallop, Lucy and Fred Baker, Richard Butt. 1980's More massage schools opened: Brenneke School of Massage, Acadia, Spectrum Center School of Massage, Alexandar's School of Natural Therapeutics, Fairhaven and Brian Utting School of Massage.LMPs began doing Labor and Industry injured worker claims CHAPTER 279 [Substitute House Bill No HEALTH AND HEALTH-RELATED PROFESSIONS AND BUSINESSES CONSOLIDATION OF DISCIPLINARY PROCEDURES It is the intent of the legislature to strengthen and consolidate disciplinary and licensure procedures for the licensed health and health-related professions and businesses by providing a uniform disciplinary act with standardized procedures for the licensure of health care professionals and the enforcement of laws the purpose of which is to assure the public of the adequacy of professional competence and conduct in the healing arts. It is also the intent of the legislature that all health and health-related professions newly credentialed by the state come under the Uniform Disciplinary Act. Further, the legislature declares that the addition of public members on all health care commissions and boards can give both the state and the public, which it has a

3 statutory responsibility to protect, assurances of accountability and confidence in the various practices of health care. Uniform Disciplinary Act (UDA) defines and governs all providers in WA State. LMPs were included for the first time, which gave us status as healthcare providers. Because of this action, Labor and Industries opened up to us in July the following year.(1984) LMPs began working with L&I. And PIP 1987 Engrossed Substitute Senate Bill No MASSAGE THERAPY Massage operator to massage practitioner /Massage Examining Board to Board of Massage "massage therapy" health care service involving the external manipulation or pressure of soft tissue for therapeutic purposes. Massage therapy includes massage techniques such as methods of effleurage, petrissage, tapotement, tapping, compression, vibration, friction, nerve stokes, and Swedish gymnastics or movements either by manual means, as they relate to massage, with or without the aids of superficial heat, cold, water, lubricants, or salts. Massage therapy does not include diagnosis or attempts to adjust or manipulate any articulations of the body or spine or mobilization of these articulations by the use of a thrusting force. Washington State began approving massage schools ( 1988). (1) Effective June 1, 1988, successful completion of a course of study in an approved massage program or approved apprenticeship program; (2) Successful completion of an examination administered or approved by the board; and (3) Be eighteen years of age or older. In addition, applicants shall be subject to the grounds for denial or issuance of a conditional license under chapter RCW. The director may require any information and documentation that reasonably relates to the need to determine whether the applicant meets the criteria for licensure provided for in this chapter and chapter RCW. The director shall establish by rule what constitutes adequate proof of meeting the criteria. The board shall give an appropriate alternate form of examination for persons who cannot read or speak English to determine equivalent competency. LMPs began doing auto injury insurance treatments. PIP And Labor and Industry claims. Our love/ hate relationship with third party billing begins

4 The Dept. of Health is created as a state agency and the licensing and regulation of all health care providers moves from DOL to DOH. ABMP Founded in 1987 (Associated Massage and Bodywork Professionals) State Standards for Massage Education set at 500 hours. Unchanged until possibly soon?? Sales tax added to LMP fees. LMPs organized protest and win. (Entered the era of "Healthcare Provider") NCBTMB (National Certification Board for Therapeutic Massage and Bodywork) formed. WA State Health Care Reform Act Passed 1994 SUBSTITUTE HOUSE BILL 2424 RCW enacted classifies LMPs as offices and clinics of health practitioners under section 8049 of the Federal Standard Industrial Classification Manual SUBSTITUTE HOUSE BILL 1387 License number in all print advertising. State dropped practical exam, adopted National Certification Exam. SESB 5555 Legislature removed massage services from the definition of sales in RCW and adopted a finding that: It is the intent of the legislature that massage services be recognized as health care practitioners for the purpose of business and occupations tax application SUBSTITUTE HOUSE BILL 2151 The secretary, in consultation with health profession boards and commissions, shall establish by rule the administrative procedures, administrative requirements, and fees for initial issue, renewal, and reissue of a credential for professions under RCW , including procedures and requirements for

5 late renewals and uniform application of late renewal penalties. Failure to renew invalidates the credential and all privileges granted by the credential. Administrative procedures and administrative requirements do not include establishing, monitoring, and enforcing qualifications for licensure, scope or standards of practice, continuing competency mechanisms, and discipline when such authority is authorized in statute to a health profession board or commission. For the purposes of this section, "in consultation with" means providing an opportunity for meaningful participation in development of rules consistent with processes set forth in RCW Every Category of Provider Health plan requirements -- Annual reports -- Exemptions (1) Every health plan delivered, issued for delivery, or renewed by a health carrier on and after January 1, 1996, shall: (a) Permit every category of health care provider to provide health services or care for conditions included in the basic health plan services to the extent that: (i) The provision of such health services or care is within the health care providers' permitted scope of practice; and (ii) The providers agree to abide by standards related to: (A) Provision, utilization review, and cost containment of health services; (B) Management and administrative procedures; and (C) Provision of cost-effective and clinically efficacious health services. "Every Category of Provider" law passed - giving individuals the right to choose the provider they will see for a covered condition as long as it is within a healthcare provider's scope of practice. Will go on to become the most challenged health care law in WA. Withstood legal challenge up to the 9 th Circuit Court of Appeals who allowed the decision by the lower court to stand, which is why the law continues (although re-numbered by the OIC in law documents due to changes in the federal laws) (had it memorized for years!) 1997 Atlanta Olympic/Paralympic Games - First time that sports massage was included as a member of medical service for the games by a local organizer.

6 Health Care Reform is declared constitutionally legal all the way to the Supreme Court in San Francisco. Eisenburg Study on low back pain with Dan Cherkin at the Center for Health Studies began. Somatic Practitioners were exempted in RCW. SUBSTITUTE HOUSE BILL 1875 Individuals who have completed a somatic education training program approved by the secretary. AMTA-WA participated in the Clinicians' Workgroup on the Integration of CAM (CWIC) with Insurance Commissioner Deborah Senn from The workgroup existed for three full years addressing myths, fears and coverage issues from service that were not understood by insurers. The relationships developed through that workgroup are still supporting the CAM professions today. White House Commission Town Hall Meeting in Seattle (AMTA-WA testimony). Northwest Integrated Health Care King County; AMTA-WA participated SUBSTITUTE SENATE BILL 5621 ANIMAL MASSAGE A massage practitioner licensed under this chapter may apply for an endorsement as a small or large animal massage practitioner. RCW a note was added, The Legislature finds that massage therapists have contributed significantly to the welfare of humans /11 Eisenburg Study published in the Journal of the American Medical Association (JAMMA). Salt Lake City Olympic/Paralympic Games - Sports massage was again recognized as a member of medical services. The AMTA petitioned the

7 2004 International Olympic Committee to make sports massage a mandated service of the Games. Chapter Volunteer Gathering held. Reflexologists were exempted in RCW. SENATE BILL 6698 Persons who limit their practice to reflexology. For purposes of this chapter, the practice of reflexology is limited to the hands, feet, and outer ears. The services provided by those who limit their practice to reflexology are not designated or implied to be massage or massage therapy. MYOPAC raises $11,000 to help defeat I-895. This initiative threatened a patient's right to access the healthcare provider of their choice to deliver covered services in their health insurance policy. I-895 dies. Biggest political contribution by the massage profession ($11,000 in donations to MYOPAC). HB 2460 dismantles much of Washington State healthcare reform, but "Every Category Provider" law still intact. I-895 challenged again (2004) through Initiative and I chaired a coalition (with Sandi Cutler and David Matteson) to shut it down-and they didn t get the signatures to repeal. Still the most challenged law in healthcare (every year a bill to repeal) MYOPAC is retired and a new political action committee, Washington Massage Alliance for Health, is created. Worked with the Association of Washington cities to end discriminatory local massage ordinances Department of Health issues new rules which define professional misconduct for all healthcare providers in Washington. National Provider Identifier (NPI) required for all healthcare providers by the U.S. Department of Health and Human Services in accordance with HIPAA.

8 AMTA-WA wrote and worked to pass HB 1397 which expanded scope of practice to include intraoral massage as an endorsement to the massage license. RCW Chapter AMTA-WA wrote and worked to pass HB 1341 which repealed language from the massage practice act that allowed local jurisdictions to charge additional fees for massage businesses that were not required for non-massage businesses SB 5403 passed which created a new category of animal massage therapists under the purview of the veterinary board for those who only want to work with animals and not humans AMTA-WA wrote and worked to pass SHB 2959 which placed the massage continuing education requirement into law (RCW) and not just in rule (WAC) and created an inactive license category for massage. Health Electronic Resource for WA (HEAL-WA) an evidence-based health sciences information website is launched. Site funded by an additional fee added on to state healthcare providers Department of Health issues new rules for continuing education for massage practitioners. Another attempt to place a sales tax on massage, defeated. SHB 1133 passed A massage practitioner's name and license number must conspicuously appear on all of the massage practitioner s advertisements. Certification of Reflexologists ENGROSSED SUBSTITUTE SENATE BILL 6103 effective date July 1, 2013.

9 EFFECTIVE DATE: 06/07/12 - Except sections 1 through 19, which become effective 07/01/13. Secretary or (DOH inspectors) given authority to inspect massage/reflexology businesses during business hours. Certification of Reflexologist required SUBSTITUTE HOUSE BILL 1252 The following penalties must be imposed upon an owner of a massage business or reflexology business where the unlicensed practice of massage therapy or reflexology has been committed: (1) Any person who with knowledge or criminal negligence allows or permits the unlicensed practice of massage therapy or reflexology to be committed within his or her massage business or reflexology business by another is guilty of a misdemeanor for a single violation. (2) Each subsequent violation, whether alleged in the same or in subsequent prosecutions, is a gross misdemeanor punishable according to chapter 9A.20 RCW SUBSTITUTE HOUSE BILL 2425 LMP to LMT effective date July (1 st. renewal in 2017) LMP changes to LMT July 1 Numerous WAC revisions/updates and new rules.

10 This is the future of Bodywork, why talk about the history to understand our current reality and guide us in developing our future we need to understand where we came from the time, effort, money that it all took Span of 42 years, to accomplish all of this SLOW MONEY for PAC and Lobbyists VOLUNTEERS to attend meetings, lobby your Legislators, assist massage therapy organizations Your profession needs you to commit to some Call to Action!