BILL REQ. #:  S-4261.2 

READ FIRST TIME 01/31/12.   

     AN ACT Relating to the practice of reflexology and massage therapy; amending RCW 18.108.010, 18.108.025, 18.108.030, 18.108.040, 18.108.050, 18.108.070, 18.108.073, 18.108.095, 18.108.130, 18.108.085, 18.120.020, and 18.130.040; and adding new sections to chapter 18.108 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   A new section is added to chapter 18.108 RCW to read as follows:
     The legislature finds that reflexology and massage are different and specific bodywork professions. This chapter provides for licensure to differentiate the two professions which both have attained maturity through established history and the creation of credible professional associations and training.

Sec. 2   RCW 18.108.010 and 2007 c 272 s 1 are each amended to read as follows:
     In this chapter, unless the context otherwise requires, the following meanings shall apply:
     (1) "Board" means the Washington state board of massage.
     (2) "Massage" and "massage therapy" mean a health care service involving the external manipulation or pressure of soft tissue for therapeutic purposes. Massage therapy includes techniques such as tapping, compressions, friction, Swedish gymnastics or movements, gliding, kneading, shaking, and fascial or connective tissue stretching, 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, nor does it include genital manipulation.
     (3) "Massage practitioner" means an individual licensed under this chapter.
     (4) "Secretary" means the secretary of health or the secretary's designee.
     (5) "Massage business" means the operation of a business where massages are given.
     (6) "Animal massage practitioner" means an individual with a license to practice massage therapy in this state with additional training in animal therapy.
     (7) "Intraoral massage" means the manipulation or pressure of soft tissue inside the mouth or oral cavity for therapeutic purposes.
     (8) "Reflexologist" means an individual who is certified under this chapter.
     (9) "Reflexology" means a health care service that is limited to applying alternating pressure with thumb and finger techniques to reflexive areas of the lower one-third of the extremities, feet, hands, and outer ears based on reflex maps. Reflexology does not include the diagnosis or treatment for specific diseases, or joint manipulations.
     (10) "Reflexology business" means the operation of a business where reflexology services are provided.

Sec. 3   RCW 18.108.025 and 2008 c 25 s 1 are each amended to read as follows:
     In addition to any other authority provided by law, the board of massage may:
     (1) Adopt rules in accordance with chapter 34.05 RCW necessary to implement this chapter, subject to the approval of the secretary;
     (2) Define, evaluate, approve, and designate those massage schools, massage programs, and massage apprenticeship programs including all current and proposed curriculum, faculty, and health, sanitation, and facility standards from which graduation will be accepted as proof of an applicant's eligibility to take the massage licensing examination;
     (3) Review approved massage schools and programs periodically;
     (4) Prepare, grade, administer, and supervise the grading and administration of, examinations for applicants for massage licensure;
     (5) Establish and administer requirements for continuing education, which shall be a prerequisite to renewing a massage practitioner license under this chapter; and
     (6) Determine which states have educational and licensing requirements for massage practitioners equivalent to those of this state.
     The board shall establish by rule the standards and procedures for approving courses of study and may contract with individuals or organizations having expertise in the profession or in education to assist in evaluating courses of study. The standards and procedures set shall apply equally to schools and training within the United States of America and those in foreign jurisdictions.

Sec. 4   RCW 18.108.030 and 1995 c 198 s 15 are each amended to read as follows:
     (1) No person may practice or represent himself or herself as a massage practitioner without first applying for and receiving from the department a license to practice.
     (2) A person represents himself or herself as a massage practitioner when the person adopts or uses any title or any description of services that incorporates one or more of the following terms or designations: Massage, massage practitioner, massage therapist, massage therapy, therapeutic massage, massage technician, massage technology, massagist, masseur, masseuse, myotherapist or myotherapy, touch therapist, ((reflexologist,)) acupressurist, body therapy or body therapist, or any derivation of those terms that implies a massage technique or method.
     (3) No person may practice reflexology or represent oneself as a reflexologist by use of any title without first being certified as a reflexologist by the department.
     (4) A person represents himself or herself as a reflexologist when the person adopts or uses any title in any description of services that incorporates one or more of the following terms or designations: Reflexologist, reflexology, foot pressure therapy, foot reflex therapy, or any derivation of those terms that implies a reflexology technique or method.

Sec. 5   RCW 18.108.040 and 2011 c 223 s 1 are each amended to read as follows:
     (1) It shall be unlawful to advertise the practice of massage using the term massage or any other term that implies a massage technique or method in any public or private publication or communication by a person not licensed by the secretary as a massage practitioner.
     (2) Any person who holds a license to practice as a massage practitioner in this state may use the title "licensed massage practitioner" and the abbreviation "L.M.P.". No other persons may assume such title or use such abbreviation or any other word, letters, signs, or figures to indicate that the person using the title is a licensed massage practitioner.
     (3) A person licensed as a massage practitioner may not adopt or use any title or description of services, including for purposes of advertising, that incorporates one or more of the following terms or designations: Reflexologist, reflexology, foot pressure therapy, foot reflex therapy, or any derivation of those terms that implies a reflexology technique or method unless the person is also certified under this chapter as a reflexologist.
     (4) A massage practitioner's name and license number must conspicuously appear on all of the massage practitioner's advertisements.
     (5) It is unlawful to advertise the practice of reflexology or any other term that implies reflexology technique or method in any public or private publication or communication by a person not certified by the secretary as a reflexologist.
     (6) A person certified as a reflexologist may not adopt or use any title or description of services, including for purposes of advertising, that incorporates one or more of the following terms or designations: Massage, masseuse, massager, massagist, masseur, myotherapist or myotherapy, touch therapist, body therapy or therapist, or any derivation of those terms that implies a massage technique or therapy unless the person is also licensed under this chapter as a massage practitioner.
     (7) A reflexologist's name and certification number must conspicuously appear on all of the reflexologist's advertisements.

Sec. 6   RCW 18.108.050 and 2002 c 277 s 2 are each amended to read as follows:
     This chapter does not apply to:
     (1) An individual giving massage or reflexology to members of his or her immediate family;
     (2) The practice of a profession by individuals who are licensed, certified, or registered under other laws of this state and who are performing services within their authorized scope of practice;
     (3) Massage or reflexology practiced at the athletic department of any institution maintained by the public funds of the state, or any of its political subdivisions;
     (4) Massage or reflexology practiced at the athletic department of any school or college approved by the department by rule using recognized national professional standards;
     (5) Students enrolled in an approved massage school, approved program, or approved apprenticeship program, practicing massage techniques, incidental to the massage school or program and supervised by the approved school or program. Students must identify themselves as a student when performing massage services on members of the public. Students may not be compensated for the massage services they provide;
     (6) Students enrolled in an approved reflexology school, approved program, or approved apprenticeship program, practicing reflexology techniques, incidental to the reflexologist school or program and supervised by the approved school or program. Students must identify themselves as a student when performing reflexology services on members of the public. Students may not be compensated for the reflexology services they provide;
     (7) Individuals who have completed a somatic education training program approved by the secretary((;
     (7) 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)).

Sec. 7   RCW 18.108.070 and 1991 c 3 s 257 are each amended to read as follows:
     (1) The secretary shall issue a massage practitioner's license to an applicant who demonstrates to the secretary's satisfaction that the following requirements have been met:
     (((1))) (a) Effective June 1, 1988, successful completion of a course of study in an approved massage program or approved apprenticeship program;
     (((2))) (b) Successful completion of an examination administered or approved by the board. The board shall give an appropriate alternate form of examination for persons who cannot read or speak English to determine equivalent competency; and
     (((3))) (c) Be eighteen years of age or older.
     (2) In addition, applicants for a massage practitioner's license shall be subject to the grounds for denial or issuance of a conditional license under chapter 18.130 RCW.
     (3) The secretary shall issue a certification to an applicant who completes an application form that identifies the name and address of the applicant, the certification request, and demonstrates to the secretary's satisfaction that the following requirements have been met:
     (a) Successful completion of a course of study in reflexologist program approved by the secretary;
     (b) Successful completion of an examination administered or approved by the secretary. The secretary shall give an appropriate alternate form of examination for persons who cannot read or speak English to determine equivalent competency; and
     (c) Be eighteen years of age or older.
     (4) The secretary may require any information and documentation that reasonably relates to the need to determine whether the massage practitioner or reflexologist applicant meets the criteria for licensure provided for in this chapter and chapter 18.130 RCW. The secretary 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.))

Sec. 8   RCW 18.108.073 and 1995 c 198 s 17 are each amended to read as follows:
     (1) The date and location of the massage practitioner examination shall be established by the secretary. Applicants who demonstrate to the secretary's satisfaction that the following requirements have been met shall be scheduled for the next examination following the filing of the application:
     (a) Effective June 1, 1988, successful completion of a course of study in an approved massage program; or
     (b) Effective June 1, 1988, successful completion of an apprenticeship program established by the board; and
     (c) Be eighteen years of age or older.
     In addition, the secretary shall establish a deadline for receipt of completed and approved applications.
     (2) The board or its designee shall examine each massage practitioner applicant in a written examination determined most effective on subjects appropriate to the massage scope of practice. The subjects may include anatomy, kinesiology, physiology, pathology, principles of human behavior, massage theory and practice, hydrotherapy, hygiene, first aid, Washington law pertaining to the practice of massage, and such other subjects as the board may deem useful to test applicant's fitness to practice massage therapy. Such examinations shall be limited in purpose to determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.
     (3) All records of a massage practitioner candidate's performance shall be preserved for a period of not less than one year after the board has made and published decisions thereupon. All examinations shall be conducted by the board under fair and impartial methods as determined by the secretary.
     (4) ((An)) A massage practitioner applicant who fails to make the required grade in the first examination is entitled to take up to two additional examinations upon the payment of a fee for each subsequent examination determined by the secretary as provided in RCW 43.70.250. Upon failure of three examinations, the secretary may invalidate the original application and require such remedial education as is required by the board before admission to future examinations.
     (5) The board may approve an examination prepared or administered, or both, by a private testing agency or association of licensing boards for use by ((an)) a massage practitioner applicant in meeting the licensing requirement.

Sec. 9   RCW 18.108.095 and 1987 c 443 s 12 are each amended to read as follows:
     ((An)) A massage practitioner applicant holding a license in another state or foreign jurisdiction may be granted a Washington license without examination, if, in the opinion of the board, the other state's or foreign jurisdiction's examination and educational requirements are substantially equivalent to Washington's: PROVIDED, That the applicant demonstrates to the satisfaction of the board a working knowledge of Washington law pertaining to the practice of massage. The applicant shall provide proof in a manner approved by the department that the examination and requirements are equivalent to Washington's.

Sec. 10   RCW 18.108.130 and 1975 1st ex.s. c 280 s 14 are each amended to read as follows:
     This chapter does not apply to:
     (1) Massage or reflexology practiced at the athletic department of any institution maintained by the public funds of the state, or any of its political subdivisions;
     (2) Massage or reflexology practiced at the athletic department of any primary or secondary school, or institution of higher education; and
     (3) Massage or reflexology practiced at the athletic department of any nonprofit organization licensed under RCW 66.24.400 and 66.24.450.

Sec. 11   RCW 18.108.085 and 1996 c 154 s 1 are each amended to read as follows:
     (1) In addition to any other authority provided by law, the secretary may:
     (a) Adopt rules, in accordance with chapter 34.05 RCW necessary to implement this chapter;
     (b) Set all license, examination, and renewal fees in accordance with RCW 43.70.250;
     (c) Establish forms and procedures necessary to administer this chapter;
     (d) Issue a massage practitioner's license to any applicant who has met the education, training, and examination requirements for licensure; ((and))
     (e) Issue a reflexology certification to any applicant who has met the requirements for certification and deny certification to applicants who do not meet the requirements of this chapter; and
     (f) Hire clerical, administrative, and investigative staff as necessary to implement this chapter, and hire individuals licensed under this chapter to serve as examiners for any practical examinations.
     (2) The Uniform Disciplinary Act, chapter 18.130 RCW, governs the issuance and denial of licenses and the disciplining of persons under this chapter. The secretary shall be the disciplining authority under this chapter.
     (3) Any license issued under this chapter to a person who is or has been convicted of violating RCW 9A.88.030, 9A.88.070, 9A.88.080, or 9A.88.090 or equivalent local ordinances shall automatically be revoked by the secretary upon receipt of a certified copy of the court documents reflecting such conviction. No further hearing or procedure is required, and the secretary has no discretion with regard to the revocation of the license. The revocation shall be effective even though such conviction may be under appeal, or the time period for such appeal has not elapsed. However, upon presentation of a final appellate decision overturning such conviction, the license shall be reinstated, unless grounds for disciplinary action have been found under chapter 18.130 RCW. No license may be granted under this chapter to any person who has been convicted of violating RCW 9A.88.030, 9A.88.070, 9A.88.080, or 9A.88.090 or equivalent local ordinances within the eight years immediately preceding the date of application. For purposes of this subsection, "convicted" does not include a conviction that has been the subject of a pardon, annulment, or other equivalent procedure based on a finding of innocence, but does include convictions for offenses for which the defendant received a deferred or suspended sentence, unless the record has been expunged according to law.
     (4) The secretary shall keep an official record of all proceedings under this chapter, a part of which record shall consist of a register of all applicants for licensure under this chapter, with the result of each application.

NEW SECTION.  Sec. 12   A new section is added to chapter 18.108 RCW to read as follows:
     (1) The secretary may certify an applicant as a reflexologist without examination if:
     (a) The applicant has practiced reflexology for at least five years prior to the effective date of this section; and
     (b) The applicant applies for certification within one year of the effective date of this section.
     (2) An applicant holding a reflexology credential in another state or a territory of the United States may be certified to practice in this state without examination if the secretary determines that the other jurisdiction's credentialing standards are substantially equivalent to the standards in this state.

NEW SECTION.  Sec. 13   A new section is added to chapter 18.108 RCW to read as follows:
     For the purposes of ascertaining violations of this chapter and chapter 18.130 RCW, the secretary has the authority to inspect the premises of any massage or reflexology business establishment during hours such business is open. If the secretary is denied access to any premises or establishment the secretary may apply to any court of competent jurisdiction for a warrant authorizing access to such premises or establishment for such purposes. The court may, upon such application, issue a warrant for the purpose requested.

Sec. 14   RCW 18.120.020 and 2010 c 286 s 14 are each amended to read as follows:
     The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Applicant group" includes any health professional group or organization, any individual, or any other interested party which proposes that any health professional group not presently regulated be regulated or which proposes to substantially increase the scope of practice of the profession.
     (2) "Certificate" and "certification" mean a voluntary process by which a statutory regulatory entity grants recognition to an individual who (a) has met certain prerequisite qualifications specified by that regulatory entity, and (b) may assume or use "certified" in the title or designation to perform prescribed health professional tasks.
     (3) "Grandfather clause" means a provision in a regulatory statute applicable to practitioners actively engaged in the regulated health profession prior to the effective date of the regulatory statute which exempts the practitioners from meeting the prerequisite qualifications set forth in the regulatory statute to perform prescribed occupational tasks.
     (4) "Health professions" means and includes the following health and health-related licensed or regulated professions and occupations: Podiatric medicine and surgery under chapter 18.22 RCW; chiropractic under chapter 18.25 RCW; dental hygiene under chapter 18.29 RCW; dentistry under chapter 18.32 RCW; denturism under chapter 18.30 RCW; dispensing opticians under chapter 18.34 RCW; hearing instruments under chapter 18.35 RCW; naturopaths under chapter 18.36A RCW; embalming and funeral directing under chapter 18.39 RCW; midwifery under chapter 18.50 RCW; nursing home administration under chapter 18.52 RCW; optometry under chapters 18.53 and 18.54 RCW; ocularists under chapter 18.55 RCW; osteopathic medicine and surgery under chapters 18.57 and 18.57A RCW; pharmacy under chapters 18.64 and 18.64A RCW; medicine under chapters 18.71 and 18.71A RCW; emergency medicine under chapter 18.73 RCW; physical therapy under chapter 18.74 RCW; practical nurses under chapter 18.79 RCW; psychologists under chapter 18.83 RCW; registered nurses under chapter 18.79 RCW; occupational therapists licensed under chapter 18.59 RCW; respiratory care practitioners licensed under chapter 18.89 RCW; veterinarians and veterinary technicians under chapter 18.92 RCW; health care assistants under chapter 18.135 RCW; massage practitioners under chapter 18.108 RCW; East Asian medicine practitioners licensed under chapter 18.06 RCW; persons registered under chapter 18.19 RCW; persons licensed as mental health counselors, marriage and family therapists, and social workers under chapter 18.225 RCW; dietitians and nutritionists certified by chapter 18.138 RCW; radiologic technicians under chapter 18.84 RCW; ((and)) nursing assistants registered or certified under chapter 18.88A RCW; and reflexologists registered under chapter 18.108 RCW.
     (5) "Inspection" means the periodic examination of practitioners by a state agency in order to ascertain whether the practitioners' occupation is being carried out in a fashion consistent with the public health, safety, and welfare.
     (6) "Legislative committees of reference" means the standing legislative committees designated by the respective rules committees of the senate and house of representatives to consider proposed legislation to regulate health professions not previously regulated.
     (7) "License," "licensing," and "licensure" mean permission to engage in a health profession which would otherwise be unlawful in the state in the absence of the permission. A license is granted to those individuals who meet prerequisite qualifications to perform prescribed health professional tasks and for the use of a particular title.
     (8) "Professional license" means an individual, nontransferable authorization to carry on a health activity based on qualifications which include: (a) Graduation from an accredited or approved program, and (b) acceptable performance on a qualifying examination or series of examinations.
     (9) "Practitioner" means an individual who (a) has achieved knowledge and skill by practice, and (b) is actively engaged in a specified health profession.
     (10) "Public member" means an individual who is not, and never was, a member of the health profession being regulated or the spouse of a member, or an individual who does not have and never has had a material financial interest in either the rendering of the health professional service being regulated or an activity directly related to the profession being regulated.
     (11) "Registration" means the formal notification which, prior to rendering services, a practitioner shall submit to a state agency setting forth the name and address of the practitioner; the location, nature and operation of the health activity to be practiced; and, if required by the regulatory entity, a description of the service to be provided.
     (12) "Regulatory entity" means any board, commission, agency, division, or other unit or subunit of state government which regulates one or more professions, occupations, industries, businesses, or other endeavors in this state.
     (13) "State agency" includes every state office, department, board, commission, regulatory entity, and agency of the state, and, where provided by law, programs and activities involving less than the full responsibility of a state agency.

Sec. 15   RCW 18.130.040 and 2011 c 41 s 11 are each amended to read as follows:
     (1) This chapter applies only to the secretary and the boards and commissions having jurisdiction in relation to the professions licensed under the chapters specified in this section. This chapter does not apply to any business or profession not licensed under the chapters specified in this section.
     (2)(a) The secretary has authority under this chapter in relation to the following professions:
     (i) Dispensing opticians licensed and designated apprentices under chapter 18.34 RCW;
     (ii) Midwives licensed under chapter 18.50 RCW;
     (iii) Ocularists licensed under chapter 18.55 RCW;
     (iv) Massage operators and businesses licensed under chapter 18.108 RCW;
     (v) Dental hygienists licensed under chapter 18.29 RCW;
     (vi) East Asian medicine practitioners licensed under chapter 18.06 RCW;
     (vii) Radiologic technologists certified and X-ray technicians registered under chapter 18.84 RCW;
     (viii) Respiratory care practitioners licensed under chapter 18.89 RCW;
     (ix) Hypnotherapists and agency affiliated counselors registered and advisors and counselors certified under chapter 18.19 RCW;
     (x) Persons licensed as mental health counselors, mental health counselor associates, marriage and family therapists, marriage and family therapist associates, social workers, social work associates--advanced, and social work associates -- independent clinical under chapter 18.225 RCW;
     (xi) Persons registered as nursing pool operators under chapter 18.52C RCW;
     (xii) Nursing assistants registered or certified under chapter 18.88A RCW;
     (xiii) Health care assistants certified under chapter 18.135 RCW;
     (xiv) Dietitians and nutritionists certified under chapter 18.138 RCW;
     (xv) Chemical dependency professionals and chemical dependency professional trainees certified under chapter 18.205 RCW;
     (xvi) Sex offender treatment providers and certified affiliate sex offender treatment providers certified under chapter 18.155 RCW;
     (xvii) Persons licensed and certified under chapter 18.73 RCW or RCW 18.71.205;
     (xviii) Denturists licensed under chapter 18.30 RCW;
     (xix) Orthotists and prosthetists licensed under chapter 18.200 RCW;
     (xx) Surgical technologists registered under chapter 18.215 RCW;
     (xxi) Recreational therapists (([under chapter 18.230 RCW])) under chapter 18.230 RCW;
     (xxii) Animal massage practitioners certified under chapter 18.240 RCW;
     (xxiii) Athletic trainers licensed under chapter 18.250 RCW;
     (xxiv) Home care aides certified under chapter 18.88B RCW; ((and))
     (xxv) Genetic counselors licensed under chapter 18.290 RCW; and
     (xxvi) Reflexologists registered under chapter 18.108 RCW.
     (b) The boards and commissions having authority under this chapter are as follows:
     (i) The podiatric medical board as established in chapter 18.22 RCW;
     (ii) The chiropractic quality assurance commission as established in chapter 18.25 RCW;
     (iii) The dental quality assurance commission as established in chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW and licenses and registrations issued under chapter 18.260 RCW;
     (iv) The board of hearing and speech as established in chapter 18.35 RCW;
     (v) The board of examiners for nursing home administrators as established in chapter 18.52 RCW;
     (vi) The optometry board as established in chapter 18.54 RCW governing licenses issued under chapter 18.53 RCW;
     (vii) The board of osteopathic medicine and surgery as established in chapter 18.57 RCW governing licenses issued under chapters 18.57 and 18.57A RCW;
     (viii) The board of pharmacy as established in chapter 18.64 RCW governing licenses issued under chapters 18.64 and 18.64A RCW;
     (ix) The medical quality assurance commission as established in chapter 18.71 RCW governing licenses and registrations issued under chapters 18.71 and 18.71A RCW;
     (x) The board of physical therapy as established in chapter 18.74 RCW;
     (xi) The board of occupational therapy practice as established in chapter 18.59 RCW;
     (xii) The nursing care quality assurance commission as established in chapter 18.79 RCW governing licenses and registrations issued under that chapter;
     (xiii) The examining board of psychology and its disciplinary committee as established in chapter 18.83 RCW;
     (xiv) The veterinary board of governors as established in chapter 18.92 RCW; and
     (xv) The board of naturopathy established in chapter 18.36A RCW.
     (3) In addition to the authority to discipline license holders, the disciplining authority has the authority to grant or deny licenses. The disciplining authority may also grant a license subject to conditions.
     (4) All disciplining authorities shall adopt procedures to ensure substantially consistent application of this chapter, the Uniform Disciplinary Act, among the disciplining authorities listed in subsection (2) of this section.

NEW SECTION.  Sec. 16   If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.