2013 -- S 0648 SUBSTITUTE A AS AMENDED

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LC01924/SUB A

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2013

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A N A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF MASSAGE THERAPISTS

     Introduced By: Senators Lynch, and Doyle

     Date Introduced: March 06, 2013

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 23-20.8-1 of the General Laws in Chapter 23-20.8 entitled

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"Licensing of Massage Therapy Establishments" is hereby amended to read as follows:

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     23-20.8-1. Definitions. -- As used in this chapter:

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     (1) "Massage therapist" means a person engaged in the practice of massage and is

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licensed in accordance with this chapter of the general laws of the state of Rhode Island. who has

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completed a program in or is certified by a school or institution of learning which is approved by

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the American massage and therapy association or equivalent academic and training program

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approved by the director of health, other than a correspondence course, which school or

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institution has for its purpose the teaching of the theory, practice, method, profession, or work of

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massage, including at least anatomy, physiology, hygiene, and professional ethics.

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     (2) "Physical fitness facility" means any bona fide health club which offers or provides

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facilities for any instruction in controlled exercise, weight lifting, and calisthenics and its gross

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income from massages is less than ten percent (10%) of the total gross business income derived

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from all physical fitness sales contracts at any one location;

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     (3)(2) "Practice of massage" means engaging in applying a scientific system of activity to

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the muscular structure of the human body by means of stroking, kneading, tapping, and vibrating

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with the hands or vibrators for the purpose of improving muscle tone and circulation. the manual

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manipulation of the soft tissues of the human body through the systematic application of massage

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techniques including: effleurage, petrissage, compression, friction, vibration, percussion,

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pressure, positional holding, movement, range of motion for purposes of demonstrating muscle

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excursion or muscle flexibility and nonspecific stretching. The term massage includes the

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external application of lubricants or other topical preparations such as water, heat and cold via the

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use of the hand, foot, arm or elbow with or without the aid of massage devices for the purpose of

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aiding muscle relaxation, reducing stress, improving circulation increasing range of motion,

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relieving muscular pain and the overall enhancement of health. Massage shall not include the

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touch of genitalia, diagnosis of illness or disease, the prescribing of drugs, medicines or exercise,

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high-velocity thrust applied to the joints or spine, electrical stimulation, application of ultrasound

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or any services or procedures for which a license to practice medicine, chiropractic, occupational

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therapy, physical therapy or podiatry as required by law.

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     (3) “Board” means the Rhode Island State Board of Licensed Massage Therapists as

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established within this chapter.

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     SECTION 2. Chapter 23-20.8 of the General Laws entitled "Licensing of Massage

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Therapy Establishments" is hereby amended by adding thereto the following section:

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     23-20.8-2.1. Board of massage therapists. – (a) Within the division of professional

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regulation of the department of health, there shall be a state board of massage therapy examiners

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to be appointed by the director of the department of health with the approval of the governor. The

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board shall consist of seven (7) members who reside in the state of Rhode Island, four (4) of

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whom shall be licensed pursuant to this chapter and one of whom shall be a member of the

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general public, and who does not have financial interest in the profession, or is married to

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someone in the profession. At no time shall more than one board member be an owner of, an

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instructor of, or otherwise affiliated with a board-approved massage therapy school or course of

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instruction. The four (4) members who are licensed pursuant to this chapter shall represent both

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solo practitioners as well as members of a group practice.

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     (b) The initial board shall be appointed for staggered terms, the longest of which shall not

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exceed three (3) years. After the initial appointments, all terms shall be for two (2) years and a

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member may be reappointed for a second (2nd) term. No member shall serve more than three (3)

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consecutive terms. Upon the death, resignation or removal of any member, the director of the

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department of health, with the approval of the governor, shall appoint to fill vacancies, as they

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occur, a qualified person to serve on the board for the remainder of his or her term or until his or

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her successor is appointed and qualified.

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     (c) The board shall meet at least quarterly thereafter, shall hold a meeting and elect a

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chairman. The board may hold additional meetings at the call of the chair or at the written request

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of any three (3) members of the board. The board may appoint such committees as it considers

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necessary to carry out its duties. A majority of the sitting members of the board shall constitute a

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quorum.

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     (d) The director of the department of health may remove any member of the board for the

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neglect of any duty required by law or for any incompetent, unprofessional, or dishonorable

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conduct. Before beginning his or her term of office, each member shall take the oath prescribed

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by law, a record of which shall be filed with the secretary of state.

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     SECTION 3. Sections 23-20.8-3, 23-20.8-4, 23-20.8-5, 23-20.8-6, 23-20.8-7, 23-20.8-9,

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23-20.8-10 and 23-20.8-11 and 23-20.8-10 of the General Laws in Chapter 23-20.8 entitled

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"Licensing of Massage Therapy Establishments" are hereby amended to read as follows:

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     23-20.8-3. Practice of massage -- Use of titles limited -- Qualifications for licenses –

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Fees Practice of massage – Licensed required – Use of title limited -- Qualifications for

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licenses continuing education – Fees. -- (a) Only a person licensed under this chapter shall

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practice massage. A person shall not practice or hold himself or herself out to others as practicing

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massage therapy, or as a massage therapist without first receiving from the board a license to

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engage in that practice.

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     (b) Only a person licensed under this chapter as a massage therapist may use the title

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"massage therapist." Only a person licensed under this chapter may use the title "masseur" or

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"masseuse." A person shall hold himself or herself out to others as a massage therapist when the

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person adopts or uses any title or description including “massage therapist,” “masseur,”

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“masseuse,” “massagist,” “massotherapist,” “myotherapist,” “body therapist,” “massage

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technician,” “massage practitioner,” or any derivation of those terms that implies this practice.

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     (c) No person, firm, partnership, or corporation shall describe its services under the title

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"massage" or "massage therapy" unless these services, as defined in section 23-20.8-1, are

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performed by a person licensed to practice massage under this chapter, and, if described as

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"massage therapy," by a massage therapist. It shall be unlawful to advertise the practice of

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massage using the term massage or any other term that implies a massage technique or method in

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any public or private publication or communication by a person not licensed by the state of Rhode

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Island department of health as a massage therapist. Any person who holds a license to practice as

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a massage therapist in this state may use the title “licensed massage therapist” and the

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abbreviation “LMT.” No other persons may assume such title or use such abbreviation or any

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other word, letters, signs, or figures to indicate that the person using the title is a licensed massage

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therapist. A massage therapist’s name and license number must conspicuously appear on all of

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the massage therapist’s advertisements. A massage therapist licensed under this chapter must

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conspicuously display his or her license in his or her principal place of business. If the massage

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therapists does not have a principal place of business or conducts business in any other location,

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he or she must have a copy of his or her license available for inspection while performing any

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activities related to massage therapy.

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     (d) Application for licenses as a masseur or masseuse, or as a massage therapist, shall be

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issued by the department of health. Except for persons licensed as massage therapists, the

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department shall establish minimum educational and training requirements for the persons to be

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licensed under this chapter and shall have the authority to take disciplinary action against a

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licensee for knowingly placing the health of a client at serious risk without maintaining the proper

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precautions.

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     (d)(1) The board shall, by rule, establish requirements for continued education. The board

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may establish such requirements to be completed and verified biennially or annually. The board

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shall require no more than twelve (12) hours biennially or six (6) hours annually.

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     (2) Applicants for biennial licensure renewal shall meet continuing education

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requirements as prescribed by the board. On application for renewal of license, massage

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therapists shall attest to completion of six (6) hours annually in scope of practice-specific

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offerings that may include, but not be limited to:

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     (i) Formal presentations;

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     (ii) Conferences;

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     (iii) Coursework from a regionally accredited college/university; and/or

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     (iv) Self-study course, such as online courses awarding one education hour for each hour

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completed.

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     Such programs or offerings shall be approved or sponsored by a board-approved

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organization. The board shall require no more than two (2) hours of ethics or standards of practice

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biennially.

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     (3) A licensee who fails to complete the continuing education requirements described

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herein may be subject to disciplinary action pursuant to section 5-40-13 of this chapter.

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     (4) A license may be denied to any applicant who fails to provide satisfactory evidence of

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completion of continuing education relevant to massage therapy as required herein.

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     (5) The board may waive the requirement for these educational requirements if the board

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is satisfied that the applicant has suffered hardship, which may have prevented meeting the

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educational requirements.

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     (e) The fee for original application for licensure as a massage therapist and for annual

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license renewal shall be as set forth in section 23-1-54. Fees for all other licenses under this

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chapter shall be fixed in an amount necessary to cover the cost of administering this chapter.

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     (f) Any person applying for a license under this chapter shall undergo a criminal

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background check. Such persons shall apply to the bureau of criminal identification of the state

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police or local police department for a nationwide criminal records check. Fingerprinting shall be

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required. Upon the discovery of any disqualifying information as defined in section 23-20.8-5

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subsection (g), the bureau of criminal identification of the state police or the local police

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department shall inform the applicant, in writing, of the nature of the disqualifying information

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and, without disclosing the nature of the disqualifying information, shall notify the board, in

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writing, that disqualifying information has been found. In those situations in which no

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disqualifying information has been found, the bureau of criminal identification shall inform the

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applicant and the board in writing of this fact. An applicant against whom disqualifying

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information has been found may request that a copy of the criminal background report be sent to

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the board, which shall make a judgment regarding the licensure of the applicant. The applicant

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shall be responsible for payment of the costs of the criminal records check.

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     (g) “Disqualifying information” means those offenses, including, but not limited to, those

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offenses defined in sections 11-37, 11-37-8.1, 11-37-8.3, 23-17-37, 11-34 and 11-34.1.

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     23-20.8-4. Establishment of rules and regulations – Hearings Establishment – Board

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of massage therapists—Powers and duties. -- (a) The authority to promulgate regulations for

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the efficient enforcement of this chapter is vested in the director of health.

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     (b) Hearings authorized or required under this chapter shall be conducted by the director

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of health or any officer, agent, or employee as the director of health may designate for this

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purpose.

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     (c) Before promulgating any regulation, the director of health shall give appropriate

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public notice of its proposal and the time and place for a public hearing on this regulation. The

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regulation promulgated shall be filed with the office of the secretary of state and shall become

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effective on a date fixed by the director of health (which date shall not be prior to thirty (30) days

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after its promulgation). The regulation may be amended or repealed in the same manner as is

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provided for in its adoption.

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     Subject to the provisions of this chapter, the board shall have the following powers and

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duties:

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     (1) Adopt rules and regulations governing the licensure of massage therapists in a manner

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consistent with the provisions of this chapter and in accordance with the procedures outlined in

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the Administrative Procedures Act;

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     (2) Establish standards of professional and ethical conduct;

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     (3) Adopt rules that endorse equivalent licensure examinations of another state or

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territory of the United States, the District of Columbia, or a foreign country and that may include

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licensure by reciprocity; hold hearing, as necessary, in accordance with the Administrative

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Procedures Act.

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     (4) Maintain a complete record of all licensed massage therapists, ensure licensee

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compliance with all established requirements. The board will make an annual report to the

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governor which shall contain duties performed, actions taken and appropriate recommendations.

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Consult and advise other regulatory entities as necessary regarding issues pertaining to massage

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therapy practice, education and/or issues related to the regulation of massage therapists.

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     23-20.8-5. Issuance or denial of license -- Minimum qualifications Application for

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license -- Issuance or denial of license -- Minimum qualifications. -- The director shall, within

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thirty (30) days from the time any application for a license is received, grant the application and

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issue a license to practice massage for a year from that date, if the director shall be satisfied that

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the applicant complies with the rules and regulations promulgated in accordance with sections 23-

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20.8-3 and 23-20.8-4, establishing standards for the qualifications of these personnel. The

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standards for qualification of persons practicing massage shall include provisions for minimum

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standards of professional education or experience, as determined by the director. The director

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may provide for the examination of these applicants to determine his or her qualifications. An

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applicant, whose criminal records check reveals a conviction for any sexual offense, including,

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but not limited to, those offenses defined in chapters 34 and 37 of title 11, shall be denied a

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license under this chapter.

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     (a) Every person desiring to begin the practice of massage therapy, except exempt

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persons as provided in this chapter, shall present satisfactory evidence to the division of

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professional regulation of the department of health, verified by oath, that he or she is:

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     (1) Over eighteen (18) years of age;

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     (2) Of good moral character (via background check in accordance with section 23-20.8-

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3);

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     (3) Has successfully completed an educational program, meeting minimum requirements

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established by the board, including at least five hundred (500) hours of in-class, hands-on and

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supervised coursework and clinical work; and

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     (4) Has successfully completed an examination approved by the board. Any examination

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approved by the board must meet generally recognized standards including development through

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the use of a job-task analysis and must meet appropriate psychometric standards.

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     (b) The department may grant a license to any applicant satisfying the requirements of

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subdivisions 23-20.8-5(a)(1) and (2), has completed all appropriate forms, paid all appropriate

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fees and has met substantially equivalent standards in obtaining a valid license, permit, certificate

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or registration issued by any other state or territory of the United States or by a foreign country.

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     (c) The department shall, within sixty (60) days from the time any application for a

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license is received, grant the applications and issue a license to practice massage for a year from

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that date if the department is satisfied that the applicant complies with the rules and regulations

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promulgated in accordance with this chapter. An applicant, whose criminal records check reveals

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a conviction for any sexual offense, including, but not limited to, those offenses defined in

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chapters 34 and 37 of title 11, shall be denied a license under this chapter.

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     (d) The fee for original application for licensure as a massage therapist and the fee for

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annual license renewal shall be determined by the board and shall not exceed one hundred dollars

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($100).

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     23-20.8-6. Suspension and revocation of licenses. -- Whenever the director board, or

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board designee, shall have reason to believe or that any person licensed under this chapter to

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practice massage therapy has been convicted of any sexual offense, or that any person is

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practicing massage in violation of this chapter or regulations promulgated under this chapter, the

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director board, or board designee, may, pending an investigation and hearing, suspend for a

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period not exceeding thirty (30) ninety (90) days any license issued under authority of this

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chapter and may, after due notice and hearing, revoke the license if he or she finds that the person

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practicing massage is in violation of those rules and regulations or any provision of this chapter.

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The holder of a license shall upon its revocation promptly surrender it to the director board, or

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board designee,.

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     23-20.8-7. Judicial review of license action. -- Any person aggrieved by a decision of

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the director board, or board designee refusing to grant an application for a license under this

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chapter or suspending or revoking any license already issued may, within thirty (30) days,

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exclusive of Sundays and holidays, after receiving notice of that decision, appeal to the superior

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court for the counties of Providence and Bristol, by filing in the court his or her reasons of appeal,

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and the court shall, as soon as possible after any notice to the director as the court may prescribe,

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hear and determine the appeal, following the course of equity. or order of the boards,

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administrator of professional regulation or director department of health may be taken by an

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aggrieved party to the superior court in the manner provided for in chapter 35 of title 42.

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     23-20.8-9. Persons exempt. -- Nothing contained in this chapter shall prohibit:

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     (1) The practice of massage by any person who is authorized to practice medicine,

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nursing, osteopathy, physiotherapy, chiropractic, or podiatry in this state A person who is

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otherwise licensed certified or registered in accordance with the general laws of Rhode Island,

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from performing service within his/her or authorized scope of practice and who does not hold

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himself/herself out to be a massage therapist.

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     (2) The practice of that massage which is customarily given in barber shops or beauty

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parlors for the purpose of beautification by any licensed barber, hairdresser, or cosmetician A

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person duly licensed, certified, or registered in another state or territory, the District of Columbia,

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or a foreign country when incidentally in this state to provide service as part of an emergency

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response team working in conjunction with disaster relief official or as part of a charity event.

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     (3) The practice of massage by any person employed in a medical institution licensed or

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chartered by the state or enrolled in a program of a school or institute of massage approved by the

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board of regents Nonresident practitioners holding a valid license, permit, certificate or

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registration issued by any other state or territory of the United States or by a foreign country and

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temporarily practicing massage in this state for a period not exceeding thirty (30) days for the

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purpose of presenting educational or clinical programs, lectures, seminars or workshops to

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massage therapists.

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     (4) The practice of massage by any person duly employed as a trainer by a professional

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athletic association, club, or team, or as a member of the physical education department of an

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accredited university, college, or high school Graduates from an approved educational program,

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may practice massage therapy only under the supervision of one, assigned, onsite licensed

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massage therapist. Graduates have ninety (90) days from the date on the application fee receipt, to

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meet licensure requirements of this state in accordance with regulations prescribed by the board.

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     (5) The practice of massage by any person in a physical fitness facility operated by a

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corporation or association organized exclusively for the moral or mental improvement of men,

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women, or children. Persons who provide acceptable evidence of being currently licensed to

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practice massage by examination or endorsement under the laws of other states of the United

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States and the District of Columbia have a grace period of forty-five (45) days from the date on

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the application fee receipt to meet licensure requirements of this state in accordance with

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regulations prescribed by the board. The original privilege to work forty-five (45) days from the

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date on the application fee receipt shall not be extended or renewed.

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     (6) Nothing in the article shall be construed to prevent or restrict the practice of any

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person in this state who uses touch, words and directed movement to deepen awareness of

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existing patterns of movement in the body as well as to suggest new possibilities of movement

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while engaged within the scope of practice of a profession with established standards and ethics,

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provided that his or her services are not designated or implied to be massage or massage therapy.

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Such practices include, but are not limited to, the Feldenkrais Method( or somatic education, the

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Rolf Institute’s Rolf Movement Integration, the Trager Approach( to movement education, and

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Body-Mind Centering(. Practitioners must be recognized by or meet the established standards of

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either a professional organization or credentialing agency that represents or certifies the

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respective practice based on a minimal level of training, demonstration of competency and

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adherence to ethical standards.

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     (7) Nothing in the section shall be construed to prevent or restrict the practice of any

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person in this state who uses touch to affect the energy systems, acupoints or Qi meridians

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(channels of energy) of the human body while engaged within the scope of practice of a

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profession with established standards and ethics, provided that his or her service is not designated

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or implied to be massage or massage therapy. Such practices include, but are not limited to,

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Polarity, Polarity Therapy, Polarity Bodywork Therapy, Rosen Method, Asian Bodywork

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Therapy, Acupressure, Jin Shin Do(, Qi Gong, Reiki and Shiatsu. Practitioners must be

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recognized by or meet the established standards of either a professional organization or

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credentialing agency that represents or certified the respective practice based on a minimal level

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of training, demonstration of competency and adherence to ethical standards.

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     23-20.8-10. Enforcement. -- Except for the provisions of section23-20.8-11 section 23-

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20.8-11 this chapter shall be enforced by the director of health.

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     23-20.8-11. Penalties. -- (a) Any person who practices massage or acts in any capacity

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where a license is required by this chapter, without a license provided for in this chapter, shall be

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guilty of a misdemeanor and subject to a fine of up to one thousand dollars ($1,000) or thirty (30)

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days in jail.

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      (b) Any owner, operator, manager, or licensee in charge of or in control of a massage

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therapy establishment who knowingly employs a person who is not licensed as a massage

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therapist, or who allows an unlicensed person to perform, operate, or practice massage is guilty of

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a misdemeanor and subject to a fine of up to one thousand dollars ($1,000) five thousand dollars

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($5,000) and thirty (30) days in jail.

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      (c) The practice of massage by a person without a license issued under this chapter is

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declared to be a danger to the public health and welfare. In addition to any other civil, criminal, or

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disciplinary remedy, the attorney general or prosecuting attorney of any municipality where the

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person is practicing, or purporting to practice, may maintain an action to enjoin that person from

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practicing massage until this person secures a valid license.

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      (d) [Deleted by P.L. 2008, ch. 100, art. 6, section 1].

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     SECTION 4. Section 23-20.8-8 of the General Laws in Chapter 23-20.8 entitled

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"Licensing of Massage Therapy Establishments" is hereby repealed.

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     23-20.8-8. Access and inspection powers. -- For the purpose of this chapter, the director

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or his or her duly authorized agents or employees shall at all reasonable times have authority to

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enter upon any and all parts of the premises on which any massage therapy establishment is

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located and of the premises appurtenant to these premises to make any examination or

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investigation for the purpose of determining whether the provisions of this chapter and any rules

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or regulations of the department are being violated.

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     SECTION 5. The title of Chapter 23-20.8 of the General Laws entitled "LICENSING

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OF MASSAGE THERAPY ESTABLISHMENTS" is hereby amended to read as follows:

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     CHAPTER 23-20.8

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Licensing of Massage Therapy Establishments

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LICENSING OF MASSAGE THERAPISTS

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     SECTION 6. This act shall take effect upon passage.

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LC01924/SUB A

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF MASSAGE THERAPISTS

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     This act would make changes to the process of licensing of massage therapists.

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     This act would take effect upon passage.

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LC01924/SUB A

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