2019 -- S 0576 SUBSTITUTE A

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LC001511/SUB A

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO HEALTH AND SAFETY - LICENSING OF MASSAGE THERAPISTS

     

     Introduced By: Senator Joshua Miller

     Date Introduced: March 14, 2019

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Sections 23-20.8-1, 23-20.8-2.1, 23-20.8-3, 23-20.8-4, 23-20.8-5, 23-20.8-9

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and 23-20.8-11 of the General Laws in Chapter 23-20.8 entitled "Licensing of Massage

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Therapists" are hereby amended to read as follows:

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     23-20.8-1. Definitions.

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     As used in this chapter:

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     (1) "Board" means the Rhode Island State Board of Licensed Massage Therapists as

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established within this chapter.

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     (2) "Body works" and "body-works services" means body rubs, body stimulation,

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manipulation, or conditioning of any part or parts of the body, spa services, and spa treatments

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performed by any person not licensed under title 23.

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     (3) “Continuing education” means a course of study subsequent to the completion of and

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in addition to, an approved entry-level program of massage therapy education.

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     (4) “Continuing education units” means an instructional period of at least fifty (50)

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continuous minutes per hour in a recognized or approved course.

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     (5) “Massage” means the systematic and scientific manipulation of the soft tissues of the

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body accomplished by the use of digits, hands, forearms, elbows, knees, or feet, hand-held tool or

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other external apparatus. Massage may include the use of topical applications.

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     (3)(6) "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.

 

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     (4)(7) "Practice of massage" "Massage therapy" means the manual manipulation of the

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

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including: effleurage, petrissage, compression, friction, vibration, percussion, pressure, positional

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holding, movement, range of motion for purposes of demonstrating muscle excursion or muscle

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flexibility, and nonspecific stretching. The term massage includes the external application of

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lubricants or other topical preparations, such as water, heat, and cold, via the use of the hand,

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foot, arm, or elbow, with or without the aid of massage devices, for the purpose of aiding muscle

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relaxation, reducing stress, improving circulation, increasing range of motion, relieving muscular

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pain, and the overall enhancement of health. Massage shall not include: the touch of genitalia;

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diagnosis of illness or disease; the prescribing of drugs, medicines, or exercise; high-velocity

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thrust applied to the joints or spine; electrical stimulation; application of ultrasound or any

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

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therapy, physical therapy, or podiatry is required by law. use of massage for therapeutic purposes,

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including, but not limited to: pain management, stress reduction, promotion of relaxation and

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enhancement of general health and well-being. Massage therapy includes, but is not limited to,

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manipulation of soft tissue and normal movement of the body to develop an appropriate massage

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therapy session and the delivery of self-care and health maintenance information. Massage

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therapy does not encompass:

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     (1) Diagnosis;

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     (2) The prescribing of drugs or medicines;

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     (3) Spinal manipulation; and

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     (4) Any service or procedure which a license or registration is required by law including,

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but not limited to, the practice of medicine, chiropractic, naturopathy, physical therapy,

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occupational therapy, nutrition, psychotherapy, behavioral health services or podiatry.

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     (8) “Practice of massage therapy” means, the exchange of massage therapy services for

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currency, goods or services.

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     (9) “Topical applications” means, but is not limited to, lubricants, emollients, non-

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prescription analgesics, and the use of heat and cold.

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     23-20.8-2.1. Board of massage therapists.

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     (a) Within the division of professional regulation of the department of health, there shall

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be a state board of massage therapy examiners to be Rhode Island state board of licensed massage

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therapists appointed by the director of the department of health with the approval of the governor.

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Composition of board members: The board shall consist of seven (7) members who reside in the

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state of Rhode Island,. At all times at least four (4) members shall be massage therapists in good

 

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standing, and shall have engaged in the practice of massage therapy for not less than five (5)

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years. of whom shall be licensed pursuant to this chapter and one of whom One member shall be

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a member of the general public, and who does not have financial interest in the profession, or is

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married to or in domestic partnership with someone in the profession. At no time shall more than

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one board member be an owner of, an instructor of, or otherwise affiliated with a board-approved

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massage therapy school or a course of instruction. The four (4) members who are licensed

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pursuant to this chapter shall represent both solo practitioners as well as members of a group

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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. All terms shall be for two (2) years. No

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member shall serve more than three (3) consecutive terms. Upon the death, resignation or

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removal of any member, the director of the department of health, with the approval of the

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governor, shall appoint to fill vacancies, as they occur, a qualified person to serve on the board

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for the remainder of his or her term or until his or her successor is appointed and qualified.

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     (c) The board shall elect, at its first meeting of the calendar year, from its members a

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chair and such other officers as it deems appropriate and necessary to conduct business. The chair

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shall preside at meetings of the board and shall be responsible for the performance of all duties

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and functions of the board and shall perform those duties customarily associated with the position

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in addition to other duties assigned by the board. The board shall designate a member to serve in

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the absence of the chair.

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     (d) The chair and any other officer shall serve a term of one year commencing with the

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day of his or her election and ending upon the election of his or her successor.

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

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the 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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     (f) A board member may be suspended or removed by the director of the department of

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health for unprofessional conduct, refusal or inability of a board member to perform his or her

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duties as a member of the board in an efficient, responsible and professional manner, conviction

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of a felony or of a crime related to the practice of the health care profession, failure to meet the

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qualifications of this statute, or committing any act prohibited by this statute.

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     (g) Members of the board shall not receive compensation for their attendance at official

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meetings of the board, or attendance at any meeting that would constitute official board business,

 

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including teleconference calls or other board responsibilities.

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     (c)(h) 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. The chair of the board shall have the authority to call other meetings at his or her

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discretion.

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     (i) The board may appoint such committees as it considers necessary to carry out its

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duties.

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     (j) A quorum shall be necessary to conduct official board business or any committee

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thereof. A majority of the members shall constitute a quorum. The board may enter into executive

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(closed) session according to relevant law.

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     23-20.8-3. Practice of massage -- License required -- Use of title limited --

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Qualifications for licenses continuing education -- FeesPractice of massage therapy --

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License required -- Use of title limited -- Qualifications for licenses continuing education --

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Fees.

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     (a) 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) 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) It shall be unlawful to advertise the practice of massage therapy using the term

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massage therapy, or any other term that implies a massage technique or method, in any public or

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

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

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massage therapist in this state may use the title "licensed, massage therapist" and the abbreviation

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"LMT." No other persons may assume such title or use such abbreviation or any other word,

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

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A massage therapist's name and license number must conspicuously appear on all of the massage

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therapist's advertisements print and electronic material. A massage therapist licensed under this

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chapter must conspicuously display his or her have available his or her license in his or her

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principal place all places of business practice. If the massage therapist does not have a principal

 

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place of business, or conducts business in any other location, he or she must have a copy of his or

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her license available for inspection while performing any activities related to massage therapy.

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

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

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

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continuing education units annually.

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     (2) Applicants for biennial annual 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 continuing education units annually in scope

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of practice-specific 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 massage school or program, accredited

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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 or online coursework.

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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 § 5-40-13.

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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 continuing

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education if the board is satisfied that the applicant has suffered hardship, which may have

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prevented meeting the 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 § 23-1-54. Fees for all other licenses under this chapter

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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 national 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 national criminal records background check.

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Fingerprinting shall be required. Upon the discovery of any disqualifying information as defined

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in 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 national criminal background report be

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

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applicant shall be responsible for payment of the costs of the national criminal records

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background check.

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

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offenses defined in chapters 34, 34.1, and 37 of title 11, and § 23-17-37.

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     (h) Notwithstanding the above, any city or town may, by ordinance, regulate the opening,

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the presence, the location, and the operation of any body-works business or any business

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providing body-works services. Provided, however, no ordinance may impose additional

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qualifications beyond those adopted by the department of health pursuant to this chapter

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respecting national criminal background checks for persons applying for a license.

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     23-20.8-4. Establishment -- Board of massage therapists -- Powers and duties.

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

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duties authority to implement, interpret and enforce this statute including, but not limited to, the

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authority to:

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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 and promulgated in accordance with state law;

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     (2) Evaluate the qualifications of applicants for licensure;

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     (3) Assess entry-level competence through the use of an examination approved by the

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board;

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     (4) Recommend the issuing or renewal of a license to applicants or licensed massage

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therapists who meet the qualifications of the statute and all rules applicable to this chapter as

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promulgated by the board;

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     (2)(5) Establish and enforce standards of professional and ethical conduct for licensed

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massage therapists;

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     (3)(6) 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)(7) 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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     (8) The board will make an annual report to the governor that shall contain duties

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performed, actions taken and appropriate recommendations.

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     (9) Consult The board will consult and advise other regulatory entities as necessary

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regarding issues pertaining to massage therapy practice, education and/or issues related to the

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regulation of massage therapists.

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     (10) Upon receipt of a complaint, the department of health shall authorize the

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investigation of any allegations of wrongdoing undertaken by any person, entity, license or

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organization related to the practice of massage therapy.

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     (11) The board shall review investigative reports deemed necessary by the director and

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make appropriate recommendations to the director for action including, but not limited to,

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issuance of a letter of concern or warning of the possible infraction of this statute; suspension for

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a period not to exceed ninety (90) days of any license issued under the authority of this chapter;

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and may, after due notice and hearing revoke the license if it is found that the person practicing

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

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holder of a license shall upon its revocation promptly surrender it to the board or its designee.

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

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qualifications.

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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 that he or she is:

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

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     (2) Of good moral character (via background check Has submitted to a national criminal

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background check in accordance with § 23-20.8-3);

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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) six hundred fifty (650) hours of

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supervised in-class, hands-on and 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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subsections (a)(1) and (a)(2) § 23-20.8-5(a), has completed all appropriate forms, paid all

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

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permit, certificate or registration issued by any other state or territory of the United States or by a

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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 therapy for a

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

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regulations promulgated in accordance with this chapter. An applicant, whose national criminal

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records background check reveals a conviction for any sexual offense, including, but not limited

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to, those offenses defined in chapters 34 and 37 of title 11, shall be denied a license under this

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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) department of health.

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     23-20.8-9. Persons exempt.

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     Nothing contained in this chapter shall prohibit:

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     (1) A person who is otherwise licensed certified or registered in accordance with the

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general laws of Rhode Island, from performing service within his/her or authorized scope of

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practice and who does not hold himself/herself out to be a massage therapist.

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     (2) A person duly licensed, certified, or registered in nonresident massage therapist

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holding a valid license, permit, certificate or registration issued by another state or territory of the

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United States, the District of Columbia, or a foreign country when incidentally in this state to

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provide service as part of an emergency response team working in conjunction with disaster relief

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official or as part of a charity event officials.

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     (3) Nonresident practitioners A nonresident massage therapist holding a valid license,

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permit, certificate or registration issued by any other state or territory of the United States, the

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District of Columbia or by a foreign country and temporarily practicing massage therapy in this

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state for a period not exceeding thirty (30) days for the purpose of presenting educational or

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clinical programs, lectures, seminars or workshops to massage therapists.

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     (4) Graduates A graduate from an approved educational program, may practice massage

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therapy only under the supervision of one, assigned, onsite licensed massage therapist. Graduates

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have ninety (90) days from the date on the application fee receipt, to meet licensure requirements

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

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     (5) Persons A massage therapist who provide provides acceptable evidence of being

 

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currently licensed to practice massage therapy by examination or endorsement under the laws of

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other states or territories of the United States, and the District of Columbia, or by a foreign

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country have a grace period of forty-five (45) 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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The original privilege to work forty-five (45) days from the date on the application fee receipt

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shall not be extended or renewed.

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     (6) A nonresident massage therapist holding a valid license, permit, certificate or

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registration issued by any other state or territory of the United States, the District of Columbia or

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by a foreign country when in this state as part of a charity/event where massage is appropriate.

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Nothing in the article shall be construed to prevent or restrict the practice of any person in this

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state who uses touch, words and directed movement to deepen awareness of existing patterns of

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movement in the body as well as to suggest new possibilities of movement while engaged within

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the scope of practice of a profession with established standards and ethics, provided that his or

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her services are not designated or implied to be massage or massage therapy. Such practices

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include, but are not limited to, the Feldenkrais Method/rs or somatic education, the Rolf Institute's

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Rolf Movement Integration, the Trager Approach/rs to movement education, and Body-Mind

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Centering/rs. Practitioners must be recognized by or meet the established standards of either a

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professional organization or credentialing agency that represents or certifies the respective

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

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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/rs, 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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     23-20.8-11. Penalties.

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     (a) Any person who practices massage therapy or acts in any capacity where a license is

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required by this chapter, without a license provided for in this chapter, shall be guilty of a

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

 

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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 practice 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 therapy is

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

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(30) days in jail.

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

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

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

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

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person from practicing massage therapy until this person secures a valid license.

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

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     SECTION 2. This act shall take effect upon passage.

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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 sweeping changes to the law on massage therapy licensing

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including the following: It would change the composition of the board of licensed massage

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therapists so that a majority of its members would be licensed massage therapists. It would

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require that the department of health investigate complaints and have the board review their

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report. It would remove the mandatory $1000 fine and jail time for a conviction for practicing

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massage therapy without a license. It would increase the required hours of education from 500 to

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650. It would specify that massage therapy does not encompass diagnosis, prescribing medicines,

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or any service such as chiropractic, naturopathy, physical therapy, occupational therapy, nutrition,

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psychotherapy, behavioral health services or podiatry.

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     This act would take effect upon passage.

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