When you get in your car and drive to a neighboring state, your driver's license is still valid and recognized there without any need for another license. This is because states have a provision that allows licensed drivers to move freely from state to state. But is your massage license still valid when you cross a state line or move from one state to another?

Reciprocity and Endorsement

License reciprocity—or the ability to practice your profession in one state based on holding a license in another—has different meanings for different professions.

True reciprocity does not exist for massage licensees. Your state license, even your national certification, does not allow you to practice massage freely outside your state. Most of the time, a license in the new state must be obtained before you can legally work as a massage therapist. This means filling out an application, paying fees, submitting additional paperwork (license verifications, transcripts, or exam scores), and displaying a lot of patience.

In the massage field, we often use the word endorsement instead of reciprocity when talking about transferring a license to another state. Endorsement refers to the process by which a licensed massage therapist from one jurisdiction (state) becomes licensed in a new jurisdiction (state). For instance, a state board may grant a new license if the massage therapist's previous license was held in a state or jurisdiction where the licensing requirements are equal to, or exceed those of, the new state.

If you are moving, most state massage board websites have instructions for out-of-state applicants applying for a license by endorsement.

The Problem with Portability

Even with endorsement, the process of obtaining a new massage license can be complicated and expensive. Regulation of massage varied drastically in the past, and it has since changed rapidly. Here are some of the problems frequently seen due to these rapid changes.

Grandfathering

When establishing massage laws and rules, some states issued licenses to applicants who had no formal massage training. It is very difficult for these people to transfer a license, due to their lack of minimum training hours and passage of licensing exams. This means people who were grandfathered into licensure and have safely practiced massage for 30-plus years have a difficult time continuing to practice massage if they move, unless they return to school.

Variations in Minimum Educational Hours

Most states require completion of a minimum of 500 hours of training. A few states require 600, 750, or 1,000 hours. So, what happens when a massage therapist in Texas, where the requirement is 500 hours, moves to Arizona, which requires 700 hours? It is hard to say. Every state is different.

Florida, for example, makes no exceptions for training hours. An applicant must complete 500 hours of training, regardless of experience.

If you do not meet the minimum hours of training for the state in which you wish to obtain a license, contact that state's board office to see whether they accept applications for a variance.

True reciprocity does not exist for massage licensees. Your state license, even your national certification, does not allow you to practice massage freely outside your state.

ABMP Government Relations: Licensing and Portability

By Laura Embleton and Nancy Potter

From 1996 to 2016, the primary government relations energies of Associated Bodywork & Massage Professionals (ABMP) were directed to states initially adopting statewide regulation of massage therapists. We worked for regulation fairly balanced between public protection and equitable treatment of massage therapists, including grandfathering provisions for long-established practitioners. During that period, the number of states regulating massage grew from 20 to 46. More recently, ABMP government relations staff has spent its time advocating for our members in states adopting establishment licensing laws and implementing regulations. It's a dynamic, evolving universe. ABMP never loses sight of fair, reasonable rules for massage practitioners.

ABMP's position on license portability is that massage therapy licenses should be fully portable between states. However, most state massage boards are currently very concerned about fraudulent massage license applications, and, as a result, are increasingly requiring out-of-state licensees to satisfy the same license application requirements as people getting a license for the first time. We work with state massage boards whenever there is an opening to do so to increase license portability, but we face strong headwinds in the current board climate.

Licensing Exams

Currently, the MBLEx is the entry-level licensing exam required by most state massage boards. One of the missions of the Federation of State Massage Therapy Boards (FSMTB), the administrators of the MBLEx, is:

"Support efforts among member boards to establish compatible requirements and cooperative procedures for the legal regulation of massage therapists in order to facilitate professional mobility and to simplify and standardize the licensing process."¹

However, not every state currently requires completion of an entry-level licensing exam like the MBLEx. Also, there are still a few states that use their own licensing exam in lieu of the MBLEx. For example, Massachusetts did not require a licensing exam for applicants until 2010. If a Massachusetts massage therapist (licensed before 2010) wants to work in Connecticut, according to the Connecticut licensing requirements, the applicant will need to show proof of passing the MBLEx.

Hawaii and New York still have their own state licensing exams. Anyone moving to either of these states must take the state massage exam, even if they previously passed the MBLEx or NCETMB.

The good news is that for most states, you will not need to take a licensing exam again. Your exam scores from a previously passed licensing exam (like the NCETMB or MBLEx) can be "reused" when applying for a new license. It just requires a small fee and filling out a mobility form.

Where to Start

The best thing to do when considering a move is to look at the state board of massage website and application (available at www.abmp.com/practitioners/state-requirements). If you have questions about specific requirements, call or email the state board office. Board office employees have heard nearly every situation that exists in the massage field and will provide you with the most up-to-date information.

Here are a few examples of requirements you may need to complete, along with a new application and license fee.

• Florida: 10-hour Law and Rules course

• Texas: Juris Test

• Background screenings (several states)

• Washington: Four-hour HIV/AIDS course

• Oregon: Practical exam

Can I Have a License in More Than One State?

Yes! One license does not negate the other. If you are living in New York and plan to spend winters in Arizona, there are no regulations that say you can only have one license.

What If I Am Moving to a State that Has No Massage License?

The number of states that do not require licenses is dwindling. Only a handful remain. States without licensing may still regulate massage or massage establishments at a local level.

The Future of License Portability

In 2017, the Council of Nursing Boards (similar to FSMTB) announced the creation of the Nurse Licensure Compact (NLC, www.ncsbn.org/nurse-licensure-compact.htm). The goal of the NLC is to increase access to care (telehealth or disaster response) while maintaining public protection at the state level. Under the NLC, nurses can practice in other NLC states without having to obtain additional licenses. About 30 states currently take part in the new compact.

Is something similar to this possible in the massage field? With regulations currently all over the place, it is hard to imagine that a similar compact could exist for massage professionals anytime soon. However, wide acceptance of the MBLEx certainly has opened the door to the possibility of license portability. Only time will tell whether it becomes a reality.

Note

1. Federation of State Massage Therapy Boards, "Mission and History," accessed November 2018, www.fsmtb.org/about-fsmtb/mission-and-history.

What Does ABMP Government Relations Do for You?

By Laura Embleton and Nancy Potter

• ABMP's Government Relations Department advocates on behalf of our members for reasonable regulation of the massage therapy profession in all 50 states.
• We work with our members, massage therapy boards, state legislatures, and massage therapy coalitions nationwide to ensure that the regulation of the profession stays focused on public protection and does not overly burden massage professionals with high licensing costs or bureaucratic red tape. Occasionally, we may even work with local governments, though we don't have sufficient resources to be on the scene in thousands of local jurisdictions.
• We travel the country throughout the year to meet with massage professionals, licensees, and regulators in every state to learn about issues facing professionals locally and help craft solutions. Visit ABMP.com's news and blog sections frequently to learn about our recent state visits and hear about upcoming meetings.
• We keep our members informed about regulation that's coming down the pike and let them know how to get involved in the process and have their voices heard.

What Can You Do to Engage in the Process?

• Get in touch with us, your ABMP Government Relations team! Call us at 800-458-2267 or email [email protected]. Let us know what regulation-related issues are concerning you, and also what's working. Tell us what you're hearing in your state, city, or town regarding massage legislation and regulation—past, present, or future. Let us know if we can help advocate on your behalf.
• Get involved! Get the contact information from your state's massage therapy board and find out when the next board meeting is, and attend. Learn about what your state's board is thinking about and planning for, especially with regard to rules and legislation. Submit public comments to let the board know your opinions. Apply for a board seat, attend meetings of massage coalitions, and get to know other massage professionals in your area.
• Want to work on local issues? When your city is looking at local regulation of massage therapists, engage with your city council. Educate your city decision makers about what legitimate massage therapy practice is and looks like. Attend council meetings and public hearings when issues involving massage therapy are being discussed.