On May 13, 2022, Governor McMaster signed into law Senate Bill 227 (SB 227), which amends the massage therapy scope of practice, definitions, fees, license qualifications, and misconduct. SB 227 also adds the following new sections: public roster, licensure by endorsement, and establishment licensure. SB 227 does not go into effect until May 23, 2023. In the meantime, the Massage Therapy Panel will draft rules to implement the changes in the bill. ABMP has summarized how SB 227 impacts South Carolina massage therapy below.
Scope of Practice
The previous act defined massage/bodywork therapist. In the amended act, the definition of massage therapy was amended to include “bodywork modalities as approved by the board.” As such, SB 227 now uses massage therapist to define those who practice both massage and bodywork modalities. The Panel will likely draft rules that define which bodywork modalities are approved by the Board.
SB 227 adds the following new definitions that do not exist in the current practice act:
Approved massage therapy education program—a supervised educational program in a school approved by the Commission on Higher Education. The program must meet minimum qualifications, including course content, approved by the Massage/Bodywork Board (Board). SB 227 also defines both massage therapy education program and massage therapy school.
Client—a person who receives massage therapy from a licensed massage therapist in exchange for compensation.
Currently enrolled student—a student who is enrolled and participating in an approved massage therapy school or education program.
Entity—a sole proprietorship, partnership, limited liability partnership, limited liability company, or other business entity or association as approved by the Board.
Licensed massage therapy supervisor—a licensed massage therapist who has been in good standing for at least two years, who supervises an enrolled student and is on school premises observing the student, and is available for consultation and/or instruction.
Licensure—in addition to the process of granting an individual approval to practice massage, this definition was expanded to include the process of granting an establishment the approval to operate as a massage therapy establishment or a sole practitioner establishment.
Massage therapy establishment—a licensed entity with a physical site or location in which licensed massage therapists are employees or contractors practicing massage therapy on clients. Establishment licensing was added to the requirements of massage therapists through SB 227.
Sole practitioner establishment—a licensed massage therapist who is not an employee or contractor of the sole practitioner establishment who provides massage therapy to clients at a specific location, including rental space, home office space, or outcall space. Establishment licensing was added to the requirements of sole practitioners through SB 227. ABMP argued against such a requirement for sole practitioners.
Licensee and Business Roster
SB 227 now requires the South Carolina Department of Labor, Licensing and Regulation (Department) to prepare and publish a current roster on its website that lists the names and businesses of licensed individuals, establishments, and their owners. A copy of the roster must be provided upon request and after receipt of payment. The list must be updated annually.
SB 227 changes the “massage/bodywork massage therapist” license category name to “massage therapist,” and amends the fee schedule as follows:
- Massage therapist initial license application fee: not to exceed $150 (previously not to exceed $50)
- Massage therapist endorsement application fee: not to exceed $200 (previously not to exceed $100)
- Biennial massage therapist licensure renewal fee: not to exceed $75 (previously not to exceed $200)
- Reinstatement application fee from lapsed status of a massage therapist license: not to exceed $210 (previously not to exceed $250)
- Renewal fee for inactive status of a massage therapist license: not to exceed $150 (previously not to exceed $250)
- Massage therapy establishment initial license application fee for each location: not to exceed $150 (new fee)
- Biennial massage therapy establishment license renewal fee for each location: not to exceed $100 (new fee)
- Massage therapy establishment license reinstatement fee from lapsed status for each location: not to exceed $250 (new fee)
- Sole practitioner establishment initial license application fee: not to exceed $75 (new fee)
- Biennial sole practitioner establishment license renewal fee: not to exceed $50 (new fee)
- Sole practitioner establishment license reinstatement fee from lapsed status: not to exceed $150 (new fee)
SB 227 defines the exemptions from licensure, which do not currently exist in law:
- Students engaging in the practice of massage therapy who are part of a massage therapy program. The student cannot be compensated for work experience and must be supervised on-site by a licensed massage therapy supervisor.
- Student clinics operated by a massage therapy school or approved massage therapy education program.
- Unlicensed individuals providing massage therapy to family members or household members, so long as they do not claim to be a massage therapist or receive compensation for massage therapy services.
- Out-of-state licensed LMTs providing massage therapy on a temporary basis in South Carolina for no longer than 30 days. These individuals will need to submit a written application prior to engaging on a temporary basis. Any practice that is over 30 days will need to obtain an LMT license.
- An out-of-state licensed LMT responding to a disaster or emergency. This individual will also need to provide notice to the Board and is only eligible to practice during the time of the declared emergency. The out-of-state individuals must follow the massage therapy laws and rules of South Carolina while in South Carolina.
- CE providers and other LMTs may participate in CE in South Carolina but are not authorized to practice massage therapy on the public without approval or licensure from the Board.
Those exempt from having an establishment license are:
- Hospitals and long-term care facilities
- Physical therapists
SB 227 changes the requirements to become a licensed massage therapist in South Carolina. Applicants must now complete 650 hours from an approved massage therapy program, which is an increase from the previously required 500 hours. Applicants must also speak English as a native language or provide proof that they have received a passing score from the Test of English as a Foreign Language (TOEFL). All applicants must submit to the Board:
- Completed application form
- Applicable application fee
- 2” x 2” current photo
- Official transcript demonstrating completion of 650 hours of massage therapy education
- Proof of passing the Federation of State Massage Therapy Boards (FSMTB) exam
- State criminal history records check, supported by fingerprints
- Evidence of English proficiency, if applicable
A person licensed as a massage therapist must display their license with a 2” x 2” current photo in a prominent place visible by the public in the massage therapy or sole practitioner establishment. If a massage therapist provides massage therapy services outside the establishment, the therapist must carry an original licensing card to show upon request.
SB 227 introduces establishment licensure for businesses and sole practitioners and outlines the steps owners need to take to apply for establishment licenses.
To apply for a massage therapy establishment or sole practitioner establishment license, applicants must submit:
- Completed application form
- All applicable fees for each massage therapy or sole practitioner establishment location
- The name, address, and telephone number of each owner
- The physical address, mailing address, and telephone number of the premises of the massage therapy or sole practitioner establishment
Once the Board has received and approved an application, the Department will conduct a pre-licensing inspection of the proposed establishment to determine whether it may be licensed as a massage therapy or sole practitioner establishment. The Department may periodically inspect massage therapy establishments and sole practitioner establishments during business hours without prior notice. Failure to cooperate with departmental inspections may lead to disciplinary actions, cease and desist orders, or temporary suspension. If a massage therapy establishment or sole practitioner establishment license lapses, the establishment must pass an inspection prior to licensure reinstatement.
- A licensed establishment can only employ or contract massage therapists who hold active licenses in good standing to perform massage therapy.
- A licensed establishment may operate in the residence of a licensed massage therapist.
- Establishment licenses are valid only for the owners listed on the licensure application. If there is a change in ownership, the new owner must apply for a new establishment license.
- Establishment licenses are valid only for the location listed on the initial and renewal licensure application. If there is an address change, the owner must notify the Department within 15 business days and apply for a new establishment license.
- Establishment licenses are valid only for the name of the establishment provided on the licensure and renewal application. If there is an establishment name change, the owner must notify the Department within 15 business days of this change; a departmental inspection will be required.
- If an establishment’s license is revoked, a new establishment license cannot be issued to operate on the same premises for one year after the date of revocation.
- A massage establishment or sole practitioner establishment must display its license in a place that is visible to the general public.
Licensure by Endorsement
SB 227 adds a new section regarding license reciprocity. The Board may issue a license by endorsement to a massage therapist who holds an active massage therapist license in another state if the Board determines that the standards for licensure are substantially equivalent to the licensing standards in South Carolina. The Board may require the applicant to provide additional information or meet certain requirements before issuing a license by endorsement.
SB 227 provides that citations can be issued for each violation and separate penalties may be assessed. That said, no more than $5,000 combined can be issued against an establishment or individual. Appeals may be filed. If no appeal is filed, the penalties must be paid within 30 days of receipt of the citation or demand.
SB 227 adds to the list of delinquent behaviors for which the Board may deny massage therapy licensure to an applicant or may take disciplinary action against an individual. The Board may deny licensure or take disciplinary action if an applicant or individual:
- Has engaged in, or has assisted another to engage in, unlicensed practice
- Has presented another licensee’s license as their own or falsely impersonated another licensee
- Has allowed the use of a license by an unlicensed individual or entity
- Has used, or attempted to use, a license that has been revoked, suspended, or otherwise restricted
Note: The Board may not deny an individual a license solely because of a prior criminal conviction unless the criminal conviction directly relates to the practice of massage therapy.
The Board may deny an applicant for a massage therapy or sole practitioner establishment license or may take disciplinary action against an entity licensed as a massage therapy or sole practitioner establishment that:
- Used a false or forged statement or document or committed a dishonest act when applying for a license
- Has had a license, permit, certificate, or registration from South Carolina or another state denied, canceled, revoked, suspended, or restricted
- Has violated a provision of this act, a rule, or an order of the Department or the board either intentionally or indirectly, or has aided or abetted another individual or entity in violating a provision, rule, or order
- Has intentionally used a fraudulent statement in a document connected to the business of its establishment, or has made false/deceptive/misleading statements in the business of its establishment or in related advertising
- Has obtained fees, or assisted in obtaining fees, under intentionally fraudulent circumstances
- Has engaged in unlicensed practice
- Has allowed an individual, employee, or independent contractor to practice massage therapy on the premises of the establishment without an active license to practice massage therapy
- Has presented the license of another establishment as its own license
- Has allowed the use of a license by an unlicensed establishment
- Has falsely impersonated another license holder
- Has used, or has attempted to use, a license that has been revoked, suspended, or otherwise restricted