The meeting kicked off with a long, grisly report on sexual misconduct cases from Assistant Attorney General Krystl Murphy.
It was eye opening to see some of the horrendous acts that are perpetrated by people who are thought to be trusted health care practitioners. Medical abuse is a terrible trauma. State prosecutors have requested clearer guidelines regarding draping and breast massage, so that it is easier to bring cases to court for practitioner misconduct. The discussion that did NOT happen is what specifically would help these cases, versus hinder honest practitioners. (More on that in the breast massage discussion below.) Points were also made that many of the cases mentioned were assaults, independent of a massage practitioner being involved. So how would revising the massage regulations change the fact that there are already laws against assault?
Prosecutors are specifically looking for ways to sanction therapists when cases do not go to court. This happens because complainants are not willing to go through the grueling process of prosecuting a sex offender. So if a case does not go to trial so that a person would actually go to jail, there would at least be measures that could be taken to put a questionable therapist on probation through the Department of Health. It is still not clear what exactly would aid this endeavor, but at least there is a method to the madness.
For complaints from the public on inappropriate draping, those are handled through the office of investigations, but currently these cases are not being prosecuted because the draping law, as it stands, is so vague; investigators do not have enough guidelines to refer to, to properly pursue the allegations. A point was also made that the draping laws can also protect practitioners from clients who are trying to expose themselves to the therapist.
Rules Development report on comments sent to the Board:
Request was made for a definition of breast massage to be included in the WAC. (Amen!)
Gail McCaffick (attorney for AMTA) has sent comment to the Board that the definition of massage should be modernized. Problem being that this might not be allowed by the current legislation.
Reviewed Structural Integration request for exemption again. Sorry, but exempting these practitioners from being regulated by the Board of Massage would require changes in legislation. Time to hire a lobbyist and stop taking up time at the meetings.
Increasing the training hours to 625 was debated… again. (Despite the fact that this seemed to be decided at the last meeting....)
There was concern that requiring WA licensees complete 625 hours, while requiring out of state transfers study only 500 hours (plus 3 years in practice) could be considered discrimination. The Board wants to move to 625 and follow the Entry Level Analysis Project (ELAP) guidelines. This will go out to legal to verify parity before spending more time on it.
Continuing education was reviewed:
The CPR re-certification requirement for each license renewal will be maintained. Emphasis was made on this training being in person, not online.
Language was tweaked to attempt to indicate that teachers of any continuing education classes are required to have 3 years of experience in the topic they are teaching. After long discussion, it was made abundantly clear that semantics are important in writing regulations and this subsection needs to be moved for clarity, but no one was clear about how to make it, ahem, clearer. The legal department is going to be asked to review where in the section this subsection needs to be moved for said clarity.
Breast massage section was (finally!!) reviewed!
The Board agreed that the subsection requiring specialized training for any breast massage, not just nipple massage, needed to move. (One nation conquered!) However, they are still stuck on requiring a referral for nipple massage, adding "areola or nipple" to the text. In this humble (if opinionated) reporter's mind, this is over-sexualizing the nipple, and not taking into account all the breast surgeries that are happening through the nipple— not to mention women having lactation issues— that could require work on the areola and nipple. Is any other woman feeling that having to ask an authority figure for permission to have her nipples touched is perhaps a bit condescending? No other changes were made to this section. So this reporter is one-for-four in battle wins in the Breast Massage Wars.
One lining in the clouds is that some of the Board members discussed with yours truly what some other options there could be to better protect practitioners, patients and prosecutors. (Pretty flattering! Trying not to get a big head ;-) To whit, there is a re-written Breast Massage section submitted to the Board that includes minimum training requirements, written consent with the option of discontinuing the treatment at any time, and removing the referral requirement. (It’s just not going to protect anyone, but rather cause unnecessary headaches).
The record keeping rules were adamantly unchanged.
To be fair, the changes made at the January Board meeting were a significant step in the right direction. So dudes will have to have their chests draped, unless they sign a consent to be undraped. The sentiment from the Board is "deal with it."
Public comment issues discussed:
There are many concerns (still) about the contrary requirement for male chest draping, despite the fact that men can display their chests in public. (There is a work around in the draping rules using a signed consent, so chests can be uncovered during a session.)
It was repeated that the record keeping rule still has not been amended to indicate who is the custodian of these records that now must be kept. Hypothetically, all the “independent contractor” massage therapists (many of whom should probably actually be treated as employees) could easily be stuck with this burden by companies that don’t what the expense and liability. Perhaps someone should ask the HIPAA police how they handle these situations.
Requests were made again to change the breast massage section to remove the requirement for referral.
Frustration with this whole bureaucratic kerfuffle was voiced, as well as disappointment in how the Board is interfacing with the public throughout said process. And voiced again. And again.
That concludes this report. Next meeting is 9am on July 8 in Tumwater, WA.