As a profession, massage therapy is ripe for legislation that allows for interstate practice. On May 13, 2021, the Council of State Governments (CSG), along with the National Center for Interstate Compacts, hosted its virtual Massage Therapy Compact Kickoff Meeting to begin outlining the work now being done to make an interstate compact a reality for the massage profession.

What is an Interstate Compact? 

Simply put, interstate compacts are contracts between states. Specific to the massage therapy profession, an interstate compact for massage would be an agreement between states to allow reciprocity for licensees, with specific requirements that have yet to be determined. That would mean, for example, a massage therapist who works in Ohio would be able to relocate to Florida with less hurdles if both states had signed onto the compact. “An interstate compact for the massage therapy profession will facilitate multistate practice for licensed practitioners in states that are members of the compact,” Matt Shafer, program manager for The Council of State Governments (CSG), explains. “Compacts create streamlined pathways for interstate practice, increase public access to care or services, and enhance the state’s ability to protect the public’s health and safety.”

Why Now and Why Massage Therapy?

CSG, through a cooperative agreement with the Department of Defense, identified five professions eligible for technical and consulting assistance with the development of an interstate compact for licensure portability. “Similar to other professions with an interstate compact, like occupational therapy or physical therapy, the massage therapy profession has the size, regulatory consistency and existing infrastructure to support a potential interstate compact,” Shafer says. Military spouses are one of the primary drivers of the push for license portability, most specifically because they move often, which requires they hold multiple licenses concurrently.

But, that doesn’t mean that only military spouses will benefit. For the whole massage profession, an interstate compact would lessen the challenges of portability over time as states buy into the compact, as well as ease the overly burdensome administrative and at times financial challenges of moving a license across state lines.

How Will an Interstate Compact Affect a State’s Ability to Regulate Massage Therapy?

First, states that are not regulated are ineligible to be part of the compact. States that do regulate the practice of massage would not lose their authority or sovereignty. 

In other words: A massage therapist’s home state license is what punches their ticket, so to speak, to practice in other member compact states. But, scope of practice and state laws and regulations are set and enforced by the state a massage therapist is practicing in—not their home state—and the massage therapist is who is responsible for learning and understanding each state’s laws and regulations.

What are Next Steps and When Can the Massage Profession Expect to See Some Results?

Beginning in August 2021 and for the next 12 to 18 months, CSG will work with technical assistance groups and compact document teams to develop and write a draft compact. These teams include state regulators, subject-matter experts and other industry stakeholders. According to CSG, once draft compact language is finalized, stakeholders are invited to submit feedback.

Post-draft development is where the hard work begins in lobbying states to adopt and enter into the compact. A minimum of 10 states is needed for massage therapists to begin seeing the actual benefit of the interstate compact. Even in a favorable environment, passing any sort of legislation is long and hard work. Enactment of an interstate compact happens in the same way as any other bill: The compact would need to be passed by a state’s legislature and signed into law by the state’s governor. According to Shafer, the hope is that the legislation will be ready to be introduced to states in the Fall of 2022.

What Resources are Needed to Advance a Massage Interstate Compact?

It’s important to remember that the application for funding covers the cost of creating a draft model compact bill for massage therapy that the industry, as a whole, will have to agree on. The work of continuing to push forward the model compact developed by CSG and the Department of Defense (DoD) will require large amounts of additional resources, time and money, as the DoD is only funding this initial process.    

What is a Home State?

A home state is any state or territory of the United States in which a licensee maintains their principal place of residence or principal place of business and is licensed by the state.

How Common Are Interstate Compacts?

• 151: Number of pieces of compact legislation passed since 2016
• 9: Professions with active interstate compacts for occupational licensure
• 42: States that have joined at least one occupational licensing compact

Interested in providing feedback on the draft compact? Submit your name, title and organization to compact@csg.org to sign up.

For more information, visit compacts.csg.org.

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