Pursuing Portability: Interstate Compacts Bring Big Changes to the Spa Industry
By Josh Corman

ONE OF THE SELLING POINTS of a career in the spa industry is that it can provide the opportunity to see the world, to live and work almost anywhere given the industry’s huge global footprint. For massage therapists working within the United States, however, those opportunities are often undercut by the wide variation in licensing requirements and the lack of massage licenses’ state-to-state portability.

A quick glance at massage therapist licensing requirements in the U.S. reveals part of the challenge massage therapists face. According to the American Massage and Bodywork Practitioners (ABMP), nearly every state requires massage therapists to be licensed (Minnesota, Wyoming and Kansas have no statewide licensure requirements). The requirements that must be met to attain licensure are often similar from state to state— usually, candidates must pass one of two qualifying exams and perform a certain number of hours’ worth of massage therapy practice acts verified by a massage therapy school or program to apply for their license. But the number of practice hours required varies. Florida requires 500 hours, for example, while Nevada requires 550 hours and New York and Nebraska require 1000.

The requirements for license renewal in each state often varies as well, which means that any massage therapist looking to practice in a new state must, at the very least, pay the cost associated with obtaining a new license and may, in some cases, have to make up any difference in practice hours between their old state and their new one. At best, it’s a clunky process that makes any such move inconvenient. At worst, the process drags down the spa industry both by keeping existing massage therapists from pursuing opportunities in other states and discouraging others from pursuing a career in massage therapy at all.

Earlier this year, those advocating for greater portability of massage therapy licensure were given new hope that a solution to these problems would arrive sooner, rather than later. In March, the U.S. Department of Defense selected the profession of massage therapy to receive technical assistance from The Council of State Governments (CSG) to craft an interstate compact that would allow therapists to practice in any state that joins the compact, all without requiring a separate license. The Department of Defense’s involvement is owed to the fact that interstate compacts of this type are often designed specifically to benefit spouses of military personnel, who must frequently relocate. The agreement, however, would not apply solely to those affiliated with the military but to any practicing therapist in a state belonging to the compact.

The process of developing the compact and determining which states will ultimately participate will take time, but the ball is already rolling. The Council of State Governments is working with stakeholders from various organizations such as the American Massage Therapy Association (AMTA), ABMP and state board administrators and attorneys. “This group is going to be convening in August to come up with a set of recommendations as to the contents of the compact, the core components, which will be handed off to the drafting team, who will actually write the compact legislation,” says Matthew Shafer, project manager at CSG. This team, known as a “compact technical assistance group,” will work with CSG to analyze the massage therapy profession, looking for uniformity in licensing requirements related to training hours, required examinations, supervision, education and experience. This analysis will serve as the foundation upon which the compact will be built.

As for the timeline of the compact’s development from research and analysis to final legislation, Shafer explains that the industry should expect the legislation to be written by the end of 2022 and implemented in early 2023. “We usually say it takes about 12 to 18 months from that first meeting until the model legislation is finalized,” he says.

Although the compact technical assistance group is limited to around a couple dozen stakeholder members, that doesn’t mean that others with a vested interest are unable to get involved. “If any ISPA members are particularly interested in the model legislation, we would invite them to participate in the stakeholder review process,” Shafer says. “We do not want to run a closed process; we want this to be open and transparent, so we run a robust stakeholder review process where we publish the draft document, let everyone read it who wants to read it, collect all the feedback and go line by line and talk about every comment that was brought up and make changes accordingly. Then we get the document finalized.”

Aside from participating in the stakeholder review process, there are other ways that interested parties (such as ISPA members) can influence the compact. CSG, Shafer notes, encourages interested parties to participate in advocacy efforts. “From our perspective, we’ve seen the most benefit from efforts that are aligned with a state association or a state board, rather than just an individual practitioner writing to their state legislator. That’s obviously great, and it can make an impact, but working with your state association is probably the best route we’ve seen folks take from other professions.”

CSG can also assist those who live in states that may not show much interest in joining the compact. “If one of your members is struggling— maybe their state is not on board with this idea and is not receptive—feel free to reach out to CSG,” says Shafer. “We do tons of education to different organizations, state associations and state boards. We’re happy to provide written materials or give an educational presentation to dispel some of the myths around compacts.” States may be hesitant, Shafer adds, because they may see other states’ requirements for licensure as less rigorous than their own. And because a compact involving more than 10 states triggers the involvement of an interstate commission (essentially, a body that oversees execution of the compact), some legislators are hesitant to support their state’s addition to a compact out of concern that they are ceding regulatory authority of the industry to a large government body.

“There’s a lot of stuff that people think compacts do that they actually don’t do,” Shafer explains. “They’re pretty narrow in scope, actually. All the interstate commission does is facilitate compact activities and ensure that the compact is working properly, facilitating multi-state practice. The only authority it has is over compact activities.”

The kinds of education and advocacy Shafer mentions are essential to creating a compact that benefits as many people as possible. An interstate compact is only as useful as the number of states that agree to participate in it, after all, so whatever can be done to bring more states into the fold is essential.

CSG’s goal for every interstate compact is for all 50 states to participate, but that can be a challenge. “There are always going to be states that have a sense of independence, and they don’t want to accept licensees from other states. That’s their prerogative. We’re always doing education; we’re always doing legislative testimony and outreach to states who are considering these in hope that they’ll join. That work doesn’t stop until every state has joined.” As of now, the largest number of states participating in a single compact developed in league with CSG is 35, which may provide some sense of the work required to bring all 50 onboard under a single agreement.

Daunting though the task may seem to those of us whose work doesn’t involve legislative consensus building, there is little doubt that, once the massage therapy interstate compact is in place, it will be an enormous positive for the spa industry. In terms of the industry’s recruiting potential alone, the compact will make the profession of massage therapy that much more appealing to a generation that prizes flexibility and will benefit from the ability to move from state to state without facing the barriers to opportunity currently posed by geography.

For a spa industry eager to put a dent in the talent shortage that has made hiring massage therapists and other service providers such a challenge, the development of this compact cannot happen rapidly enough.