Town Hall Recap: Ready to Move
By Josh Corman

FOR MANY LICENSED professionals working in the U.S. spa industry, the lack of reciprocal licensure between states has meant that those eager to take advantage of the industry’s reputation for flexibility and its many employment opportunities often find themselves frustrated. For example, those licensed to practice massage therapy or cosmetology in a given U.S. state often face barriers that make, say, moving to a new state—or practicing in multiple states at once— a serious challenge. Because regulations often differ (sometimes significantly) from state to state, a practitioner moving from one state to another can face additional fees, examinations or practice hour requirements just to obtain an equivalent license. Naturally, these potential burdens have the practical effect of suppressing state-to-state movement among practitioners, which can severely limit their career opportunities.

However, as Pulse detailed in September, that is all expected to change soon. Work is well underway on interstate compacts for both massage therapy and cosmetology that should go a long way toward breaking down barriers and making those licenses portable between any states that sign on to the compact. At a recent ISPA Town Hall, stakeholders from inside and outside of the spa industry discussed the compacts’ progress and other related issues in a conversation with ISPA Board Chair Patrick Huey.

The Ball is Rolling
The entire process began in earnest earlier this year when the Department of Defense selected massage therapy, along with the paired professions of cosmetology and barbering, to receive technical assistance from the Council of State Governments (CSG) to help craft the compacts. But Debra Persinger, executive director of the Federation of State Massage Therapy Boards (FSMTB), was quick to point out that this year’s developments have been a long time in the making. “It’s been a long-held goal of the federation to simplify and standardize the licensing process,” said Persinger. “Now it’s all coming together and coalescing.”

Part of that “coming together and coalescing” involves the assembly of technical assistance group, a selection of stakeholders that helps CSG navigate the nuances of and potential challenges inherent to establishing reciprocal licensure. Deirdre Strunk, vice president of spa, fitness and beauty at Canyon Ranch, is a member of the technical assistance group working on the massage therapy compact. “It has about 25 stakeholders: regulators, therapists, business owners and different associations are all part of it,” said Strunk. “We help create, basically, the vision for [the compact], and then [CSG] can create the content for the people that are actually writing the compact.”

This last detail is an important one: For all the work being done on the front end by people who are likely to know the spa industry well, these interstate compacts carry with them the power of law, which means they must be written, debated and then passed by state legislatures, just like other laws. And as with other pieces of legislation, those parts of the process take plenty of time. “These things… usually take, from start to finish, about 12 to 18 months to develop,” said Matthew Shafer, project manager at CSG. “It’s a long negotiation process with all the stakeholders in the profession to come to an agreement on what’s going to end up in that document. So, they take time, but it’s worth it. In the end, you have something that is permanent and lasting in the profession, something that’s viable and has a significant amount of buy-in.”

Because states’ participation in interstate compacts is voluntary, creating that sense of buy-in is crucial. Thankfully, Leslie Roste of BlueCo Brands (makers of Barbicide), who is involved with the technical assistance group for the cosmetology compact, believes that interest in the compacts is high. “It really didn’t take many phone calls to get a whole bunch of states very interested in this idea,” Roste said. The more states that come on board, the merrier, of course, but don’t expect all 50 states to join the compact right away. As Roste noted, the largest professional interstate compact currently in existence—for nursing— has been adopted by 38 (or just over 75 percent) of the 50 U.S. states.

Finding Common Ground
Enabling licensed massage therapy and cosmetology professionals to work in different or multiple states without requiring them to jump through additional regulatory hoops may seem like a no-brainer solution to an obvious yet simple problem. However, there are a number of reasons why legislation like these interstate compacts has been slow to develop, and stakeholders are going to have to address each of them as they move forward.

As Leslie Roste noted, one significant hurdle interstate compacts can be the lack of uniform requirements—be they for examinations, practice hours or continuing education requirements—between states. “As we all know, in cosmetology, not all schools are accredited, and there isn’t just one exam. So it’s trying to get everyone to agree what that standard is that we can all agree on,” Roste said. “The biggest hang-up is a lack of standardization in the education and testing processes.”

In massage therapy, Debra Persinger explained, things are further along on that front, as 44 states and several U.S. territories already use the Massage and Bodywork Licensing Exam (MBLex) as the “gatekeeper” to licensure. And though the patchwork of other education requirements will no doubt garner a lot of attention as the compact is shaped, Persinger reminded attendees that the point of the compact is simply to benefit licensed professionals, not to align every state’s licensure requirements perfectly. “Our focus is not on the entry level education to be in the compact; we’re talking about licensed professionals. We’re not talking about the emerging professionals who are still in school,” she said. On the cosmetology side, Leslie Roste agrees: “Hopefully, we can get away from talking about hours and what it took to get licensed in one state and say that, regardless of how you get to sit for an exam… if you pass that exam, or if you can work safely for two years, [your license will be portable].

Testing and education aren’t the only potential barriers to adoption of the compacts, however. As Debra Persinger noted, concerns about human trafficking are very real, and she anticipates that some kind of database will be crafted to track the credentials and movement of licensed therapists (FSMTB has been developing their own over the last two to three years). Such a database, Persinger said, “will go a long way toward combating not just the criminal element, but the people that you don’t want to employ— they’re not safe, nor are they competent.”

One Step at a Time
Planning and negotiations around both the massage therapy and cosmetology compacts will continue in the months to come, as the technical assistance groups and CSG work to establish their respective parameters. But the final step in the compact adoption process cannot happen until those parameters have been drafted as model legislation, which state legislatures then debate and vote on. “There will be model legislation, and every state is free to make changes to it that are non-substantive,” said Matthew Shafer. “CSG reviews every introduction of the model legislation to make sure that there are no changes that we would deem substantive. Little things like tweaks of definitions… we’re fine with, but you have to remember that this is a contract. There can be very minor tweaks, but the language will be 98 percent the same from most states that pass it.”

As for the process of passing the fully drafted compact into law, that remains up to the individual states considering joining the compact. Because the legislation is months from its final form, there is no way to know yet which states may ultimately sign on, though Shafer and CSG understand the curiosity. “That’s logically everyone’s first question: Is my state involved in this? I would just say wait and give it time,” said Shafer. Despite some uncertainty surrounding which and how many states will ultimately agree to operate under the compact—and how long it will take—there are at least a couple of things working in the compact’s favor. One of those is that the legislation that will ultimately be drafted will be presented to legislatures as standalone legislation. As a result, lawmakers won’t have to consider whether other, possibly unrelated, provisions in the law might require them to vote against adopting the compact.

As Debra Persinger pointed out, the Department of Defense’s support of the development of these and other interstate compacts should also help generate support among legislators (though the benefits extend to professionals who are not a part of the military community, interstate compacts are often designed to support spouses in military families, who may have no choice but to relocate due to a new base assignment). “I’d be hard pressed to imagine any legislator raising their hand saying, ‘I’m against getting military spouses to work,‘” Persinger said. “So, I think we’re in a good position to move forward with adoption.”

The benefits these interstate compacts would have on the spa industry would likely be substantial and immediate, but patience is the order of the day. Spa leaders like Deirdre Strunk may be waiting calmly, but there is no hiding the excitement that these agreements are generating. “I think some of these smaller operators will just have more flexibility in hiring people because people will be able to move easily,” Strunk said. “I truly believe at the end of the day, for the entire industry and our economy, this is such a brilliant move.”