HB192ENROLLED Page 0 U9HEXX-2 By Representative Reynolds RFD: Conference Committee on HB192 First Read: 23-Mar-23 2023 Regular Session 1 2 3 4 5 HB192 EnrolledHB192 Enrolled Page 1 Enrolled, An Act, Relating to the Alabama Sunset Law; to continue the existence and functioning of the Alabama Board of Massage Therapy until October 1, 2024, with certain modifications: To amend Sections 34-43-6, 34-43-9, 34-43-11, 34-43-12, 34-43-13, 34-43-14, 34-43-15, 34-43-20, and 34-43-21, Code of Alabama 1975, as amended by Act 2022-408, 2022 Regular Session; to require representation on the board from each Congressional District; to require meetings to be recorded, upon request; to require the publication of proposed rules and related proceedings on the board website; to require the board to accept a criminal history check from an approved national board under certain circumstances; and to cap certain fees charged by the board. BE IT ENACTED BY THE LEGISLATURE OF ALABAMA: Section 1. Pursuant to the Alabama Sunset Law, the Sunset Committee recommends the continuance of the Alabama Board of Massage Therapy until October 1, 2024, with the additional recommendation for statutory change as set out in Section 3. Section 2. The existence and functioning of the Alabama Board of Massage Therapy, created and functioning pursuant to Sections 34-43-1 to 34-43-21, inclusive, Code of Alabama 1975, is continued until October 1, 2024, and those code sections are expressly preserved. Section 3. Sections 34-43-6, 34-43-9, 34-43-11, 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 HB192 EnrolledHB192 Enrolled Page 2 34-43-12, 34-43-13, 34-43-14, 34-43-15, 34-43-20, and 34-43-21 of the Code of Alabama 1975, as amended by Act 2022-408, 2022 Regular Session, are amended to read as follows: "§34-43-6 (a) There is created the Alabama Board of Massage Therapy. The purpose of the board is to protect the health, safety, and welfare of the public by ensuring that licensed massage therapists, massage therapy schools, and massage therapy instructors meet prescribed standards of education, competency, and practice. To accomplish this mission, the board shall establish standards pursuant to this chapter to complete all board functions in a timely and effective manner and to provide open and immediate access to all relevant public information. The board shall communicate its responsibilities and services to the public as part of its consumer protection duties. The board shall develop and implement a long range plan to ensure effective regulation and consumer protection. (b) The board shall consist of seven members appointed by the Governor, subject to confirmation by the Senate. No member of the board shall serve more than two full consecutive terms. The members initially appointed to the board shall be appointed not later than July 16, 1996. Five of the members initially appointed to the board shall have been actively engaged in the practice of massage therapy for not less than three consecutive years prior to the date of their appointment to the board. Successor members to these initial five appointees shall be licensees of the board. Two members shall 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 HB192 EnrolledHB192 Enrolled Page 3 be public members who shall not be licensed, nor have been licensed in the past, and shall not have any direct financial interest in the massage therapy profession. Each board member shall be a high school graduate or shall have received a graduate equivalency diploma. Each board member shall be selected upon personal merit and qualifications, not per membership or affiliation with an association. Each board member shall be a citizen of the United States and this state and a resident of this state for two years immediately preceding the appointment. The Governor shall coordinate his or her appointments to assure that the membership of the board shall be is inclusive and reflect reflects the racial, gender, geographic, urban/rural urban, rural, and economic diversity of the state. As the terms of members serving on the board on the effective date of the act amending this subsection expire, or as vacancies occur, new members shall be appointed so that not more than one member from each United States Congressional District in the state is appointed to serve at the same time. (c) Of the initial seven appointees to the board, three members shall be appointed for terms ending September 30, 1997, and four members shall be appointed for terms ending September 30, 1999. Thereafter, successors shall be appointed for terms of four years, each term expiring on September 30. (d) Vacancies on the board occurring prior to the expiration of a term shall be filled by the Governor within 30 days of the vacancy to serve for the remainder of the unexpired term. Each member of the board shall serve until his or her successor has been duly appointed and qualified. 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 HB192 EnrolledHB192 Enrolled Page 4 (e) At the first meeting, and annually thereafter in the month of October, the board shall elect a chair and vice chair from its membership. (f) The board shall hold its first meeting within 30 days after the initial members are appointed. The board shall hold meetings during the year as it the board determines necessary, two of which shall be the biannual meetings for the purpose of reviewing license applications. Additional meetings may be held at the discretion of the chair or upon written request of any three members of the board. A quorum of the board shall be a majority of the current appointed board members. Upon the written request of any person, submitted to the board at least 24 hours in advance of a scheduled meeting, the meeting shall be recorded. (g) Board members shall not receive compensation for their services, but shall receive the same per diem and allowance as provided to state employees for each day the board meets and conducts business. (h) The board shall adopt the rules necessary to implement this chapter pursuant to the Administrative Procedure Act. Proposed rules, and a schedule of proceedings relating to their adoption, shall be conspicuously posted and routinely updated on the website of the board. (i) The board may employ, and at its pleasure discharge, an executive secretary and other officers and employees which may be necessary, including an attorney, to implement this chapter. The board shall also outline the duties and fix the compensation and expense allowances of the 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 HB192 EnrolledHB192 Enrolled Page 5 employees. (j) An affirmative vote of a majority of the members of the board shall be required to grant, suspend, or revoke a license to practice massage therapy or a license to operate a massage therapy establishment. The board may grant authority to the executive director to approve licenses. (k) The board shall be financed only from income accruing to it the board from fees, licenses, other charges and funds collected by it the board, and any monies that are appropriated to it the board by the Legislature. (l) Each board member shall be accountable to the Governor for the proper performance of his or her duties as a member of the board. The board shall report to the Governor annually and at other times as requested by the Governor. The Governor shall investigate any complaints or unfavorable reports concerning the actions of the board and take appropriate action thereon, including removal of any board member for misfeasance, malfeasance, neglect of duty, commission of a felony, incompetence, or permanent inability to perform official duties. A board member may be removed at the request of the board after failing to attend two consecutive properly noticed meetings. (m) Members of the board are immune from liability for all good faith acts performed in the execution of their duties as members of the board. (n) Appointees to the board shall take the constitutional oath of office and file it in the office of the Governor before undertaking any duties as a board member. Upon 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 HB192 EnrolledHB192 Enrolled Page 6 receiving the oath, the Governor shall issue a certificate of appointment to each appointee." "§34-43-9 (a) A person desiring to be licensed as a massage therapist shall apply to the board on forms provided by the board. Unless licensed pursuant to subsection (b), applicants for licensure shall submit evidence satisfactory to the board that they have met each of the following requirements: (1) Satisfactorily completed a minimum of 650 hours of instruction. By rule of the board, the minimum 650 hours shall consist of the following: 100 hours of anatomy and physiology to include 35 hours of myology, 15 hours of osteology, 10 hours of circulatory system, and 10 hours of nervous system, with the remaining 30 hours to address other body systems at the discretion of the school; 250 hours of basic massage therapy, the contradistinctions of massage therapy, and related touch therapy modalities, to include a minimum of 50 hours of supervised massage; 50 hours to include business, hydrotherapy, first aid, cardiopulmonary resuscitation, and professional ethics; and 250 hours of electives to be determined by the school. The board may adopt a rule to further increase the minimum number of hours of instruction required for licensure, not to exceed the number of hours recommended by the National Certification Board for Therapeutic Massage and Bodywork. Before performing therapeutic massage on an animal, a massage therapist shall graduate from a nationally approved program and complete at least 100 hours of postgraduate training and education in 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 HB192 EnrolledHB192 Enrolled Page 7 animal anatomy, pathology, and physiology for the type of animal upon which the massage therapist wishes to perform therapeutic massage. (2) Successfully passed a national standardized examination approved by the board. (3) Completed a criminal history check. (4) Paid all applicable fees. (b) Notwithstanding the requirements in subdivisions (1) and (2) of subsection (a), the board may license an applicant if the applicant is licensed or registered in another state, which, in the opinion of the board, has standards of practice or licensure that are equal to or stricter than the requirements imposed by this chapter at the time of licensure in that state. (c) Notwithstanding any other provision of this section to the contrary, each applicant for licensure shall be a citizen of the United States or, if not a citizen of the United States, a person who is legally present in the United States with appropriate documentation from the federal government. (d) The board may shall notify each applicant that his or her application has been received and is pending and shall also notify each applicant of the acceptance or rejection of his or her application. If the application is rejected, the board shall list the reasons for rejection." "§34-43-11 (a) Establishments shall be licensed by the board. A sexually oriented business may not be licensed as an 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 HB192 EnrolledHB192 Enrolled Page 8 establishment and shall not operate as an establishment licensed pursuant to this chapter. (b) Establishments shall contract with or employ only licensed massage therapists to perform massage therapy. (c) Each establishment shall contract with or employ at least one licensed massage therapist who is registered with the board as the individual designated to ensure the establishment follows state law and administrative rules. (d) An establishment license issued pursuant to this chapter is not assignable or transferable . (e) Each unlicensed massage therapist applying for an establishment license shall be subject to a criminal history check or shall submit to the board proof of a completed criminal history check performed through the National Certification Board of Therapeutic Massage and Bodywork, or other national certifying board approved by the board, during the previous two-year period . No licensed massage therapist shall be subject to an additional criminal history check when applying for an establishment license. (f) An establishment owned by an individual who is not a resident of this state shall be subject to an initial inspection before licensure. The amount of the initial inspection fee shall be determined by rule of the board. " "§34-43-12 (a) Applications for initial licensure or renewal shall be on forms provided by the board and shall be accompanied by the proper fee. A two-by-two photograph, taken no more than six months earlier, showing a frontal view of the head and 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 HB192 EnrolledHB192 Enrolled Page 9 shoulders of the applicant, shall be submitted with the application. All documents shall be submitted in English. (b) Each applicant for initial licensure shall be subject to a criminal history check. Refusal to consent to a criminal history check constitutes grounds for the board to deny the applicant's application for licensure. (c) The board shall issue a license to each person who qualifies to be a massage therapist and to each qualified massage therapy establishment. To be qualified for a license as a massage therapist the applicant shall successfully pass the examination, pay the examination fee, pass the criminal history check pursuant to rules adopted by the board, pay the criminal history check fee, and pay the license fee. A license grants all professional rights, honors, and privileges relating to the practice of massage therapy. (d) Each licensed therapist shall display his or her license in the manner specified by the board. Each establishment shall post its license in plain sight and the license of each massage therapist who practices in the establishment. (e) A license is the property of the board and shall be surrendered upon demand of the board." "§34-43-13 (a) Each license shall be renewed biennially, on or before the anniversary date, by forwarding to the board a renewal application accompanied by the renewal fee. Each applicant for renewal for licensure shall be subject to a 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 HB192 EnrolledHB192 Enrolled Page 10 criminal history check. Any license not renewed biennially on or before the anniversary date shall expire. (b) Each licensee, upon application for renewal of a license, shall do both of the following: (1) Submit submit evidence of satisfactory completion of the continuing education requirements contained in Section 34-43-21. (2) Consent to a criminal history check. Refusal to consent to a criminal history check constitutes grounds for the board to deny the licensee's application for renewal of the license. (c) Licenses are valid for two years from the date of issuance. An individual whose license has expired and who has ceased to practice massage therapy for a period of not longer than five years may have his or her license reinstated upon payment of a renewal fee and a late fee and submission of a renewal application and evidence satisfactory to the board that the applicant has fulfilled continuing education requirements, passed a criminal history check pursuant to rules adopted by the board , paid the criminal history check fee, and passed the examination. (d) Subsequent to an official complaint, the board may request a criminal background check of the licensee through the district attorney of the circuit in which the licensee is located." "§34-43-14 (a) By rule, the board shall assess and collect the following fees not to exceed: 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 HB192 EnrolledHB192 Enrolled Page 11 (1) Two hundred fifty dollars ($250) One hundred dollars ($100) for the initial massage therapist license. (2) Three hundred dollars ($300) One hundred dollars ($100) for all biennial license renewals postmarked or received at the office of the board by the date in on which the license expires. (3) Three hundred dollars ($300) One hundred dollars ($100) for the initial, and fifty dollars ($50) for any renewal of, an establishment license. (4) Five hundred dollars ($500) One hundred fifty dollars ($150) for the initial registration, and any renewal registration, as a massage therapy school in this state. (5) Two hundred fifty dollars ($250) One hundred dollars ($100) to register and renew registration as a massage therapy instructor in this state. (6) One hundred fifty dollars ($150) Seventy-five dollars ($75) to reactivate an expired license. (7) One hundred dollars ($100) Twenty-five dollars ($25) shall be added to all license fees not post-marked or received by the board before the expiration date of the license. (8) Twenty-five dollars ($25) to verify a license. (9) Twenty-five dollars ($25) (8) Ten dollars ($10) for a duplicate license certificate or a name change on a license certificate. The board may issue a duplicate certificate for each establishment on file with the board where the massage therapist practices massage therapy. The board may issue additional duplicate certificates only after receiving a sworn 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 HB192 EnrolledHB192 Enrolled Page 12 letter from the massage therapist that the an original certificate was lost, stolen, or destroyed. The records of the board shall reflect that a duplicate certificate was issued. (10) A fee, set by the board, for the criminal history check. (11) A fee, set by the board, for an establishment inspection. (b) Necessary administrative fees may be charged by the board, including, but not limited to, reasonable costs for copying, labels, and lists. Examination and license fees may be adjusted as by rule of the board shall deem appropriate . (c) There is hereby established a separate special revenue trust fund in the State Treasury to be known as the Alabama Board of Massage Therapy Fund. All receipts collected by the board under this chapter are to shall be deposited in this fund and used only to carry out this chapter. Such receipts Receipts shall be disbursed only by warrant of the state Comptroller, upon itemized vouchers approved by the chair of the board ; provided that no . No funds shall be withdrawn except as budgeted and allotted according to the provisions of Sections 41-4-80 to 41-4-96, inclusive, 41-19-1, and 41-19-12, as amended, and only in amounts as stipulated in the general appropriations bill or other appropriations bills." "§34-43-15 (a) Any person may file with the board a written complaint regarding an allegation of impropriety by a licensee, establishment, or person. Complaints shall be made 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 HB192 EnrolledHB192 Enrolled Page 13 in the manner prescribed by the board. Complaints received by the board shall be referred to a standing investigative committee consisting of a board member, the Executive Director, the board attorney, and the board investigator. If no probable cause is found, the investigative committee may dismiss the charges and prepare a statement, in writing, of the reasons for the decision. (b) If probable cause is found, the board shall initiate an administrative proceeding. Upon a finding that the licensee has committed any of the following instances of misconduct, the board may suspend, revoke, or refuse to issue or renew a license or impose a civil penalty after notice and opportunity for a hearing pursuant to the Administrative Procedure Act: (1) The license was obtained by means of fraud, misrepresentation, or concealment of material facts, including making a false statement on an application or any other document required by the board for licensure. (2) The licensee sold or bartered or offered to sell or barter a license for a massage therapist or a massage therapy establishment. (3) The licensee has engaged in unprofessional conduct that has endangered or is likely to endanger the health, safety, and welfare of the public, as defined by the rules of the board. As used in this subdivision, unprofessional conduct includes, but is not limited to, allowing any individual to remain in a massage therapy establishment overnight. (4) The licensee has been convicted of a felony or of 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 HB192 EnrolledHB192 Enrolled Page 14 any crime arising out of or connected with the practice of massage therapy. (5) The licensee has violated or aided and abetted in the violation of this chapter. (6) The licensee is adjudicated as mentally incompetent by a court of law. (7) The licensee uses controlled substances or habitually and excessively uses alcohol. (8) The licensee engaged in false, deceptive, or misleading advertising. (9) The licensee engaged in or attempted to or offered to engage a client in sexual activity , including, but not limited to, genital contact, within the client-massage therapist relationship. (10) The licensee has knowingly allowed the massage therapy establishment to be used as an overnight sleeping accommodation. (11) The licensee had a license revoked, suspended, or denied in any other territory or jurisdiction of the United States for any act described in this section. (c)(1) A person governed by this chapter who has a reasonable belief that another massage therapist has engaged in or attempted to or offered to engage a client in sexual activity, as provided in subdivision (9) of subsection (b)(9), shall inform the board in writing within 30 calendar days from the date the person discovers this activity. Upon finding that a person has violated this subsection, the board shall alert local law enforcement and may do any of the following: 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 HB192 EnrolledHB192 Enrolled Page 15 a. Impose an administrative fine of not more than twenty-five thousand dollars ($25,000) ten thousand dollars ($10,000) according to a disciplinary infraction fine schedule adopted by rule of the board . b. Suspend or revoke the person's license to practice massage therapy. (2) Upon a finding that a person has violated this subsection three or more times, the board shall impose a mandatory license suspension for a period of no less than three years and a fine of twenty-five thousand dollars ($25,000) ten thousand dollars ($10,000) . (d) Any person who has been convicted of, or entered a plea of nolo contendere to, a crime or offense involving prostitution or other sexual offenses offense is ineligible to hold a license as a massage therapist for a period of at least three years after the entry of the conviction or plea. The board retains the right to revoke a license indefinitely if the licensee is proven guilty of a crime or of sexual misconduct. Reinstatement of licensure is contingent upon proof of weekly counseling by a licensed professional counselor. (e) An establishment where a person has been convicted of, or entered a plea of nolo contendere to, an offense involving prostitution or any other type of sexual offense may not receive a license for a massage therapy establishment for a period of three years after the date of conviction or entry of the plea. The board shall revoke the establishment license of any establishment which the board determines is a sexually 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 HB192 EnrolledHB192 Enrolled Page 16 oriented business. The board may revoke an establishment license if a person is convicted of, or enters a plea of nolo contendere to, any crime involving prostitution or any other sexual offense against a client which occurred on the premises of the establishment. The violation is attached to the address of the establishment. (f)(1) Upon finding a person, who is governed by this chapter, performing massage therapy without having obtained a license, the board may do any of the following: a. Impose an administrative fine of not more than twenty-five thousand dollars ($25,000) ten thousand dollars ($10,000). b. Issue a cease and desist order. c. Petition the circuit court of the county where the act occurred to enforce the cease and desist order and collect the assessed fine. (2) Any person aggrieved by any adverse action of the board must shall appeal the action to the Circuit Court of Montgomery County in accordance with the Alabama Administrative Procedure Act. (g) The board shall present any incident of misconduct to the local district attorney for review and appropriate action. (h) The board may adopt rules to implement and administer this section." "§34-43-20 (a) To be approved by the board, a massage therapy school shall meet all of the following requirements: 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 HB192 EnrolledHB192 Enrolled Page 17 (1) File a completed application prescribed by the board with the board and pay a registration fee as specified in Section 34-43-14. (2) Provide documentation of a curriculum which includes a minimum number of required hours of instruction in the subjects required pursuant to Section 34-43-9. (3) Register annually with the board by filing a renewal form, accompanied with by the renewal fee pursuant to Section 34-43-14, and submit a current curriculum and a list of instructors. (b) Every instructor teaching course work titled massage therapy at a board approved school located in Alabama shall be licensed in Alabama as a massage therapist and registered as a massage therapy instructor. Instructors who are not teaching massage therapy do not need to be registered. Any adjunct instructors shall be dually licensed in the state where they reside , or be nationally certified, or both. (c) The board shall register as a massage therapy instructor any applicant who meets all of the following requirements: (1) Is currently licensed as a massage therapist in Alabama. (2) Has filed a completed application prescribed by the board and paid a one-time application fee pursuant to Section 34-43-14. (3) Documents three years of experience in the practice of massage therapy. The documentation may be considered by the board on a case-by-case basis. 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 HB192 EnrolledHB192 Enrolled Page 18 (4) Any other requirements adopted by rule of the board." "§34-43-21 (a) The board is subject to the Alabama Sunset Law of 1981, and is classified as an enumerated agency pursuant to Section 41-20-3. The board shall automatically terminate on October 1, 2007, and every four years thereafter, unless continued pursuant to the Alabama Sunset Law. (b) The board shall adopt a program of continuing education for licensees which shall be a requisite for the renewal of licenses issued pursuant to this chapter and not exceed the requirements of a board approved nationally recognized board certification organization such as the National Certification Board of Therapeutic Massage and Bodywork." Section 4. This act shall become effective on July 1, 2023, following its passage and approval by the Governor, or its otherwise becoming law. 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 HB192 EnrolledHB192 Enrolled Page 19 ________________________________________________ Speaker of the House of Representatives ________________________________________________ President and Presiding Officer of the Senate House of Representatives I hereby certify that the within Act originated in and was passed by the House 06-Apr-23. John Treadwell Clerk Senate 18-Apr-23 Amended and Passed House 03-May-23 Passed, as amended by Conference Committee Senate 06-Jun-23 Passed, as amended by Conference Committee 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534