Legislative Testimony for LB347: Exempt reflexology from licensure under the Massage Therapy Practice Act

Legislative Testimony for LB347: Exempt reflexology from licensure under the Massage Therapy Practice Act

Good afternoon, Chairwoman Howard and members of the HHS Committee.  My name is Nicole Fox, and I am the Director of Government Relations for the Platte Institute.  I’d like to thank Senator Murman for introducing this bill.  I am here today to testify in support.

A few years ago, a reflexologist contacted the Platte Institute about her situation.  After being invited to provide training in reflexology at a local school, she received a cease-and-desist letter from the Nebraska Department of Health and Human Services demanding that she stop reflexology services under the threat of a felony charge.  Since that time, this woman has moved to Indiana, a state where reflexology is exempt from massage law.

There have been other individuals who have called us in support of this bill who are practicing without a license and are in fear of being served a cease and desist order.  They want to openly practice reflexology without first having to go to massage school and get a massage therapy license. They want to be able to grow their businesses and contribute to our state’s economy.  These individuals were encouraged to submit written testimony as an alternative. 

Currently, Nebraska law requires persons desiring to work solely as a reflexologist seek licensure as a massage therapist. 

Reflexology and massage therapy are two different practices. Reflexologists limit their services to the application of specific pressure, using their hands, thumbs, and fingers, to soft tissue exclusively in the hands, feet, and outer ears of the client.

In order to obtain a Nebraska license as a massage therapist, a license applicant must complete a massage therapy program of at least 1000 clock hours and pass a national exam. The 1000 clock hours required in this state are the highest in the country.  In Nebraska, this means a time commitment of at least 9-12 months to complete the program and a financial obligation of $8500 to over $15,000 in tuition plus additional fees and supplies depending upon which of the state’s programs one chooses. 

I reviewed the coursework descriptions of the available programs in the state.  If reflexology is even noted in the curriculum, it is typically listed as one of several other modalities covered under “Eastern Wellness” or “Complementary Therapies.”  Essentially, out of the 1000 required hours of massage training potential reflexologists are required to take, approximately 20-30 hours is dedicated to reflexology at most. 

Reflexology is exempt from massage laws in 32 states and the District of Columbia.  There are 4 states that have no massage law, and reflexology is not regulated or licensed.  Our neighbors, Colorado, Iowa, Missouri and South Dakota exempt reflexology from massage law.  Kansas and Wyoming do not have massage laws. 

I ask the committee to consider 2 questions.  The first question I’d like to pose is, “If your desire was to start a business providing only reflexology services to clients, would you be willing to obtain a massage therapy degree at the previously mentioned time and cost so that you could practice in Nebraska, or would you consider opening that business somewhere else?”  The second question is, ”If you were a reflexologist who had practiced for several years in one of the states where reflexology is exempted from massage, and you were needing to move to a city/town on one of Nebraska’s borders, would you be willing to go back and get your massage therapy degree (again at the prior mentioned time/cost) so that you could get licensed so you could practice in Nebraska, or would you go across the border to the neighboring state to work?”

This same bill was brought before this committee in 2017.  After the 2017 hearing, it was decided to put reflexology through the 407 credentialing review process, and the Platte Institute initiated this.  Unfortunately, the review was not complete in time to move the bill forward in 2018, which is why a new bill was introduced this year.

I’d like to discuss the 407 review.  When we completed the application, it was decided to request approval for licensure separate from massage.  We decided that this would be the best way to determine whether reflexologists should be licensed at all.  Ultimately Dr. Williams, former Medical Director for DHHS, recommended against licensing reflexologists in Nebraska. 

In his report dated July 30, 2018, he stated, “The creation of a licensed Reflexology profession in Nebraska is not necessary.  I see no reason why Reflexology should not become an independent profession separate from Massage Therapy.  Most states recognize Reflexology as a separate and distinct profession in its own right.  I see no reason why Nebraska needs to be different in this regard…. Given that Reflexology is arguably safely unregulated in most states, it is difficult to justify Nebraska holding possibly the most arduous Reflexology requirements in the United States…. It is difficult to conceive of any treatment or approach more medically risk free than Reflexology.”

LB347 will exempt those wanting to solely practice reflexology from having to obtain licensing as a massage therapist.  This will make Nebraska more consistent and competitive with our neighboring states, so that we keep individuals from leaving our state in search of opportunities elsewhere and provide greater reciprocity for reflexologists wanting to move to Nebraska.

I want to touch briefly on 2 opposition arguments that may be raised today – both were brought up at the 2017 hearing and the 407 review.  First, a letter from 1985 making reference to an Attorney General Opinion stating reflexology is the practice of massage was distributed.  Per subsequent correspondence with the AG’s office in 2018, we learned that this letter is not a formal Attorney General’s Opinion.

Second, the argument of human trafficking was mentioned.  I want to make it clear, that while those running trafficking operations may use “massage parlor” as their front, these individuals are not applying for occupational licensing.  I don’t care how high you set the bar, the tragedy of human trafficking will not be derailed by excessive licensing requirements.  This is an issue that needs to be handled by law enforcement.  For those of you that follow the news in Omaha, approximately 1 year ago, an employee at a spa owned by an individual affiliated with a Nebraska massage school who also sits on Nebraska’s massage board was charged with sexual assault of multiple clients.  This individual is now in jail, but occupational licensing did not prevent these sexual assaults.

In 2016 and 2018 this committee, and ultimately the Nebraska Legislature, advanced and passed 2 bills very much like LB347 – one exempting hair braiders from cosmetology licensing, and one exempting equine, feline and canine massage from massage licensing.  You have an opportunity to score a 3rd similar win for Nebraska’s workers.  I ask that you advance LB347 out of committee.

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