1     
MASSAGE THERAPY PRACTICE ACT AMENDMENTS

2     
2023 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Curtis S. Bramble

5     
House Sponsor: Candice B. Pierucci

6     

7     LONG TITLE
8     Committee Note:
9          The Business and Labor Interim Committee recommended this bill.
10               Legislative Vote:     10 voting for     3 voting against     7 absent
11     General Description:
12          This bill amends the Massage Therapy Practice Act.
13     Highlighted Provisions:
14          This bill:
15          ▸     creates and amends definitions;
16          ▸     creates a license classification for a massage assistant and a massage assistant
17     in-training;
18          ▸     establishes the qualifications and scope of practice for a massage assistant and a
19     massage assistant in-training;
20          ▸     amends massage therapist examination and background check requirements;
21          ▸     addresses supervision of a massage apprentice, massage assistant, and massage
22     assistant in-training;
23          ▸     requires certain signage and disclosures when a massage assistant or massage
24     assistant in-training provides a massage service; and
25          ▸     makes technical and conforming changes.
26     Money Appropriated in this Bill:
27          None
28     Other Special Clauses:
29          None
30     Utah Code Sections Affected:
31     AMENDS:
32          58-47b-102, as last amended by Laws of Utah 2012, Chapter 34
33          58-47b-301, as last amended by Laws of Utah 2013, Chapter 278
34          58-47b-302, as last amended by Laws of Utah 2020, Chapter 339
35          58-47b-303, as enacted by Laws of Utah 1996, Chapter 76
36          58-47b-304, as last amended by Laws of Utah 2021, Chapter 403
37          58-47b-305, as last amended by Laws of Utah 1998, Chapter 159
38          58-47b-501, as last amended by Laws of Utah 2018, Chapter 318
39          58-47b-502, as last amended by Laws of Utah 1998, Chapter 159
40     ENACTS:
41          58-47b-302.1, Utah Code Annotated 1953
42          58-47b-306, Utah Code Annotated 1953
43     

44     Be it enacted by the Legislature of the state of Utah:
45          Section 1. Section 58-47b-102 is amended to read:
46          58-47b-102. Definitions.
47          In addition to the definitions in Section 58-1-102, as used in this chapter:
48          (1) "Board" means the Board of Massage Therapy created in Section 58-47b-201.
49          (2) "Breast" means the female mammary gland and does not include the muscles,
50     connective tissue, or other soft tissue of the upper chest.
51          (3) "Homeostasis" means maintaining, stabilizing, or returning to equilibrium the
52     muscular system.
53          (4) "Massage apprentice" means an individual licensed under this chapter as a massage
54     apprentice [to work under the direct supervision of a licensed massage therapist].
55          (5) "Massage assistant" means an individual licensed under this chapter as a massage
56     assistant.
57          (6) "Massage assistant in-training" means an individual licensed under this chapter as a
58     massage assistant in-training.
59          [(5)] (7) "Massage therapist" means an individual licensed under this chapter as a
60     massage therapist.
61          (8) "Massage therapy supervisor" means:
62          (a) a massage therapist who has at least three years of experience as a massage
63     therapist and has engaged in the lawful practice of massage therapy for at least 3,000 hours;
64          (b) a physical therapist licensed under Chapter 24b, Physical Therapy Practice Act;
65          (c) a physician licensed under Chapter 67, Utah Medical Practice Act;
66          (d) an osteopathic physician licensed under Chapter 68, Utah Osteopathic Medical
67     Practice Act;
68          (e) an acupuncturist licensed under Chapter 72, Acupuncture Licensing Act; or
69          (f) a chiropractic physician licensed under Chapter 73, Chiropractic Physician Practice
70     Act.
71          (9) "Practice of limited massage therapy" means:
72          (a) the systematic manual manipulation of the soft tissue of the body for a purpose
73     described in Subsection (10)(b);
74          (b) seated chair massage;
75          (c) the use of body wraps;
76          (d) aromatherapy;
77          (e) reflexology; or
78          (f) in connection with an activity described in this Subsection (9) the use of:
79          (i) the hands;
80          (ii) a towel;
81          (iii) a stone;
82          (iv) a shell;
83          (v) a bamboo stick; or
84          (vi) an herbal ball compress.
85          [(6)] (10) "Practice of massage therapy" means:
86          (a) the examination, assessment, and evaluation of the soft tissue structures of the body
87     for the purpose of devising a treatment plan to promote homeostasis;
88          (b) the systematic manual or mechanical manipulation of the soft tissue of the body for
89     [the purpose of: (i)] the purpose of promoting the therapeutic health and well-being of a client[;
90     (ii)], enhancing the circulation of the blood and lymph[; (iii)], relaxing and lengthening
91     muscles[;(iv)], relieving pain[;(v)], restoring metabolic balance[; (vi)], or achieving
92     homeostasis[; or], or for any other purpose;
93          [(vii) other purposes;]
94          (c) the use of the hands or a mechanical or electrical apparatus in connection with this
95     Subsection [(6)] (10);
96          (d) the use of rehabilitative procedures involving the soft tissue of the body;
97          (e) range of motion or movements without spinal adjustment as set forth in Section
98     58-73-102;
99          (f) [oil] the use of oil rubs, heat lamps, salt glows, hot and cold packs, or tub, shower,
100     steam, and cabinet baths;
101          (g) manual traction and stretching exercise;
102          (h) correction of muscular distortion by treatment of the soft tissues of the body;
103          (i) counseling, education, and other advisory services to reduce the incidence and
104     severity of physical disability, movement dysfunction, and pain;
105          (j) [similar or related] activities and modality techniques similar or related to the
106     activities and techniques described in this Subsection (10);
107          (k) [the] a practice described in this Subsection [(6)] (10) on an animal to the extent
108     permitted by:
109          (i) Subsection 58-28-307(12);
110          (ii) the provisions of this chapter; and
111          (iii) division rule made in accordance with Title 63G, Chapter 3, Utah Administrative
112     Rulemaking Act; or
113          (l) providing, offering, or advertising a paid service using the term massage or a
114     derivative of the word massage, regardless of whether the service includes physical contact.
115          [(7)] (11) "Soft tissue" means the muscles and related connective tissue.
116          [(8)] (12) "Unlawful conduct" [is as] means the same as that term is defined in Sections
117     58-1-501 and 58-47b-501.
118          [(9)] (13) "Unprofessional conduct" [is as] means the same as that term is defined in
119     Sections 58-1-501 and 58-47b-502 and as may be further defined by division rule made in
120     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
121          Section 2. Section 58-47b-301 is amended to read:
122          58-47b-301. Licensure required.
123          (1) An individual shall hold a license issued under this chapter in order to engage in the
124     practice of massage therapy or the practice of limited massage therapy, except as specifically
125     provided in Section 58-1-307 or 58-47b-304.
126          (2) An individual shall have a license in order to:
127          (a) represent [himself] oneself as a massage therapist [or], massage apprentice,
128     massage assistant, or massage assistant in-training;
129          (b) represent [himself] oneself as providing a service that is within the practice of
130     massage therapy or the practice of limited massage therapy or use the word massage or any
131     other word to describe [such] the services; or
132          (c) charge or receive a fee or any consideration for providing a service that is within the
133     practice of massage therapy or the practice of limited massage therapy.
134          Section 3. Section 58-47b-302 is amended to read:
135          58-47b-302. License classifications -- Qualifications for licensure.
136          (1) The division shall issue licenses under this chapter in the classifications of:
137          (a) massage therapist; [and]
138          (b) massage apprentice[.];
139          (c) massage assistant; and
140          (d) massage assistant in-training.
141          (2) [Each] An applicant for licensure as a massage therapist shall:
142          (a) submit an application in a form prescribed by the division;
143          (b) pay a fee determined by the department under Section 63J-1-504;
144          (c) be 18 years [of age] old or older;
145          (d) have either:
146          (i) (A) graduated from a school of massage having a curriculum [which] that meets
147     standards established by division rule made in collaboration with the board and in accordance
148     with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; or
149          (B) completed equivalent education and training in compliance with division rule made
150     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; or
151          (ii) completed a massage apprenticeship program consisting of a minimum of 1,000
152     hours of supervised training over a minimum of 12 months and in accordance with standards
153     established by [the] division [by] rule made in collaboration with the board and in accordance
154     with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; and
155          (e) pass [examinations]:
156          (i) the Federation of State Massage Therapy Boards Massage and Bodywork Licensing
157     Examination; or
158          (ii) any other examination established by [rule by the division] division rule made in
159     collaboration with the board and in accordance with Title 63G, Chapter 3, Utah Administrative
160     Rulemaking Act.
161          (3) [Each] An applicant for licensure as a massage apprentice shall:
162          (a) submit an application in a form prescribed by the division;
163          (b) pay a fee determined by the department under Section 63J-1-504;
164          (c) be 18 years [of age] old or older;
165          (d) provide satisfactory evidence to the division that the [individual] applicant will
166     practice as a massage apprentice only under the direct supervision of a licensed massage
167     therapist in good standing [and who has] who, for at least 6,000 hours, has engaged in the
168     lawful practice of massage therapy as a licensed massage therapist [for not less than 6,000
169     hours]; and
170          (e) [successfully complete] pass an examination as required by division rule made in
171     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
172          (4) An applicant for licensure as a massage assistant shall:
173          (a) submit an application in a form prescribed by the division;
174          (b) pay a fee determined by the department in accordance with Section 63J-1-504;
175          (c) be 18 years old or older;
176          (d) complete at least 150 hours of education and training approved by division rule
177     made accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, while:
178          (i) enrolled in a massage school; or
179          (ii) (A) licensed as a massage assistant in-training; and
180          (B) under the direct supervision of a massage therapist in good standing who, for at
181     least 6,000 hours, has engaged in the lawful practice of massage therapy;
182          (e) complete at least 150 hours of education and training approved by division rule
183     made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, while:
184          (i) licensed as a massage assistant in-training; and
185          (ii) under the indirect supervision of a massage therapy supervisor;
186          (f) provide satisfactory evidence to the division that the applicant will practice as a
187     massage assistant only under the indirect supervision of a massage therapy supervisor; and
188          (g) pass an examination as required by division rule made in accordance with Title
189     63G, Chapter 3, Utah Administrative Rulemaking Act.
190          (5) An applicant for licensure as a massage assistant in-training shall:
191          (a) submit an application in a form prescribed by the division;
192          (b) pay a fee determined by the department in accordance with Section 63J-1-504;
193          (c) be 18 years old or older; and
194          (d) provide satisfactory evidence to the division that the applicant will practice as a
195     massage assistant in-training under the supervision of a massage therapist for a period of no
196     more than six months to satisfy the requirements described in Subsections (4)(d)(ii) and (e) for
197     licensure as a massage assistant.
198          (6) (a) A massage therapist may supervise at one time up to six individuals licensed as
199     a massage apprentice or massage assistant in-training.
200          (b) A massage therapy supervisor may supervise at one time up to six individuals
201     licensed as a massage assistant.
202          [(4) (a) Any] (7) A new massage therapist [or], massage apprentice, massage assistant,
203     or massage assistant in-training applicant shall submit [fingerprint cards in a form acceptable to
204     the division at the time the license application is filed and shall consent to a fingerprint
205     background check by the Utah Bureau of Criminal Identification and the Federal Bureau of
206     Investigation regarding the application.] to and pass a criminal background check in accordance
207     with Section 58-47b-302.1 and any requirements established by division rule made in
208     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
209          [(b) The division shall request the Department of Public Safety to complete a Federal
210     Bureau of Investigation criminal background check for each new massage therapist or
211     apprentice applicant through the national criminal history system (NCIC) or any successor
212     system.]
213          [(c) The cost of the background check and the fingerprinting shall be borne by the
214     applicant.]
215          [(5) (a) Any new massage therapist or massage apprentice license issued under this
216     section shall be conditional, pending completion of the criminal background check. If the
217     criminal background check discloses the applicant has failed to accurately disclose a criminal
218     history, the license shall be immediately and automatically revoked.]
219          [(b) Any person whose conditional license has been revoked under Subsection (5) (a)
220     shall be entitled to a post-revocation hearing to challenge the revocation. The hearing shall be
221     conducted in accordance with Title 63G, Chapter 4, Administrative Procedures Act.]
222          [(6) An applicant who successfully completes a fingerprint background check under
223     Subsection (4) may not be required by any other state or local government body to submit to a
224     second fingerprint background check as a condition of lawfully practicing massage therapy in
225     this state.]
226          Section 4. Section 58-47b-302.1 is enacted to read:
227          58-47b-302.1. Criminal background check.
228          (1) An applicant for licensure under this chapter who requires a criminal background
229     check shall:
230          (a) submit fingerprint cards in a form acceptable to the division at the time the license
231     application is filed; and
232          (b) consent to a fingerprint background check conducted by the Bureau of Criminal
233     Identification and the Federal Bureau of Investigation regarding the application.
234          (2) The division shall:
235          (a) in addition to other fees authorized by this chapter, collect from each applicant
236     submitting fingerprints in accordance with this section the fee that the Bureau of Criminal
237     Identification is authorized to collect for the services provided under Section 53-10-108 and the
238     fee charged by the Federal Bureau of Investigation for fingerprint processing for the purpose of
239     obtaining federal criminal history record information;
240          (b) submit from each applicant the fingerprint card and the fees described in Subsection
241     (2)(a) to the Bureau of Criminal Identification; and
242          (c) obtain and retain in division records a signed waiver approved by the Bureau of
243     Criminal Identification in accordance with Section 53-10-108 for each applicant.
244          (3) The Bureau of Criminal Identification shall, in accordance with the requirements of
245     Section 53-10-108:
246          (a) check the fingerprints submitted under Subsection (2)(b) against the applicable state
247     and regional criminal records databases;
248          (b) forward the fingerprints to the Federal Bureau of Investigation for a national
249     criminal history background check; and
250          (c) provide the results from the state, regional, and nationwide criminal history
251     background checks to the division.
252          (4) For purposes of conducting a criminal background check required under this
253     section, the division shall have direct access to criminal background information maintained
254     under Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
255          (5) The division may not disseminate outside of the division any criminal history
256     record information that the division obtains from the Bureau of Criminal Identification or the
257     Federal Bureau of Investigation under the criminal background check requirements of this
258     section.
259          (6) (a) A new license issued under this chapter is conditional pending completion of the
260     criminal background check.
261          (b) Notwithstanding Title 63G, Chapter 4, Administrative Procedures Act, if the
262     criminal background check required in Subsection 58-47b-302(7) demonstrates the applicant
263     has failed to accurately disclose a criminal history, the license is immediately and automatically
264     revoked upon notice to the licensee by the division.
265          (c) A person whose conditional license is revoked under Subsection (6)(b) is entitled to
266     a postrevocation hearing to challenge the revocation.
267          (d) The division shall conduct a postrevocation hearing in accordance with Title 63G,
268     Chapter 4, Administrative Procedures Act.
269          (7) An applicant who successfully completes a background check under this section
270     may not be required by any other state or local government body to submit to a second
271     background check as a condition of lawfully engaging in the practice of massage therapy or the
272     practice of limited massage therapy in this state.
273          Section 5. Section 58-47b-303 is amended to read:
274          58-47b-303. Term of license -- Expiration -- Renewal.
275          (1) (a) [Each] Except as provided in Subsection (3), the division shall issue a license
276     [issued] under this chapter [shall be issued] in accordance with a two-year renewal cycle
277     established by [rule] division rule made in accordance with Title 63G, Chapter 3, Utah
278     Administrative Rulemaking Act.
279          (b) A renewal period may be extended or shortened by as much as one year to maintain
280     established renewal cycles or to change an established renewal cycle.
281          (2) [Each] Subject to Subsection (3), a license automatically expires on the expiration
282     date shown on the license unless renewed by the licensee in accordance with Section 58-1-308.
283          (3) A massage assistant in-training license expires six months after the day on which
284     the division issues the massage assistant in-training license.
285          Section 6. Section 58-47b-304 is amended to read:
286          58-47b-304. Exemptions from licensure.
287          (1) In addition to the exemptions from licensure in Section 58-1-307, the following
288     individuals may engage in the practice of massage therapy [as defined under this chapter,] or
289     the practice of limited massage therapy, subject to the stated circumstances and limitations,
290     without being licensed[, but may not represent themselves as a massage therapist or massage
291     apprentice:] under this chapter:
292          (a) a physician or surgeon licensed under Chapter 67, Utah Medical Practice Act;
293          (b) a physician assistant licensed under Chapter 70a, Utah Physician Assistant Act;
294          (c) a nurse licensed under Chapter 31b, Nurse Practice Act, or under Chapter 44a,
295     Nurse Midwife Practice Act;
296          (d) a physical therapist licensed under Chapter 24b, Physical Therapy Practice Act;
297          (e) a physical therapist assistant licensed under Chapter 24b, Physical Therapy Practice
298     Act, while under the general supervision of a physical therapist;
299          (f) an osteopathic physician or surgeon licensed under Chapter 68, Utah Osteopathic
300     Medical Practice Act;
301          (g) a chiropractic physician licensed under Chapter 73, Chiropractic Physician Practice
302     Act;
303          (h) a hospital staff member employed by a hospital, who practices massage as part of
304     the staff member's responsibilities;
305          (i) an athletic trainer licensed under Chapter 40a, Athletic Trainer Licensing Act;
306          (j) a student in training enrolled in a massage therapy school approved by the division;
307          (k) a naturopathic physician licensed under Chapter 71, Naturopathic Physician
308     Practice Act;
309          (l) (i) an occupational therapist licensed under Chapter 42a, Occupational Therapy
310     Practice Act; and
311          (ii) an occupational therapy assistant licensed under Chapter 42a, Occupational
312     Therapy Practice Act, while under the general supervision of an occupational therapist;
313          (m) an individual performing gratuitous massage; and
314          (n) an individual:
315          (i) certified by or through, and in good standing with, an industry organization that is
316     recognized by the division and that represents a profession with established standards and
317     ethics:
318          (A) who is certified to practice reflexology and whose practice is limited to the scope
319     of practice of reflexology;
320          (B) who is certified to practice a type of zone therapy, including foot zone therapy, and
321     whose practice is limited to the scope of practice for which the individual is certified;
322          (C) who is certified to practice ortho-bionomy and whose practice is limited to the
323     scope of practice of ortho-bionomy;
324          (D) who is certified to practice bowenwork and whose practice is limited to the scope
325     of practice of bowenwork; or
326          (E) who is certified to practice a type of brain integration and whose practice is limited
327     to the scope of practice for which the individual is certified;
328          (ii) whose clients remain fully clothed from the shoulders to the knees; and
329          (iii) whose clients do not receive gratuitous massage from the individual.
330          (2) An individual described in Subsection (1) may not represent oneself as a massage
331     therapist, massage apprentice, massage assistant, or massage assistant in-training.
332          (3) This chapter may not be construed to:
333          (a) authorize any individual licensed under this chapter to engage in any manner in the
334     practice of medicine as defined by the laws of this state[.];
335          [(3) This chapter may not be construed to:]
336          [(a)] (b) require insurance coverage or reimbursement for massage therapy or limited
337     massage therapy from third party payors; or
338          [(b)] (c) prevent an insurance carrier from offering coverage for massage therapy or
339     limited massage therapy.
340          Section 7. Section 58-47b-305 is amended to read:
341          58-47b-305. State and local jurisdiction.
342          (1) (a) The division is the only agency authorized to license individuals to [practice]
343     engage in the practice of massage therapy or the practice of limited massage therapy within the
344     state or any of [its] the state's political subdivisions.
345          (b) This chapter does not prevent any political subdivision of the state from enacting:
346          (i) ordinances governing the operation of establishments offering massages; or
347          (ii) ordinances regulating the practice of massage therapy or the practice of limited
348     massage therapy, if the ordinances are not less stringent than this chapter.
349          (2) This chapter does not prohibit any political subdivision of the state from
350     prosecuting [unlicensed individuals]:
351          (a) an unlicensed individual who is engaged in the practice of massage therapy [or from
352     prosecuting licensed individuals who are] or the practice of limited massage therapy; or
353          (b) a licensed individual who is engaged in unlawful conduct.
354          Section 8. Section 58-47b-306 is enacted to read:
355          58-47b-306. Required signage and disclosures.
356          (1) As used in this section, "massage establishment" means an establishment in which
357     an individual lawfully engages in the practice of massage therapy or the practice of limited
358     massage therapy.
359          (2) If a massage assistant or massage assistant in-training engages in the practice of
360     limited massage therapy at a massage establishment, the massage establishment shall
361     prominently display to the public a sign that indicates certain massage services offered at the
362     massage establishment are performed by a massage assistant or a massage assistant in-training.
363          (3) If an individual requests a massage service that is performed by a massage assistant
364     or a massage assistant in-training, the licensee performing or the massage therapy supervisor
365     supervising the massage service shall ensure that the individual is notified before scheduling or
366     agreeing to the massage service that the massage service is performed by a massage assistant or
367     massage assistant in-training.
368          Section 9. Section 58-47b-501 is amended to read:
369          58-47b-501. Unlawful conduct.
370          (1) "Unlawful conduct" includes:
371          [(1)] (a) practicing, engaging in, or attempting to practice or engage in the practice of
372     massage therapy without holding a current license as a massage therapist or a massage
373     apprentice under this chapter;
374          [(2)] (b) advertising or representing [himself as practicing] oneself as engaging in the
375     practice of massage therapy when not licensed to do so; [and]
376          (c) practicing, engaging in, or attempting to practice or engage in the practice of limited
377     massage therapy without holding a current license as a massage therapist, massage apprentice,
378     massage assistant, or massage assistant in-training under this chapter;
379          (d) advertising or representing oneself as engaging in the practice of limited massage
380     therapy when not licensed to do so; and
381          [(3)] (e) massaging, touching, or applying any instrument or device by a licensee in the
382     course of [practicing or] engaging in the practice of massage therapy or the practice of limited
383     massage therapy to the:
384          [(a)] (i) genitals;
385          [(b)] (ii) anus; or
386          [(c)] (iii) except as provided in Subsection (2), breasts of a female patron[,except when
387     a female patron].
388          (2) Subsection (1)(e)(iii) does not apply if a female patron:
389          (a) requests breast massage, as may be further defined by division rule[,] made in
390     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; and
391          (b) signs a written consent [form, which must also include] form before the procedure
392     is performed that includes the signature of a parent or legal guardian if the patron is a [minor,
393     authorizing the procedure and outlining the reason for it before the procedure is performed.]
394     minor and authorizes and outlines the reason for the procedure.
395          Section 10. Section 58-47b-502 is amended to read:
396          58-47b-502. Unprofessional conduct.
397          "Unprofessional conduct" includes the following and may be further defined by division
398     rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act:
399          (1) maintaining, operating, or assisting in the establishment or operation of any place of
400     business for the purpose of performing the practice of massage therapy or the practice of
401     limited massage therapy without first obtaining a business license, if a license is required;
402          (2) failing to comply with any applicable ordinances relating to the regulation of
403     massage establishment;
404          (3) failing to comply with all applicable state and local health or sanitation codes;
405          (4) failing to properly supervise [an apprentice] a massage apprentice, massage
406     assistant, or massage assistant in-training;
407          (5) failing to maintain mechanical or electrical equipment in a safe operating condition;
408          (6) failing to adequately monitor patrons utilizing steam rooms, dry heat cabinets, or
409     water baths;
410          (7) prescribing or administering medicine or drugs;
411          (8) engaging in any act or practice in a professional capacity that is outside of the
412     practice of massage therapy or the practice of limited massage therapy; and
413          (9) engaging in any act or practice in a professional capacity for which the licensee is
414     not competent to perform through training or experience.