AMTA OR Newsletter Fall 2018

I’ve been spending a lot of time thinking about the massage profession and our future. On one hand, I’m optimistic about our potential to make healthcare more humane, effective, and affordable. Today, we know much more about the costs and risks associated with chronic opioid use and invasive medical procedures for pain management. Alternatives like massage therapy, yoga, and acupuncture are now included in pain management guidelines published by Oregon Health Authority, the Center for Medicare Services, and others. A lot of credit goes to AMTA National Government Relations team, who has done some great lobbying work, which you can read about here.

At the same time, LMTs still face significant obstacles to being recognized by the healthcare and insurance systems. Lack of coverage for massage, low reimbursement rates, administrative costs, and byzantine insurance systems all combine to make it difficult for people to utilize our services, and for LMTs to make a living wage.

I wonder: how can we improve this situation? One answer I often hear is that we need to raise the standards of what it takes to be an LMT. Maybe we increase the number of hours of education, require college-level health sciences courses, or mandate clinical supervision. That would probably help convince the healthcare system that we belong. It might also be our best argument for higher wages. But there’s a problem with that – not all LMTs want to work in a healthcare setting. Is it really fair to make all LMTs take advanced training when their job doesn’t necessitate it?

This is a tough question our Government Relations Committee had to ask in relation to proposed changes to Continuing Education requirements for LMTs (which you can read more about in Julie’s article below). In case you haven’t heard, OBMT is currently considering rule changes that would reduce the number of CE hours to make it easier for LMTs to renew their licenses every two years. Like many of you, we read the proposal and were concerned about the impact of lowering the standards for massage therapists. We created a survey to gauge our members’ reaction to the proposed rules and we followed the lively discussions on various Facebook groups.

From our engagement with the community, we learned that most LMTs who took the time to comment (either on Facebook or to OBMT) were strongly in favor of maintaining a high standard for Continuing Education. However, a narrow majority of survey respondents actually wanted to reduce the number of hours required (50% to 42%). This was a surprise to me, but may be explained by the different priorities of our members – not all of us are interested in working in the healthcare field. Some feel that additional training doesn’t necessarily translate into better massage therapists.

Through this process, I’ve come to better appreciate the challenges of regulating a diverse profession like massage. Our formal response to OBMT goes into greater detail about the various proposed changes, and you can read it here. At the end of the day, all LMTs in Oregon are categorized as allied health providers, with the ability to bill insurance and see clients without supervision. We at AMTA want to protect those responsibilities, and believe that robust CE standards – in line with comparable healthcare providers – are an important component of the evolving art and science of massage therapy. We’ll continue to track this story, and keep you all informed as we go. We are always open to hearing from you, so please don’t hesitate to reach out with your ideas and feedback!

The thing I love most about volunteering for AMTA is that I get to interact with so many passionate massage practitioners. Though we have our differences, it’s easy to recognize our commonalities. Each of us wants what is best for our clients, and for our communities – access to quality massage therapy delivered from the heart. Our shared commitment to that ideal gives me hope for a bright future for our profession.

Thanks, and hope to see you at an AMTA event soon!

Government Relations – what does that even mean?  Our state has had a busy year with regard to politics, policy and things that directly affect our practice of massage, license renewal and challenges with Insurance billing.

Oregon is one of only a few states to have written into statute (State Law) that LMT’s are considered Healthcare Providers.  What that means is we, LMT’s are legally allowed to perform massage (within Scope of Practice) and bill insurance companies for reimbursement. AMTA OR will continue to work to safeguard this right.

One battle we have been fighting is with the OBCE (Oregon Board of Chiropractic Examiners) over the current board policy revisions regarding what CA’s (Chiropractic Assistants) can do as part of their job.  Here are some major concerns we have:

LMT’s have a practice act.  This act sets the guidelines for who can legally practice massage therapy and how that is defined.  The chiropractic board has had an interesting interpretation of this and in the past few years have pushed the blurred line of that definition to allow Chiropractic Assistants (CAs) to perform massage therapy techniques and bill for Insurance reimbursement.

Our concern has been that CAs require very little training (12 hours) and can practice under minimal supervision (the chiropractor does not need to be in the room, just in the building). Unfortunately, this year, the board, has decided to increase the role of the CAs to include advanced massage techniques such as myofascial release.

The most recent work the GR committee has been involved with is with our own board (OBMT) and proposed changes to the Rules regarding renewal of licensure and the CE’s program.  Back last Spring, the board proposed changes to the CE requirements on recommendation from the FSMTB (Federation of State Massage Therapy Boards).  The reasoning for these proposed changes was unclear and AMTA OR as a whole opposed these changes.  In our statute it mandates for 6 hours each year in CE for license renewal or 12 hours biannually.  In the past, the board ruled to match the 25 hours NCTMB required for their Board Certification and we have had that rule/policy in place for a number of years.

The current board chair, Jon Grossart, has stated that due to a Supreme Court decision regarding the Dentistry Board of North Carolina, (https://en.m.wikipedia.org/wiki/North_Carolina_State_Board_of_Dental_Examiners_v._FTC) that our Independent Massage Therapy Board should only be tasked with policy regarding Public Safety and Minimal Competency for Licensure.

Proposed changes included slashing the hours required and eliminating significant categories currently accepted (including hands on technique classes)

AMTA and ABMP collaborated on a survey to find out how Oregon LMT’s felt about these changes. (Thanks to everyone who participated – we had over 800 responses!)

At the OBMT meeting on September 17th, we had over 25 LMT’s attend (might be a record) and voice their opposition to these changes.

A few takeaways…

The OBMT members are responsive to our voices when we take the time to speak out. Please consider being more involved in the discussions that affect our profession. Submit written comments on issues you care about and attend board meetings when possible.

Keep up-to-date by reading the OBMT newsletter “The Boarderline” – https://www.oregon.gov/OBMT/Pages/publications.aspx and the OBMT Board Meeting Minutes – https://www.oregon.gov/OBMT/Pages/minutes.aspx. The minutes from this past meeting should be posted within the next week.

The next draft of CE rule changes will be presented at the next board meeting, November 5, 2018 in Salem at the OBMT Office. We hope to have another good turnout!

We will continue to keep you informed on Facebook, in future newsletters, and with occasional emails posted via Constant Contact.

AMTA-OR Lobbyist Report:

Election Update

The House is currently 35 Democrats and 25 Republicans. The Senate is 17-13. Current thoughts (and bets) are on Democrats garnering more seats in the upcoming election and securing a super majority in both bodes, making passage of new taxes much easier. Registration in Oregon has shifted to a majority of “non-affiliated” voters with statewide numbers showing 36% Democrat, 26% Republican and 38% “other”.

In coming months, Oregonians will see contentious campaigns for the legislature as well as for the Governorship which some polls show in a tie between Kate Brown and Knute Buehler. Much of the political posturing will use the federal political chaos as a spring board to take advantage of both fears and frustrations that will likely be evidenced as election results come in. Ballot measures will reflect the angst of citizens as well with bonding, three-fifths vote requirements in legislature for fees & taxes, for affordable housing, sanctuary state/city status, grocery taxes, and abortion being debated.

Quarterly Legislative Committee Days

Legislative Committees will take place September 24-27 and the full Senate will convene to consider Gubernatorial nominations for various state boards and commissions. As agendas for committee are developed, we watch for issues that may be of interest to AMTA-OR members. So far nothing impactful to our profession, but a couple issues of that may be of interest:

Senate Health Care Committee

9/25/2018

Report from the Task Force on Health Care Cost Review

Regional Health Equity Coalitions in Oregon

House Health Care Committee

Report from OHA on Public Health Modernization 2019 and Beyond

Task Force on Health Care Cost Review

In Senate confirmations, Meng Chen will be considered for reappointment to the State Board of Massage Therapists.

You can always tune into a hearing or House/Senate floor session by going to www.oregonlegsialture.gov, scroll down to “Today’s Events at the Capitol” and simply selecting the committee you want to hear and clicking on room.

 Health Care Legislation Work Group

AMTA-OR has been working with other health professionals on Utilization Management Reform legislation.

The health care delivery system continues to transform, creating opportunities for collaborative partnerships and providing improved tools for patients to make better informed decisions. Unfortunately, the cost of health care has steadily increased and as payers and pharmacy benefit managers take more active roles in the transformation, programs have been introduced that focus on cost containment and quality assurance, which often result in higher levels of administrative burden.

Utilization Management programs, such as prior authorization (PA) and step therapy, can create significant barriers to quality patient care – delaying treatment or contributing to negative patient outcomes. The work group seeks to address these issues to ensure that if commercial or state payers employ such cost-containment programs, the process be transparent, efficient, and fair.

Convention Recaps:

This year National Convention held many firsts for me. My first time on the East Coast, my first time attending the convention as a Chapter Volunteer, and my first time attending CVOP. To be honest I was a little nervous and overwhelmed, not knowing what to expect. After touching down in D.C. I made my way to the convention hotel, where I was to meet my roommate and fellow “CVOPer,” Britney Von Trap. After grabbing a bite to eat, at one of the fabulous restaurants near the hotel, I prepared for my first day at CVOP and turned in for the night.

The next morning, I attended CVOP and was graced by the presence of Chapter Volunteers from around the country, rookies and pros. During CVOP, we had some amazing speakers and activities designed to help us get acquainted with each other. Later we broke into groups and learned about communication and how we can better understand and work with different personalities within our chapters and the organization as a whole. Overall, what I took away from CVOP is every one has their niche in the AMTA community and with the right type of communication and understanding we can have a well run chapter that can meet the needs of our members.

After CVOP was finished, I attended a few of the amazing classes that AMTA offered. I was particularly impressed by the wide range of classes offered and the caliber of many of the instructors. In addition to the classes the expo hall was fantastic! The vendors were well organized and ready to demo their products. The only pitfall to the expo was I didn’t bring enough luggage to carry all the new products that I purchased.

By the end of the convention my nervousness had subsided and I was overjoyed by my experience. Not only did I become closer with my own Chapter but members from all over the country. I gained a valuable experience and some wonderful contacts, massage therapist come from all walks of life and each and every one has wisdom, experience, and a story to share! Thank you to all of our members who make the convention possible, AMTA and our Chapter couldn’t do this without your support.

-Amie

This being my first year attending AMTA’s national convention I wasn’t so sure what to expect and frankly, I was a little nervous to meet so many new people. However, those nerves also filled me with excitement. In my mind I was going to fly to Washington D.C., attend a Chapter Volunteer Orientation Program (CVOP), take a few continuing education courses, go to a dinner dance at the end of it all, and have fun bonding with my fellow board members. Having said that, I was able to cross all of the above off my list and so much more.

Attending CVOP allowed me to connect with other AMTA volunteers that I normally would never have had the chance to converse with. And the best part, we were all from different state chapters – this made for a great ice breaker! These volunteers ranged from board members to fellow committee chairs, chapter delegates, and even board members at the national level. We were given meaningful tools to help us better communicate within our chapters and learn how to work stronger as a team. We learned new ways to find useful information and exchange information amongst other state chapters, and how to stay up to date with the happenings at the national level. But most importantly, we made friends and created new contacts that we can look forward to seeing at the next convention or that we can call if we want to bounce ideas off someone new.

After we wrapped up CVOP our CE courses commenced! I enjoyed all of the CE’s I attended, especially James Waslaski’s – Orthopedic Massage for Complicated Shoulder Conditions, partly because it was a hands-on course, but I also found his approach to assessment and treatment valuable and one that has already proven successful within my own practice. Relevant and worthwhile CE’s are important to me and I was not at all let down by the variety we were able to pick from this year.

Everything considered, I would say my first national convention is one for the books. And if anyone reading this decides to go to national convention next year, do not miss the dinner dance. And if you do attend the dance, please find me if Bohemian Rhapsody starts to play.

-Britney

My adventure to the AMTA National Convention in Washington D.C. was interesting, as this is my second year being a Delegate for AMTA. I notice the difference between the House of Delegates (HOD) and Assembly of Delegates (AOD). This year, I felt that the flow of conversation on the topics were smoother. Even with the preparation for this new year for the AOD it seems to me there was a much clarifying of what the delegates do and not do at the AOD Assembly. The primary topics that were covered was the position statements (PS) for “Massage for Osteoarthritis of the Knee” and “Massage and Integrated Healthcare. Plus there was a short mention about “Workplace Safety”and “Human Trafficking and the Massage Therapy Profession”. The platform of discussion and the use of mediators to accelerate the process seemed to me a very effective way to proceed the flow of the conversation and topic. Even when at midpoint of the assembly we had to swap tables, which allowed myself to meet more delegates from other states and exchange ideas from one another. Even though the AOD is not putting out the final part of the position statements, I believe as a collective we can steer how the position statement is going to appear. Since this is the first time for this situation only time will tell. I like the concept of being able to follow in the delegates forum on the AMTA Hub, on the website after the convention. I am personally looking forward to see the positive results for this method.

The convention was well organized and very enjoyable, from the opening ceremony to the closing ceremony. Washington DC was very interesting place to visit also many things to see, but the biggest enjoyment was experiencing the people from other states exchanging thoughts and ideas that all are in the massage industry. It’s a memory that I will not soon forget.

-Lowell