1-1  By:  Madla                                             S.B. No. 873
    1-2        (In the Senate - Filed March 11, 1993; March 15, 1993, read
    1-3  first time and referred to Committee on Health and Human Services;
    1-4  April 1, 1993, reported adversely, with favorable Committee
    1-5  Substitute by the following vote:  Yeas 9, Nays 0; April 1, 1993,
    1-6  sent to printer.)
    1-7                            COMMITTEE VOTE
    1-8                          Yea     Nay      PNV      Absent 
    1-9        Zaffirini          x                               
   1-10        Ellis              x                               
   1-11        Madla              x                               
   1-12        Moncrief           x                               
   1-13        Nelson             x                               
   1-14        Patterson          x                               
   1-15        Shelley            x                               
   1-16        Truan              x                               
   1-17        Wentworth          x                               
   1-18  COMMITTEE SUBSTITUTE FOR S.B. No. 873                    By:  Madla
   1-19                         A BILL TO BE ENTITLED
   1-20                                AN ACT
   1-21  relating to the regulation of massage therapy.
   1-22        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
   1-23        SECTION 1.  Section 1, Chapter 752, Acts of the 69th
   1-24  Legislature, Regular Session, 1985 (Article 4512k, Vernon's Texas
   1-25  Civil Statutes), is amended by amending Subdivisions (1), (2), (3),
   1-26  and (10) and adding Subdivisions (15) and (16) to read as follows:
   1-27              (1)  "Massage therapy" means the manipulation of soft
   1-28  tissue. The term includes, but is not limited to, effleurage
   1-29  (gliding strokes) <(stroking)>, petrissage (kneading), tapotement
   1-30  (percussion), compression, vibration, superficial and deep
   1-31  friction, nerve strokes, superficial warming techniques, jostling,
   1-32  rocking, shaking, and Swedish gymnastics, either by hand or with
   1-33  mechanical or electrical apparatus for the purpose of body massage.
   1-34  Massage therapy may include the use of oil<, salt glows, heat
   1-35  lamps, hot> and hydrotherapy <cold packs, tub, shower, or cabinet
   1-36  baths>.  Equivalent terms for massage therapy are massage,
   1-37  therapeutic massage, massage technology, myo-therapy, body massage,
   1-38  body rub, or any derivation of those terms. Massage therapy is a
   1-39  health care service when the massage therapy is for therapeutic
   1-40  purposes.  As used in the Act, the terms "therapy" and
   1-41  "therapeutic" do not include diagnosis, the treatment of illness or
   1-42  disease, or any service or procedure for which a license to
   1-43  practice medicine, chiropractic, physical therapy, or podiatry is
   1-44  required by law.  Massage therapy does not constitute the practice
   1-45  of chiropractic.
   1-46              (2)  "Massage therapist" means an individual who
   1-47  practices or administers massage therapy to a client <patron> of
   1-48  either gender for compensation.  The term includes a registered
   1-49  massage therapist, therapeutic massage practitioner, massage
   1-50  technician, masseur, masseuse, myo-therapist, body worker, body
   1-51  massager, <body rubber,> or any derivation of those titles.
   1-52              (3)  "School-based massage <Massage> therapy
   1-53  instructor" means an individual who is a registered massage
   1-54  therapist, who is instructing one or more students in the soft
   1-55  tissue manipulation section of the course of instruction required
   1-56  for registration as a massage therapist <therapy>, and whose
   1-57  instruction is approved by the department.  A school-based massage
   1-58  therapy instructor may also teach other courses the instructor is
   1-59  qualified to teach.
   1-60              (10)  "Instructor" means an individual who instructs
   1-61  one or more students in any section of the course of instruction
   1-62  required for registration as a massage therapist other than the
   1-63  soft tissue manipulation section of the course of instruction.
   1-64              (15)  "Independent massage therapy instructor" means an
   1-65  individual who is a registered massage therapist, who is not
   1-66  associated with a massage school, and who is the sole instructor of
   1-67  the course of instruction required for registration as a massage
   1-68  therapist under this Act.
    2-1              (16)  "Advanced study" means the concentrated study of
    2-2  any area of coursework listed in Section 2(b)(1)(A) of this Act or
    2-3  of hydrotherapy.
    2-4        SECTION 2.  Section 2, Chapter 752, Acts of the 69th
    2-5  Legislature, Regular Session, 1985 (Article 4512k, Vernon's Texas
    2-6  Civil Statutes), is amended by amending Subsections (b) and (c) and
    2-7  adding Subsection (d) to read as follows:
    2-8        (b)  An individual who registers as a massage therapist under
    2-9  this Act must present evidence satisfactory to the board that the
   2-10  person:
   2-11              (1)  has satisfactorily completed massage therapy
   2-12  studies in:
   2-13                    (A)  a 575-hour, supervised course of instruction
   2-14  in which the person enrolled after December 31, 1996, provided by
   2-15  an independent massage therapy instructor, by a massage school
   2-16  registered by the department, by a state-approved educational
   2-17  institution, or by any combination of instructors or schools in
   2-18  which 125 hours are dedicated to the study of anatomy, physiology,
   2-19  and kinesiology; 175 hours to the study of soft tissue
   2-20  manipulation; 50 hours to the study of business practices,
   2-21  professionalism, and ethics; 30 hours to the study of health,
   2-22  hygiene, cardiopulmonary resuscitation, and first aid; 25 hours to
   2-23  the study of pathology and contraindications; 20 hours to the study
   2-24  of history, legal issues, and the rules of the board; 75 hours to
   2-25  an internship program; and 75 hours of advanced study to be
   2-26  determined by the school or independent massage therapy instructor;
   2-27  or
   2-28                    (B)  a 300-hour, supervised course of instruction
   2-29  in which the person enrolled before January 1, 1997, provided by an
   2-30  independent <a> massage therapy instructor, by a massage school
   2-31  registered by the department, by a state-approved educational
   2-32  institution, or by any combination of instructors or schools, in
   2-33  which 125 hours are dedicated to the study of soft tissue
   2-34  manipulation <Swedish massage therapy techniques> taught by a
   2-35  massage therapy instructor, 50 hours to the study of anatomy, 25
   2-36  hours to the study of physiology, 15 hours to the study of
   2-37  hydrotherapy, 15 hours to the study of business practices and
   2-38  professional ethics standards, 20 hours to the study of health and
   2-39  hygiene, and 50 hours to an internship program;
   2-40              (2)  is registered as a massage therapist in another
   2-41  state or country that has and maintains standards and requirements
   2-42  of practice and licensing or registration that substantially
   2-43  conform to those of this state, as determined by the department;
   2-44  <or>
   2-45              (3)  has practiced massage therapy as a profession for
   2-46  not less than five years in another state or country that does not
   2-47  have or maintain standards and requirements of practice and
   2-48  licensing or registration that substantially conform to those of
   2-49  this state, as determined by the department; or
   2-50              (4)  has satisfactorily completed a training program in
   2-51  soft tissue manipulation by a school regulated by a state or
   2-52  national regulating or accrediting body that maintains standards
   2-53  and requirements that substantially conform to those of this state,
   2-54  as determined by the department.
   2-55        (c)  A student in a state-approved course of instruction that
   2-56  consists of a minimum of 600 <300> hours is exempt from
   2-57  registration under this Act if the student provides massage therapy
   2-58  as part of an internship program or for no compensation.
   2-59        (d)  Beginning on September 1, 1994, a massage therapist must
   2-60  provide proof to the department, at a time required by rules
   2-61  adopted under this Act, that during the registration period about
   2-62  to expire the registration holder has completed 12 hours of
   2-63  classroom instruction recognized by the department and designed to
   2-64  enhance the registration holder's career.
   2-65        SECTION 3.  Subsection (f), Section 2A, Chapter 752, Acts of
   2-66  the 69th Legislature, Regular Session, 1985 (Article 4512k,
   2-67  Vernon's Texas Civil Statutes), is amended to read as follows:
   2-68        (f)  A student who is participating in an internship program
   2-69  may:
   2-70              (1)  practice marketing skills;
    3-1              (2)  make an appointment with an internship <a> client;
    3-2              (3) <(2)>  interview a client;
    3-3              (4) <(3)>  perform massage therapy;
    3-4              (5) <(4)>  collect and review a client evaluation with
    3-5  the student's supervisor; and
    3-6              (6) <(5)>  perform other tasks necessary to the
    3-7  business of providing massage therapy to the public.
    3-8        SECTION 4.  (a)  Except as provided by Subsection (b) of this
    3-9  section, this Act takes effect September 1, 1993, and applies only
   3-10  to the holder of a registration certificate issued or renewed after
   3-11  that date.  The holder of a registration certificate issued or
   3-12  renewed before the effective date of this Act is governed by the
   3-13  law in effect at the time the registration certificate was issued
   3-14  or renewed, and the former law is continued in effect for that
   3-15  purpose.
   3-16        (b)  The additional 275 hours of massage therapy studies
   3-17  required for registration under Paragraph (A), Subdivision (1),
   3-18  Subsection (b), Section 2, Chapter 752, Acts of the 69th
   3-19  Legislature, Regular Session, 1985 (Article 4512k, Vernon's Texas
   3-20  Civil Statutes), as added by this Act, applies only to a student
   3-21  who enrolls in a course of instruction in massage therapy after
   3-22  December 31, 1996.
   3-23        SECTION 5.  In the event that both H.B. No. 1259 or S.B. No.
   3-24  704 and this Act are enacted during the 73rd Legislature, Regular
   3-25  Session, 1993, the Texas Department of Health and the Central
   3-26  Education Agency shall enter into an interagency agreement to
   3-27  coordinate the transition and administration of those Acts.
   3-28        SECTION 6.  The importance of this legislation and the
   3-29  crowded condition of the calendars in both houses create an
   3-30  emergency and an imperative public necessity that the
   3-31  constitutional rule requiring bills to be read on three several
   3-32  days in each house be suspended, and this rule is hereby suspended.
   3-33                               * * * * *
   3-34                                                         Austin,
   3-35  Texas
   3-36                                                         April 1, 1993
   3-37  Hon. Bob Bullock
   3-38  President of the Senate
   3-39  Sir:
   3-40  We, your Committee on Health and Human Services to which was
   3-41  referred S.B. No. 873, have had the same under consideration, and I
   3-42  am instructed to report it back to the Senate with the
   3-43  recommendation that it do not pass, but that the Committee
   3-44  Substitute adopted in lieu thereof do pass and be printed.
   3-45                                                         Zaffirini,
   3-46  Chair
   3-47                               * * * * *
   3-48                               WITNESSES
   3-49                                                  FOR   AGAINST  ON
   3-50  ___________________________________________________________________
   3-51  Name:  Constance Jakubcin                                x
   3-52  Representing:  Austin School of Massage
   3-53      Thera
   3-54  City:  Austin
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   3-56  Name:  Ronald Clark                                      x
   3-57  Representing:  Massage Educators
   3-58  City:  Austin
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   3-60  Name:  Terry Boucher                             x
   3-61  Representing:  Tx Osteopathic Medical Asso.
   3-62  City:  Fort Worth
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   3-64                                                  FOR   AGAINST  ON
   3-65  ___________________________________________________________________
   3-66  Name:  David Lauterstein                         x
   3-67  Representing:  Lauterstein-Conway Massage
   3-68  City:  Austin
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   3-70  Name:  Kay Hayden                                x
    4-1  Representing:  American Massage Therapy
    4-2  City:  Austin
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