Monday, July 29, 2013



A model act is a draft of suggested occupational licensing  that is written with the intention of providing an example for legislation. A special interest group, a lawyers' conference, or a government agency may draft a model act. The goal is that the model act will be passed into law by local, state, or federal governments.
For Massage the Federation of State Massage Boards is creating the model practice act.

There are a couple of organizations that help  create model practice act legislation.

The National Conference of Commissioners on Uniform State Laws (NCCUSL) works to propose model act legislation in the United States. The NCCUSL is a group of attorneys appointed by states who write model legislation for states, focusing on areas of statutory law. The model legislation provided by this organization strives to be non-partisan.

The American Legislative Exchange Council (ALEC) is another organization known for writing model legislation. ALEC is conservative and has both private members and state legislators as members. At its three annual meetings, ALEC’s members vote on proposed model legislation. From there, the model legislation goes to the organization's board of directors. If the board approves it, the draft becomes an official model bill.

I do not know if the Federation of state massage boards  is using such a group but it would seem to be a good idea.

Model licensure for massage therapy is is a good concept. The massage community needs to be active in the development.  The most current aspect of the development of a model practice act is the Entry Level Analysis Project.  The Federation of State Massage Boards actually has a task force about ELAP which interests me. I thought the ELAP idea came from the Leadership group of the massage professional organizations.  I tried to find out more information about the Federation task force but it was not available at least to my searches.  A main goal of the ELAP is to inform the Federation for the development of the Model Practice Act for massage which seems to be the end result of the endeavor. A model practice act will define massage, set educational standards, set forth scope of practice and be the platform of standards of practice.  My educated guess is that many in the massage there community do not understand the process or ramifications of this project.

I searched around and found the procedures and information for the development Emergency Medical Services (EMS). The pathway is very similar to massage therapy so instead of reinventing the wheel I suggest the massage community learn from them.  HERE IS SOME GENERAL INFORMATION.  I ENCOURAGE YOU TO CLICK THE LINKS AND READ THE DOCUMENTS. NOTE: CAPS INDICATE MY THOUGHTS.

The National EMS Scope of Practice Model defines and describes four levels of EMS licensure: Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced EMT (AEMT), and Paramedic. Each level represents a unique role, set of skills, and knowledge base. National EMS Education Standards will be developed for each level. When used in conjunction with the National EMS Core Content, National EMS Certification, and National EMS Education Program Accreditation, the National EMS Scope of Practice Model and the National EMS Education Standards create a strong and interdependent system that will provide the foundation to assure the competency of out-of-hospital emergency medical personnel throughout the United States.

I AM NOT SUGGESTING A TIERED SYSTEM FOR MASSAGE BUT I AM NOT DISCOURAGING IT EITHER. IT COULD WORK.  Following is a link to the information and I suggest you read it keeping massage therapy in mind.

National EMS Scope of Practice Model

Here are some clips from the document. See if this does not sound like massage therapy. Remember the document is for EMS ok.

“identify 39 different licensure levels between the EMT

and Paramedic levels. This patchwork of EMS personnel certifications has created

considerable problems, including but not limited to:

• public confusion;

• reciprocity challenges;

• limited professional mobility; and

• decreased efficiency due to duplication of effort. “


“The National EMS Scope of Practice Model supports a system of licensure common in

other allied health professions. Such a system offers the following benefits:

• establishes national standards for the minimum psychomotor skills and

knowledge for EMS personnel;

• improves consistency among States’ scopes of practice;

• facilitates reciprocity;

• improves professional mobility;

• promotes consistency of EMS personnel titles; and

• improves the name recognition and public understanding of EMS personnel.

The licensure of EMS personnel, like that of other health care licensure systems, is part of an integrated and comprehensive system to improve patient care and safety and to protect the public. The challenge facing the EMS community is to develop a system that establishes national standards for personnel licensure and their minimum competencies while remaining flexible enough to meet the unique needs of State and local jurisdictions. This document recognizes the need for “freedom within limits.” ( I LIKE THIS)


“In 1993, the National Registry of EMTs (NREMT) released the National Emergency

Medical Services Education and Practice Blueprint. The Blueprint defined an EMS

educational and training system that would provide both the flexibility and structure

needed to guide the development of national standard training curricula and guide the

issuance of licensure and certification by the individual States.”




As a relatively young discipline, EMS has a limited research base which makes it

difficult to make evidence-based decisions; however, this project was guided by research

whenever possible. The development process used the National EMS Core Content,

State EMS office and medical director surveys, the National EMS Practice Analysis, the

National EMS Information System (NEMSIS) pilot project data, the Longitudinal EMT

Attributes and Demographics Study (LEADS), and peer-reviewed literature where



The Scope of Practice Model was also influenced by extensive literature review of other

professions, systematic analysis of policy documents regarding health care licensing and

patient safety, presentations by other allied health credentialing bodies, and crossprofessional

and international comparative analysis.


Statistical analysis and research on patient safety, scope of practice, and EMS personnel

competency must become a priority among the leadership of national associations,

Federal agencies, and research institutions. When EMS data collection, subsequent

analysis, and scientific conclusions are published and replicated, later versions of the

National EMS Scope of Practice Model should be driven by those findings.


I THINK THE ELAP PROJECT IS KIND OF TRY TO DO THIS BUT I WONDER WHY CURRENT MASSAGE LEGISLATION WAS NOT INCLUDED AS PART OF THE DATA.  ALSO I HOPE THAT  WE ALSO DO - extensive literature review of other professions, systematic analysis of policy documents regarding health care licensing and patient safety, presentations by other allied health credentialing bodies, and cross professional and international comparative analysis.


The National EMS Education Standards are not a stand-alone document. EMS education

programs will incorporate each element of the education system proposed in the Education

Agenda. These elements include:

• National EMS Core Content

• National EMS Scope of Practice

• National EMS Education Standards

• National EMS Certification

• National EMS Program Accreditation

This integrated system is essential to achieving the goals of program efficiency, consistency of

instructional quality, and student competence as outlined in the Education Agenda.

For the purpose of this model, one licensure level is substantially different from other

licensure levels in:

• Skills

• Practice environment

• Knowledge

• Qualifications

• Services provided

• Risk

• Level of supervisory responsibility

• Amount of autonomy

• Judgment/critical thinking/decision


The National EMS Education Standards comprise four components :

1. Competency - This statement represents the minimum competency required for entry-level personnel at each licensure level.

2. Knowledge Required to Achieve Competency - This represents an elaboration of the knowledge within each competency (when appropriate) that entry-level personnel would need to master in order to achieve competency.

3. Clinical Behaviors/Judgments  - This section describes the clinical behaviors and judgments essential for entry-level EMS personnel at each licensure level.

4. Educational Infrastructure  - This section describes the support standards necessary for conducting EMS training programs at each licensure level.


Course Length

Course length is based on competency, not hours

Course material can be delivered in multiple formats including but not limited to:

Independent student preparation

Synchronous/Asynchronous distributive education

Face-to-face instruction

Pre- or co-requisites



At the EMT-Basic level, training includes instruction in assessing patients' conditions, dealing with trauma and cardiac emergencies, clearing obstructed airways, using field equipment, and handling emergencies. Formal courses include about 100 hours of specialized training. Some training may be required in a hospital or ambulance setting. The EMT-Intermediate 1985 or EMT-Intermediate 1999 level, also known as the Advanced EMT level, typically requires 1,000 hours of training based on the scope of practice. At this level, people must complete the training required at the EMT level, as well as more advanced training, such as training in the use of complex airway devices, intravenous fluids, and some medications. Paramedics have the most advanced level of training. They must complete EMT-level and Advanced EMT training, as well as training in advanced medical skills. Community colleges and technical schools may offer this training, in which graduates may receive an associate's degree. Paramedic programs require about 1,300 hours of training and may take up to 2 years. Their broader scope of practice may include stitching wounds or administering IV medications.


So what does this mean for us right now?  Here is my take on it.


Model legislation will define who we are and what we do (scope of practice) . 

Model legislation will direct educational content and delivery

ELAP was meant to inform development of model legislation

We need to organize our definition of massage, our competencies, our body of knowledge and our core educational content into a unified statement.

The EMS model gives us an idea about how other occupations did these things.
Vocational education is appropriate for entry level massage practice based on clock hours.
Based on EMS scope of practice example the 500-600 model for entry level massage education may be more accurate than we think.
We should be using “outside of the massage community” experts to help us do this.  

WE NEED TO BE INFORMED !!!!!!!!!!!!!!!!!!!!!!!!!!!






1 comment:

  1. I know how to do first aid during injuries. But I cannot deny that I have learned a lot with regards to EMS after visiting the link you have provided in order for someone like me to know more which is beyond my knowledge. Just like what I learned after being in physio nedlands.