This post was updated on 3/11/22.  Click on the link for "WSMTA--Masking for LMTs Starting 031222" for new information.

Over the past several weeks, Governor Inslee has announced changes to his August 23, 2021 mask mandate.  However, for healthcare providers, there will be no change for us regarding masking.  Masking for healthcare is still required in our treatment rooms or clinics.  Please click on the following link for a one page summary of what the new masking requirements entail and how this applies to massage therapists.  Should you still have questions, at the bottom of the document is the contact information for the L&I contact person to follow up with.

WSMTA--Masking for LMTs Starting 031222

For a sign that can be posted in your massage room or clinic, please click on the following link:

Sign -- Face Masks Still Required

Remembering Deborah Senn:

Washington’s massage therapy community lost a great friend and supporter with the passing of former Washington State Insurance Commissioner Deborah Senn. A true champion of integrative and consumer-focused health care, Commissioner Senn introduced the "every category of provider" provision to Washington State Insurance Law in the 1990s which granted significant recognition and protection to massage therapists in this state. This provision not only paved the way for inclusion of massage therapists within private and state-run insurance plans, but it also provided the framework used by the federal government in the drafting of the "every category of provider" clause within the Affordable Care Act in 2010.

As a consummate consumer advocate, she transformed the Office of the Insurance Commissioner from insurance company-friendly to a consumer-centric one when she won her first term in 1992, becoming the first woman to serve in that statewide elected position.

She died at Swedish Medical Center on February 18 from complications related to pancreatic cancer. Senn is survived by her husband, Rudi Bertschi, as well as a brother and a sister.

1.      Is Temperature Taking Still Required?

Here is the history and the current guidelines for healthcare providers in a healthcare setting:

The requirement for taking temperatures was originally mandated for all healthcare providers in healthcare settings (includes massage regardless of where it is done) on 5/18/20 by the governor in Proclamation 20-24.1 Reducing Restrictions on, and Safe Expansion of, Non-Urgent Medical and Dental Procedures: https://www.governor.wa.gov/sites/default/files/proclamations/20-24.1%20-%20COVID-19%20Non-Urgent%20Medical%20Procedures%20Ext%20%28tmp%29.pdf

In this proclamation, it is specifically required in the 5th bullet from the bottom on page 4:

Use on-site fever screening and self-reporting of COVID-19 symptom screening for all patients, visitors and staff prior to (the preferred approach), or immediately upon, entering a facility or practice.

On 11/25/20 the governor updated this proclamation to 20-24.2 Requirements for Non-Urgent Medical and Dental Procedures which you can read at: https://www.governor.wa.gov/sites/default/files/proclamations/proc_20-24.2.pdf.  This proclamation is still in effect.

Unlike proclamation 20-24.1, 20-24.2 does not specifically call out temperature taking.  Instead, it states at the bottom of page 4:

Follow CDC Guidance on Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, including any subsequent amendments, for COVID-19 symptom screening for all patients, visitors, contractors, volunteers, and staff prior to, or immediately upon, entering a facility or practice.

Temperature taking is a part of COVID-19 symptom screening for all patients, but it's no longer specifically called out, to include on the CDC website.  So either you would need to know that your clients are taking their own temperatures and are truthfully stating that they do or do not have a fever, or you would need to take it as it's the only measurable sign/symptom.

2.      Can Clients Take Their Masks Off When Receiving Massage?

As of 12/8/21 when this article was published, the answer is still no, neither the massage therapist or the client can take off their mask when a massage is being provided unless they qualify for an exemption that is listed in the Secretary of Health’s exemptions which is found in his Order 20-3.6 on mask wearing.

The current mandate requiring mask wearing is the Governor’s Proclamation 20-25.15 which went into effect on 8/23/21.  You can find this at: https://www.governor.wa.gov/sites/default/files/proclamations/20-25.15%20-%20COVID-19%20Washington%20Ready.pdf

The Secretary of Health’s order on masks 20-03.6 can be found at: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/Secretary_of_Health_Order_20-03_Statewide_Face_Coverings.pdf

WAC 246-830-475 Continuing Education Requirements states:

1) To renew a license, a massage therapist must complete twenty-four hours of continuing education every two years, as provided in chapter 246-12 WAC, Part 7. Continuing education must be provided by an individual who has at least three years of professional experience in the subject area being taught. Massage therapists have a duty to ensure the continuing education they complete meets the requirements in this section.

There are many changes to the massage CE WAC.  We've blogged about CPR and changes to CE certificate requirements.  However, there are two important changes that are more subtle, I've highlighted them in the above WAC language.

The yellow section indicates that the instructor has to have "...at least three years of professional experience in the subject area being taught".  Prior to the WAC update on 9/1/21, anyone could have taught anything with or without the experience to do so.  Now, there is an experience requirement that CE teachers need to meet.  This means that if you travel to another state, take a class from an out-of-state instructor or take a class from a local instructor you need to make sure that they have the experience to be eligible to give CE credit for you to take their class to have it count in Washington State for license renewal.  The three year's experience requirement does not mean that a CE instructor has to have taught the subject matter for three years, but that they must have learned the material and be experienced in it for three years worth of time.  If someone only has one or two years experience in a subject, it does not mean that you can't take their class to learn the material, it just means that you can't use the class to count as part of your CE hours to renew your Washington State massage license.

The blue section indicates that it is every LMT's responsibility to make sure that the CE they take meets the state CE requirements.  This means knowing if your instructor has appropriate experience (check their website or contact them if you can't exactly determine if they do or not), that you've met the correct CE categories and hours and that the certificates that you receive have all of the information required on them to be acceptable.

Before making a decision to do something different with your massage license (letting it expire, putting it into inactive status, etc) you should contact the Department of Health at 360-236-4700 to find out what you need to do.

If you are thinking about taking time off from doing massage and your renewal is coming up, you can put your license into inactive status instead of just letting it expire.  At the time of your renewal, instead of renewing at the $166 rate (current renewal fee at the time of this posting), you would renew at $66 (current inactive license renewal fee) to maintain an inactive license. 

If you continue to stay inactive over several years, you only pay the reduced inactive renewal fee at each renewal point.

If you want to renew your license at some point after going inactive, you can reactive your license by contacting the Department of Health, satisfying any CE requirements and paying the difference of $166 (or whatever the current renewal fee is) and $66 (or whatever the last inactive renewal fee that you paid was)  --- that is, you don't need to pay the full renewal fee, just the difference between the two fees.

This email is directly copied from an email sent from the Department of Health on 8/20/21.

The state personal protective equipment (PPE) stockpile (referred to as “the backstop”) has been available to help support state agencies, counties, tribes and other partners through the COVID-19 pandemic.

The state backstop will be available to meet COVID-19 PPE requests through Oct. 31, 2021. Now is the time to submit requests for PPE through your county emergency managers.

State, local, and tribal agencies, partner associations, health care providers, including long-term services and supports providers (e.g. adult family homes, supported living agencies, home care agencies, assisted living facilities and skilled nursing facilities), and businesses are encouraged to order PPE to return state backstops to pre-COVID levels and allow entities to utilize existing available PPE before it expires.

After Oct. 31, availability of PPE from the state backstop and the process for ordering will change. These future processes are currently under development and will be communicated to partners broadly.

How to Order:

1. Contact your local county emergency management agency to determine how orders should be placed with them; they are able to answer questions about the forms and ordering process.
2. Complete the forms/process provided from the local emergency management.
3. If local emergency management is able to fill this request from their supply, they will let you know how that process will be completed.
4. If local emergency management is not able to fill this request, they will send the request to the state for fulfillment.

For more information, please visit the Department of Health PPE website.

Washington State Department of Health 2022 Draft Legislative Agenda

The Department of Health (DOH) recently released the draft of their legislative requests for 2022. In this first document (power point) you can see the types of requests that are being proposed and from where within the state budget the dollars would come from. 

Department of Health_2022 Webinar 8-23_Slides.pdf

In this next document you can see a brief explanation of each proposed piece of legislation that DOH is moving forward with at this time. There are three items that are likely most interesting to us as massage therapists.

Enhanced Capacity and Diversity of Health Profession Boards and Commissions. 

This proposal modifies boards and commission statutes in order to achieve consistency, allow for more diversity, and increase effectiveness by:

• expanding the size of membership and number of public members; 
• removing the membership restrictions, such as congressional district or specialty requirements;
• increasing compensation so all boards and commissions are reimbursed at a Class 5 rate ($250 a day).
• removing specific quorum requirements for disciplinary actions and aligning terms requirements.

Improve Credentialing Performance. 

This would have the effect of adding staff to the credentialing unit in order to be able to meet the goal of issuing credentials within 7 calendar days of receiving a complete application.

Complete the HELMS Project.

The new Healthcare Enforcement and Licensing System (HELMS) has had some unexpected delays which will increase costs.

Department of Health_2022 Budget and Legislative Requests_August2021_v4.pdf

Marybeth Berney WSMTA President

Compliance with Proclamation 21-14 Vax Washington

 

The Washington Chiropractic Association (WSCA) has been kind enough to allow WSMTA to share with you the compliance tool that they created for complying with Governor Inslee’s Proclamation 21-14. Please make sure to download both pages.

WSCA -- Proclamation_21_14_Compliance_Document.pdf

First some background on the validity of governor Proclamations. The validity and enforceability of governor issued Proclamations has been upheld in the courts many times over many decades. Those court decisions have, in a nutshell, said that states have the right to infringe on individual liberties in some cases and especially in the case of public health matters. There are several Washington healthcare provider associations and unions that have expressed displeasure with the proclamation, as written, to the Governor’s office. But many attorneys have agreed that any type of prospective legal challenge would have zero chance of success as there is no standing to challenge. Once enforcement begins that may provide some type of standing for a legal challenge.

Please read the disclaimer on page 2 carefully as it contains steps that will help you to fill out the forms completely. This disclaimer page applies to WSCA and WSMTA. If you have questions beyond the scope of this article, please consult your attorney.

Who needs to fill out/maintain these documents

• Every employee, contractor, and volunteer performing any kind of work in the facility where healthcare/massage is offered--whether directly interfacing with patients or not--must disclose the information requested in this document.
• If you operate a massage facility and you have MTs that are independent contractors renting space inside your massage facility you, as the healthcare facility operator, must maintain these documents for those contractors.
• If you employ your child/children to clean, do landscape maintenance or anything else at your healthcare facility they must have this document filled out and maintained by you.
• In short anyone who is in your healthcare facility and is under your control needs to fill out this document and you need to maintain it.
• Any new employees, contractors, volunteers that come to work in your healthcare facility on or after Oct 18, 2021, must fill out this document and you need to maintain it.
•  If any of the information/conditions reflected in these documents changes at any time undated documents and supporting documents must be filled out to replace the outdated documents
• If you are self-employed and are vaccinated, you need only have your vaccination record.  If you are self-employed and are filing a medical or religious exemption/accommodation, fill out the form and sign both as the employer and the employee.

How do I need to maintain the compliance document and supporting documents

• This document and all supporting documents need to be maintained by you until the COVID-19 State of Emergency is ended or Proclamation 21-14 is amended or rescinded.
• These documents should be maintained with the same security as healthcare records.
• This document and all supporting documents need to be maintained at your healthcare facility and be readily available to any inspectors from the Department of Health, Labor and Industries, or any law enforcement agency.

Section 1

• If you are self-employed, you will put your name in as employee and employer,

Section 2

• You have 4 choices. If you/your employee, contractor, volunteer check the “fully vaccinated” box, then move to Section 3.
• If you/your employee, contractor, volunteer check “request a medical exemption” then skip to Section 4.
• If you/your employee, contractor, volunteer check “request a religious exemption” then skip to Section 5.
• If you/your employee, contractor, volunteer check “will not comply with the Proclamation” then skip to Section 6. 

Section 3 - only if fully vaccinated

• Fill in the appropriate dates of vaccination, brand of vaccination and what proof of vaccination was received. Keep a copy of the proof of vaccination with this document.

Section 4 - only when requesting medical accommodation

• This section should be filled out by the employee, contractor, or volunteer. Attach supporting documentation from a medical provider with all the information that is indicated on the form.
•  Make sure that the employee, contractor, or volunteer signs and dates this section.

Section 5 - only when requesting religious accommodation

• This section should be filled out by the employee, contractor, or volunteer. Attach supporting documentation that provides all the information that is indicated on the form.
• The religion does not need to be a “named” religion, written documentation from clergy is not required.

Section 6 - only when not complying with the Proclamation

• Make sure that it is understood what the consequences are, have this section signed and dated by the employee, contractor, or volunteer.

Section 7 - to be completed by Employer/healthcare facility operator

• Make sure this section is filled out completely and signed and dated by both parties.

Enforcement

We really will have no idea as to what enforcement is going to look like until it begins to happen. The Washington Department of Labor and Industries (L&I) has the authority to issue fines and shut you down until you come into compliance. The Department of Health has the authority to issue fines and provide other sanctions against your license. Law enforcement has the authority to charge you with a gross misdemeanor. 

The Department of Health has indicated that enforcement will be complaint driven, much like it is with any regulatory issue. Will the Department of Health or Labor and Industries come knocking on your door? We believe this is highly unlikely, but it could happen. Do you have other complaints against you, have you been flagged as a non-complier, then this could be more likely to happen to you. Will law enforcement come knocking on your door? Again, we think this is highly unlikely, but it is possible. If you have all your documentation for yourself, employees, contractors, and volunteers at the ready and you have made a good faith attempt to fully comply with the Proclamation you should be on firm ground from a legal/regulatory perspective.

Miscellaneous

• The Proclamation allows the healthcare facility operator to handle exemptions, in good faith. This means the forms must be completely true and accurate to the best knowledge of those signing the documents.
• When you issue a qualified exemption/accommodation you can impose conditions. For example, if you employ a biller who has requested a religious exemption/accommodation you can have that biller work off-site instead of on-site, or if you have a provider in your facility who is an independent contractor and you have issued a qualified medical exemption/accommodation you could impose the condition of being tested for COVID-19 on a regular basis.
• It is not discrimination to not hire/not contract with someone who is not vaccinated.

We hope that you find this information to be helpful.

Marybeth Berney LMT

WSMTA President

 

As I've mentioned in a prior GR blog, CPR is required for anyone renewing their massage license after September 1, 2021. The new requirement states, "Maintenance of certification in American Heart Association CPR or equivalent".

WSMTA has received questions about a) whether the class has to be in-person or not and b) what does equivalent mean?

The Format of the CPR Class:

Like the ethics requirement, the CPR requirement does not call out a specific mode of education which means that you can fulfill the requirement by taking an in-person class, an online class or a hybrid of in-person and online.  If there are other formats for taking CPR, then it would be acceptable as well.

What Does Equivalent Mean?

The American Heart Association’s CPR is based on the resuscitation knowledge of the “International Liaison Committee on Resuscitation”.  The American Red Cross is an equivalent organization and their CPR methods are based on the "International Consensus on Cardiopulmonary Resuscitation".  If you take a CPR class from another organization, find out what their CPR methods are based on.  More than likely you’ll find that it’s based on one of these two sets of guidelines.  If it is, then it will be equivalent.  Often you can find this information on the website’s FAQs page or on the page that talks about their CPR.  If not, then call them.   If it is not based on one of these two organizations’ resuscitation methods then you’ll need to do some homework to determine if it is equivalent or not.

To read our other blog article on CPR, please click on the following link: https://www.mywsmta.org/gr-news/10443398

WSMTA wants to make sure that you have access to reliable information with which you can create an educated and informed response for yourself, your massage business, your family, friends and your community.

By now most of you are likely aware of Proclamation 21-14 COVID-19 Vax Washington. Here is a link to the Proclamation: https://www.governor.wa.gov/sites/default/files/proclamations/21-14%20-%20COVID-19%20Vax%20Washington%20%28tmp%29.pdf 

We encourage you to read the Proclamation in its entirety, paying particular attention to pages 6-7 which reference massage therapists in particular.

Another document that we encourage you to read in its entity is the FAQ that was just recently released by the WA Department of Health. Here is a link to the FAQ: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/505-160-VaccinationRequirementFAQs.pdf

If you receive email notifications directly from DOH you should have seen these documents in your inbox. 

Since there are differing views amongst the WSMTA board as well as many of our members regarding this topic, WSMTA is choosing a neutral stance. We encourage our membership to avoid the temptation to rely on hearsay and false narratives and to do the research for themselves using reliable and science based resources which will empower them to make the best decision for themselves, their business, their families, friends and communities.

WSMTA Government Relations Program