Massage Therapy Licensing: Expert Guidance from the Texas Department of Licensing and Regulation

Transcript

Narrator: 0:01

This podcast is for educational purposes only, does not constitute legal advice and does not create an attorney-client relationship. If you need legal assistance about a legal problem, contact an attorney.

Speaker 2: 0:14

Thanks for joining us on another episode of Know your Regulator, the podcast that inspires you to engage. I’m your host, simone Murphy, and co-hosting with me today is Associate Carrie Bloodsaw. Hey, carrie, we’ve got a great episode lined up. We’re going to be discussing licensing and enforcement for massage therapists in Texas. Joining us for this exclusive chat is the Director of Enforcement, ron Foster, and Heather Muir, director of Licensing, and thank you guys so much for being with us. How are y’all doing?

Speaker 3: 0:48

Doing great. Thank you for inviting me yes, doing well.

Speaker 4: 0:51

Thank you for having me as well. We always enjoy opportunities to talk about our programs and what we do.

Speaker 2: 0:57

So I think we’ll start off kind of at the very beginning, probably when you first come in contact with you know a young hopeful which would be an application. How many applications do you guys see over in your department in? You know a six-month period or a 12-month period, however you, you know, collect that data.

Speaker 4: 1:18

Okay. So the licensing department is responsible for four different license types. We issue student permits, we also license massage therapists and we do massage therapy instructors who teach in the schools and we also license massage establishment. I’m going to talk a little bit about each one of them. So the students we generally get about a little over 4,000 applications a year. About a little over 4,000 applications a year. Massage therapists we get about 16,000 a year and that’s initial and renewal Instructors about 850 a year, and then establishments about 2,000 a year. Generally initial massage therapy applicants about 4,000 a year. Instructors around 170 a year. Establishments a little over a thousand a year and those are initials, and then the rest of that number would be in renewals. So a little over 12,000 renewals for massage therapists, about 650 instructor renewals and then about 950 establishment renewals.

Speaker 2: 2:27

Wow, okay, so you guys are very busy over there in the application department, especially when you’re dealing with right, just not new applications but renewals. And then if you have four categories and for our listeners could you walk them through in your experience the typical application process. We’ll get into some of the intricacies or some issues that could come up, but in general, what could someone anticipate it looking like? The general process?

Speaker 4: 2:59

So at a very high level. To start off with, we receive an application it’s either through the mail or it’s online Then we review it to make sure it meets all of the requirements and then, if we need additional information, we send them a request for information, or RFI for short and if everything is there, we issue the license. And then the license is generated and printed and then it gets mailed out to the applicant. Students are pretty easy process you have to be enrolled in the school. That’s it Very, very quick. When you’re talking about a massage therapy license, there are several ways which they can obtain Texas licensure. First they would be a. They would have gone through a massage school in Texas and once they complete that education, they submit their application. It’s reviewed same process they would take the Texas, the Texas examination and then we send them a At that point a fingerprint request because they have to be fingerprinted. Once they get that information and those instructions, they schedule that and go do that and then that gets sent to enforcement on Ron’s team for review and then, once that’s cleared and they pass the exam, we issue the license. The second is if they’ve completed it at, as at a learning institution, that is probably not a licensed massage school, um, like a community college or through some other method. They have some college courses at a college but also then maybe kind of stitch it together, their education together, to meet those 500 hours. They can take the Imblex, which is an exam that’s offered by the Federation of State Massage Therapy Boards, or they can take the Texas exam. But if they already have their exam scores, they submit that to us with their application and then we also have, if they do take the IMLX, they have to take a jurisprudence exam and that’s a law and rule knowledge for the state of Texas.

Speaker 4: 5:18

And then we also have a lot of applicants that come from other states, in other countries. The addition, the one thing that they have to do, if they’re in another state and they’re licensed in another state, they have to submit us a letter of good standing and licensure from the state that they’re in another state and they’re licensed in another state, they have to submit us a letter of good standing and licensure from the state that they’re licensed in currently. And so out of country kind of gets a little more hairy and technical because they have to go to a credentialing evaluation service and get that evaluated through them and then submit that in with their application, evaluated through them and then submit that in with their application. There are times when maybe that education doesn’t meet our requirements and they have to go back to school and get some additional education. But once everything is received, no matter what pathway they go through, as long as everything is complete, then we issue that license.

Speaker 4: 6:09

Instructors same process. And then establishments massage establishments their owners have to be fingerprinted, so that is an additional step that they have to go through as well. But that’s generally the process that we go through.

Speaker 2: 6:29

Okay, and so it sounds like you know. If somebody’s going to ask well, how long would this process take? Would it be fair to say that it really seems to be placed on the applicant to make sure that they’re getting TDLR everything that y’all are asking for and, however you know, efficient or organized they are in that process, would probably be the number one factor in how slow or their favorite application to process was meaning like what program?

Speaker 4: 6:57

and the employee’s response was a complete application, no matter what program it is. So yes, we definitely want complete applications and overall, we generally will touch an application within two weeks of it coming to us, if it’s online, and process it to the point of completion.

Speaker 4: 7:29

that we can if it’s online and we process it to the point of completion. That we can process it to, that means we have reviewed everything and we either have approved it or send an RFI to the applicant. If it is mailed in, it takes a little bit longer to go through the mail process and then it touches our finance department before it comes to us and then it touches our finance department before it comes to us. So yeah, it depends on the method of submittal and it also depends on the level of completeness for the application.

Speaker 2: 7:59

Okay, so then, looking at some kind of some common challenges, what are some general issues that you see applicants having to kind of deal with during this process?

Speaker 4: 8:13

Yeah, that’s a good question, so we’ve talked about it, we’ve touched on it. They’re not sending all the required documents. They are licensed in another state and they have to submit that document to us saying that they’re free and clear, they’re in good standing in that other state. That kind of is a sticking point. Sometimes Applicants who indicate that they have a criminal history and then they have to complete and submit a criminal history questionnaire that then goes through our enforcement division, ron’s division, for review. That takes an additional, a little bit of additional time in getting all that correct information submitted. Education equivalency for out of state and out of country applicants is another kind of sticking point. Credentialing review done for out of country applicants, out of state applicants.

Speaker 4: 9:12

We have this really nifty tool on our website. You can go and you can from a drop down menu you can select your state that you’re licensed in and it will give you information about what you have to meet based on your licensure in that other state. So it is pretty cool, wow, okay. And fingerprinting state. So it is pretty cool, wow, okay. And fingerprinting Fingerprinting is a process. Federal law stipulates that we cannot have access to their fingerprint records until we have an application. So we have to wait till they apply to supply them with that information and then they have to go do the process. So it’s going to be very rare that we’re able to process something fully to completion because of that requirement.

Speaker 2: 9:55

Okay, and so it sounds like, especially for, like, out of state applicants or or applicants that maybe are uncertain if they meet y’all’s requirements, sounds like the first thing that would be very helpful for them to do would be to go and look at that y’all’s website and really kind of do their own research first, before they go ahead and just submit an application without kind of fully understanding what they may need to do.

Speaker 4: 10:20

Yes, that is correct. We would say read, read, read and then read again. There is one more time of information on the Web page and, even though we encourage online application processing and renewal processing, we do offer a PDF of our application, and the first couple of pages on that application walk through everything that you need to submit, so that is another really good tool for them to use.

Speaker 2: 11:03

Okay, yeah, definitely look at that. Read through that. Don’t skip those first pages to just start filling out the application. Are you seeing that applicants are disclosing things like criminal history, or do you run into an issue where it’s not disclosed and now it’s kind of a worse case because the applicant wasn’t honest?

Speaker 3: 11:25

and they do submit the application in good faith. They’re trying to provide our licensing team everything that they need and they do try to provide the criminal history questionnaire in full. Sometimes there are issues with the questionnaire that we get and we have to do our own RFI letter requesting them to provide more complete information and unfortunately, there are always going to be some folks that try to get around the system and think that if they don’t disclose something, they’re going to get away with something. They won’t. We check criminal histories on everyone, so I would say that most of the, I guess, challenges that you see with the criminal histories are things that we find going through our normal criminal history process, but I don’t think it’s intentional deception from most people.

Speaker 2: 12:25

Well, that’s good to hear, Kind of in that same line of questioning is there any prior criminal history or anything? That’s an automatic disclosure, like our listeners should know. Hey,

Speaker 3: 12:51

right now may be true right now, but it may not be in the future. And we’ve had changes recently in the law that eliminated some of the restrictions on who can get a license and who cannot. So, for example, right now if you’re trying to get a massage establishment license, if you’re a sexually oriented business, you can’t get a license. The law strictly does not allow that.

Speaker 3: 13:13

But for the most part, what we’re going to do is we’re going to look at our criminal history guidelines and we’re going to apply those guidelines that we have for every one of our programs and we’re going to see if the crime that the person committed falls within those guidelines. So is it something about going against a person like a crime against a person, kidnapping or homicide or assault? Is it a crime involving some kind of sexual conduct or a crime against a child or a crime involving human trafficking? What we’re going to do, carrie, in those situations is we’re going to go ahead and review that, open up a case, most likely, and give that person an opportunity to request a hearing on their case. We generally do not automatically disqualify. When I hear the term automatic disqualify in my mind I think of no due process, no hearing. We don’t do that.

Speaker 3: 14:10

We usually almost every kind of crime unless the law specifically says you can’t have a license, like the sexually oriented business we’re going to give you an opportunity to have a contested hearing no, it seems like TDLR has a good amount of discretion and eventually they could have their day in court, so to speak, to really argue for why they think they should have a license.

Speaker 3: 14:40

Exactly, and I’ll be happy to talk about some of those statistics, because the numbers that get denied really are quite small.

Speaker 2: 14:47

And it sounds like that from what Heather was saying earlier.

Speaker 4: 14:51

I don’t think I heard Ron touch on this. We do have a process called a criminal history evaluation letter that if someone does have a criminal history they can actually request a review before submitting their application or before going to school. Even Our licensed Texas massage schools are required to tell potential applicants of the risks of having a criminal history and explain that process to them. So before they even go down that road, if they do feel like there’s a potential or they have a question, I would strongly advise them to use that tool before going to school even.

Speaker 2: 15:35

Okay, yeah, that does. I don’t think we touched on that, but that certainly is helpful and again, I think kind of just goes to the totality of what you have been talking about, which is like kind of doing your own research and putting in your due diligence first before going ahead and just throwing together an application. Really understanding what you need to do and what TDLR needs from you, getting everything together and then starting the process seems like the best way to go.

Speaker 3: 16:04

I would like to add one point about that criminal history evaluation letter that Heather mentioned is it’s very affordable. I think it’s a $10 fee right now, which is much less than many of the license application fees and obviously much less than paying to go to school and then finding out later that you can’t get a license.

Speaker 2: 16:24

Yeah, oh, okay, yeah, that’s definitely the way to go.

Speaker 2: 16:27

Then, if anybody has questions, I know that, Ron, we have another episode that you know talks solely about enforcement, and so I think some of these more general questions can be answered there. But I’d like to kind of hone in on the massage therapy department, and you know, are there any things that you are seeing in the enforcement division that kind of stand out as far as complaints go? Are there, you know, common issues that these licensees are facing?

Speaker 3: 17:04

Thank you, simone. Let me start off by giving a shout out to our website, tdlrtexasgov. All of the information that I’m going to provide is under the complaints and enforcement section, so you can go and look at these statistics. It’s publicly available information. There’s also all kinds of licensing information on our website for each one of the programs, so tdlrtexasgov is the place to go. It’s a really good question, Simone.

Speaker 3: 17:32

We do have some common issues. So what happens is usually when a complaint gets filed, we open the case based upon the allegations that are alleged. As you can imagine, sometimes those allegations are not true. They’re just what people are telling us, and so what we see is we have trends in the case, types of cases that are being filed with us. We see violations that are unlicensed activity, unlicensed establishments.

Speaker 3: 18:02

Unfortunately, there’s quite a bit of sexual misconduct type of activity that we see that’s happening where the client, which is non-consensual, and then of course, there is some misconduct that is consensual conduct. That’s going on as well, but it’s also illegal to be doing in a massage therapy setting. So those are the most common type of violations we see. We do see some administrative type of violations with the paperwork, the consultation documents and such that get filed. So those are all the allegations we see at the opening. When it comes to the disciplinary actions that we issue, we tend to kind of focus on the more serious public health risks. So the sexual misconduct, the human trafficking, is a big issue for us right now. Of activity, unlicensed activity from the establishment and establishments that allow unlicensed persons to work there, those are the big trends that we see right now in the massage industry.

Speaker 2: 19:04

Gotcha, yeah, yeah, no, and that would make sense. Are these complaints generally kind of like we were talking about earlier? Are these initiated by TDLR earlier? Are these initiated by TDLR? Are you guys seeing some of these things and getting tips, or are these, you know, victims that are coming forward or you?

Speaker 3: 19:31

know consumers that are submitting these complaints. So in the last so I’ll just run through some statistics real quick In fiscal year 23, we had 608 consumer complaints and in fiscal year 24, we had 840 consumer complaints. We also do department inspections of the massage establishments in this program. So we had 566 cases that were open because of department inspections and 585 that were open in fiscal year 24. So the bottom line is we get a pretty substantial number of people that are complaining to us. There are a lot of people that step forward when they’ve been assaulted or when they’ve had something inappropriate happen. Our inspections team does a very good job of getting out there and inspecting these locations and looking for indicators of human trafficking, which is actually required in many of these for these establishments to have signs up to advise people about the danger of human trafficking. So that’s something we’re looking for and we open up a pretty good number of cases on our own. Based upon that.

Speaker 2: 20:35

What advice?

Speaker 2: 20:35

would you have for these licensees that are receiving complaints? You know, like you said, sometimes they know that they’ve done nothing wrong and they’re completely innocent. Do they still have to go through this process?

Speaker 3: 20:50

They really do, simone. They need to engage with us. I know it’s the big bad government sometimes is the way people look at us, but we’re here to really do a fair and unbiased investigation. That’s what I expect of my team members. So when that complaint comes in the door, we don’t know what the truth is. Right, we need to interview the investigators are interviewing the witnesses and interviewing the complainant and the respondent. They need to be who is the licensee. They need to be who is the licensee. Usually they need to respond to us, and so the worst thing that they can do is just to ignore that letter or that phone call that comes from us asking for them to you know. Allow us to ask them some questions or provide us some documents.

Speaker 2: 21:34

What do you generally see, that is, you know, is productive or is not productive in providing a response?

Speaker 3: 21:41

Well getting in contact with us or responding to the calls that we have. Usually what happens is we’re requesting some documents or something your side of the story or maybe some kind of business record. So when they produce that, that’s helpful. But I want to do back up and say when they do retain a lawyer, it’s very important that they reach out and they let us know that they’ve done that, because a lot of times respondents are dealing directly with our attorney or our investigator and they’re not letting us know whether or not they have representation. So it’s very important from our perspective that if they do have representation, that we’re dealing with the attorney that we’re asking our request through the attorney, and the attorney very often is able to explain to the respondent what the violations are that are alleged or what documents are needed to come into compliance.

Speaker 2: 22:39

Yes, and I, as an attorney, would also like to tell listeners if you’ve hired an attorney, please tell TDLR, don’t keep talking to them.

Speaker 2: 22:47

Well, as today’s episode comes to a close, I really want to highlight the importance of not only being proactive when you’re applying for your license, but, you know, also when you’re experiencing some issues too. Thanks again, Ron and Heather, for being with us today. We really appreciate you guys taking some time.

Speaker 3: 23:05

Thank you.

Speaker 2: 23:06

Yes, thank you guys so much. I think we’ve just really explained to people that you are. You know PDLR is encouraging them to reach out to look at the website, to look at the you, to look at the actual applications, follow their own instructions, and I think this process could be really really easy for some folks. So, thank you guys so much. Thank you

Narrator: 23:28

Know your Regulator the podcast that inspires you to engage.