GENERAL GOVERNMENT CABINET
Kentucky Board of Licensure for Massage Therapy
RELATES TO: KRS 309.355(3), 309.362
STATUTORY AUTHORITY: KRS 309.355(3)
NECESSITY, FUNCTION, AND CONFORMITY: KRS 309.355(3) requires the Board of Licensure for Massage Therapy to establish by administrative regulation a code of ethics and standards of practice for massage therapists. This administrative regulation establishes those standards, which, if violated, are a basis for disciplinary action under KRS 309.362.
Section 1. Code of Ethical Standards for the Massage Therapist. A massage therapist shall:
(1) Maintain the confidentiality of all client information, unless law or court order mandates disclosure;
(2) Keep the client well informed of procedures and methods that will be employed during the session;
(3) Report to the board if the massage therapist has first-hand knowledge or evidence indicating any unethical, incompetent, or illegal act has been committed by another licensee;
(4) Take precautions to do no harm to the physical, mental, and emotional well being of clients or associates;
(5) Make every reasonable effort to report unlicensed practice of massage therapy to the board;
(6) Represent his or her educational and professional qualifications honestly;
(7) Inform clients of the limitations of the licensee’s practice;
(8) Consistently take measures to improve professional knowledge and competence by a regular assessment of personal and professional strengths and weaknesses through continuing education training;
(9) Respect the client’s right to treatment with informed and voluntary consent, either verbal or written, and to refuse, modify, or terminate treatment regardless of prior consent;
(10) Not initiate or engage in sexual conduct or activities with a client;
(11) Not engage in an interest, activity, or influence that conflicts with the practitioner’s obligation to act in the best interest of the client;
(12) Respect the client’s boundaries with regard to privacy, disclosure, exposure, emotional expression, beliefs, and reasonable expectations of professional behavior;
(13) Refuse to accept gifts or benefits, which are intended to influence a referral or treatment that are purely for personal gain and not for the good of the client;
(14) Conduct all business and professional activities with honesty and integrity;
(15) Respect the inherent worth of all clients;
(16) Provide only those services that the licensee is qualified to perform; and
(17) Respect the client’s autonomy.
Section 2. Standards of Practice for the Massage Therapist. (1) In the practice of massage therapy, a massage therapist shall:
Perform a written or verbal intake interview with the client to determine
whether any contraindications to massage therapy exist and whether
modifications including pressure, technique, and duration of treatment are
Acknowledge the limitations of, and contraindications for, massage;
Refer the client to other professionals or services if the treatment or service
is beyond the massage therapist's[ therapists] scope of practice;
Maintain for a minimum period of five (5) years accurate, timely, and organized
records of every client;
Provide massage therapy services that meet or exceed the generally accepted
practice of the profession;
If a plan of care or treatment is appropriate, explain the plan to the client,
to others designated by the client, and to appropriate professionals with
Unless prohibited by law, be allowed to pool or apportion fees received with
other members of a business entity in accordance with any business agreement;
Practice massage therapy in sanitary and safe conditions; and
Have the right to refuse to treat any person or part of the body at the
(2) Breast massage. A licensee performing massage of the tissue of the breast shall:
(a) Obtain the client’s informed written consent prior to providing the service;
(b) Maintain proof documenting specialized training in breast massage which addresses breast anatomy, breast pathology, and breast massage technique and which was provided by an approved massage therapy program or board approved continuing education provider;
(c) Inform the client prior to the commencement of the service that this service may be performed through a draping sheet if the client so desires and the licensee shall provide the service through a draping sheet if the client so prefers;
(d) Inform the client prior to the commencement of the service that the client may discontinue the service at any time and the licensee shall honor that election by discontinuing the provision of the service if that request is made;
(e) Keep detailed SOAP notes for the service including but not limited to notes related to all emotional factors that the client reports to the licensee which might impact the client’s suitability for the service and the precautions that the licensee has taken to ensure that the service is provided in an appropriate manner given those factors; and
(f) Refrain from an act or statement which the client might subjectively construe as being sexual in nature.
Section 3. Standards for Documentation. The massage therapist and client shall agree upon the purpose of the massage session.
(1) Documentation shall not be required if the massage session is for general relaxation, a sports event massage, or public demonstration as in chair massage.
(2) If a written plan of treatment is requested or required, the client file shall include the following documentation:
(a) The initial evaluation, which shall include:
1. The client’s name, age, and gender;
2. Date of the session; and
3. Pertinent medical history, including:
a. Client sensitivities and allergies;
b. Medical diagnoses, if available, and the source of the diagnosis;
c. Contraindications; and
d. Medications as disclosed by the client;
(b) Progress notes signed by the massage therapist rendering the massage therapy, which shall include:
1. Subjective information including the area of complaint as stated by the client and the date of onset;
2. Objective information including any observations and objective testing, if applicable;
3. Ongoing assessments, if applicable;
4. Actions taken by the massage therapist; and
5. The client response to massage therapy treatment; and
(c) A plan of treatment, if applicable, consisting of:
1. Modalities to be rendered;
2. Frequency and duration of treatment;
3. Referral to other professionals, if indicated;
4. Client self-help education and instruction; and
5. The goals or desired outcome of the treatment.
THOMAS HANSEN, Board Chair
APPROVED BY AGENCY: January 27, 2014
FILED WITH LRC: February 13, 2014 at 3 p.m.
PUBLIC HEARING AND PUBLIC COMMENT PERIOD: A public hearing on this administrative regulation shall be held on March 21, 2014 at 9:00 a.m. (EST) at 911 Leawood Drive, Frankfort, Kentucky 40601. Individuals interested in being heard at this hearing shall notify this agency in writing five (5) working days prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be cancelled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until 11:59 pm on March 31, 2014. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: Carolyn Benedict, Board Administrator, Board of Licensure for Massage Therapy, P.O. Box 1360, Frankfort, Kentucky 40602, phone 502-564-3296.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person: Michael West
(1) Provide a brief summary of
(a) What this administrative regulation does: This regulation establishes an ethical parameter for breast massage.
(b) The necessity of this administrative regulation: This regulation is necessary to implement the provisions of KRS 309.355(3).
(c) How this administrative regulation conforms to the content of the authorizing statutes: The regulation is in conformity as the authorizing statute gives the board the ability to promulgate regulations generally and specifically with respect to a code of ethics.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes: This regulation will assist the board in administering this program by clarifying ethical issues related to breast massage.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation: The amendment reflects greater clarity regarding breast massage.
(b) The necessity of the amendment to this administrative regulation: The amendment is necessary to ensure that licensees understand the boundaries of acceptable breast massage.
(c) How the amendment conforms to the content of the authorizing statutes: The amendment to this administrative regulation is in conformity as the authorizing statute that gives the board the ability to promulgate regulations generally regarding a code of ethics.
(d) How the amendment will assist in the effective administration of the statutes: The amendment will provide the licensees with greater notice regarding the expectations of the board with respect to breast massage.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation: Approximately 2,500 individuals are licensed by the board.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment: A licensee will need to ensure that he or she acts within the ethical guidelines dictated by the amendment.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3): None.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3): The individual will better understand the ethical boundaries of his or her profession.
(5) Provide an estimate of how much it will cost to implement this administrative regulation:
(a) Initially: No new costs will be incurred by the changes.
(b) On a continuing basis: No new costs will be incurred by the changes.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation: The board’s operations are funded by fees paid by licensees.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment: No fees will be required to implement this administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees: The amendment to this administrative regulation does not establish any new fees. Nor does it increase any existing fees.
(9) TIERING: Is tiering applied? Tiering is not applied to this regulation.
FISCAL NOTE ON STATE OR LOCAL GOVERNMENT
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation? Kentucky Board of Licensure for Massage Therapy
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation: KRS 309.355(3).
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect. None
(a) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect. None
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years? None
(c) How much will it cost to administer this program for the first year? None
(d) How much will it cost to administer this program for subsequent years? None
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.