Consolidated Fiscal Note Session

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H1925-0 (R) Page 1 of 12

Consolidated Fiscal Note – 2013-14 Session

Bill #: H1925-0 (R) Complete Date: 03/26/14 Chief Author: NEWTON, JERRY

Title: MN MASSAGE & BODYWORKS THERAPY ACT

Fiscal Impact Yes No

State X

Local X

Fee/Departmental Earnings X

Tax Revenue X

Agencies: Nursing Board (03/24/14) Public Safety Dept (03/26/14) Office of Higher Education (03/04/14) Health Dept (03/04/14)

This table reflects fiscal impact to state government. Local government impact is reflected in the narrative only.

Dollars (in thousands) FY13 FY14 FY15 FY16 FY17

Net Expenditures

General Fund (6) (6) (6)

Health Dept (6) (6) (6)

Health Related Boards Fund 339 283 288

Nursing Board 339 283 288

Misc Special Revenue Fund 26 7 7

Public Safety Dept 26 7 7

Revenues

Net Cost <Savings>

Health Dept (6) (6) (6)

Total Cost <Savings> to the State

133 70 53

FY13 FY14 FY15 FY16 FY17

Full Time Equivalents

General Fund (0.08) (0.08) (0.08)

Health Dept (0.08) (0.08) (0.08)

Health Related Boards Fund 2.00 2.00 2.00

Nursing Board 2.00 2.00 2.00

Total FTE

1.92 1.92 1.92

Consolidated EBO Comments

I have reviewed this Fiscal Note for reasonableness of content and consistency with MMB's Fiscal Note policies. EBO Signature: KEITH BOGUT

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H1925-0 (R) Page 2 of 12

Fiscal Note – 2013-14 Session

State X

Local X

Tax Revenue X

Agency Name: Nursing Board

Expenditures

Less Agency Can Absorb

-- No Impact --

Net Expenditures

Revenues

Net Cost <Savings>

Total Cost <Savings> to the State

139 76 59

FY13 FY14 FY15 FY16 FY17

Full Time Equivalents

Health Related Boards Fund 2.00 2.00 2.00

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H1925-0 (R) Page 3 of 12 House File Number 1925 bill establishes registration for massage and bodywork therapists; establishes fees; amends Minnesota Statutes 2013 Supplement, section 116J.70, subdivision 2a. The Alliance for Licensing Massage Therapists requested the Board of Nursing to consider regulating massage therapists through an Advisory Council model used by the Board of Medical Practice. The Board of Nursing voted to register and regulate massage therapists if the Legislature authorized such activity.

Assumptions

Under this bill massage therapist registration would be voluntary.

Section 6 of the bill provides the powers to the Board of Nursing with the advice of the advisory council to issue registrations to massage and bodywork therapists, adopt rules, approve exams, impose discipline, take

applications and employ staff needed to receive massage and bodywork therapist licensing services.

Section 7 of the bill establishes an Advisory Council that would consist of 5 members: 3 professional and 2 public. Section 8 of the bill defines registration requirements.

Section 9 of the bill establishes annual renewal of registration.

Section 10 of the bill creates the requirements for approved education providers. Section 12 of the bill provides grounds for disciplinary action.

Expenditure and/or Revenue Formula

The bill establishes voluntary registration for massage and bodywork therapists effective August 1, 2014. Because the Board of Nursing does not have occupational expertise, the Board will administer the registration, education program approval, and disciplinary process using an Advisory Council. Due to the short time between the enactment and effective dates, the Board of Nursing will not have sufficient time to develop a data and operating system. The Board will need to quickly convene an Advisory Council and initially process applications and issue documents using a manual process. The program administrator will concurrently develop a data and operating system and a program approval process while processing applications for licensure manually. Expenditures: It is estimated that staff needed to run the program would be a full time State Program Manager and a full time Office and Administrative Specialist Principal. The Board of Nursing expects to use a version of the small health-related licensing boards licensing data base to record and maintain registrations. Startup costs during FY 2015 include $25,000 for computer services and $11,000 for equipment. The CIO has reviewed and approved IT related expenses.

Revenues Applicants for registration will pay an initial registration fee and renew registration annually. Fees are included in the bill. We anticipate 1,500 applications for initial licensure within five years; 700 applicants year one, 200 applicants in years two, three, four and five. Renewals expected: 0 in year one, 700 in year two, 900 in year three, 1,100 in year four and 1,300 in year five.

Expenditures:

Description FY 2015 FY 2016 FY 2017 FY 2018 FY 2019

FT Salaries (1.0 State Program Mgr.

And 1.0 OAS Principal) 183,800 187,963 192,252 196,669 201,220

Bd Per Diems 12,000 10,000 8,000 8,000 8,000

Space 6,000 6,000 6,500 6,500 7,000

Printing 2,000 2,000 500 500 500

Professional / Tech Consultants 1,000 1,000 1,000 1,000 1,000

Computer Services 25,000 5,000 2,000 2,000 2,000

Postage/Communications 10,000 12,000 12,000 12,000 12,000

In State Travel 4,000 4,000 4,000 4,000 4,000

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H1925-0 (R) Page 4 of 12

Supplies 3,000 3,000 3,000 3,000 3,000

Equipment 14,000 3,000 3,000 3,000 3,000

Other Operations 33,700 4,700 4,700 4,700 4,700

Office of Administrative Hearings 0 0 0 0 0

Administrative Service Unit 13,000 13,000 13,000 13,000 13,000 Health Professional Serv Prog 1,000 1,000 2,000 2,000 2,000

Attorney General 30,000 30,000 30,000 30,000 30,000

Statewide Indirect Costs 0 0 6,000 6,000 6,000

Total Expenses 338,500 282,663 287,952 292,369 297,420 Revenues:

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Long-Term Fiscal Considerations

Because registration would be voluntary, it is difficult to say how many will apply in the future. The estimated numbers are from the Massage Therapists Association who surveyed their members.

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H1925-0 (R) Page 5 of 12 The impact on local government is unknown.

References/Sources

Board staff and members of the Alliance for Licensing Massage Therapists.

FN Coord Signature: JULI VANGSNESS Date: 03/24/14 Phone: 651-201-2732

EBO Comments

I have reviewed this Fiscal Note for reasonableness of content and consistency with MMB's Fiscal Note policies. EBO Signature: SUSAN MELCHIONNE

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H1925-0 (R) Page 6 of 12

Fiscal Note – 2013-14 Session

State X

Local X

Tax Revenue X

Agency Name: Office of Higher Education

Expenditures

-- No Impact --

Less Agency Can Absorb

-- No Impact --

Net Expenditures

-- No Impact --

Revenues

-- No Impact --

Net Cost <Savings>

-- No Impact --

Total Cost <Savings> to the State

FY13 FY14 FY15 FY16 FY17

Full Time Equivalents

-- No Impact --

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H1925-0 (R) Page 7 of 12 Bill Description - The bill establishes that massage and bodywork therapists must be registered with the state, establishes a fee for the registration and requires that education providers be approved by the Board of Nursing in addition to the Office of Higher Education.

Assumptions

Massage schools currently have to be licensed with the Office of Higher Education, so we do not anticipate a fiscal impact on the Office.

The bill requires the Nursing Board to approve the schools, but also requires the schools to be licensed by the Office of Higher Education (except for the programs at Minnesota State Colleges and Universities). (148.988 Subd. 1 (2))

It gives the Nursing Board the responsibility to determine if the school is maintaining standards and revoke their approval, if necessary (Sec. 148.988 Subd. 3). This could create a conflict. The Office of Higher Education licenses the schools if they meet the standards for operating as a postsecondary school. What would happen if the Nursing Board were to revoke a school’s approval? In that case, a school licensed by one state agency, but it would not be approved to offer instruction by another.

The bill may create additional expense for Minnesota massage schools, by requiring them to be

approved/licensed by two different state agencies. Schools may have to pay a fee to be approved by the Board of Nursing in addition to the fee to be licensed by the Office of Higher Education.

Expenditure and/or Revenue Formula - none

Long-Term Fiscal Considerations

As written, the bill could require additional work to make sure the schools are complying with any curriculum requirements approved by the Nursing Board and that graduates could sit for any mandated exam.

Advertisements and promotional material from the schools would also have to be carefully watched to make sure the schools are giving accurate information to potential students.

Local Government Impact - none

References/Sources- none

Agency Contact Name: George Roedler (651-259-3975) FN Coord Signature: TRICIA GRIMES

Date: 03/04/14 Phone: 651-259-3964

EBO Comments

I have reviewed this Fiscal Note for reasonableness of content and consistency with MMB's Fiscal Note policies. EBO Signature: AMELIA CRUVER

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H1925-0 (R) Page 8 of 12

Fiscal Note – 2013-14 Session

State X

Local X

Tax Revenue X

Agency Name: Public Safety Dept

Expenditures

Less Agency Can Absorb

-- No Impact --

Net Expenditures

Revenues

Net Cost <Savings>

Total Cost <Savings> to the State

FY13 FY14 FY15 FY16 FY17

Full Time Equivalents

-- No Impact --

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H1925-0 (R) Page 9 of 12 Bill Description

The Department of Public Safety, Bureau of Criminal Apprehension (DPS/BCA) is the repository for Minnesota criminal history records and the gateway for access to national criminal history records maintained by the Federal Bureau of Investigation (FBI).

The bill requires that every massage and bodywork applicant for registration have both a state and national criminal history records check.

The bill requires a state and federal background check through the BCA in lines 6.24-6.27. Assumptions

The background check language in lines 6.24-6.27 is amended so that it will be approved by the U.S. Attorney General as required by Public Law 92-544.

There will be 700 registrations in the first year and 200 registrations in each subsequent year. There will be no background check at renewal.

The effective date in Section 16 is changed to August 1, 2014.

The FBI will continue to charge $21.50 for a national criminal history records check. The BCA will continue to charge $15.00 for the Minnesota criminal history records check. Expenditure and/or Revenue Formula

The cost for each background check is $36.50. Multiplied by 700 checks the first year is a total of $25,550. . Of that revenue, the FBI must be paid $21.50 per check the first year or a total of $15,050.

For 200 checks per year in subsequent years, the total per year is 200 multiplied by $36.50 or $7,300. Of that revenue, the FBI must be paid $21.50 per check each year or a total of $4,300 each subsequent year.

The Minnesota portion of the fee is kept by DPS/BCA to pay for the employees who conduct the checks. Long-Term Fiscal Considerations

None

Local Government Impact None

Agency Contact Name: Katie Engler (651-793-2721) FN Coord Signature: LARRY FREUND

Date: 03/26/14 Phone: 651-201-7050

EBO Comments

I have reviewed this Fiscal Note for reasonableness of content and consistency with MMB's Fiscal Note policies. EBO Signature: KEITH BOGUT

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H1925-0 (R) Page 10 of 12

Fiscal Note – 2013-14 Session

State X

Local X

Tax Revenue X

Agency Name: Health Dept

Expenditures

Less Agency Can Absorb

-- No Impact --

Net Expenditures

Revenues

-- No Impact --

Net Cost <Savings>

Total Cost <Savings> to the State

(6) (6) (6)

FY13 FY14 FY15 FY16 FY17

Full Time Equivalents

General Fund (0.08) (0.08) (0.08)

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H1925-0 (R) Page 11 of 12 Bill Description

This bill creates a voluntary massage and bodywork therapy registration and title protection system administered by the Minnesota Board of Nursing.

Article 1

Section 1: Title. Section 2: Definitions.

Section 3: Describes the practice of massage and bodywork therapy.

Section 4: Describes when a massage and bodywork therapist must refer a client to other health care providers. Section 5: Prohibits the use of the title “registered massage and bodywork therapist” or “RMBT” alone or in combination of any other words or titles unless the individual is registered.

Section 6: Requires the Minnesota Board of Nursing to adopt a system and rules for regulating registered massage and bodywork therapists.

Section 7: Establishes an advisory council to assist the Board in issuing registrations to qualified applicants. Section 8: Establishes the eligibility requirements to be a registered massage and bodywork therapist including fees, criminal background check requirements, reason for denying registration and qualifying methods for registration.

Section 9: Establishes the expiration and renewal requirements for registered massage and bodywork therapists; conditions for placing a practitioner in an inactive status; provisions for registration following a lapse in status; and cancellation of registration.

Section 10: Requires the Board to approve massage and bodywork education providers.

Section 11: Requires the Board to take action on an individual’s application for registration as a massage and bodywork therapist, authorizes the Board and Advisory Council to conduct an investigation on information provided by the applicant; and authorizes the applicant to make a written request to appear before the advisory council if denied registration.

Section 12: Authorizes the Board to investigate and take disciplinary action against a registered massage and bodywork therapist for violating the prohibited acts. Clarifies that the chapter does not restrict the authority of local welfare agencies, the commissioner of human services, local law enforcement, or the state to take action regarding maltreatment of minors.

Section 13: Authorizes the Board to take other action against massage and bodywork therapists as authorized by sections 148.262 to 248.266.

Section 14: Preempts the licensure and regulation of massage and bodywork therapists by municipal

governments. This section does not prohibit municipal governments from requiring massage therapy businesses to obtain a local permit or license and does not prohibit municipalities from prosecuting unregistered therapists and therapists who engage in unlawful activities.

Section 15: Establishes application and renewal fees. Section 16: Establishes an effective date.

Article 2

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H1925-0 (R) Page 12 of 12 Section 2: Prohibits individuals who have a massage business license issued by a municipal or city government from advertising as a licensed massage therapist unless the individual holds a current credential from another state.

Assumptions

As written, the bill has an effective date of August 1, 2013. For the purposes of this fiscal note, we assume that the effective date is August 1, 2014.

Minnesota Statutes, 146A.08 directs the Minnesota Department of Health’s Office of Complementary and Alternative Healthcare Practice (OCAP) to investigate complaints and take enforcement actions against all unlicensed complementary and alternative health care practitioners for violations of prohibited conduct. Massage and bodyworks therapy is one of twenty-two types of complementary and alternative health care practices named in the law. Currently, MDH devotes 0.15 FTE and $12,000 per year to investigations and enforcement related to massage and bodyworks therapy. By creating a separate regulatory program within the Minnesota Board of Nursing for massage and bodyworks therapy, the bill would eliminate the effort OCAP spends on those massage and bodywork therapists who become registered. At this time, we are not able to project the number of massage and bodyworks therapists who would become registered and under this bill and would no longer be subject oversight by OCAP. However, we assume that this legislation would result in some reduction in costs to OCAP. This fiscal note reflects a 50% reduction in staffing and costs to OCAP for investigations and enforcement related to massage and bodyworks therapy.

Expenditure and/or Revenue Formula

EXPENDITURES SFY13 SFY14 SFY15 SFY16 SFY17

Salary and Fringe Benefits 0 0 (5) (5) (5)

Other Operating Costs 0 0 0 0 0

Grants 0 0 0 0 0

Administrative Services 0 0 (1) (1) (1)

OR Indirect Cost 0 0 0 0 0

TOTAL EXPENSES ₀ ₀ ₍₆₎ ₍₆₎ ₍₆₎

Long-Term Fiscal Considerations

Local Government Impact

Currently, local governments may require massage therapy businesses, technicians or both to obtain a local permit or license. It is unclear how this bill would impact local government costs.

References/Sources

FN Coord Signature: DAVE GREEMAN Date: 03/03/14 Phone: 651-201-5235

EBO Comments

I have reviewed this Fiscal Note for reasonableness of content and consistency with MMB's Fiscal Note policies. EBO Signature: SUSAN MELCHIONNE