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Department of Health files notice to increase LMT licensure fees

Friday, April 19, 2019  
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The Board of Massage (Board) has notified LMTs that the Department of Health (DOH) has started the process to raise initial licensure and renewal fees beginning on October 1, 2019. The fees will increase as follows:


Description Current As of October 1, 2019
Initial Application $125 $210
Renewal $90 $150



A public hearing will be held on May 7 at 1:00pm at DOH’s Town Center 2, room 158, located at 111 Israel Road SE, Tumwater. AMTA-WA President, Michael Mandell, LMT, will attend.

Unfortunately, regardless of the testimony at this public meeting or letters written, DOH will adopt the fee increase. DOH must comply with state law that requires health care professions to be self-supporting. Because the Board is projected to be at a $2.2 million deficit by June 2019 and a $4.8 million deficit by June 2025, fees must be increased. Bottom line, the Board in essence borrowed money, and now it needs to be repaid.

The following information attempts to answer the questions of how we got in this situation where LMT licensure renewal fees have increased from $65 in 2012 to a projected $150 in 2019 , and what we can do to prevent this from happening in the future.

Unlicensed illegal practice. The part of the deficit related to unlicensed illegal practice began with the passage of SB 6103 in 2012. That was the legislation that regulated reflexology. A part of that legislation was the following authorization for DOH to inspect massage businesses.



RCW 18.108.195 (1) For the purposes of ascertaining violations of this chapter and chapter 18.130 RCW, the secretary or authorized representative has the authority to inspect, within reasonable limits and in a reasonable manner, the premises of any massage or reflexology business establishment during hours such business is open. If the secretary is denied access to any premises or establishment the secretary may apply to any court of competent jurisdiction for a warrant authorizing access to such premises or establishment for such purposes. The court may, upon such application, issue a warrant for the purpose requested. (2) This section does not require advance notice of an inspection.”



Of course, everyone had the best of intentions in 2012, but what we didn’t know at the time was that authorizing DOH to do these types of inspections—that we were told generated on average 5 complaints each—was going to be expensive—but not effective. Here’s how the world looked in 2012. This was the intent section of SB 6103: 


“NEW SECTION.  Sec. 1   The legislature finds that protecting the public health and safety from the harms of human trafficking has become more difficult and complex, with severe consequences for the victims and the public. The purpose of this legislation is to provide additional tools so that the regulatory agency has authority to make reasonable inspections of the premises in which services subject to this chapter are being provided in order to determine whether the services are being provided in compliance with this chapter and to support state investigations of human trafficking and other illicit activity.”


Complaints against LMTs. While the complaint rates against LMTs have remained steady at about 2.7% since 2010, LMTs have a higher proportion of complaints related to sexual misconduct. In talking with Board staff, there is a sense these complaints are decreasing as informed consent requirements are now in place. The complaints seem to be more about a client/patient being surprised by some part of the massage, rather than sexual misconduct. However, all of these types of complaints need to be investigated and that costs money.


LMTs have a 50% failure rate for CE audits. That is well above any other health profession with CE requirements. When asked for more specifics, Board staff noted that some LMTs are simply not getting any CE credits, thinking that they won’t get caught. In addition, a lack of ethics credits is often a problem. AMTA-WA remains committed to offering low cost CE for members. Bottom line, failed audits cost money.


Department of Health budgeting. While AMTA-WA has great respect for the many dedicated DOH employees, the reality is that the Board, as well as stakeholders, did not receive timely information concerning the growing deficit. Without that information, no policy changes were made, and the deficit just kept growing. 

Moving forward. Changes are already being made. DOH now refers unlicensed illegal massage complaints to law enforcement. The reality is that these illegal massage entities are sophisticated criminal enterprises that are best dealt with by law enforcement.

AMTA-WA will continue to emphasize the importance of complying with CE requirements. The Board recently developed a “Continuing Education Tracking Form.”

DOH has changed its budgeting procedures to provide more detail. Prior to the CR-102 being filed, DOH prepared a detailed analysis of the cost drivers behind the proposed fee increase. Please go to Cost Drivers Document for that information. In addition, DOH will be providing more detailed information on a regular basis. The result will be that the Board and stakeholders will be able to be more proactive when fiscal challenges arise. 

AMTA-WA position on LMT fee increases. To conclude, AMTA-WA is in a challenging position concerning this rate increase because it was our legislation that triggered more licensure revenue being spent on unlicensed illegal massage. Our recommendation is to oppose the increase, acknowledge our role in advocating for SB 6103, while emphasizing that DOH was slow to recognize the growing deficit. As a result, DOH’s only option is to raise fees for the second time in three years. That’s not okay. And we need to say that on behalf of our members. 

Your Board
AMTA-WA Chapter


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