Robert Bernstein, M.D. Opinion No. JM-609
Commissioner -
Texas Department of Realth Re: Whether a self-employed massage
1100 West 49th Street therapy instructor who supervises
Austin, Texas 78756 more than two apprentices conducts a
massage therapy school for purposes
of article 4512k. V.T.C.S., and
related questions
Dear Dr. Bernstein:
You have asked two questions concerning the T&as Department of
Health's authority to regulate massage therapists. You first ask
whether article 4512k. V.T.C.S., authorizes the Texas Department of
Flealth to enact a rule requiring a massage therapy instructor, who is
self-employed and supervises more than two apprentices-.to comply with
the department's requirements for a massage therapy school. Those
requirements are:
5141.9 MASSAGE TRERAPY SCHOOLS RECOGNIZED BY THE
DEPARTMENT.
(a) Purpose. This section sets forth the
guidelines by which a massage therapy school may
be recognized by the department.
(b) General. After January 1. 1986. the
department shall recognize only those establish-
ments or organizations which meet the following
criteria as a massage therapy school:
(1) Minimum standards for operation.
(A) Each school shall designate one
parson as the director of the school who is
responsible for the school program and
curriculum, the organization of classes, the
maintenance of the school facilities, the
maintenance of proper administrative records,
and all other procedures related to the
administration of the school.
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Dr. Robert Bernstein - Page 2 (34-609)
(B). All instructors of Swedish massage
therapy technique in a recognized massage
therapy school shall meet the definition of a
massage therapy instructor as defined in $141.2
of this title (relating to Definitions).
('3 A recognized massage therapy
school shall have written admission require-
ments, tuition and fee schedules, a refund
POliCY * a student conduct policy, conditions
for dismissal and re-entrance, attendance
requirements, curriculum and course require-
ments which shall be made available to every
apprentice/student and prospective appren-
tice/student before registration.
(D) Each recognized massage therapy
school shall keep on file and available for
inspection by the department the following:
(0 applications of apprentices1
students;
(ii) attendance records;
(iii) log of apprentice/student
hours; and
(iv) academic records which
relate to grades.
03 A recognized massage therapy
school shall offer as a minimum the curriculum
requirements as set forth in 5141.5 of this
title (relating to Registration Requirements).
25 T.A.C. 1141.9 (1986).
Article 4512k. V.T.C.S., provides in part:
Sec. 1. In this Act:
. . . .
(2) 'Massage therapist' means an individual
who practices or administers massage therapy to a
patron of either gender for compensation. The
term includes a therapeutic massage practitioner,
maesaginist. massage technician, masseur. mas-
*ewe, myo-therapist. or any derivation of those
titles.
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Dr. Robert Bernstein - Page 3 (J-M-609)
. . . .
(4) ‘Massage establishment’ means any place of
business in which massage therapy is practiced by
a massage therapist.
Registration Requirements
Sec.2 (a) . . . .
(b) An individual who registers under this Act
must present evidence satisfactory to the board
that the person:
(1) has satisfactorilv comuleted massase
therapy studies in a 250 hour, supervised course
of instruction provided by a massage therapy
instructor, by a massage therapy school recognized
by the department, by a state approved educational
institution, or by any combination of instructors
or schools, in which 125 hours are dedicated to
the study of Swedish massage therapy techniques,
50 hours to the study of anatomy, 25 hours to the
study of physiology, 25 hours to the study of
hydrotherapy, five hours to the study of business
practices and professional ethics standards, and
20 hours to the study of health and hygiene;
(2) is registered as a massage therapist in
another state or country that has and maintains
standards and requirements of practice and
licensing or registration that substantially
conform to those of this state, as determined by
the department; or
(3) has practiced massage therapy as a pro-
fession for not less than five years in another
state or country that does not have or maintain
standards and requirements of practice and
licensing or registration that substantially
conform to those of this state, as determined by
the department. (Emphasis added).
It is clear that sections l(2) and 2(b)(l) do not specifically require
a massage therapy instructor to conply with the department’s require-
ments for a massage therapy school, but the legislature has provided
that the department, through the Board of Health, may adopt rules
consistent with article 4512k which are necessary for the performance
of its duties under the statute. V.T.C.S. art. 4512k, 67(a).
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Dr. Robert Bernstein - Page 4 (.I&609)
A rule promulgated by the department must be reasonable and
within the ambit of the statutory requirements. See, e.g.. Gerst v.
Oak Cliff Savings & Loan Association, 432 S.W.2d 702 (Tex. 1968);
State Board of Insurance v. Deffebach, 631 S.W.2d 794. 798 (Tex. Civ.
APP . - Austin 1982, writ ref’d c.r.e.). Section Z(b)(l) of article
4512k authorizes the department to “recognize” massage therapy
schools. The board has adopted regulations setting forth guldelines
by which these schools may be recognized (registered) by the
department. See 25 T.A.C. $141.9. These regulations, which became
effective beginning January 1, 1986, set minimum standards for the
administration and operation of these schools. Id. But these
regulations do uot make provisions governing self-exoyod massage
therapy instructors who teach two or more apprentices.
Section l(3) of article 4512k specifies that-one of the require-
ments of becoming a massage therapy instructor is to instruct one or
more apprentices in massage therapy. The statute does not specify
whether the instructor must teach at a school or an establishment. it
is reasonable to assume that a self-employed massage therapist may
teach one or more apprentices. A rule requiring the self-employed
instructor who is teaching more than two apprentices to comply with
the department’s requirements for a massage therapy school would
foreclose au option explicitly provided by the legislature. V.T.C.S.
art. 4512k. 12(b)(1). Section 2(b)(l) provides that a person seeking
registration by the board may receive all his instruction through
a school recognized by the department or by a “combination of
instructors or schools.” Id. Accordingly. we conclude that such a
rule promulgated by the department would be inconsistent with its
statutory authority. See, e.g., Bexar County Bail Bond Board v.
Deckard, 604 S.W.2d 214 (Tex. Civ. App. - San Antonio 1980, no writ).
You also ask whether the department may promulgate a rule
requiring each massage establishment to include on all forms of
advertising the uame of the establishment as it appears ou the
registration certificate, aud the state registration number of each
massage therapist practicing in the establishment. The legislature
has enacted section 5 of article 4512k. V.T.C.S., which provides:
Sec. 5. (a) Each massage establishment nust
post in plain sight the certificate of registra-
tion of each massage therapist who practices in
the massage establishment.
(b) A person who is not registered under this
Act may not use the word ‘massage’ on any m or
other form of advertising. (Emphasis added).
The United States Supreme Court has held that statutes and
regulations requiring mandatory disclosure of certain facts must be
reasonably related to the state’s interest in preventing deception oi
consumers. Zauderer V. Office of Disciplinary Counsel of the Suprrae
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Dr. Robert Bernstein - Page 5 (JM-609)
Court of Ohio, 105 S.Ct. 2265, 85 L.Ed.2d 652 (1985). A statute or
regulation which imposes unjustified or unduly burdensome disclosure
requirements might offend the First Amendment by chilliog protected
commercial speech. Id. We believe that section 5 is rationally
related to the legislative purpose of preventing the deception of
consumers seeking this type of service. See Bill Analysis to B.B. No.
2012, prepared for Eouse Committee on Business and Commerce. filed in
Bill File to E.B. No. 2012. Legislative Reference Library.
Section 5 does not explicitly provide that this information be
placed in all forms of advertising about a massage establishment. We
believe that the legislature intended, by enacting section 5, to grant
the department implicit authority to regulate the advertising of
massage establishments. A rule, however, requiring that each massage
establishment include in all forms of advertising. the came as it
appesrs on the registration certificatr. and the state registration
number of each massage therapist practicing in the establishment may
be unreasonable. See Zauderer v. Office of Disciplinary Counsel of
the Supreme Court of Ohio, m; cf. State Board of Insurance v.
Deffebach, 631 S.W.2d 794 (Tex. Civ. App. - Austin 1982, writ ref'd
n.r.e.) (regulation must be reasonable and within the statutory
authority). You have not submitted any proposed rule or specified the
kinds of advertising you have in mind, and as a result, we do not
reach specific examples.
SUMMARY
The Texas Department of Realth is not authorized
under article 4512k. V.T.C.S.. to promulgate a rule
requiring a massage therapy instructor, who is self-
employed and teaches more than two apprentices, to
;z;; with its requirements for a massage therapy
.
The department is not authorized under sections
5 and 7(a) of article 4512k. V.T.C.S., to promulgate
a rule requiring each massage establishment to
include in all forms of advertising, the name as it
appears on the registration certificate, and the
state registration number of each massage therapist
practicing in the establishment, but it is empowered
to reasonably regulate advertising.
Very truly your
Ll /ikit&
JIM&TO,
Attorney General of Texas
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Dr. Robert Bernstein - Page 6 (34-609)
JACK HIGETOWER
First Assistant Attorney General
MARY KBLLER
Executive Assistant Attorney General
RICK GILPIN
Chairman, Opinion Committee
Prepared by Tony Guillory
Assistant Attorr.eyGeneral
p. 2724