# COMAR Title 10 — Maryland Department of Health ## Subtitle 65 — Board of Massage Therapy Examiners ### Chapter 11 — Curriculum Approval **Authority:** Health Occupations Article, §6-302(b)(3)(i) and (c)(3)(i), Annotated Code of Maryland **Administrative History:** Effective date: December 25, 2023 (50:25 Md. R. 1088) #### Regulation .01 Definitions. *COMAR 10.65.11.01* A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Approval” means the status granted to a massage therapy education program that is in compliance with the regulations of the Board. (2) “Board-recognized massage therapy accreditation agency (BRMTA)” means an institutional accreditation agency recognized by the United States Department of Education (USDOE). (3) “Clinical faculty” means a clinical faculty member of a program who is licensed or registered to practice massage therapy in the State of Maryland. (4) Clinical Learning Experience. (a) “Clinical learning experience” means faculty planned and guided learning activities designed to assist students to: (i) Meet course objectives; and (ii) Apply massage therapy knowledge and skills in the direct care of clients. (b) “Clinical learning experience” includes: (i) Direct care of clients within the relevant practice setting; and (ii) Clinical support activities such as student clinics. (5) “Conditional approval” means a limited-time status that: (a) Is imposed by the Board if the Board finds evidence that the curriculum has failed to meet or maintain the regulations or requirements, or both, set by the Board; and (b) Allows the curriculum to continue to operate subject to the curriculum conforming to the Board’s requirements and recommendations within a time period set by the Board. (6) “Controlling institution” means an organization that offers a massage therapy education curriculum. (7) “Cooperating clinical entity” means an entity that provides the facilities and clinical resources for clinical learning experiences in massage therapy, with the massage therapy faculty or the clinical massage therapy faculty of the program responsible for the planning, implementation, and evaluation of these experiences. (8) “Endorsement” means having a curriculum approved by: (a) COMTA; or (b) An equivalent entity that accredits both institutions of higher education and programs offering instruction in massage therapy. (9) “Initial approval” means the approval period from the first admission of massage therapy students to the program through the first full implementation of the curriculum and graduation. (10) “Licensed massage therapist” means an individual who is licensed by the Board to practice massage therapy. (11) “Massage therapy faculty” means an individual who is employed to teach the practice of massage therapy full-time or part-time in a massage therapy education program. (12) “MBLEx” means the Massage and Bodywork Licensing Examination, a national entry-level licensure exam, governed and administered by the Federation of State Massage Therapy Boards (FSMTB). (13) “MHEC” means Maryland Higher Education Commission. (14) Program. (a) “Program” means a massage therapy educational program. (b) “Program” includes: (i) A college; or (ii) A school. (15) “Regional massage therapy education accrediting agency” means an accrediting agency that operates in a specific geographic region of the United States and accredits post-secondary institutions and primary and secondary schools. (16) “Registered massage practitioner” means an individual who is registered by the Board to practice massage therapy in a setting that is not a health care setting. (17) “USDOE” means the United States Department of Education. #### Regulation .02 Approval of Curriculum Accredited by a Board-Recognized Massage Therapy Accreditation Agency. *COMAR 10.65.11.02* A. The Board shall approve any massage therapy education curriculum in Maryland whose program has been granted accreditation by a BRMTA, provided the curriculum meets all requirements of this chapter. B. A program that has been accredited by a BRMTA shall submit to the Board within 30 days of that accreditation: (1) Evidence of current accreditation and endorsement status; (2) Accreditation reports; and (3) Any correspondence related to the status of the curriculum’s accreditation and endorsement. C. The Board shall continue to grant approval to curricula in Maryland provided that there is evidence of continuing accreditation by a BRMTA, and endorsement, and that those curricula continue to meet all requirements of this chapter. D. The Board shall be notified in writing within 10 business days of any change in accreditation or endorsement status by the massage therapy program. E. Withdrawal of accreditation or endorsement, accreditation or endorsement with warning, or failure to meet the requirements of this chapter or the standard for performance on the licensing examination shall be cause for Board review of the curriculum in accordance with Regulations .07B and C and .08 of this chapter. F. A curriculum on which the Board has taken action under Regulations .07B and C and .08 of this chapter shall be reported to MHEC. #### Regulation .03 Massage Therapy Faculty and Clinical Massage Therapy Faculty. *COMAR 10.65.11.03* A. Qualifications of Massage Therapy Faculty. (1) Unless otherwise provided in this chapter, massage therapy faculty shall: (a) Be currently licensed or registered to practice massage therapy in Maryland; (b) Be academically and professionally qualified; (c) Maintain expertise appropriate to their teaching responsibilities; (d) Have a minimum of 5 years of clinical experience as a licensed massage therapist or registered massage practitioner; and (e) Have an unencumbered license or registration for the past 5 years. (2) Non-massage therapy faculty or a licensed massage therapist or a registered massage practitioner not meeting the requirements for massage therapy faculty may teach selected portions of the curriculum that: (a) Are unrelated to the practice of massage therapy; and (b) Relate to their areas of expertise. B. Waiver. (1) A program experiencing a faculty shortage or a demonstrable difficulty in hiring appropriate faculty may petition the Board for a waiver of any provision of this regulation in massage therapy. (2) The petition for a waiver of any requirement in massage therapy faculty qualification shall include documentation that the institution has made good faith attempts to hire massage therapy faculty. C. Qualifications of Clinical Massage Therapy Faculty. Unless otherwise provided in this chapter, a clinical massage therapy faculty member shall: (1) Be currently licensed or registered to practice massage therapy in Maryland; (2) Have a minimum of 5 years of clinical experience practicing massage therapy; (3) Have the clinical experience necessary to function effectively and safely in the clinical massage therapy area of responsibility; and (4) Have an unencumbered license or registration for the past 5 years. #### Regulation .04 Resources, Facilities, and Services. *COMAR 10.65.11.04* A. All facilities used for clinical learning experiences shall comply with all applicable federal, state, and local requirements. B. Cooperating clinical entities shall have: (1) Clinical massage therapy faculty on-site and physically available for consultation with massage therapy student; and (2) A dedicated student area for training demonstrations. C. Students participating in clinical learning experiences shall be clearly identified as students. #### Regulation .05 Curriculum. *COMAR 10.65.11.05* A. The curriculum shall meet criteria as stated under COMAR 10.65.01.07. B. Changes in course offerings that will alter the curriculum, objectives, outcomes, competencies, or conceptual framework of the program shall: (1) Be reported to the Board in the annual report; and (2) Include the following information: (a) The rationale for changes; and (b) The methods of evaluation to be used to determine the effect of the change. C. Clinical learning experiences shall be sufficient in quantity and quality to provide opportunities for students to achieve the stated objectives, outcomes, or competencies. D. Students shall have sufficient opportunities to develop the knowledge, skills, and abilities essential for a safe and effective massage therapy practice. E. Evaluation methods and tools used for measuring students’ knowledge, skills, and abilities shall be developed and implemented in order to ensure satisfactory progression of students. #### Regulation .06 Curriculum Evaluation. *COMAR 10.65.11.06* A. The program shall develop and implement a Board-approved evaluation plan for evaluating the total massage therapy education program not less than every 5 years for curricula that are accredited by a BRMTA. B. The evaluation plan shall include: (1) All components of the curriculum; (2) Evaluation time intervals; (3) Student, graduate, faculty, cooperating clinical entities, and administration participation; (4) Instruments or methods used; and (5) Evidence that prior recommendations from the Board have been acted upon. C. The evaluation process shall provide evidence that the program is meeting its objectives or outcomes as well as the changing needs of massage therapy and society. D. The outcome of evaluation includes: (1) Recommendations for necessary curriculum revisions; and (2) Direction for future action. #### Regulation .07 Annual Review. *COMAR 10.65.11.07* A. A program shall submit the following to the Board no later than July 1 of each year: (1) An annual report detailing the program; (2) A program catalog; (3) Any annual reports to the BRMTA; (4) Any correspondence related to the status of the program’s accreditation; (5) A summary of practices followed in safeguarding the health and well-being of students; (6) Accurate and complete data including, but not limited to, number of enrollments, admissions, graduates, and faculty; and (7) A report detailing: (a) Annual pass rates for first-time candidates who have taken the MBLEx exam; and (b) Student retention and program completion rates. B. Annually the Board shall: (1) Review each program’s annual report, supporting documentation, and the licensure examination performance of first-time candidates from each program; and (2) If necessary, conduct a survey or site visit, issue recommendations, place a program on conditional approval, or issue a formal notice of violation and withdraw approval in accordance with Regulation .08 of this chapter. C. Approval may be reduced to conditional status for the following reasons: (1) Noncompliance with this chapter; (2) Failure to hire faculty who meet the qualifications as stated in Regulation .03 of this chapter; (3) Failure to submit records and reports to the Board in a timely manner; (4) Failure to implement the approved curriculum; (5) In accordance with §D of this regulation, failure to maintain the required passing rate on the licensing examination by first-time candidates; (6) Failure to annually document that all faculty have current licenses; and (7) Other activities or situations, as determined by the Board, that indicate a program is in jeopardy of violating statutory and regulatory requirements and standards. D. Below Standard Performance on Licensure Examination. (1) A program shall maintain a minimum pass rate of 65 percent for first-time candidates. (2) The Board shall issue a warning to a program when the pass rate of first-time candidates is below 65 percent. (3) For the first year a program does not meet the 65 percent pass rate requirements of §D(1) of this regulation and following the warning in §D(2) of this regulation, the program shall, within 30 calendar days, provide to the Board: (a) A report that identifies the factors believed to have contributed to the below standard performance; and (b) An action plan to be approved by the Board. (4) Second Successive Year Not in Compliance. (a) For the second successive year that a program is not in compliance with §D(1) of this regulation, the program shall: (i) Be placed on conditional approval; and (ii) Provide the Board with a report analyzing all aspects of the educational program and identifying areas that may be contributing to the below standard performance. (b) The Board’s professional staff may conduct a survey visit to the school and provide a report to the Board. (5) If compliance with the minimum licensure examination performance standard for first-time candidates is not made by the program within 1 examination year from the date of conditional approval, approval may be withdrawn. #### Regulation .08 Withdrawal of Curriculum Approval. *COMAR 10.65.11.08* A. At least 30 days before issuing a formal notice of violation of regulations to a program, the Board shall notify the chief administrator of: (1) The controlling institution, if applicable; and (2) The massage therapy education program that the Board is considering issuing a formal notice of violation. B. During the 30-day period, the Board shall provide the chief administrator of the controlling institution, if applicable, and the massage therapy education program with an opportunity to meet with representatives of the Board to discuss the Board’s proposed action against the program. C. The program shall notify the Board within the 30-day period if it is interested in meeting with the Board. If the program requests a meeting, the Board shall make the arrangements. D. At the meeting, the program shall submit to the Board a plan with a proposed timeframe for correcting the violations. E. The Board shall: (1) Evaluate the plan; (2) Approve or modify the plan; and (3) Have discretion to make changes to the timeframes for correcting violations or other components of the plan. F. The program shall correct the violations within the timeframes approved by the Board. G. Approval may be withdrawn for the following reasons: (1) Noncompliance with any of the regulations in this chapter; (2) Failure to: (a) Hire faculty who meet the qualifications as stated in Regulation .03 of this chapter; (b) Submit records and reports to the Board in a timely manner; (c) Implement the approved curriculum; (d) Comply with the Board’s requirements within the specified timeframes; (e) Maintain the required passing rate on the MBLEx exam by first-time candidates; and (f) Annually document that all faculty have current licenses; and (3) Other activities or situations, as determined by the Board, that indicate a program is not meeting statutory and regulatory requirements and standards. H. Withdrawal of Approval. If the program does not correct the violations within the approved timeframes, the Board shall begin proceedings to remove the program from its list of institutions that offer approved massage therapy education programs in Maryland pursuant to Health Occupations Article, §§6-308—6-310, Annotated Code of Maryland. #### Regulation .09 New Programs and Continuing Approval Requirements. *COMAR 10.65.11.09* A. New Program Requirements. The Board shall cooperate with MHEC when approving and reviewing curricula. B. Approval. (1) Upon review of an application for curriculum approval, the Board may: (a) Grant approval; (b) Place the curriculum on provisional approval; (c) Request revisions of the curriculum to align with the Board’s statute and regulations; or (d) Deny the application. (2) Approval: (a) Is required before the admission of students; and (b) Requires concurrence of the Maryland Higher Education Commission. C. Provisional Approval. A program seeking accreditation or endorsement may be granted provisional approval to graduate students if the program submits: (1) Proof of application status for accreditation or endorsement; (2) An application for provisional curriculum approval; and (3) Otherwise meets the requirements of this regulation. D. A program may not operate under provisional status for longer than 2 years. #### Regulation .10 Closure of Programs. *COMAR 10.65.11.10* A. Upon request, the Board shall provide consultation concerning closing of a program. B. Upon the decision by a program to close, and at least 90 days before closing, the program shall notify the Board of its intent, giving the following information: (1) Date and reason for closing; (2) Plans for phasing out the program, including a teach-out program; (3) Disposition of the records of students, graduates, and faculty; and (4) Title of the position of the individual to be responsible for the records and the name of the agency in which the records will be located.