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<chapter num="11" heading="Curriculum Approval" title_num="10" subtitle_num="65">
  <regulation prefix="Regulation" num=".01" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Approval” means the status granted to a massage therapy education program that is in compliance with the regulations of the Board.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Board-recognized massage therapy accreditation agency (BRMTA)” means an institutional accreditation agency recognized by the United States Department of Education (USDOE).</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Clinical faculty” means a clinical faculty member of a program who is licensed or registered to practice massage therapy in the State of Maryland.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Clinical Learning Experience.</text>
        <paragraph num="(a)">
          <text>“Clinical learning experience” means faculty planned and guided learning activities designed to assist students to:</text>
          <paragraph num="(i)">
            <text>Meet course objectives; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Apply massage therapy knowledge and skills in the direct care of clients.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Clinical learning experience” includes:</text>
          <paragraph num="(i)">
            <text>Direct care of clients within the relevant practice setting; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Clinical support activities such as student clinics.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>“Conditional approval” means a limited-time status that:</text>
        <paragraph num="(a)">
          <text>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</text>
        </paragraph>
        <paragraph num="(b)">
          <text>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.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>“Controlling institution” means an organization that offers a massage therapy education curriculum.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“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.</text>
      </paragraph>
      <paragraph num="(8)">
        <text>“Endorsement” means having a curriculum approved by:</text>
        <paragraph num="(a)">
          <text>COMTA; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>An equivalent entity that accredits both institutions of higher education and programs offering instruction in massage therapy.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(9)">
        <text>“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.</text>
      </paragraph>
      <paragraph num="(10)">
        <text>“Licensed massage therapist” means an individual who is licensed by the Board to practice massage therapy.</text>
      </paragraph>
      <paragraph num="(11)">
        <text>“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.</text>
      </paragraph>
      <paragraph num="(12)">
        <text>“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).</text>
      </paragraph>
      <paragraph num="(13)">
        <text>“MHEC” means Maryland Higher Education Commission.</text>
      </paragraph>
      <paragraph num="(14)">
        <text>Program.</text>
        <paragraph num="(a)">
          <text>“Program” means a massage therapy educational program.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Program” includes:</text>
          <paragraph num="(i)">
            <text>A college; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>A school.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(15)">
        <text>“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.</text>
      </paragraph>
      <paragraph num="(16)">
        <text>“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.</text>
      </paragraph>
      <paragraph num="(17)">
        <text>“USDOE” means the United States Department of Education.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Approval of Curriculum Accredited by a Board-Recognized Massage Therapy Accreditation Agency.">
    <paragraph num="A.">
      <text>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.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A program that has been accredited by a BRMTA shall submit to the Board within 30 days of that accreditation:</text>
      <paragraph num="(1)">
        <text>Evidence of current accreditation and endorsement status;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Accreditation reports; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Any correspondence related to the status of the curriculum’s accreditation and endorsement.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>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.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The Board shall be notified in writing within 10 business days of any change in accreditation or endorsement status by the massage therapy program.</text>
    </paragraph>
    <paragraph num="E.">
      <text>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.</text>
    </paragraph>
    <paragraph num="F.">
      <text>A curriculum on which the Board has taken action under Regulations .07B and C and .08 of this chapter shall be reported to MHEC.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Massage Therapy Faculty and Clinical Massage Therapy Faculty.">
    <paragraph num="A.">
      <text>Qualifications of Massage Therapy Faculty.</text>
      <paragraph num="(1)">
        <text>Unless otherwise provided in this chapter, massage therapy faculty shall:</text>
        <paragraph num="(a)">
          <text>Be currently licensed or registered to practice massage therapy in Maryland;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Be academically and professionally qualified;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Maintain expertise appropriate to their teaching responsibilities;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Have a minimum of 5 years of clinical experience as a licensed massage therapist or registered massage practitioner; and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Have an unencumbered license or registration for the past 5 years.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>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:</text>
        <paragraph num="(a)">
          <text>Are unrelated to the practice of massage therapy; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Relate to their areas of expertise.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Waiver.</text>
      <paragraph num="(1)">
        <text>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.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>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.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Qualifications of Clinical Massage Therapy Faculty. Unless otherwise provided in this chapter, a clinical massage therapy faculty member shall:</text>
      <paragraph num="(1)">
        <text>Be currently licensed or registered to practice massage therapy in Maryland;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Have a minimum of 5 years of clinical experience practicing massage therapy;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Have the clinical experience necessary to function effectively and safely in the clinical massage therapy area of responsibility; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Have an unencumbered license or registration for the past 5 years.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Resources, Facilities, and Services.">
    <paragraph num="A.">
      <text>All facilities used for clinical learning experiences shall comply with all applicable federal, state, and local requirements.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Cooperating clinical entities shall have:</text>
      <paragraph num="(1)">
        <text>Clinical massage therapy faculty on-site and physically available for consultation with massage therapy student; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>A dedicated student area for training demonstrations.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Students participating in clinical learning experiences shall be clearly identified as students.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Curriculum.">
    <paragraph num="A.">
      <text>The curriculum shall meet criteria as stated under COMAR 10.65.01.07.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Changes in course offerings that will alter the curriculum, objectives, outcomes, competencies, or conceptual framework of the program shall:</text>
      <paragraph num="(1)">
        <text>Be reported to the Board in the annual report; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Include the following information:</text>
        <paragraph num="(a)">
          <text>The rationale for changes; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The methods of evaluation to be used to determine the effect of the change.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Clinical learning experiences shall be sufficient in quantity and quality to provide opportunities for students to achieve the stated objectives, outcomes, or competencies.</text>
    </paragraph>
    <paragraph num="D.">
      <text>Students shall have sufficient opportunities to develop the knowledge, skills, and abilities essential for a safe and effective massage therapy practice.</text>
    </paragraph>
    <paragraph num="E.">
      <text>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.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Curriculum Evaluation.">
    <paragraph num="A.">
      <text>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.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The evaluation plan shall include:</text>
      <paragraph num="(1)">
        <text>All components of the curriculum;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Evaluation time intervals;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Student, graduate, faculty, cooperating clinical entities, and administration participation;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Instruments or methods used; and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Evidence that prior recommendations from the Board have been acted upon.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>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.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The outcome of evaluation includes:</text>
      <paragraph num="(1)">
        <text>Recommendations for necessary curriculum revisions; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Direction for future action.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Annual Review.">
    <paragraph num="A.">
      <text>A program shall submit the following to the Board no later than July 1 of each year:</text>
      <paragraph num="(1)">
        <text>An annual report detailing the program;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>A program catalog;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Any annual reports to the BRMTA;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Any correspondence related to the status of the program’s accreditation;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>A summary of practices followed in safeguarding the health and well-being of students;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Accurate and complete data including, but not limited to, number of enrollments, admissions, graduates, and faculty; and</text>
      </paragraph>
      <paragraph num="(7)">
        <text>A report detailing:</text>
        <paragraph num="(a)">
          <text>Annual pass rates for first-time candidates who have taken the MBLEx exam; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Student retention and program completion rates.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Annually the Board shall:</text>
      <paragraph num="(1)">
        <text>Review each program’s annual report, supporting documentation, and the licensure examination performance of first-time candidates from each program; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>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.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Approval may be reduced to conditional status for the following reasons:</text>
      <paragraph num="(1)">
        <text>Noncompliance with this chapter;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Failure to hire faculty who meet the qualifications as stated in Regulation .03 of this chapter;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Failure to submit records and reports to the Board in a timely manner;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Failure to implement the approved curriculum;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>In accordance with §D of this regulation, failure to maintain the required passing rate on the licensing examination by first-time candidates;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Failure to annually document that all faculty have current licenses; and</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Other activities or situations, as determined by the Board, that indicate a program is in jeopardy of violating statutory and regulatory requirements and standards.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Below Standard Performance on Licensure Examination.</text>
      <paragraph num="(1)">
        <text>A program shall maintain a minimum pass rate of 65 percent for first-time candidates.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The Board shall issue a warning to a program when the pass rate of first-time candidates is below 65 percent.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>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:</text>
        <paragraph num="(a)">
          <text>A report that identifies the factors believed to have contributed to the below standard performance; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>An action plan to be approved by the Board.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>Second Successive Year Not in Compliance.</text>
        <paragraph num="(a)">
          <text>For the second successive year that a program is not in compliance with §D(1) of this regulation, the program shall:</text>
          <paragraph num="(i)">
            <text>Be placed on conditional approval; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>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.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>The Board’s professional staff may conduct a survey visit to the school and provide a report to the Board.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>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.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Withdrawal of Curriculum Approval.">
    <paragraph num="A.">
      <text>At least 30 days before issuing a formal notice of violation of regulations to a program, the Board shall notify the chief administrator of:</text>
      <paragraph num="(1)">
        <text>The controlling institution, if applicable; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The massage therapy education program that the Board is considering issuing a formal notice of violation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>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.</text>
    </paragraph>
    <paragraph num="C.">
      <text>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.</text>
    </paragraph>
    <paragraph num="D.">
      <text>At the meeting, the program shall submit to the Board a plan with a proposed timeframe for correcting the violations.</text>
    </paragraph>
    <paragraph num="E.">
      <text>The Board shall:</text>
      <paragraph num="(1)">
        <text>Evaluate the plan;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Approve or modify the plan; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Have discretion to make changes to the timeframes for correcting violations or other components of the plan.</text>
      </paragraph>
    </paragraph>
    <paragraph num="F.">
      <text>The program shall correct the violations within the timeframes approved by the Board.</text>
    </paragraph>
    <paragraph num="G.">
      <text>Approval may be withdrawn for the following reasons:</text>
      <paragraph num="(1)">
        <text>Noncompliance with any of the regulations in this chapter;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Failure to:</text>
        <paragraph num="(a)">
          <text>Hire faculty who meet the qualifications as stated in Regulation .03 of this chapter;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Submit records and reports to the Board in a timely manner;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Implement the approved curriculum;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Comply with the Board’s requirements within the specified timeframes;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Maintain the required passing rate on the MBLEx exam by first-time candidates; and</text>
        </paragraph>
        <paragraph num="(f)">
          <text>Annually document that all faculty have current licenses; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>Other activities or situations, as determined by the Board, that indicate a program is not meeting statutory and regulatory requirements and standards.</text>
      </paragraph>
    </paragraph>
    <paragraph num="H.">
      <text>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.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="New Programs and Continuing Approval Requirements.">
    <paragraph num="A.">
      <text>New Program Requirements. The Board shall cooperate with MHEC when approving and reviewing curricula.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Approval.</text>
      <paragraph num="(1)">
        <text>Upon review of an application for curriculum approval, the Board may:</text>
        <paragraph num="(a)">
          <text>Grant approval;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Place the curriculum on provisional approval;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Request revisions of the curriculum to align with the Board’s statute and regulations; or</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Deny the application.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Approval:</text>
        <paragraph num="(a)">
          <text>Is required before the admission of students; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Requires concurrence of the Maryland Higher Education Commission.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Provisional Approval. A program seeking accreditation or endorsement may be granted provisional approval to graduate students if the program submits:</text>
      <paragraph num="(1)">
        <text>Proof of application status for accreditation or endorsement;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>An application for provisional curriculum approval; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Otherwise meets the requirements of this regulation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>A program may not operate under provisional status for longer than 2 years.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".10" heading="Closure of Programs.">
    <paragraph num="A.">
      <text>Upon request, the Board shall provide consultation concerning closing of a program.</text>
    </paragraph>
    <paragraph num="B.">
      <text>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:</text>
      <paragraph num="(1)">
        <text>Date and reason for closing;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Plans for phasing out the program, including a teach-out program;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Disposition of the records of students, graduates, and faculty; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>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.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health Occupations Article, §6-302(b)(3)(i) and (c)(3)(i), Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: December 25, 2023 (50:25 Md. R. 1088)</annotation>
  </annotations>
</chapter>