Justification for Administrative Rule Adoption
JUSTIFICATION FOR ADMINISTRATIVE RULE ADOPTION
Massage Therapy Program
16 TAC Chapter 117, adopts amendments at Subchapter C, §117.20 and §117.24; Subchapter D, §117.30 and §117.31; Subchapter G, §117.82; Subchapter H, §§117.90, 117.91, and 117.92 ; and withdraws new rule Subchapter D, §117.35 and proposed amendments at Subchapter F, §117.64 .
The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 117, Subchapter C, §117.24; Subchapter D, §117.30 and §117.31; Subchapter G, §117.82; Subchapter H, §§117.90, 117.91, and 117.92, regarding the Massage Therapy Program, without changes to the proposed text as published in the November 20, 2020, issue of the Texas Register (45 TexReg 8231).
The Commission also adopts amendments to an existing rule at 16 TAC Chapter 117, Subchapter C, §117.20, regarding the Massage Therapy Program, with changes to the proposed text as published in the November 20, 2020, issue of the Texas Register (45 TexReg 8231).
The Commission withdraws the proposed new rule at 16 TAC, Chapter 117, Subchapter D, §117.35; and proposed amendments to an existing rule at Subchapter F, §117.64, regarding the Massage Therapy Program, as published in the November 20, 2020, issue of the Texas Register (45 TexReg 8231)
EXPLANATION OF AND JUSTIFICATION FOR THE RULES
The rules under 16 TAC Chapter 117 implement Texas Occupations Code, Chapter 455.
The adopted rules are necessary to implement House Bill (HB) 2059, 86th Legislature, Regular Session (2019). HB 2059 requires massage therapists and other health care practitioners to complete a human trafficking prevention training course in order to renew their license. The Executive Commissioner of the Health and Human Services Commission (HHSC) approves human trafficking prevention courses, including at least one course that is available without charge, and posts a list of approved courses on the HHSC website. The statutory provisions created by HB 2059 are located in Texas Occupations Code, Chapter 116. The adopted rules implement this training requirement. The adopted rules also clearly require that a new written consent be obtained before each session involving breast massage of a female client. Additionally, the adopted rules make clean-up and clarification changes designed to update the rules and make them easier to understand.
The adopted rules amend §117.20 by requiring massage therapist applicants to ensure that a certified transcript or other record of all relevant coursework is submitted to the Department. This change clarifies that massage schools in Texas may send a record of coursework electronically to the Department, through the new PALMS (Program Automation for the Licensing of Massage Students) system for reporting hours and enrolled students. The adopted change also allows applicants from out-of-state schools to send the Department a certified transcript. Changes were made to subsection (a)(4) by adding the word “acceptable” to the proposed amended language.
The adopted rules amend §117.24 by requiring massage therapists to complete an HHSC-approved human trafficking prevention training and provide proof of completion to renew their massage therapist license. This training must be completed before each license renewal.
The adopted rules amend §117.30 by correcting a typographical error.
The adopted rules amend §117.31 by re-wording subsection (a) for clarity.
The adopted rules amend §§117.82, 117.90, and 117.92 to refer to the new written consent that must be obtained before each massage therapy session involving breast massage of a female client.
The adopted rules amend §117.91 to clearly require a new written consent be obtained before each session involving breast massage of a female client. The adopted rules also re-title §117.91 to refer to written consent.
The Department drafted and distributed the proposed rules to persons internal and external to the agency. The proposed rules were published in the November 20, 2020, issue of the Texas Register (45 TexReg 8231). The deadline for public comments was December 21, 2020. The Department received comments from nine interested parties on the proposed rules during the 30-day public comment period. The public comments are summarized below.
Comment: Three commenters opposed the requirement to take a human trafficking prevention course. One of these commenters also stated that time is better spent in field-related CE courses.
Department Response: The human trafficking prevention training is required by statute, and the Department does not have authority to waive it. Regarding continuing education requirements, the Department agrees with the comment and the Massage Therapy Advisory Board’s recommendation to not allow the human trafficking prevention training to count as continuing education. The Department made changes to the proposed rules in response to this portion of the comment. Specifically, the Department withdrew the proposed new §117.35. The Department did not make changes in response to the portion of the comments opposing the requirement to take the human trafficking prevention training course.
Comment: Two commenters alerted the Department to errors on the Department’s webpage containing the text of the proposed rules. The Department corrected the webpage and notified the commenters that the errors had been corrected. The Department also sent the commenters links to the corrected webpage and to the Texas Register, where the proposed rules were published without error.
Department Response: The Department appreciates the comments and thanks the commenters for alerting the Department to the errors. The Department did not make any changes to the proposed rules in response to these comments.
Comment: One commenter would like the requirement for written consent prior to breast massage to apply for all clients, not just female clients. The commenter opposed a rule which applies only to females and wondered how it would apply to non-binary clients and males.
Department Response: The Department disagrees with making this change in the adopted version of these rules. To require written consent prior to breast massage for all clients, the Department would need to propose additional rule amendments beyond what have been proposed for this rule package. The Department did not make any changes to the proposed rules in response to this comment.
Comment: One commenter requested language translation for the massage therapist licensing examination.
Department Response: This comment is outside the scope of the proposed rules. The Department did not make any changes to the proposed rules in response to this comment.
Comment: One commenter opposed the proposed changes to §117.20. Specifically, the commenter disagreed with massage schools being required to submit reports to TDLR through the PALMS electronic system. The commenter also was concerned that the proposed change to §117.20 does not clearly indicate whether an applicant may choose the format in which the applicant’s coursework is submitted to TDLR, or whether massage schools will still be required to use PALMS to submit reports to the Department regarding student coursework. The commenter stated that he believes that other proposed changes are reasonable, but he disputed TDLR’s assessment that the changes will have no financial impact. He also raised concerns about the content and administration of the massage therapy licensing examination, the features and operation of the PALMS system, the implementation of HB 2747 (86th Legislature, Regular Session—2019), the Department’s license application processing time, and whether the massage therapy rules are sufficiently clear regarding who must obtain a student permit. The commenter also suggested alternative technologies to PALMS, a report on the effectiveness of student permits in reducing human trafficking, various additional changes to the massage therapy rules, and repealing HB 1865 (86 th Legislature, Regular Session—2019), which requires a student permit and other measures intended to combat human trafficking.
Department Response: The Department disagrees with the commenter’s statements regarding §117.20. The requirement for massage schools to submit monthly reports to the Department regarding student attendance and credit hours is contained in statute. The Department has provided PALMS as a way for schools to submit these reports electronically rather than through paper correspondence. The proposed changes to §117.20 do not affect the requirement for massage schools to submit monthly reports via PALMS. The Department believes that the proposed language in §117.20 is sufficiently clear regarding this.
The Department also disagrees with the comments regarding fiscal impact. Most of the proposed changes will not require any change in practice for licensees. The human trafficking prevention training is already required by statute, and incorporating it into the rules will not increase costs to licensees. Any costs associated with obtaining written consent before each session involving breast massage are so minimal as to not have a financial impact.
The remainder of this comment is outside the scope of the proposed rules. The Department did not make any changes to the proposed rules in response to this comment.
Comment: One commenter stated that he agreed with the previous comment, described above. He also stated that he opposed “taking the transcripts away from the schools,” disagreed with the Department’s administration of the Massage Therapy program, and stated that he would like for massage therapy intern students be allowed to accept gratuities.
Department Response: Please see above for the Department’s response to the previous comment. The remainder of this comment is outside the scope of the proposed rules. The Department did not make any changes to the proposed rules in response to this comment.
ADVISORY BOARD RECOMMENDATIONS AND COMMISSION ACTION
The Massage Therapy Advisory Board met on January 21, 2021, to discuss the proposed rules and the public comments received. The Advisory Board recommended that the Commission adopt the proposed rules as published in the Texas Register with changes to §117.20(a)(4) and the withdrawal of proposed rules at §117.35 and §117.64. The Department recommended the change to §117.20(a)(4) and withdrawing the proposed change to §117.64. The Advisory Board and one commenter recommended that the human trafficking prevention training course not count as continuing education (withdrawal of proposed §117.35).
At its meeting on March 3, 2021, the Commission adopted the proposed rules with changes as recommended by the Advisory Board.
The adopted rules are adopted under Texas Occupations Code, Chapters 51 and 455, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.
The statutory provisions affected by the adopted rules are those set forth in Texas Occupations Code, Chapters 51 and 455. No other statutes, articles, or codes are affected by the adopted rules.
SUBCHAPTER C. LICENSED MASSAGE THERAPIST AND STUDENT PERMIT.
§117.20. Massage Therapist License--General Requirements and Application.
(a) To be eligible for a Massage Therapist license an applicant must:
(1) submit a completed application on a department-approved form;
(2) pay the fee required under §117.100;
(3) be at least 18 years of age;
(4) ensure that a certified transcript or other acceptable record of all relevant course work is submitted to the department;
(5) provide proof of successfully passing the required exam;
(6) provide proof of successfully passing the jurisprudence exam;
(7) successfully pass a criminal history background check performed by the department in accordance with the Act, the department’s criminal conviction guidelines, and pursuant to Texas Occupations Code, Chapters 51 and 53; and
(8) satisfactorily complete massage therapy studies in a minimum 500-hour department approved course at a licensed massage school in which includes at least:
(A) 200 hours of massage therapy techniques and theory and the practice of manipulation of soft tissue, with at least 125 hours of Swedish massage therapy techniques;
(B) 50 hours of anatomy;
(C) 25 hours of physiology;
(D) 50 hours of kinesiology;
(E) 40 hours of pathology;
(F) 20 hours of hydrotherapy;
(G) 45 hours of massage therapy laws and rules, business practices and professional ethics;
(H) 20 hours of health, hygiene, first aid, universal precautions, and cardiopulmonary resuscitation (CPR); and
(I) 50-hour internship program.
(b) Unless otherwise indicated, an applicant for licensure as a massage therapist must submit all required information and documentation of credentials on department-approved forms.
(c) If the application is incomplete, the department will send a notice listing any additional materials required to complete the application.
(d) In the event that a deficiency is present in course work, the applicant may have up to one year to complete additional course work acceptable to the department; otherwise, the application may be voided.
(e) A criminal history check performed under this subsection requires an applicant for a license to submit a complete and legible set of fingerprints, on a form prescribed by the department, to the department or to the Department of Public Safety for the purpose of obtaining criminal history record information from the Department of Public Safety and the Federal Bureau of Investigation.
(f) The department may not issue a license to a person who does not comply with the requirements of this section.
(g) The department shall conduct a criminal history record information check of each applicant for a license using information:
(1) provided by the individual under this section; and
(2) made available to the department by the Department of Public Safety, the Federal Bureau of Investigation, and any other criminal justice agency under Chapter 411, Government Code.
§117.24. Massage Therapist License Term; Renewals.
(a) A massage therapist license issued under this chapter is valid for two years.
(b) To renew a massage therapist license, a licensee must:
(1) submit a completed renewal application on a department-approved form;
(2) complete all applicable continuing education requirements;
(3) submit all applicable fees as prescribed under §117.100; and
(4) complete the human trafficking prevention training required under Occupations Code, Chapter 116, and provide proof of completion as prescribed by the department. This training must be completed before each renewal.
(c) On receipt of a renewal application of a license issued under this chapter, the department shall conduct a criminal background check as authorized under §455.1525 of the Occupations Code.
(d) Each licensee is responsible for renewing the license before the expiration date and shall not be excused from paying late renewal fees.
(e) A person whose license has expired may not engage in the activities of a massage therapist and may not hold himself or herself out as a massage therapist, imply that he or she has the title of " licensed massage therapist" or "massage therapist", or use "RMT", "LMT", or "MT" or any facsimile of those titles in any manner.
SUBCHAPTER D. CONTINUING EDUCATION.
§117.30. Massage Therapist Continuing Education--Hours.
(a) Massage therapists must successfully complete at least twelve hours of approved continuing education per license term.
(b) One hour of credit will be awarded for each clock hour of attendance at acceptable continuing education activities, except as follows:
(1) one semester hour of academic credit will constitute fifteen clock hours of continuing education;
(2) one quarter hour of academic credit will constitute ten clock hours of continuing education; and
(3) 0.1 continuing education unit will constitute one clock hour of continuing education.
(c) A clock hour is equal to 50 minutes.
§117.31. Massage Therapist -- Approved Continuing Education Courses and Providers.
(a) Acceptable continuing education includes attendance at and completion of department-approved or -recognized institutes, seminars, workshops, state or national conferences, associations, courses provided by an approved massage therapy school, or college and university academic courses. These programs must be designed to increase and enhance professional knowledge, skills, or competence in the practice of massage therapy. The subject matter must be:
(1) directly related to the theory or clinical application of theory pertaining to the practice of massage therapy and the manipulation of soft tissue, massage therapy laws and rules, business practices, professional ethics, anatomy, physiology, hydrotherapy, kinesiology, pathology, or health and hygiene;
(2) first aid and/or CPR, not to exceed six hours total each renewal period; or
(3) advanced massage therapy or bodywork techniques acceptable to the department.
(b) Continuing education approved or recognized by the department must be developed and presented by qualified persons.
(1) Massage therapy techniques and courses involving the manipulation of soft tissue must be taught or presented by a licensed massage therapy instructor. Advanced massage therapy or bodywork techniques must be taught or presented by persons with licensure, registration, or education in the technique being presented.
(2) Courses, other than techniques, may be taught or presented by persons with licensure, registration, education or practical experience in the subject being presented. Instructors teaching CPR or First Aid must be certified as CPR instructors or First Aid instructors by:
(A) the American Heart Association;
(B) the American Red Cross;
(C) the National Safety Council; or
(D) another provider with curriculum that is in compliance with nationally accepted guidelines established by the above referenced organizations.
(3) Out-of-state instructors or presenters offering continuing education in Texas on massage therapy techniques or involving the manipulation of soft tissue must:
(A) be in compliance with any licensure, registration or certification requirements for massage therapists and massage therapy instructors in the instructor or presenter's home state;
(B) be licensed to practice medicine, occupational therapy, chiropractic, athletic training, physical therapy, or nursing; or
(C) provide documentation of education or practical experience specific to the continuing education being offered if the instructor or presenter's home state does not have licensure, registration or certification requirements for massage therapists and massage therapy instructors.
(c) Continuing education which otherwise meets the standards of this section but is offered or presented online or by correspondence is acceptable only if the subject matter is not massage therapy techniques or manipulation of soft tissue.
(d) The department may approve out-of-state continuing education providers and programs. Continuing education completed out-of-state may be accepted by the department if it is approved by a national board such as the National Certification Board for Therapeutic Massage and Bodywork.
(e) Additional information regarding the continuing education may be required for departmental review.
SUBCHAPTER G. LICENSED MASSAGE ESTABLISHMENTS.
§117.82. Massage Establishments--General Requirements.
(a) A massage establishment shall employ or contract with only licensed massage therapists to perform massage therapy or other massage services. Documentation of the employment or contract relationship and verification that the licensed massage therapist is a United States citizen or a legal permanent resident with a valid work permit shall be maintained by the massage establishment and made available during an inspection or investigation. Required documentation for each person providing massage therapy or other massage services shall include:
(1) a copy of the current massage therapist license;
(2) proof of eligibility to work in the United States; and
(3) if an employee, a completed I-9 form, or if under an independent contractor or contract labor agreement, a copy of the contract signed by both the owner or operator and the licensed massage therapist.
(b) No massage establishment shall be operated until the department has approved and licensed the establishment.
(c) A massage establishment must maintain separation from rooms used wholly or in part for residential or sleeping purposes by a solid wall or by a wall with a solid door which shall remain locked during business hours.
(d) A massage establishment must display the license in a prominent location in the establishment where it is available for inspection by the public.
(e) A license issued by the department is the property of the department and must be surrendered on demand.
(f) A massage establishment is subject to inspection to verify compliance with the Act and this chapter by authorized personnel of the department at any reasonable time.
(1) Massage establishments shall be inspected periodically and as a result of a complaint. These inspections will be performed to determine compliance with the requirements of the Act and this chapter.
(2) The department inspector will contact the establishment owner, manager, or their representative upon arrival at the establishment and before proceeding with the inspection.
(3) The establishment owner, manager, or their representative shall cooperate with the inspector in the performance of the inspection.
(4) Each establishment shall be inspected at least once every two years.
(5) Upon completion of the inspection, the owner, manager, or their representative shall be advised in writing of the results. The inspection report will list violations identified during the inspection.
(g) A massage establishment may not:
(1) employ or contract with an individual who is not a United States citizen or a legal permanent resident with a valid work permit;
(2) employ a minor unless the minor's parent or legal guardian authorizes in writing the minor's employment by the establishment;
(3) allow a nude or partially nude employee to provide massage therapy or other massage services to a customer;
(4) allow any individual, including a client, student, license holder, or employee, to engage in sexual contact in the massage establishment;
(5) allow any individual, including a student, license holder, or employee, to practice massage therapy in the nude or in clothing designed to arouse or gratify the sexual desire of any individual; or
(6) allow an unlicensed student to provide massage therapy or other massage services to the public beyond the department-approved internship.
(h) A massage establishment shall:
(1) properly maintain and secure for each client the initial consultation documents, all session notes, written consent documents, and related billing records; and
(2) maintain a current list of all establishment employees and/or contractors at all times which includes:
(A) full name; and
(B) license number and expiration date (if licensed as a massage therapist).
(i) For purposes of this section:
(1) "Nude" means a person who is:
(A) entirely unclothed; or
(B) clothed in a manner that leaves uncovered or visible through less than fully opaque clothing any portion of the breasts below the top of the areola of the breasts or any portion of the genitals or buttocks.
(2) "Sexual contact" includes:
(A) any touching of any part of the genitalia or anus;
(B) any touching of the breasts of a female client, unless the touching is breast massage that is specifically authorized by the client as required in §117.91;
(C) any offer or agreement to engage in any activity described in subparagraph (A) or (B);
(E) deviate sexual intercourse, sexual contact, sexual intercourse, indecent exposure, sexual assault, prostitution, and promotion of prostitution as described in Texas Penal Code, Chapters 21, 22, and 43, or any offer or agreement to engage in such activities;
(F) any behavior, gesture, or expression that may reasonably be interpreted as inappropriately seductive or sexual; or
(G) inappropriate sexual comments about or to a client, including sexual comments about a person's body.
(j) A massage establishment must display a sign containing human trafficking information as required by Texas Occupations Code, Chapter 455, §455.207, in a form and manner prescribed by the commission that is:
(1) in a conspicuous place clearly visible to the public; and
(2) acceptable to the department.
(k) A massage establishment shall not allow any individual, including a student, license holder, or employee, to reside on the premises of the massage establishment. This does not apply to a place of business exempted by Texas Occupations Code Chapter 455, §455.155(c)(2), from the requirement to hold a license as a massage establishment or to a licensed massage therapist who practices as a solo practitioner and who is exempted under Texas Occupations Code Chapter 455, §455.155(b), from the requirement to hold a license as a massage establishment.
SUBCHAPTER H RESPONSIBILITIES OF THE LICENSEE AND CODE OF ETHICS
§117.90. General Ethical Requirements.
(a) A licensee shall not make deceptive, untrue, or fraudulent representations in the practice of massage therapy or employ a trick or scheme in the practice of massage therapy, including, but not limited to, warranty of results of such services and false claims of proficiency in any field.
(b) A licensee shall not use a work area, equipment or clothing that is unclean or unsanitary.
(c) A licensee shall not practice massage therapy fraudulently, with gross incompetence, with gross negligence on a particular occasion, or with negligence or incompetence on more than one occasion.
(d) A licensee shall bill clients or third parties only for those services actually rendered or as agreed to by mutual understanding at the beginning of services or as later modified by mutual agreement.
(e) A licensee must either honor an unexpired gift certificate issued by that licensee or provide a full refund.
(f) For each client, a licensee shall keep accurate records of the dates of massage therapy services, types of massage therapy and billing information. Such records must be maintained for a minimum of two years.
(g) A licensee must obtain the written consent of a parent or guardian to provide massage therapy services to a person under the age of 17.
(h) On the written request of a client, a client's guardian, or a client's parent if the client is under the age of 17, a licensee shall provide a written explanation of the charges for massage therapy services previously made on a bill or statement of the client. This requirement applies even if the charges are to be paid by a third party.
(i) A licensee shall not abuse alcohol or drugs in any manner which detrimentally affects the provision of massage therapy or massage therapy instruction.
(j) A licensee may not overcharge or over treat a client.
(k) A licensee shall not practice in an unlicensed massage establishment or massage school.
(l) A licensee shall not allow an unlicensed person to engage in activity for which licensure is required.
(m) A licensee shall not provide false information on material submitted to the department.
(n) A licensee shall not interfere with a department investigation by the willful misrepresentation of facts to the department or its authorized representative, or by the use of threats, retaliation, or harassment against any person.
(o) A licensee shall comply with any formal order issued by the department relating to the licensee.
(p) A licensee shall be subject to disciplinary action by the department if the licensee is issued a public letter of reprimand, is assessed a civil penalty by a court, or has an administrative penalty imposed by the attorney general's office under the Texas Code of Criminal Procedure, Chapter 56, Subchapter B.
(q) A licensee shall notify each client of the name, mailing address, telephone number, and web address of the department for the purpose of directing complaints to the department by providing notification:
(1) on each written contract for services of a licensee;
(2) on a sign prominently displayed in the primary place of business of each licensee;
(3) on a bill for service provided by a licensee to a client or third party; or
(4) by another written and documented method.
(r) A licensee shall keep his or her licensure file updated by notifying the department, in writing, of changes of names, address, telephone number and employment.
(s) A licensee shall be subject to disciplinary action for failure to truthfully respond in a manner that fully discloses all information in an honest, materially responsive, and timely manner to a complaint filed with or by the department.
(t) A licensee shall not make any false, misleading, deceptive, fraudulent, or exaggerated claim or statement about the licensee's services, including, but not limited to:
(1) the effectiveness of services;
(2) the licensee's qualifications, capabilities, background, training, experience, education, certification or licensure, professional affiliations, fees, products, or publications; or
(3) the practice or field of massage therapy.
(u) A licensee shall provide draping and treatment services sufficient to protect a client’s safety, comfort, and privacy, and must drape:
(1) the genital area and gluteal cleavage of all clients at all time; and
(2) the breasts of female clients at all times, unless performing breast massage that is specifically authorized by the client as required in §117.91.
§117.91. Consultation Document and Written Consent.
(a) A licensee shall provide an initial consultation to each client before the first massage therapy session and obtain the signature of the client on the consultation document. The consultation document shall include:
(1) the type of massage therapy services or techniques the licensee anticipates using during the massage therapy session;
(2) the parts of the client's body that will be massaged or the areas of the client's body that will be avoided during the session, including indications and contraindications;
(3) a statement that the licensee shall drape the breasts of all female clients and not engage in breast massage of female clients unless the client gives written consent before each session involving breast massage;
(4) a statement that draping of the genital area and gluteal cleavage will be used at all times during the session for all clients;
(5) a statement that if uncomfortable for any reason, the client may ask the licensee to cease the massage and the licensee will end the massage session; and
(6) the signature of both the client and the licensee.
(b) If the client's reason for seeking massage therapy changes at any time and any of the information in subsection (a)(1) - (4), is modified, the licensee must provide an updated consultation reflecting any changes and modifications to the techniques used or the parts of the client's body to be massaged.
(c) A licensee shall obtain a new written consent, signed and dated by the client, before each session in which breast massage of a female client will be performed. This written consent may be documented on a new consultation document or in a separate document.
§117.92. Sexual Misconduct.
(a) A licensee shall not engage in sexual contact during a session with a client. For the purposes of this section, sexual contact includes:
(1) any touching of any part of the genitalia or anus;
(2) any touching of the breasts of a female client, unless the touching is breast massage that is specifically authorized by the client as required in §117.91;
(3) any offer or agreement to engage in any activity described in paragraph (1) or (2);
(5) deviate sexual intercourse, sexual contact, sexual intercourse, indecent exposure, sexual assault, prostitution, and promotion of prostitution as described in the Texas Penal Code, Chapters 21, 22, and 43, or any offer or agreement to engage in any such activities;
(6) any behavior, gestures, or expressions which may reasonably be interpreted as inappropriately seductive or sexual; or
(7) inappropriate sexual comments about or to a client, including making sexual comments about a person's body.
(b) A licensee shall not allow any individual, including a client, student, licensee, employee, participant in a continuing education program, or one's self to engage in sexual contact on the premises of any massage school, massage establishment, or the licensee's own place of business.
(c) A licensee shall not allow any individual, including a student, licensee, employee, or one's self to practice massage therapy or provide other massage therapy services in the nude, while partially nude, or in clothing designed to arouse or gratify the sexual desire of any individual.
(d) A licensee shall not perform massage therapy, whether or not for compensation, at or for a sexually oriented business.
(e) A licensee shall immediately discontinue the massage therapy session, activity or the professional relationship when a client initiates any verbal or physical contact with the licensee that is intended to arouse or gratify the sexual desire of either person.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency’s legal authority.
Filed with the Office of the Secretary of State, on March 12, 2021.
Texas Department of Licensing and Regulation