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The California Massage Therapy Council (CAMTC) is a private company responsible for the only credential in California for massage therapists: a voluntary certification. On April 29th there will be a hearing to allow the California Massage Therapy Council to be sunsetted. A sunset provision is when a law or other regulation will expire on a set date, unless the legislature chooses to renew it. Sunsetting helps legislators regularly review laws to ensure they are functioning properly.  Allowing CAMTC to sunset would dissolve it. 

Healwell thinks that should happen. 

At the time of this blog post, it looks as though CAMTC will continue to exist. This blog is dedicated to outlining the reasons CAMTC should be dissolved. The majority of this information came from the Background Paper for The California Massage Therapy Council Sunset Review Hearing that took place on March 24, 2025. All quotes in this blog are from this background paper.

If you are a California massage therapist you can write to your representatives by following ABMP's instructions at this link.

If you are not a California massage therapist, please tell your national associations that you support state licensing.

Summary

CAMTC’s actions are in conflict with its mission, and it has demonstrated a reluctance to operate under the transparency and accountability that would be required if it was a government agency. CAMTC’s actions suggest it is happy to accept authority over massage therapists and massage schools, but does not want to accept the responsibility that comes with that authority. This means that California massage therapists who participate in voluntary certification are receiving a sub-par credential that lacks the oversight massage therapists in other states enjoy.  

It should be noted that the confusion CAMTC experiences between its mission and its attempt to participate in anti-human trafficking initiatives are not exclusive to California. Much of the massage therapy profession feels responsible for eradicating human-trafficking, or at least for mitigating the use of massage therapy businesses as a cover for illegal operations. This focus on fighting a multi-billion dollar, global enterprise is not only unfair to massage therapists, (whose average income nationally was $32,015/year in 2023 according to the AMTA Professional Report), it has resulted in the massage therapy profession misusing valuable resources on issues that do not benefit the profession or the therapists who work in it.

The massage therapy profession should be responsible for caring for clients, creating safety guidelines, expanding educational opportunities, and supporting therapists in developing meaningful, legitimate, sustainable careers. Massage therapy deserves the same opportunities other professions enjoy. The continuation of the voluntary certification overseen by the California Massage Therapy Council is contrary to these goals. CAMTC, if it is allowed to continue, will only prolong and complicate this essential process and they will continue to do it with the hard earned money of massage therapists. It is time for massage therapists, businesses, schools and the people of California to have proper licensing. 

Background

California is one of only five states that does not have state licensing for massage therapists. California is unique because it has a voluntary certification process in place of licensing. Massage therapists can earn this voluntary certification by completing five hundred hours of education from an approved school and paying a three hundred dollar application fee. There is no exam requirement to obtain a voluntary certification. Recertification costs three hundred dollars, happens every two years, and has no continuing education requirement.

Until 2008, massage therapists in California were not regulated on a state level. Individual towns and cities could choose how to regulate massage therapy. Massage therapy was often regulated as adult entertainment, which could mean requiring massage therapists to register as sex workers and to show a clean sexually transmitted infection test before being granted a city license.

In 2008, a bill was passed creating the California Massage Therapy Council, or CAMTC. CAMTC is a private nonprofit public benefit corporation. The charge of California Massage Therapy Council was:

1. Create and implement a voluntary certification program for the massage therapy profession that will enable consumers to easily identify credible Certified Massage Therapists (CMTs);

2. Ensure that certified massage professionals have completed sufficient training at approved schools; and

3. Approve massage schools. 

What does being a private nonprofit public benefit corporation mean?

• Non-governmental: CAMTC works with the government, but not for it. They can be partially funded by government grants. 

• Non-profit: CAMTC is tax exempt. They can also fundraise and accept donations from the public.  In order to increase transparency, all non-profit organizations have to file a tax document called a 990. (CAMTC's 2022 990) (CAMTC's 2023 990)

• Private: CAMTC can have shareholders 

• Public benefit corporation: CAMTC has to take into account more interests than only their shareholders. A public benefit corporation, also known as a B-corp, might support farmworker rights and sustainable farming, because workers deserve rights and climate change is real. In CAMTC’s 990, they state protecting the public as their purpose.

Part 1: CAMTC is Harmful to the Profession of Massage Therapy

CAMTC misrepresents its mission by prioritizing anti-trafficking efforts over professional advancement, without evidence of effectiveness.

Misrepresentation of the Mission

The official mission of CAMTC is 

“To protect the public by certifying massage professionals in California that meet the requirements in the law and approving massage programs that meet the minimum standards for training and curriculum"

According to the Sunset Background report,

“Through partnerships with local law enforcement, CAMTC considers efforts to combat human trafficking to be at the core of its mission and mandate from the Legislature"

Nearly all of the communications of CAMTC are about their efforts to combat human-trafficking and illicit massage businesses in California. This is not the mandate they were charged with in the Massage Therapy Act that created CAMTC in 2009, or in any of the amendments that have been passed. While public protection is the main focus of licensing, fighting human-trafficking is not. It is not the responsibility of the massage therapy profession to fund, police, create legislation, or bear administrative burdens of anti-human trafficking efforts.

CAMTC’s misrepresentation of its purpose can be seen in multiple ways.

CAMTC’s Board of Directors has reduced the number of board members from 20 to 13.

• When the Board had 20 members, there were 7 members representing the massage therapy profession

• Now that the Board has 13 members, only 2 of them are from the massage therapy profession

• Other member positions include:

  • The League of California Cities

  • The California Police Chiefs Association

  • The California State Association of Counties

  • An "anti-human trafficking" organization

  • Local government attorneys

  • The California Association of Private Postsecondary Schools

  • The Office of the Chancellor of California Community Colleges

CAMTC itself claims that it has always been actively fighting human-trafficking.

CAMTC states that it has been 'at the forefront of anti-human trafficking efforts since inception.' According to the council, 'human traffickers want the air of legitimacy provided by businesses that appear to be legitimate massage establishments but are actually fronts for illicit activity.'"

Voluntary Certification Does Not Deter Human Trafficking

Even if CAMTC’s focus on human-trafficking was its mission, the voluntary certification has not proven to be an effective deterrent. CAMTC has no control over massage therapy establishments- arguably the place where the most trafficking activity occurs. 

The Polaris Project, a group dedicated to fighting human-trafficking, says that rather than creating a standard for massage therapists in California, the voluntary nature of the certification has maintained the patchwork of regulation across the state, allowing traffickers to operate in the margins, and to relocate just outside cities that do enforce regulations.

The Polaris report says that “three counties with some of the highest concentration of [illicit massage businesses] in California, and therefore highest in the entire country, either do not have a law regulating massage business operations (Los Angeles County), have laws that regulate massage businesses as sexually-oriented businesses (San Diego County), or their major cities do not have laws regulating massage business operations (Santa Clara County).” 

CAMTC itself admits that it’s certification has never proven to be effective in anti-trafficking efforts:

"On November 16, 2017, CAMTC issued a response to the Polaris Project's findings, stating that in reviewing its data, it 'does not have evidence that its certificate holders are either victims or perpetrators of human trafficking' and that 'no CAMTC certificate holder has a criminal conviction for human trafficking and no certificate individual has stated to CAMTC that they have been trafficked.’

Perpetuation of Harmful Stereotypes

While CAMTC’s efforts have not resulted in measurable benefit to anti-human trafficking efforts, they do successfully continue to link the massage therapy profession with illegal activity. When the organization that has been tasked with ensuring public safety and appropriate training for massage therapists is instead focused on how massage therapy can be linked with human trafficking, it sends a very clear message to the public. 

"The sustained and stigmatic association between commercial sexual activity and the massage industry is doubtlessly harming the reputation of a legitimate healing art profession, and there continue to be reports of local governments enforcing draconian ordinances against lawful massage businesses in the furtherance of anti-trafficking policies."

Prevention of Massage Therapists’ Professional Advancement

Linking the public’s thoughts about massage therapy to criminal activity also makes the elevation of massage therapy as a legitimate healthcare profession more difficult. CAMTC actively protests the creation of state licensing, even though:

Even CAMTC's own feasibility study acknowledged that "transitioning from voluntary certification to a statewide license requirement would potentially elevate the profession of massage therapy and align the industry with other therapeutic practices." Yet CAMTC continues to resist this transition, preferring to maintain a system that keeps massage therapy in a regulatory category separate from other healthcare professions.

The lax requirements for certification and unevenness of their implementation prevent California massage therapists from relocating within and outside of their state. CAMTC’s voluntary certification does not qualify for license reciprocity in other states. This means that certified California massage therapists must take an exam and possibly repeat their entire education in order to achieve licensure in another state.  

The certification also prevents massage therapists in California from participating in Medicaid, Medicare, and programs aimed at increasing access to non-pharmacological solutions to pain management. Administrators in charge of these programs rightfully do not view a voluntary certification as a strong enough credential to support the inclusion of massage therapists. Additionally, the lack of licensing in the remaining five US states prevents massage therapy from developing relationships with these programs on a national level. 

Part 2: CAMTC’s Financial Mismanagement

CAMTC’s use of funds is out of alignment of its mission and it is using massage therapists' fees to create wealth.

50% Fee Increase Behind Closed Doors 

CAMTC has consistently represented itself as financially solvent and well-managed.  

In response to the issues raised by the Committees, CAMTC stated: “Unlike boards and bureaus that struggle financially, CAMTC is solvent. It is able to put money aside and keep a more than appropriate level of reserves.” CAMTC further disagreed that its reserves had “fallen significantly,” arguing that it was still meeting its self-imposed goal of a three month reserve, and that a determination had been made that “it is more prudent to provide a higher level of customer service and support of local law enforcement and local government rather than having an excessive amount of reserves sitting in the bank.” CAMTC unequivocally argued that “CAMTC’s fees are appropriately balanced to cover its specific services and provide it with an appropriate level of reserves.” 

However, almost immediately after its last review, CAMTC underhandedly increased the fees for certification from $200 to $300. The materials for the board meeting at which that decision was made were made available on a Thanksgiving holiday weekend and the meeting itself was held a few days later at 8:00AM, actions that are contrary to CAMTC’s own bylaws. The discussion for the fee increase was moved to the beginning of the meeting, and immediately passed by a narrow quorum (number of people necessary to vote).

It was found later that CAMTC had paid for and completed a fee study (page 108) without any public discussion allowed. The fee study was performed by Capital Accounting Partners, LLC, but is not listed in CAMTC’s 2021 or 2022 tax filing. CAMTC’s income from application fees grew from $5.6 million in 2022 to $7.9 million in 2023. That is an increase of over 2.3 million dollars in a single year with no noticeable increase in applications.

Certificate holders in 2022: 50,593. Certificate holders in 2023: 50,556.

Source: Background Paper for The California Massage Therapy Council Sunset Hearing

CEO Salary

The salary of the CEO of CAMTC, Ahmos Netanel, was $665,192 (including $99,983 in benefits) in 2023.

The committee in charge of CAMTC has been concerned about the CEO’s salary since 2014, when it was $302,325. In response to what the committee felt was compensation, CAMTC commissioned a “CEO Compensation Study.” The study reported that the salary was within a normal range when compared to other similar groups. 

However, the background report cites several problems with the study:

• The peers CAMTC used for comparison were not regulatory entities.

• The peers were professional and trade associations, which are a different kind of non-profit and therefore have a much different goal than a regulatory body

• Similar types of nonprofits of CAMTC rely on donations, not mandatory fees, for income.

The Department of Consumer Affairs published its own study in 2019 comparing executive officers of regulatory bodies. It found a median salary of $107,000.

The California Employment Development Department data indicates that the average hourly pay for massage therapists in California is $28.09. Twenty hours of paid work time is average for a massage therapist, which means their income is around $28,090/year. The CEO of the organization that oversees the future of those massage therapists makes 96% more than the people he serves. 

It is Healwell’s position that nobody in massage therapy leadership or regulation should be making such a large amount of money while the massage therapists they’re supposed to be serving can barely make enough to support themselves. This is particularly relevant for a public benefit corporation that is supposed to protect the public: massage therapists are part of the public.

Lobbying for Bills That Do Not Support Massage Therapists

Lobbyists are people who are paid to persuade legislators to vote in a particular way. CAMTC has been paying for lobbying since 2020. None of the bills it has been involved with support massage therapy or massage therapists. CAMTC’s lobbying history from the California Secretary of State. 

2023-2024

AB 2412 - The bill would create the California Body Contouring Council (council) for the purpose of regulating the practice of body contouring. (failed)

SB14 - This bill would include human trafficking of a minor within the definition of a serious felony for all purposes, including for purposes of the Three Strikes Law, except as specified. By expanding the scope of an enhancement, this bill would impose a state-mandated local program. (passed)

Total paid: $143,000

2021-2022

AB 2687 - Pushed back enactment of exam requirement from 2023 to 2027; allowed the attorney board member to represent a city or county, instead of exclusively a city; extended Massage Therapy Act to 2027, which preserved the existence of CAMTC. (passed)

Total paid: $156,000 

2020-2021

No bills supported

Total paid: $78,068.88

Part 3: CAMTC’s Lack of Transparency, Due Process and Accountability

CAMTC lacks transparency and accountability, operating behind closed doors with minimal oversight.

Resistance to Transparency

The Public Records Act (PRA) is a California regulation that allows anyone to request and obtain records from government agencies. CAMTC does not have to follow the Public Records Act because it works with, and not for the government. CAMTC has resisted PRA requirements, saying it would cause a “significant increase in administrative expenses.” CAMTC’s records are completely private, and mostly managed by an independent company called Advocacy and Management Group. 

CAMTC retains audio recordings of its board meetings, but claims it would be prohibitively expensive to create a webcast. Webcasts of board meetings are a standard part of government transparency in California. Government agencies in California use a dedicated service to webcast all meetings. Other businesses often use a Meeting Owl camera and a service such as Zoom.

CAMTC has an auditing committee which files tax returns and makes recommendations to the Board of Directors. The auditing committee used to have two members, but due to one of the members moving to the position of treasurer, CAMTC has one internal person auditing its finances. There is no third party providing checks and balances on CAMTC’s financial activities.

Inadequate Due Process

The staff that oversees the enforcement of CAMTC’s policies and decisions have no independent oversight. All investigations and decisions are made internally and without external review.

Approvals/disapprovals of certification for schools and massage therapists are decided by CAMTC. Applicants can be denied for a wide variety of reasons, and CAMTC is not required to disclose the reason for denial.

Applicants may also be denied if they have been “convicted of any felony, misdemeanor, infraction, or municipal code violation, or being held liable in an administrative or civil action for an act, that is substantially related to the qualifications, functions, or duties of a certificate holder,” or “committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications or duties of a certificate holder.”

Decisions can only be challenged by filing a lawsuit against CAMTC. 

CAMTC states that the lack of due process for applicants and certificate holders allows the council to act faster than a normal government body. While this is true, the lack of due process means that both fair and unfair decisions are enacted with great speed.

Board Structure and Governance

As stated previously, the CAMTC Board of Directors has only two members to represent the massage therapy profession and several members that represent law enforcement including: 

• The League of California Cities

• The California Police Chiefs Association

• The California State Association of Counties

• An "anti-human trafficking" organization

• Local government attorneys

The background report says that the board of directors has not been observing the term limits for board members resulting in some board members serving for over 10 years.

The report also states:

"...it became apparent that CAMTC's Board of Directors was expected to loyally affirm the decisions of the council's staff, rather than provide independent oversight of its functions on behalf of the public."

Conclusion

CAMTC should be sunsetted, and the state of California should establish a state license. 

CAMTC’s actions are in conflict with its mission, and it has demonstrated a reluctance to operate under the transparency and accountability that would be required if it was a government agency. CAMTC’s actions suggest it is happy to accept authority over massage therapists and massage schools, but does not want to accept the responsibility that comes with that authority. This means that California massage therapists who participate in voluntary certification are receiving a sub-par credential that lacks the oversight massage therapists in other states enjoy.  

There are 45 states and two US territories that have licensing. The three largest national massage associations: the American Massage Therapy Association (AMTA), Associated Bodywork and Massage Professionals (ABMP) and the Federation of State Massage Therapy Boards (FSMTB) each have resources to assist the state of California in its transition to licensing. FSMTB has written and published a Model Massage Therapy Practice Act that would alleviate the potential burden imposed on the state government to establish a standard.

It should be noted that the confusion CAMTC experiences between its mission and its attempt to participate in anti-human trafficking initiatives are not exclusive to California. Much of the massage therapy profession feels responsible for eradicating human-trafficking, or at least for mitigating the use of massage therapy businesses as a cover for illegal operations. This focus on fighting a multi-billion dollar, global enterprise is not only unfair to massage therapists, (whose average income nationally was $32,015/year in 2023 according to the AMTA Professional Report), it has resulted in the massage therapy profession misusing valuable resources on issues that do not benefit the profession or the therapists who work in it.

The massage therapy profession should be responsible for caring for clients, creating safety guidelines, expanding educational opportunities, and supporting therapists in developing meaningful, legitimate, sustainable careers. Massage therapy deserves the same opportunities other professions enjoy. The continuation of the voluntary certification overseen by the California Massage Therapy Council is contrary to these goals. CAMTC, if it is allowed to continue, will only prolong and complicate this essential process and they will continue to do it with the hard earned money of massage therapists. It is time for massage therapists, businesses, schools and the people of California to have proper licensing. 

If you are a California massage therapist you can write to your representatives by following ABMP's instructions at this link.

If you are not a California massage therapist, please tell your national associations that you support state licensing.

Updated 4/25/25:
If you want to know more information like this about the massage therapy profession, check out our podcast "The Rub"

If you'd like to support Healwell in bringing you more information like this, check out our Spring Auction or simply donate!

Even small donations make a big difference!