Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
S.B. 56 Final Analysis
135th General Assembly
Click here for S.B. 56’s Fiscal Note
Primary Sponsor: Sen. Roegner
Effective date: *
Effective date:
Jason Hoskins, Attorney
 Enters Ohio as a party to the Interstate Massage Compact (IMpact), the purpose of
which is to facilitate the interstate practice and regulation of massage therapy and
improve public access to and safety of massage therapy services.
 As a member of IMpact, requires Ohio to allow a massage therapist licensed in another
member state to practice in Ohio, subject to Ohio’s laws and rules governing the
practice of massage therapy.
 Requires the State Medical Board to appoint a member to the Interstate Massage
Compact Commission, a joint public agency created by IMpact to enforce the provisions
and rules of the Compact.
 Requires Ohio to submit data regarding massage therapy licensees to the Commission’s
data system, including information related to licensure, adverse action, and the
presence of investigative information.
Interstate Massage Compact (IMpact)
The act enacts the Interstate Massage Compact (IMpact) in Ohio. IMpact is an
agreement between member states to improve public access to and safety of massage therapy
services by permitting eligible massage therapists to work in multiple states.1 IMpact goes into
* The Legislative Service Commission had not received formal notification of the effective date at the
time this analysis was prepared. Additionally, the analysis may not reflect action taken by the Governor.
1 R.C. 4731.156; Article 1 (“Article” references in this analysis are to the Compact).
May 31, 2024
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effect when it is enacted by the seventh member state.2 In addition to Ohio, IMpact has been
enacted in one other state: Nevada.3 Each state’s enacting statute cannot be materially
different from the model Compact.4 Nothing in the Compact impacts Ohio’s requirements for a
license to practice as a massage therapist.5
State participation in IMpact
To participate in IMpact, a state – including Ohio – must: 6
1. License and regulate the practice of massage therapy;
2. Have a mechanism for receiving and investigating complaints;
3. Accept passage of a national licensing examination as a criterion for massage therapy
4. Require that licensees satisfy educational requirements prior to being licensed to
provide massage therapy services;
5. Fully implement a criminal background check requirement and use the results in
making licensing decisions in accordance with IMpact;
6. Have continuing competence requirements as a condition of license renewal;
7. Participate in the Commission’s data system (see “Interstate Massage Compact
Commission” and “Data system” below);
8. Notify the Commission and other member states of any disciplinary action or the
availability of investigative information about a licensee;
9. Comply with the rules of the Commission;
10. Accept licensees with valid multistate licenses from other member states.
Home state licensure
Under IMpact, a “home state” is the member state that is a licensee’s primary state of
residence where the licensee holds an active single-state license.7 Active military members, or
their spouses, must designate a home state where they have an active single-state license. That
home state designation can remain for as long as the member or spouse is on active duty
assignment, regardless of the location of that assignment.8
2 Article 12.A.
3 Nevada S.B. 161 (2023).
4 Article 12.1.
5 Article 1.K.
6 Article 3.A.
7 Article 2.N.
8 Article 7.
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Multistate license
A multistate license is a license issued by a home state that consists of authorizations to
practice massage therapy in all member states that are not a licensee’s home state (referred to
as remote states), subject to the enforcement jurisdiction of the licensing authority in the
licensee’s home state.9 A massage therapist practicing in a remote state is subject to the scope
of practice laws of that state.10
If a home state takes adverse action against a licensee’s single-state license or
multistate license, the licensee’s authorization to practice is deactivated in all member states
until all encumbrances have been removed.11
Requirements to qualify for a multistate license
To qualify for a multistate license, a licensee must:12
1. Be licensed to practice massage therapy in the applicant’s home state;
2. Have completed at least 625 hours of massage therapy education or the substantial
equivalent approved by Commission rule;
3. Have passed a national licensing examination or the substantial equivalent approved by
Commission rule;
4. Submit to a background check;
5. Have not been convicted of a felony within five years of applying for the license;
6. Have not been convicted of a misdemeanor offense related to the practice of massage
therapy within two years of applying for the license;
7. Have not been convicted at any time of kidnapping, human trafficking, human
smuggling, a violent sexual offense, or any other category of offense designated by
Commission rule;
8. Have not previously had a massage therapy license revoked or suspended in lieu of
9. Have no adverse action on any occupational or professional license within two years
prior to applying for the license;
10. Pay all required fees.
9 Article 2.T.
10 Article 4.C.
11 Article 6.F.
12 Article 4.A.
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Adverse actions
IMpact grants a home state the exclusive power to impose adverse action against a
license it issues, including a single-state license or a multistate license. Adverse action is any
administrative, civil, equitable, or criminal action permitted by a member state’s laws that is
imposed by a licensing authority or other regulatory body against a licensee.13
A home state may take adverse action on a multistate license based on investigative
information or adverse action from a remote state. Joint investigations between member states
also are permissible. While states that are not the home state that issued the multistate license
cannot impose adverse action against the license, a member state may take adverse action
against a licensee’s authorization to practice in that specific state.14
In addition to imposing adverse action against a licensee’s authorization to practice, a
remote state may issue cease and desist orders or limit a licensee’s authorization to practice,
issue subpoenas for hearings and investigations, and recover from the licensee the costs related
to the adverse action against the licensee (if authorized by state law).15
IMpact preserves a state’s ability to permit participation in an alternative program in
lieu of adverse action, but a licensee’s multistate license is suspended during the licensee’s
participation in the alternative program.16 “Alternative program” means a nondisciplinary
monitoring or prosecutorial diversion program approved by a state licensing authority.17
If a member state imposes adverse action against a licensee, it must submit information
regarding that adverse action to the Commission’s data system (see “Data system” below).18
Consequences of adverse action by a remote state
If a remote state takes adverse action against a massage therapist’s authorization to
practice in that state, the massage therapist’s authorization to practice in any other remote
state is removed until the time for which the authorization to practice was removed has passed
and all encumbrance requirements are satisfied. The licensee is not eligible to apply for a
multistate license in any other state until the adverse action has been resolved.19
13 Articles 5, 6.A, and 2.B.
14 Article 6.
15 Article 6.E.
16 Article 6.H.
17 Article 2.C.
18 Article 9.C.
19 Article 6.G.
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Interstate Massage Compact Commission
The act requires states participating in IMpact to establish a joint government agency
known as the Interstate Massage Compact Commission.20 Each member state must appoint one
delegate, who must be the state licensing authority’s primary administrative officer or the
officer’s designee. The delegate is entitled to one vote regarding all matters that are voted on
by the Commission. Meetings may take place by telecommunication, video conference, or
other similar electronic means.21
As a party to IMpact, the State Medical Board must select one delegate to the Commission
within 60 days of Ohio entering the Compact and fill any subsequent vacancy within 60 days.22
Powers and duties
The Commission must enforce the provisions and rules of IMpact.23 It must meet at least
annually. Generally, meetings must be open to the public. IMpact permits closed, nonpublic
meetings of the Commission, the Executive Committee, or other committees in limited
circumstances, such as to discuss noncompliance of member states, employment matters,
licensee discipline, litigation, contract negotiation, criminal accusations, trade secrets,
investigative records, and legal advice.24
The Commission has numerous powers and duties specified in the act, some of which
1. Establishing bylaws and a code of conduct for the Commission;
2. Electing a chair, vice chair, secretary, and treasurer, and any other officer provided by
the Commission’s bylaws;
3. Maintaining financial records, establishing a budget, making expenditures, and
borrowing money;
4. Adopting rules to effectively and efficiently implement and administer IMpact,
including emergency rules;
5. Hiring employees and performing matters related to personnel;
6. Accepting donations and gifts and taking actions regarding real and personal property;
7. Electing an Executive Committee and appointing committees;
20 Article 8.
21 Article 8.B.
22 Article 8.B and R.C. 4731.157.
23 Article 11.J.
24 Article 8.
25 Article 8.C.
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8. Determining whether a state’s adopted language is materially different from the model
Compact language to an extent that it disqualifies that state from participation;
9. Performing other functions as necessary and appropriate to achieve the purposes of
Data system
The Commission must provide for the development and operation of a database and
reporting system containing licensure, adverse action, and significant investigative information
regarding licensed individuals in member states. All member states must submit a uniform data
set to the data system regarding licensees who are subject to the Compact. The data set
includes: (1) identifying information, (2) licensure data, (3) adverse actions against a licensee,
(4) nonconfidential information related to alternative program participation, (5) any denial of
an application for licensure and reasons for the denial, (6) the presence of significant
investigative information, and (7) other information specified by Commission rules.26
Member states contributing information to the data system may designate information
that may not be shared with the public without express permission from that state.
Investigative information received by a massage therapy licensing board pertaining to the
investigation of a licensee in a member state will always only be available to other member
Commission finances
The Commission must pay the reasonable expenses of its establishment, organization,
and ongoing activities. The Commission may accept monetary and nonmonetary donations and
grants. It may impose annual assessments on member states and fees on the multistate license
holders of member states to cover costs of its operations and activities. The Commission must
keep accurate records of receipts and disbursements, which must be reviewed annually.
The Commission cannot incur obligations before securing funds to meet those
obligations and it may not pledge the credit of member states without authority.28
Executive Committee
IMpact creates an Interstate Massage Compact Commission Executive Committee, and
provides that the Executive Committee has the power to act on behalf of the Commission.
Committee meetings with formal action on a matter must be public, with at least five days’
notice. The Executive Committee, which must meet at least annually, is comprised of the
following seven members:29
26 Article 9.
27 Article 9.E. and F.
28 Article 8.G.
29 Article 8.D.
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 The chair, vice chair, secretary, and treasurer of the Commission;
 Three other voting members from the Commission, elected by the Commission.
Duties and responsibilities of the Executive Committee include:
1. Overseeing the day-to-day activities of administering IMpact;
2. Recommending changes to rules, bylaws, Compact legislation, and fees charged to
member states and licensees;
3. Ensuring IMpact administration services are appropriately provided;
4. Preparing and recommending the budget;
5. Maintaining financial records;
6. Monitoring Compact compliance of member states and providing compliance reports;
7. Establishing additional committees as necessary;
8. Exercising the powers and duties of the Commission between Commission meetings;
9. Any other duties provided in the bylaws.
The Commission may adopt rules by majority vote pursuant to the criteria and
processes set forth in the Compact. It must hold a public hearing before adopting a rule, with
advanced notice of the proposed rulemaking and other specified information. If a majority of
state legislatures of member states reject a rule by enacting a statute or resolution within four
years of the date the rule was adopted, the rule has no further force or effect.30
Qualified immunity, defense, and indemnification
IMpact provides that the members, officers, the executive director, employees, and
representatives of the Commission are immune from suit and liability for damages caused by or
arising out of acts or omissions occurring within the scope of Commission employment, duties,
or responsibilities, so long as the loss is not caused by intentional or willful or wanton
misconduct. The Commission must defend individuals entitled to immunity, but individuals also
may retain their own counsel.
The Commission must indemnify and hold harmless any member, officer, executive
director, employee, or representative of the Commission for the amount of a settlement or
judgment obtained against the individual arising out of acts or omissions occurring within the
scope of Commission employment, duties, or responsibilities, except in the case of intentional
or willful or wanton misconduct.31
30 Article 10.
31 Article 8.H.
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Enforcement and dispute resolution
IMpact requires each member state’s executive and judicial branches of government to
enforce it.32
The Commission must attempt to resolve Compact disputes that arise among member
states and between me