LINCOLN — Cheryl Crawford didn't think twice about the amount of study she had to put in to become a licensed massage therapist in Nebraska.
“When I went to massage school, it was 1,000 hours, so I did 1,000 hours,” she said.
Now the owner of Omaha's Country Comfort Massage Therapy isn't convinced all those hours were necessary.
If she worked across the river in Iowa, she could have been licensed with half as much study. And she could have become an emergency medical technician with a fraction of the training hours.
“There needs to be some training,” Crawford said. “But I don't know that 1,000 hours is necessarily more beneficial than 500 hours.”
Nebraska's massage therapy requirements, which are among the highest in the nation, were cited in a new national study on occupational licensing that says state licensing laws make it too difficult for people to enter low- and moderate-income occupations.
The License to Work report was released by the Institute for Justice, a libertarian public interest law firm based in Arlington, Va.
Iowa was cited for requiring that people spend more than two years acquiring education and experience to inspect systems designed to protect buried metal piping and tanks. Only 16 states require such a license and none is as restrictive as Iowa.
When states were ranked by number and burden of licensing requirements combined, Iowa ranked No. 20 and Nebraska No. 31.
Considering the requirements of all states, the licenses on average force aspiring workers to spend nine months in education or training, pass one exam and pay more than $200 in fees.
One-third of the licenses take more than a year to earn. At least one exam is required for 79 of the occupations.
The data collected, including wide variations among states, call into question the number of occupations licensed by states and the requirements imposed on people who seek licenses, said Lisa Knepper, the institute's director of strategic research.
“These laws are widespread, often onerous and often don't make a whole lot of sense,” she said. “When it comes to telling people, ‘You can't enter a profession,' you want to have as few of those laws as possible.”
Jordan Cash, with the Platte Institute, a conservative Nebraska think tank, said he shares Knepper's concern.
“We don't have a problem with a certain amount of licensing as long as the market stays open and regulations don't keep people from getting jobs,” he said.
State officials and others defended Nebraska's licensing requirements. They said licensing protects consumers' life, health, safety and economic well-being. It also provides a means to enforce compliance with the law, proponents said.
“I think the public generally views licensing in a favorable way. They view it as a form of consumer protection,” said Helen Meeks, licensure unit administrator for the Nebraska Department of Health and Human Services.
That's definitely the case for massage therapy, said Lorri Hibbeler, an Omaha massage therapist. She said the training requirements are important because poorly trained therapists could injure clients.
“We don't want to create obstacles that prevent people from coming into the field, but we do want to make sure they're prepared,” Hibbeler said.
Licensing requirements also help address those who would use massage as a cover for involvement with the sex trade.
Knepper said some licensing can be justified. But the study showed that states should review their licensing regulations and reduce or remove unnecessary ones, she said.
Licensing has proliferated in the United States over the past half-century.
In 1952, there were 75 state-regulated occupations. Today, there are at least 1,100, according to the Council on Licensure, Enforcement and Regulation. One in three workers is affected, according to some estimates.
In Nebraska, HHS alone licenses 36 categories of occupations and 311 subcategories, Meeks said.
Active credentials issued by the department numbered 578,243 as of April 1. Some people hold more than one credential and some credential-holders live and work outside the state, Meeks said.
Other state agencies that issue licenses include the agriculture department, labor department, Secretary of State's Office, State Fire Marshal's Office and racing commission.
The national study focused on 102 low- to moderate-income occupations.
Each is licensed in at least one state. Fifteen are licensed in 40 or more states. Most are practiced somewhere without licensing and “apparently without widespread harm,” the study concluded.
Among occupations licensed around the country are florist, interior designer, shampooer and home entertainment installer.
In the study, licensure, certification and registration requirements were included under the broad category of licensing.
The study also found that licensing requirements vary considerably from state to state, which Knepper said raises questions about whether the toughest requirements are needed.
Manicurists in 10 states, for example, must spend four or more months in training. But only three days are required in Alaska and nine days in Iowa. Nebraska's training requirements take about 10 weeks.
“A lot of licensure is unnecessary or needlessly burdensome,” and more aimed at shutting out competition rather than protecting the public, Knepper said.
In addition, the report said that licensing requirements don't necessarily correspond to the level of risk posed by a profession. Emergency medical technicians, who hold people's lives in their hands, typically require much less training than massage therapists, barbers or cosmetologists.
Meeks said the difference is that EMTs operate under the supervision of others and follow strict protocols for handling emergencies.
She acknowledged that political and economic considerations can play a role in licensing. Most requests for licensing come from within an occupation, not from the public.
To minimize those considerations, Nebraska has a review process for all proposals to license new health-related occupations or change the scope of practice of existing ones. The process looks at such issues as need, cost-effectiveness and alternatives.
But lawmakers can reject recommendations resulting from the process. This year, lawmakers voted to license genetic counselors despite recommendations that licensing was unnecessary, Meeks said.
There are no similar reviews for occupations that are not health-related.
The study said voluntary certification by professional associations, such as the certification for auto mechanics through the National Institute for Automotive Service Excellence, and consumer information sources, such as the Better Business Bureau and the online Angie's List, offer less burdensome alternatives to licensing while helping the public find qualified professionals.
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