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TO: MassageRulesComments@doh.wa.gov
RE: WAC chapter 246-830
Dear Board of Massage,
I am a concerned citizen of Washington State and I support Version B of the Breast Massage section of WAC Chapter 246-830.

I support this version because it requires specialized training to treat breast tissue.
I also support this version because it does NOT require a visit to my doctor for a diagnosis or referral, which can be costly and time consuming.
I am in favor of requiring written AND verbal consent prior to treatment to protect the public.
Below is the amended copy of Version B that I support, with changes in italics.

Thank you for your service and consideration.

WAC 246-830-xxx Breast massage. [PAGE 39]
(1) Prior to performing breast massage, a licensed massage therapist must:
(a) Acquire prior signed written consent before proceeding with the breast massage. The written consent must:
(i) Be maintained with the client’s records,
(ii) Include a statement that the client may discontinue the treatment at any time for any reason,
(iii) If the client is under 18 years of age, prior written consent will be obtained in accordance with the Revised Code of Washington and the Mature Minor Rule;
(b) Orally review the written consent with the client and obtain verbal consent from the client that they understand the purpose of breast massage and can discontinue the treatment at any time for any reason.
(c) Document in the client’s record a therapeutic rationale for the breast massage.
(d) Use appropriate draping techniques as identified in WAC 246-830-xxx (draping section);

(2) In addition to the requirements identified in subsection 1, to perform any massage to the breast, a licensed massage therapist shall maintain evidence of the completion of at least 20 specialized contact hours as training in breast massage beyond the minimum competencies, which includes but is not limited to, breast anatomy and physiology, pathology, indications, contraindications, therapeutic treatment techniques, draping, appropriate therapist-client boundaries, expected outcomes, and client safety related to breast massage. Of these 20 hours, 16 contact hours must be in person.

(3) In addition to the requirements in subsections 1 and 2, prior to performing breast and chest massage that includes the nipple and areola, practitioners must
(a) have separately delineated written consent for breast and chest massage that includes the nipple and areola, and
(b) maintain documentation of the completion of specialized training in breast and chest massage that includes the nipple and areola.