exempting holistic services practitioners from the By-law as described below:

Adopt the principles found in the Markham Body Rub Parlour By-law (Appendix 4). Holistic services are exempt. Practitioners must prove credentials only upon challenge from licensing body.

1. If A,B, and C are adopted, a permanent Advisory Committee be established and that reporting relationships, representation and the role of the Committee be referred to staff and the Advisory Committee for further development; and
2. The appropriate City Officials be authorized and directed to take the necessary action to give effect thereto.

Council Reference/Background/History

The minute of the July 14, 1998 meeting of the Emergency and Protective Services Committee, regarding the licensing of holistic services, reads:

The Emergency and Protective Services Committee referred the reports and communications [presented at the July 14, 1998 meeting, attached] together with the following motions, to the General Manager, Toronto Licensing Commission, in consultation with the City Solicitor, for a joint report thereon to the Committee in October 1998:

-that a fee be established for holistic therapy centres that reflects the licence fee for massagists and massage parlours.

-that the General Manager, Toronto Licensing Commission, be requested to:

(a)review the licence fee after it has been in effect for a period of time so that the adjustments that may be necessary can be made and submit a report thereon to the Emergency and Protective Services Committee after six months;

(b)examine the feasibility of eliminating the word 'new' from the proposed regulation requiring that owners 'close centres to all new clients between 10:00 p.m. and 7:00 a.m.';

-that the Commissioner of Urban Planning and Development Services be requested to provide clarification as to zoning;

-that after zoning approval is given by the City, there also be a process of public meetings and public consultation for the issuance of such licences and that [this] motion be referred to the City Solicitor for report;

-that the General Manager, Toronto Licensing Commission, be requested to report further on including those holistic practices where touching is incidental; and

-that the practitioner's licence clearly state that they can only practice in a place of business licensed for that particular purpose.

These motions and those outstanding issues identified by Legal and the Advisory Committee at the July 14th, 1998 the Emergency and Protective Services Committee meeting are directly incorporated into recommendation (I), listed above, with the exception of options for defining "holistic services", and the requirements for obtaining a licence. A recommended Option for these are presented in recommendation (I(B)2) and and this and other options on the requirements for qualifying are the subject of the remainder of this report.

Comments and/or Discussion and/or Justification

Earlier reports from Licensing, Legal and the Advisory Committee, highlight the major difficulties faced in developing regulations for holistic service, i.e., defining "holistic services", determining what is to be regulated, and the requirements for obtaining a holistic services licence. These remain unresolved issues. In the most recent reports brought forward to the July 14th, 1998 Emergency and Protective Services Committee meeting Licensing, Legal and the Advisory Committee addressed these issues.

Licensing put forward to the Emergency and Protective Services Committee the following recommendations in a June 22, 1998, report:

[1] A category be created for "holistic services" that includes modalities used for therapeutic and wellness purposes that involve touching or massaging, but does not include therapies where touching is incidental (p.1);

[Require that any practitioners wishing to obtain a municipal licence after the end of the sixty-day period, complete training in one or more modality (p.1);

In response to these recommendations Legal, in a June 22, 1998 report, raised the following concerns, that:

[1]The definitions of "holistic practices", "holistic services", "holistic centres" and "holistic practitioner" be further particularized (p. 1);

[2]staff review the issue of the training certificate to be provided by persons seeking licences as practitioners of holistic services (p.1);

In addition, the July 14, 1998, report of the Advisory Committee (Appendix 3) brought forward the concern that:

the holistic community makes no differentiation between its practitioners who touch and its practitioners for whom touch is incidental. Most holistic practitioners touch at some point during treatment. The Advisory Committee wants all members of the holistic community to be licensed (p.1).

Definition of Holistic Services/Requirements for Obtaining a Licence

In the most recent report and over the course of consultations on proposing "to control body rub parlours without impacting on the complementary therapy disciplines", the following issues have been identified by various stakeholders as the barriers to defining holistic services and the requirements for obtaining a licence:

Issues arising from maintaining current licensing scheme

The status quo is not workable. Without workable criteria the By-law is unable to clearly and readily distinguish holistic services practitioners and body rubbers. Holistic services practitioners are facing charges as body rubbers. Body rubbers are masquerading as holistic services providers, and as a result the allowed limit of twenty five body rub parlours operating within the City of Toronto is effectively exceeded.

Issues arising from developing a licensing scheme for holistic practitioners while maintaining the regulations established for body rub parlours

It is assumed that there is a need to leave licensing regulations for body rub intact. Body rub regulations were established in August, 1975. Council adopted regulations to control body rubs and to ensure "standards of cleanliness, competencies and ethics for the protection of the public." (From the report of the Solicitor, June 20, 1974, Council minutes, Appendix "A", p.1985). The premise for establishing these regulations has not changed. Therefore, based solely on the reasons for initially establishing regulations, change to these regulations is not needed.

However, leaving the body rub regulations intact means that any new regulations for holistic practitioners must reflect the current legislative framework. This creates two difficulties. Firstly, because "body rub" was defined in By-law 20-85, and the Municipal Act (s.224(9)) as:

the kneading, manipulating, rubbing, massaging, touching or stimulating, by any means, of a person's body or part thereof but does not include medical or therapeutic treatment given by a person otherwise duly qualified, licensed or registered so to do under the law of the Province of Ontario,

it is difficult to distinguish body rub activities from many of the techniques of holistic services practitioners, which also involve kneading, manipulating, rubbing, massaging, etc. The intentions of these practitioners differ (holistic therapists perform holistic/remedial/therapeutic services), but by-law definitions cannot be developed on the basis of intent. If body rub and holistic practitioners are to be distinguished, it will be with some criteria other than intent; one that is clear and workable for issuing and enforcement staff and for the persons subject to the proposed regulations.

Secondly, although the practices of body rubbers and holistic therapists have similarities, it can be reasonably argued that holistic practitioners should not have to describe their occupation in terms of how they can be distinguished from body rubbers, but should be defined instead by their own standards.

Should holistic services where touch is incidental be included in the licensing scheme

The primary purpose for licensing any category of business is to protect the safety and rights of the citizens of the City of Toronto. In the case of holistic therapy involving touch, the similarity of the treatment between these types of holistic therapies and body rubs are indistinguishable in terms of the definition of body rub, this led to some body rub operators holding themselves out to be holistic therapists in order to circumvent By-law 20-85 and operate outside the regulatory framework of the City.

The recommendations set out in this report are designed to prevent this circumvention of the By-law by body rub operators thereby ensuring that Council's objectives are met while having as little as possible impact on the holistic community.

However an argument can be made that:

regulating Holistic Services that use touch, only emphasizes the perceived sexual side of the business (the public at large perceives Body Rub to be a type of sexual service that uses massaging or touch).

Most Holistic Services/Practices are not subjected to any form of regulation (including self regulation). This lack of control leaves the public without clearly recognized bodies to address any concerns they may have about the industry, such as health standards, fair business practices and maintaining standards of ethical practice.

Licensing some practitioners may confuse the public who may infer that all holistic serves are licensed and are safe, clean etc. and may base their decision to use these services on this.

Regardless of the validity of the above concerns, there does not appear to be an issue or compelling reason in terms of protecting public safety and rights in relation to all Holistic Practitioners. Complaints that have been received have been in relation only to those practices that use touch/massage as part of their technique. These complaints are from citizens who complain that the person(s) holding themselves out to be a Holistic Practitioner(s) is (are) in reality operating a body rub operation. Therefore, based on the experience of licensing staff there is no public policy need to licence Holistic Practitioners who do not use touch or massaging as a normal part of their technique.

Issues arising from setting requirements to licence holistic practitioners

As indicated earlier, the difficulty faced in developing licensing regulations for holistic services is defining the business activity and determining what is to be regulated. Because holistic therapy is an emerging field, there are no universal standards for identifying holistic services practitioners and their activities (although the Office of Alternative Medicine (OAM), part of the U.S. Department of Health and Human Services, has recently proposed a useful scheme for categorizing therapies/modalities which has been adopted for the purposes of this By-law). The use of criteria for establishing requirements for obtaining a licence such as completion of courses or training, membership in professional associations, eligibility for payment from extended health benefits insurance, attended courses eligible for tax credits, eligibility for malpractice insurance were examined in previous reports where it was found the use of these criteria offered only partial solutions.

Furthermore, there is need to compensate for the lack of provincial educational and scope of practice standards for holistic practitioners if a licensing scheme is to be developed. Only a limited number of holistic practitioners have completed training at provincially-recognized training institutions. The remainder have either no formal training, have completed courses at a various private institutions, or trained with a Master.

Options for establishing qualification Requirements for Obtaining a Licence

The following are options for setting qualification requirements for holistic services practitioners, owners and operators. The conditions and goals any one option will meet are discussed and summarized in the attached chart. These are provided as a guideline to evaluating these options:

Recommended option

Require that applicants file training certificates from programs recognized by other levels of government and/or meet other standards

Under this option practitioners prove they have completed courses at a college, vocational school or any other school that issues tuition tax credits. This approach revises the current licensing scheme, gives recognition to holistic services practitioners, distinguishes holistic service practitioners by training credentials and provides a clear workable criteria to distinguish holistic practitioners. As discussed earlier in this and other reports the difficulty with this option is that only a limited number of practitioners have completed training at these institutions. This option provided no accommodation for foreign-trained practitioners and modalities where training is traditionally provided in an informal manner.

For those practitioners who do not qualify under the above training requirements, a substitute set requirements could be introduced, such as those listed in the Markham By-law (Appendix 4): Schedule "B" sections; 1(b) i-iv ;1(c) ii, iv; 3(b) i-vi; 3(d) i-x;

All practitioners would be required to file proof of training. If the training qualifications did not meet the By-law requirements, an applicant could request to prove their qualifications by meeting these additional standards.

Evaluation of recommended Option

This approach revises the current licensing scheme, gives recognition to holistic services practitioners, distinguishes holistic services practitioners by training credentials or other criteria and does not effect body rub regulations. However, as it is anticipated there will be many practitioners who do not meet the training requirements, the major concern with this approach is that the processing and evaluating of these various records could be administratively complex and tax the resources of Toronto Licensing. However cost of administration would be recovered in the fee.

Other Licensing Options

1.Require that applicants file proof of training (as recommended in the Licensing report of June 22, 1998)

Under this option, practitioners meet the requirement for obtaining a holistic services licence by showing proof of training in one or more modality. As discussed in the earlier report Toronto Licensing may find that initially it needs to rely on the expertise and honesty of applicants to correctly distinguish themselves from body rub parlour operators until an inventory of modalities, schools and courses is developed.

An initial grand parenting period was proposed, during which time applicants submit reasonable proof of carrying on a business providing holistic services, such as a lease or dated printed advertisement which clearly specify the services provided. Toronto Licensing will rely on business records to distinguish holistic services businesses from body rub parlours. During this period Toronto Licensing staff and the Advisory Committee will work on the inventory of modalities, schools and courses. After the grand parenting period expires, holistic practitioners, who wish to obtain a licence but have not submitted business records, will be required to submit proof of completion of training.

Evaluation of Option One

This approach revises the current licensing scheme, gives recognition to holistic services practitioners, and distinguishes holistic service practitioners by training credentials. However, as addressed in earlier reports, this proposal does not provide clear and workable criteria to distinguish holistic services practitioners, and may have an impact on body rub parlours.

As holistic services training is not standardized - the field is emerging and there are numerous modalities and instructional methods and centres - identifying legitimate training certification is problematic. (as discussed in the report from Legal, June 22, 1998). Without objective standards by which to evaluate the courses or training, applicants may qualify upon presentation of any certificate, regardless of its legitimacy. Accordingly, it would not be difficult to circumvent the regulations. Licensed body-rub parlours might apply under the new holistic services category, so as to avoid the restrictions and higher licence fees of body rub parlours. Operators who currently are unable able to obtain body rub parlour licences, because of the restriction on the number of operations, may apply for holistic services licences to operate a business.

2.Allow applicants to qualify for Holistic Services licences without any entry restrictions.

Under this option holistic services practitioners do not file proof of their occupation and simply self-identify.

Evaluation of Option Two

This approach revises the current licensing scheme, and gives recognition to holistic services practitioners. This option avoids the concerns regarding the verification of qualifications of practitioners addressed in the June 22, 1998 report by Legal. However, even more so than the previous option, this approach has the potential to effect body rub parlours. With no criteria for qualifying as a holistic services practitioner, body rub parlour owners/operators could easily misrepresent the nature of their operations and effectively circumvent the restrictions on the number of body rub parlours.

4. Adopt the principles of the Markham Body Rub Parlour by-law. Holistic services are exempt. Practitioners must prove credentials only upon challenge from licensing body.

Under this approach, all holistic services practitioners would be exempt from requiring a licence if they can demonstrate a level of commitment to a bona fide health care discipline. If there is any doubt as to whether the service provided is or is not a body rub, a practitioner would have to prove that they were in fact a holistic services provider by submitting evidence of sufficient education from a qualifying institution and membership in a qualifying association. It is not intended that every such practitioner apply for an exemption. Instead, they could claim the exemption if a challenge arises that they are a body-rub operating without a licence. Then the licensing officer would review and make a decision based on the applicant's supporting material.

Evaluation of Option Four

This option revises the current licensing scheme and distinguished holistic service practitioners. However, there are several concerns associated with this approach. The Markham By-law would be administratively complex. The criteria for distinguishing holistic practitioners is extensive. If more than a couple of practitioners are challenged the administration of these regulations would tax the resources of Licensing. In addition, as there are no new fees collected there would be no funding available to administer these exemption regulations.

Zoning/home-based businesses

In earlier reports the question of possible zoning regulations prohibiting the operation of home-based businesses was raised. I have been informed by various planners from the former area municipalities that throughout the City of Toronto these by-laws vary as each former area municipality continues to operate under its own By-laws. The operation of holistic services businesses in residential property is permitted in the former City of Toronto, City of York, Borough of East York and City of Etobicoke. It is not permitted in the former City of Scarborough and City of North York.

It is anticipated that eventually these zoning by-laws will be consolidated. In the meantime, it is recommended that once licensing regulations for holistic services have been adopted staff meet with Planning and Building officials to discuss the smooth implementation of the new licensing regulations for home-based businesses.

Conclusions

In summary, Council should adopt one of the options set forth in this report to regulate and distinguish Holistic Practitioners from Body Rub Operators.

Contact Name and Telephone

Carol Ruddell-Foster

General Manager, Toronto Licensing

392-3070

________________________

Carol Ruddell-Foster

General Manager, Toronto Licensing

Review by:

_________________________

Virginia M. West

Commissioner of Urban Planning and Development Services