Ep 300 – Human Trafficking in Higher Education with Dr. Debra Persinger

0:00:00.1 Kristin Coverly: Easily run your business with free online scheduling, payment processing and more from the new ABMP PocketSuite Signature Edition. ABMP has partnered with PocketSuite to bring members a free easy-to-use phone app that lets you focus on what matters most, your clients. Businesses on PocketSuite see an average 30% increase in earnings, and you can get set up in 15 minutes by choosing from curated preloaded settings or customizing the app for your practice. Features include online scheduling, HIPAA compliant intake forms and contracts and payment processing, all included in the ABMP Signature Edition and all free to ABMP members. Go to abmp.com/pocketsuite to get started and spend more time focusing on what you love.

[music]

0:01:06.1 Darren Buford: I'm Darren Buford.

0:01:07.0 KC: And I'm Kristin Coverly.

0:01:08.4 DB: And welcome to The ABMP podcast, a podcast where we speak with the massage and bodywork profession. Our guest today is Debra Persinger. Debra is the Executive Director of the Federation of State Massage Therapy Board, which is a not-for-profit corporation whose membership is comprised of the massage therapy regulatory boards and agencies in the United States and its territories. The mission of the federation is to provide programs and services that assist its member boards in public protection through regulation of the profession of massage therapy. The federation develops and administers the MBLEx exam, that is the assessment tool used by the majority of states to determine safety and competence of those seeking to be licensed massage therapists. MBLEx eligibility requirements include verification of massage therapy education and training, and this is commonly where the Federation intersect with fraudulent application documentation and tactics. Which brings us to our topic today. Hello, Debra. And hello, Kristin.

0:02:02.3 Debra Persinger: Hello. Good to be with you.

0:02:03.5 KC: It's great to have you with us today, Debra. Thanks so much for making time for this really important conversation, and to start the conversation, can you please define human trafficking and tell us why it's one of FSMTB's missions to call out human trafficking and its effects on the massage profession?

0:02:22.4 DP: So by definition from the Department of Homeland Security, human trafficking involves the use of force, fraud or coercion to obtain some type of labor or commercial sex act, and the incidents with massage therapy, it's primarily the sex trafficking that we encounter.

0:02:42.2 KC: And how did it become one of the federation's missions to call out human trafficking, was it through the state boards or how did that become one of the big missions?

0:02:51.4 DP: It was really by default, it was never a very deliberate mission, we somewhat inherited it with what we call the SOBs, the sexually oriented businesses, or the impostors trying to infiltrate the legitimate massage therapy profession. And so because the states are tasked with the public protection piece, and I'll just say that when you think of public protection, people often think of only the consuming public of massage therapy, but from the regulatory point of view, it's also protecting the profession. Massage therapists don't lose their citizenship rights just because they choose to become a licensed professional, and so because of the nature of the organized crime element that's involved in the sex trafficking, we still are seeing an influx of education fraud in the form of deployment mills, transcript mills and then that trickles into the examination fraud, and then ultimately to the licensure fraud. It wasn't anything that the state boards deliberately went out and sought to grandstand on some good social justice mission, it's unfortunately something that we are forced to address.

0:04:08.0 DB: Debra, I know that in 2017, the Federation Human Trafficking Task Force released the Human Trafficking Task Force Report, which was the combination of several years of study, what were the findings?

0:04:19.5 DP: In order to raise awareness of this problem that the profession was encountering without necessarily overtly knowing about it. We found that it is absolutely a problem that's impacting the entire massage profession, that's primary finding number one, we found that there are ways that the state regulatory boards can make a difference, uniformity of standards is one of those ways. So the Massage and Bodywork Licensing Examination, the MBLEx that you mentioned, is one of the primary ways that we, as you said, intersect with the perpetrators, not necessarily the victim, so the handlers or the people behind the scenes who are moving these girls into the trafficking lifestyle, if you will.

0:05:10.1 DP: So it's really at that juncture that we intersect and found that by collaboration an inter-state and inter-agency collaboration is where we can really make a difference, and so the federation has been focusing on a lot of education to share with and among the state boards. Everything from how to detect fraud in transcripts through to, how to behave and support these victims when they come before the state boards, so looking at the psychological impact of the people who are involved as victims in the process. So there's myriad ways actually, but the good news is we can make a difference, but honestly, some days it feels like drinking from a fire hydrant, so we have to be very focused in what we tackle one piece at a time.

0:06:03.1 KC: Absolutely, such important work, but such a big scale, and I'm sure it's bigger than any listener realizes who hasn't studied. Right?

0:06:11.7 DP: Yes, absolutely. It's happening in every state. Every single state, and even people who may typically think, well, that wouldn't happen in my community, it's happening in your community, big and small, rural, urban. Hiding in plain sight is often a term that people use to describe it.

0:06:32.6 KC: And Darren mentioned the 2017 Human Trafficking Task Force Report. And listeners, if you're interested in learning more about that and reading that report, that's available on the federation's website. In addition to that report, more recently, you launched a project called a Toolkit for Identifying Human Trafficking and Fraud in Higher Education. So like you mentioned earlier, it's in the schools as well, and it's really sort of rampant everywhere, every aspect of our profession. Can you tell us more about the impetus for creating that, were you really noticing an uptick in infiltration in the schools? Or tell us a little bit more about that.

0:07:08.7 DP: Yes, I think uptick is a good descriptor. Actually, it's even really amplified, it's not going away, and it's not even maintaining the status quo, it's absolutely increasing. The impetus for the toolkit I co-authored with Colorado Department of Higher Education. So there was actually a school in Colorado, I use that term school very loosely. You can't see me doing air quotes. It was basically a transcript mill, and so they were also selling exam questions. So it was a double-edged little business model that they had going on. And so the FBI became involved. We work closely with the Colorado Department of Higher Education, they are authorized to oversee and approve massage schools in the state of Colorado.

0:08:02.5 DP: And so from this combined effort with law enforcement, federal law enforcement, because they were selling their products across state lines and the Federation, we were able to shut down the school. It turns out that one of the principals of the little scheme confessed that it was never a school, the entire thing was a sham. He ended up... Or a couple of them ended up getting federal prison time, that's an extreme outcome, not everything that we investigate and shut down or are involved in collaborating to shut down has that kind of federal prison outcome but sometimes it's like playing whack-a-mole, honestly, you shut down under school X and they three miles down the road will open up school Y and then school Z in another state. So it's unrelenting.

0:08:52.8 DB: Debra, who is the toolkit for? I'm guessing it's the state regulators, correct? And then maybe you can tell our audience a little bit about what state regulators do.

0:09:01.5 DP: Yes, definitely for the state regulators, but not only for the state regulators, so certainly the massage therapy boards, and not necessarily the people that sit on the state boards, but their staff, their support staff. So the investigators that go out into the field, the state authorizers of higher education, which is a different entity entirely from the state boards in some states, so it helps them understand the nature of the trafficking impact on the massage therapy profession. For example, if they go into a school or the school clinic or a spa, an establishment, it's basic things like no, lingerie does not belong in the coat closet. If there is an aroma of food and mattresses on a floor in the back room, and you can tell somebody's actually residing and living in the establishment, that's another example of a red flag.

0:09:58.2 DP: So taken independently, they might think, well, this is a little odd but when we amalgamated all the information back to back, it's just a more helpful toolkit to raise their awareness, and then we have an educational component as well. The undercover law enforcement, even things that we might take for granted or members of the profession may but they'll ask questions, is it normal for her to walk on my neck? Or things like that [chuckle], that we... No, it's also not normal to have whipped cream in your treatment room, but if they've never experienced massage, they don't necessarily know the difference or they tend to brag about their MBLEx results. And so they have walls with MBLEx score reports bragging that people have passed when, of course, they haven't. They've tampered with them. So there are so many, many keys and red flags, so we wanted to combine these for the people in positions of authority to monitor and oversee this. And hopefully ultimately rescue these victims that are caught up in the human trafficking schemes.

0:11:08.4 KC: I'm curious, we're talking a lot about the entities or the people running, in this case, schools or sometimes also employers or clinics or spas. Let's talk about the individuals. How are people being pulled into that situation for people who... Listeners who haven't studied human trafficking and may not know, how are individuals finding themselves in this situation in that school?

0:11:31.4 DP: For us, the predominant population are immigrants from Asia, and so... In particular from China. And so it's their own people who are advertising and for example, Chinese newspapers saying, I can guarantee you a licence, guarantee to pass the exam. And because they are not familiar with the culture and the United States, they're just believing like, oh, this is what you have to do to do massage in this country, and then they get them into their schemes, they make them memorize exams 14 hours a day, but they're not even memorizing factual information about massage. They're literally taking maybe two key words.

0:12:18.7 DP: Like, if they see the word ankle and then the word medial malleolus or something like that. [chuckle] That's all they memorize. There's no context to it at all. So it's just a stroke memory situation. So they can say it's $10,000, and I'll get you exam questions and okay, oh, you want a license too? Well, then there's another $10,000, and then it's, oh, you can't afford to pay me back $20,000, then come and work at my spa. And again, I use that term spa loosely. And so that's how they go into the debt bondage and sexual servitude, and then the cycle repeats because of course, their business model is that they never can repay the debt and they're constantly in servitude.

0:13:05.8 KC: Let's take a short break to hear a word from our sponsors. Anatomy Trains is excited to invite you to our latest in-person fascial dissection workshop, April 10th through 14th, 2023 in Boulder, Colorado. Join Anatomy Trains author, Tom Myers and master dissector Todd Garcia on this voyage of discovery. Visit anatomytrains.com for more information. Let's get back to our conversation.

0:13:37.2 DB: Debra, I read the toolkit and found it so valuable and inside there are a lot of red flags that law enforcement could be aware of and state regulators could be aware of as well, when you're putting that together, how do you do that without exposing the answers or a workaround for those who want to commit illicit acts because you're potentially letting them know the things that you may be on the look out for.

0:14:05.6 DP: Yes. Well, what is in the toolkit honestly, is just the tip of the iceberg. There's a lot more that goes on behind the scenes that obviously we don't want to tip off the perpetrators about the operations and what's being looked for, but at the same time, even if they do know what we're looking for, they're so very brazen and they repeatedly make the same errors. Spelling the word massage incorrectly, or saying that individual A was at school in Florida and a transcript with the exact same timeline that they were at school in New Jersey, because they don't know the geography of the United States. We know that, well, you can't drive from Florida to New Jersey every morning to go to school and then drive back. And sometimes we are able to outsmart them, and sometimes they learn a tactic and they do the work around, and so they're... Everything we do, they're trying to do better.

0:15:04.4 DP: For example, we had Federal Marshals go into one of these fraudulent school operations and they had their students or their customers looking at computer screens with exam items on there, and so after... So we filed litigation, we moved through the process there, but then what happened was the next time, so as not to encounter that again, they had removed the film on the front of the computer monitors, so that when law enforcement or anybody comes in, it's just an entirely blank screen that they're looking at and they have to wear special glasses with that piece of film cut out in to the lens, so that when you look through the special glasses, you can actually see what's on the screen, but to the otherwise unwitting observer, it's just... There's nothing going on here. They're just looking at a blank screen. So it kind of feels like a cat and mouse situation, but we collaborate very closely with law enforcement because we have the information, but we don't have any authority, and rightfully so. We don't want that power and authority, but definitely a collaborative effort is what's required to address the situation.

0:16:20.7 KC: Yeah, I'm really struck by your stories, of course, but also something you said earlier about how widespread it is and how it's happening on such a higher level than any of us would guess who don't... Who haven't studied or in your position and who don't know, it can feel overwhelming. How do you, Debra, in your position, who's dealing with this day after day, how do you maintain your energy for it and what would you want our listeners to know?

0:16:51.2 DP: Gosh, the Federation is a non-profit organization, so we have a really committed staff, we really believe in the mission of the organization, we are all about standards and public protection, and that's what drives us. So you have to be unrelenting and tenacious. We're doing this on behalf of the massage therapy profession, the legitimate profession, and so nothing's going to knock us down or [0:17:15.2] ____ about that commitment. We hate when good guys finish last. That kind of a camaraderie. It can feel lonely though, because the regulatory community is, in my opinion, an unsung hero.

0:17:29.4 DP: People just think, oh, they're... State boards are mainly to take away licenses, but they don't realize that all of this other public protection aspect is going on behind the scenes. So, we're very committed to the mission. Can it be demoralizing? Yes. Do we see bad things going on and have no power to immediately address it? Yes. But that doesn't mean that we just surrender and give up or acquiesce to the dysfunction, we just have to chip away, chip away, and education is really key. I think the report that you mentioned, the Human Trafficking report, that's on our website, and then this toolkit is just the educational quest is ongoing. And that is making a difference. It really is. That also inspires us.

0:18:15.7 KC: I'm curious, if a practitioner suspects that something's happening in their community of a fraudulent nature, what do you recommend they do? What's their next step?

0:18:24.6 DP: Definitely contact the appropriate authorities, it would depend on the nature of what they think is suspect, so if they think there's people and being held captive, if you will, in a building or premises. Absolutely, contact law enforcement, more and more law enforcement have even particular agents assigned to trauma-centered victim-centered care, understanding that they're not necessarily just labeled as prostitutes and part of the problem, they're actually victims. So definitely contact law enforcement. If it's some kind of a school scam, we get tips as well from people who know something is wrong, but they don't necessarily know who to contact, so they can contact the federation as well, or their state licensing board. It depends on the nature of the circumstances.

0:19:17.1 DB: Debra, you mentioned something really important, and I know that victim support is one of the tenets of your mission. How does the federation participate or suggest other do so as well to ensure there's no re-victimization?

0:19:31.2 DP: Yes, well, we're trying these people that are coming through with fraudulent transcripts and receiving no access to the MBLEx or the people that do get through, and then at the test center, we find that their handlers are accompanying them to the test center because they take the girl or the woman... They take their identification, their passports, their driver's license, because they don't want them to be able to flee, but for our needs to get into the test center, we need identification to make sure there's no proxy testing and so forth going on. So that's where our staff or the personnel that we designate through our testing centers are trying to also contact law enforcement, and then it usually trickles out from there. There are many non-profits and other agencies in every community to assist with the social work aspect of things. The Federation, we can't be all things to all people. So that's really not in our direct mission, we are more of a behind-the-scenes supporter and facilitator of information exchange to let the other authorized people and experts do their job.

0:20:45.0 KC: Debra, I wanna reflect how appreciative I am as a practitioner to you and everyone at the Federation for the work that you do and that you have done up until now. What are the next steps, what's next for you to protect the profession and help victims?

0:21:02.2 DP: Well, for the federation, we continue to bolster our resources and services and educational programs that we have for the state regulatory boards. We're involved in a lot of education, we're also involved in a lot of education with more external to massage therapy. So for example, the Department of Homeland Security, we collaborate with FBI, there are local regional places to help educate them and understand more about the nature of massage therapy, so we're branching out further than just our own massage therapy community specifically. The next steps are really the ongoing steps, there's nothing new and innovative about helping other humans who are vulnerable and being exploited. We're continuing our education and outreach among the profession. That has not always been well received. People like to think massage therapy lives on the sunny side of the street, and it's just a nice day at the spa, not realizing that there's this other element going on that the regulatory boards are tasked with addressing and rightfully so.

0:22:18.1 DP: They're doing their job quietly and really effectively and efficiently to the best of their ability. So it's just an ongoing quest, there is no new innovative things. It's information spread, and having the support of the massage therapy profession is really enormously helpful more than they know. So reporting things that they see in their community, standing up for standards in this political climate of deregulation, if massage therapy goes unregulated, it will just be a free for all. An awful, awful thing for the profession and the professionals. So even something seemingly as innocuous of supporting state licensing for massage therapy just goes in a long way to ultimately making a difference in their little corner of the universe to address this other side of the profession that we have to deal with.

0:23:20.4 DB: Hopefully, we've done a little bit here today with, even in this short podcast, just to spread awareness about the depth of what's going on and the complexity, and we just wanna applaud you, Debra, and the work that the Federation's been doing.

0:23:36.5 DP: Thank you. I really appreciate the opportunity to raise consciousness and raise awareness. It's definitely a community collaborative effort. I sit in a privileged position on the staff at the federation, but there's a whole cadre of professionals who volunteer on their state licensing boards. And then the professionals out in the community as well. So definitely a team effort. And we're very grateful for the support. So thank you for this opportunity.

0:24:06.9 DB: I wanna thank our guest today, Debra Persinger. For more information about the work the Federation is doing visit fsmtb.org. Thanks, Debra, and thanks Kristin.

0:24:16.9 DP: My pleasure, thank you.

0:24:18.4 KC: Debra, thank you not only for this very important conversation today, but for the work that you and the Federation do on a daily basis, we appreciate you.

[music]

0:24:32.5 KC: Members are loving ABMP 5-minute muscles and ABMP pocket pathology. Two quick reference web apps included with ABMP membership. ABMP five-minute muscles delivers muscle-specific palpation and technique videos plus origins, insertions and actions for the 83 muscles most commonly addressed by body workers. ABMP pocket pathology created in conjunction with Ruth Werner, puts key information for nearly 200 common pathologies at your fingertips and provides the knowledge you need to help you make informed treatment decisions. Start learning today, ABMP members log in at abmp.com and look for the links in the featured benefits section of your Member home page. Not a member? Learn about these exciting member benefits at abmp.com/more.