HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/CS/HB 615 Massage Establishments
SPONSOR(S): Health Care Appropriations Subcommittee, Healthcare Regulation Subcommittee, Lopez, V.
TIED BILLS: IDEN./SIM. BILLS: SB 1338
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Healthcare Regulation Subcommittee 17 Y, 0 N, As CS Osborne McElroy
2) Health Care Appropriations Subcommittee 13 Y, 0 N, As CS Aderibigbe Clark
3) Health & Human Services Committee
SUMMARY ANALYSIS
Massage therapy is the manipulation of the soft tissues of the human body with the hand, foot, knee, arm, or
elbow, whether or not such manipulation is aided by hydrotherapy, including colonic irrigation or thermal
therapy, or any electrical or mechanical device, or the application of a chemical or herbal preparation to the
human body. The Board of Massage Therapy (Board), within the Department of Health (DOH), regulates
massage practice, including massage therapists and massage establishments .
DOH is required to annually inspect massage establishments for compliance with statutory requirements.
Under current law, DOH is authorized to issue an emergency suspension, restriction, or limitation of a license if
limited, specified criteria are met.
Human trafficking is a form of modern-day slavery involving the transporting, soliciting, recruiting, harboring,
providing, enticing, maintaining, or obtaining another person for the purpose of exploiting that person. Illicit
Massage Businesses (IMBs) are licensed or unlicensed massage establishments that purport to operate as
legal businesses, but where sexual services are illegally bought and sold. IMBs are considered one of the
primary venues for sex trafficking involving adults and comprised the largest group of citizen calls to the
National Human Trafficking Hotline in 2019.
Florida has implemented several regulatory measures in statute in an effort to obstruct the operation of IMBs
without interfering with legitimate massage establishments.
CS/CS/HB 615 expands DOH’s authority to issue emergency orders suspending the license of a massage
therapist or establishment. The bill authorizes law enforcement and code enforcement officers to perform
inspections and investigations regarding whether a massage establishment is compliant with certain statutory
requirements. The bill requires DOH to issue an emergency suspension of a massage therapist or
establishment’s license under specified circumstances.
The bill expressly prohibits any sexual activity within a massage establishment. The bill prohibits advertisement
by a massage therapist or establishment from being posted in any medium or website that advertises
prostitution, escort, or other sexual services. The bill outlines requirements for the operation of massage
establishments.
The bill appropriates $837,992 in recurring funds and $38,712 in nonrecurring funds from the Medical Quality
Assurance Trust Fund to the DOH, to address additional workload. The bill has no fiscal impact on local
government.
The bill provides an effective date of July 1, 2023.
This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives .
STORAGE NAME: h0615b.HCA
DATE: 4/12/2023
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Massage Therapy
Massage practice is the manipulation of the soft tissues of the human body with the hand, foot, knee,
arm, or elbow, whether or not such manipulation is aided by hydrotherapy, including colonic irrigation or
thermal therapy, or any electrical or mechanical device, or the application of a chemical or herbal
preparation to the human body.1 Massage is therapeutic and a massage therapist must know anatomy
and physiology and understand the relationship between the structure and function of the tissues being
treated and the total function of the body.2
Chapter 480, entitled the “Massage Practice Act”, governs the practice of massage therapy in Florida.
The Board of Massage Therapy (Board), within the Department of Health (DOH), regulates massage
practice, including massage therapists and massage establishments. 3 The Board is responsible for
establishing rules governing the licensure and practice of massage therapists and massage
establishments. This includes approving massage therapy schools 4, licensure exams 5, and establishing
training requirements for massage therapy apprentices 6, as well as setting minimum standards for and
periodic inspections of massage establishments. 7 The Board has disciplinary authority over massage
therapist and establishment licenses.8 DOH is responsible for providing investigative services to ensure
compliance with regulations.9
Massage Therapist Licensure
A massage therapist is a person who administers massage for compensation. 10 As of March 22, 2023,
there are 39,183 actively licensed massage therapists in Florida. 11
To qualify for licensure as a massage therapist, an applicant must:12
Be at least 18 years of age or have received a high school diploma or graduate equivalency
diploma;
Complete a course of study at a Board-approved massage school;
Undergo background screening; and
Pass an examination.13
A massage therapist is required to renew his or her license every two years and must complete 24
hours of continuing education for each renewal period. 14
Massage Establishment Licensure
1 S. 480.033(3), F.S.
2 S. 480.032, F.S.
3 S. 480.035, F.S.
4
S. 480.033(3), F.S.
5 S. 480.041(1)(c), F.S.
6 S. 480.041(5), F.S.
7 Ss. 480.043(3) and (10), F.S.
8 S. 480.046, F.S.
9 S. 480.039, F.S.
10 S. 480.033(4), F.S.
11 Department of Health, FLHealthSource.gov, Public Data Portal (search by Board/Council “Board of Massage Therapy”, then by
Profession “massage therapist”, then by license status “practicing statuses only”), available at https://mqa-
internet.doh.state.fl.us/MQASearchServices/HealthCareProviders, (last visited March 22, 2023).
12 S. 480.041(1), F.S.
13 See rule 64B7-25.001, F.A.C., for Board approved examinations.
14 S. 480.0415, F.S., and rule 64B7-28.009, F.A.C.
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A massage establishment is the premises wherein a massage therapist practices massage therapy.15 A
massage establishment must be licensed by the Board and adhere to rules set by the Board regarding
facilities, personnel, safety and sanitation requirements, financial responsibility, and insurance
coverage.16 Massage establishments must be licensed in order to operate legally.17
The Board requires the following be met for a license to be issued for a massage establishment: 18
Submit a completed application;19
Pass an inspection by DOH;20 and
Submit proof of property damage and bodily injury liability insurance coverage.
The application includes background screening of the establishment owner and identification of the
designated massage establishment manager (DEM). 21 A DEM is a massage therapist who holds a
clear and active license without restriction, is responsible for the operation of a massage establishment,
and is designated the manager by the rules or practices at the establishment. 22
Massage establishment licenses may not be transferred from a licensee to another individual or
entity.23 Board approval is required for an establishment to move locations or change names. 24
Denial of Massage Establishment Licensure
A proposed massage establishment may be denied licensure for failing to meet the standards adopted
by the Board, or if the owner or DEM has been convicted of or plead guilty or nolo contendere for a
felony or misdemeanor relating to any of the following offenses: 25 prostitution,26 kidnapping,27 false
imprisonment,28 luring or enticing a child,29 human trafficking or smuggling,30 sexual battery,31 female
genital mutilation,32 lewd or lascivious offenses in the presence of a minor, elderly, or disabled person, 33
or obscene or sexual acts involving a minor.34
DOH may investigate the proposed massage establishment based on the application contents;35 if DOH
determines that the proposed establishment would fail to meet the standards adopted by the Board,
DOH must deny the application for licensure and provide the denial in writing with a list of reasons for
the denial. The establishment may correct the recorded deficiencies and reapply for licensure.36
Human Trafficking
15 S. 480.033(7), F.S.
16
S. 480.043, F.S.
17 Id.
18 Rule 64B7-26.002, F.A.C.
19 Board of Massage Therapy, Application for Massage Estab lishment License, available at
https://floridasmassagetherapy.gov/applications/app-bus-original-mt.pdf (last viewed March 23, 2023).
20 The inspection must demonstrate that the proposed massage establishment is to be used for “massage” as defined in Section
480.033(3), F.S. and that the proposed massage establishment is in compliance with Chapters 456 and 480, F.S. , and related rules.
See rule 64B7-26.002, F.A.C.
21 Supra, note 19.
22 S. 480.033(6), F.S.
23 S. 480.043(9), F.S.
24
Id.
25 S. 480.043, F.S.
26 Ch. 796, F.S.
27 S. 787.01, FS.
28 S. 787.02, F.S.
29 S. 787.025, F.S.
30 Ss. 787.06 and 787.07, F.S.
31 S. 794.011, F.S.
32 S. 794.08, F.S.
33 Ss. 800.004 and 825.1025(2)(b), F.S.
34 S. 827.071 and Ch. 847 F.S.
35 S. 480.043(5), F.S.
36 S. 480.043(6), F.S.
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Human trafficking is a form of modern-day slavery involving the transporting, soliciting, recruiting,
harboring, providing, enticing, maintaining, or obtaining another person for the purpose of exploiting
that person.37 Human trafficking can affect individuals of any age, gender, or nationality; however, some
people are more vulnerable than others. Significant risk factors include recent migration or relocation,
substance use, mental health concerns, and involvement in the child welfare system. 38
Victims are often subjected to force, fraud, or coercion for the purpose of sexual exploitation or forced
labor.39 It is estimated that at any given time in 2021, there were approximately 27.6 million people
engaging in forced labor.40 In 2021, the National Human Trafficking Hotline41 identified 16,710
trafficking victims in the US, of which 1,253 were in Florida; 42 however, these figures do not reflect the
true scope and scale of the issue which cannot be easily quantified due to the underground nature of
the issue. An analysis of data collected by the Hotline showed that approximately 6% of reported
victims in 2021 were associated with illicit massage, health, and beauty services. 43
Illicit Massage Businesses
Illicit Massage Businesses (IMBs) are licensed or unlicensed massage establishments that purport to
operate as legal businesses, but where sexual services are illegally bought and sold. 44 IMBs are
considered one of the top venues for sex trafficking involving adults and comprised the largest group of
citizen calls to the National Human Trafficking Hotline in 2019.45 In 2018, a study estimated that there
were approximately 9,000 IMBs operating in the US;46 it is expected that his number has risen in the
years since.47 The Collier County Sheriff’s Office estimates that there are currently 40 IMBs operating in
Collier County.48
IMBs are successful in part due to their ability to operate in plain sight. They are often located in strip
malls and present themselves publicly as legitimate massage establishments. Markers of an IMB
include: opaque or covered windows, locked front doors with a buzzer to enter, listed prices significantly
lower than the market value, serves exclusively or primarily male clientele, employees appear to be
living on site, and advertising on commercial sex websites. 49
The majority of people trafficked through IMBs are Chinese or South Korean women who have recently
arrived in the US. They are typically 35-55 years of age, have no more than a high school level
education, and speak little to no English.50
Police Response to IMBs
37 S. 787.06, F.S.
38
National Human Trafficking Hotline. Human Trafficking: What Human Trafficking is, and isn’t, available at
https://humantraffickinghotline.org/en/human-trafficking (last visited March 23, 2023).
39 Id.
40 International Labour Organization, Glob al Estimates of Modern Slavery: Forced Lab our and Forced Marriage (Sep. 2022,. available
at https://www.ilo.org/wcmsp5/groups/public/---ed_norm/---ipec/documents/publication/wcms_854733.pdf (last viewed March 23, 2023).
41 The National Human Trafficking Hotline is a free service to connect victims and survivors of sex and labor trafficking with servi ces
and supports to find help and safety. The Hotline also receives tips ab out potential situations of sex and labor trafficking and facilitates
reporting that information to the appropriate authorities. See also, National Human Trafficking Hotline, Ab out Us, available at
https://humantraffickinghotline.org/en/about-us (last visited March 23, 2023).
42 National Human Trafficking Hotline, National Statistics (2021), available at https://humantraffickinghotline.org/en/statistics (last visited
March 23, 2023).
43
Polaris, Analysis of 2021 Data from the National Human Trafficking Hotline , available at https://polarisproject.org/wp-
content/uploads/2020/07/Polaris-Analysis-of-2021-Data-from-the-National-Human-Trafficking-Hotline.pdf (last viewed March 23, 2023).
44 Chin, J. & Takahashi, L. (2022). Sex for Sale: Illicit Massage Parlors. 3 rd Edition. Routledge. ISBN: 9781003228639
45 de Vries, I. (2020). Crime, place, and networks in the age of the internet: The case of online -promoted illicit massage businesses.
Northeastern University.
46 Polaris, Human Trafficking in Illicit Massage Businesses (2018), available at
https://massagetherapy.nv.gov/uploadedFiles/massagetherapy.nv.gov/content/Resources/FullReportHumanTraffickinginIllicitMassageB
usinesses.pdf (last visited March 23, 2023).
47 Det. Sgt. Wade Williams, Collier County Sheriff’s Office, Illicit Massage Businesses Presentation , (on file with the Healthcare
Regulation Subcommittee).
48 Id.
49 Supra, note 46.
50 Supra, note 46.
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Traditional police techniques for controlling crime have proven to be largely ineffective in reducing the
presence of IMBs and their impact on victims of human trafficking. Traditional tactics such as sting
operations, undercover work, and reactive investigations are still relied on heavily for addressing
human trafficking and IMBs; however, these approaches have been shown to be ineffective in holding
traffickers accountable and decreasing the risk of victimization. 51
Police response to human trafficking has been criticized for not being victim-oriented; few victims of
human trafficking are identified by police as they often do not self-identify as victims, fear retribution
from their exploiter, and mistrust the authorities.52 Obtaining a conviction for human trafficking related
crimes relies heavily on victim testimony which has proven difficult to obtain in IMB-related cases.53 As
a result very few police actions have resulted in prosecutions for human trafficking, thus signaling very
little accountability for traffickers.54
Regulatory Response to IMBs
Florida has implemented several regulatory measures in an effort to obstruct the operation of IMBs
without interfering with legitimate massage establishments. These regulations include:
Massage establishments are not authorized to operate between 12am and 5am; 55
Sexual misconduct56 is explicitly prohibited in massage establishments; 57
Advertisements must include the license number of the individual massage therapist or
establishment being advertised;58
Persons employed in a massage establishment must be able to produce government
identification upon request by a DOH or law enforcement investigator; 59 and
Massage establishments are required to have a set procedure for reporting suspected human
trafficking and conspicuously post a sign with the relevant procedures. 60
Discipline of Massage Therapists and Establishments
The Board has disciplinary authority over massage therapists and establishment licenses.61 The
purpose of imposing fines and penalties is to protect the public by assuring compliance with an
agency’s rules.62 DOH is required to inspect licensed massage establishments on an annual or more
frequent basis. Such inspections include, but are not limited to, whether the establishment is in
compliance with the requirements for facilities operation, personnel, safety, sanitary requirements, and
existing insurance coverage.63
Section 456.073, F.S. outlines the process for disciplinary proceedings for professionals licensed under
DOH. Disciplinary proceedings begin whe