The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Fiscal Policy
BILL: CS/CS/SB 1338
INTRODUCER: Appropriations Committee on Health and Human Services; Health Policy Committee;
and Senator Martin
SUBJECT: Massage Establishments
DATE: April 24, 2023 REVISED:
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Rossitto Van
Brown HP Fav/CS
Winkle
2. Howard Money AHS Fav/CS
3. Winkle Yeatman FP Favorable
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/CS/SB 1338 amends section 456.074, Florida Statutes, to authorize the Department of Health
(department) to issue an emergency suspension order (ESO) to suspend the license of massage
therapists (MTs) and massage establishments (MEs) if the MT or certain individuals connected
to the ME are arrested for committing, attempting, soliciting, conspiring, or convicted or found
guilty of, or enter criminal pleas to, specified violations in the ME.
The bill amends the massage therapy and ME practice act to redefine the term “designated
establishment owner” and to create new definitions for “advertising media,” “employee,” and
“sexual activity.” The bill permits code enforcement officers and law enforcement officers to
inspect MEs for violations and to submit affidavits to the department with photos and
documentation under certain circumstances within certain time frames, which then requires the
department to inspect the ME within a certain time frame for specified violations and to initiate
disciplinary proceedings if violations are discovered. If a law enforcement officer arrests a MT
for violations of chapter 480, Florida Statutes, or finds that a ME is operating in violation of an
ESO or an emergency restriction order (RO), the law enforcement agency must notify the
department within five business days.
The bill creates new requirements and prohibitions for MEs. The bill amends the definition of an
unlicensed ME for purposes of crimes to include employees or attendants who are licensed MTs.
BILL: CS/CS/SB 1338 Page 2
The bill requires the Board of Massage Therapy (BMT) to adopt rules governing the operation of
MEs and their facilities, employees, safety and sanitary requirements, financial responsibility,
insurance coverage, and the license application and granting process.
The bill is estimated to have a significant negative fiscal impact on the department requiring
eight additional positions and $876,703 in trust funded budget authority. The bill appropriates
eight full-time equivalent positions and the associated salary rate and budget to the Department
of Health for the implementation of this bill (See Section V. of this analysis).
The bill takes effect on July 1, 2023.
II. Present Situation:
Massage Establishments
The Board of Massage Therapy (BMT), in conjunction with the Department of Health
(department), regulates the practice of massage therapy and Massage Establishments (MEs)
pursuant to ch. 480, F.S.
Board of Massage Therapy
The BMT consists of seven members, who are appointed by the Governor, and confirmed by the
Senate, for four year terms. Five members of the BMT must be licensed Massage Therapists
(MTs) and have been engaged in the practice of MT at least five consecutive years prior to their
appointment. Two members must be laypersons. Each BMT member must be a U.S. citizen, a
Florida resident for at least five years, and a high school graduate or have a high school
equivalency diploma (GED). The BMT must meeting at least once during the year for an annual
meeting, and as necessary thereafter. A quorum for the BMT requires at least four BMT
members. The BMT has authority to adopt rules pursuant to ss. 120.536(1) and 120.54, F.S., to
implement the provisions of ch. 480, F.S.1
Definitions Relevant to Massage Establishments
A “massage establishment (ME)” is a site or premises, wherein a MT practices massage therapy. 2
A message “establishment owner” is a person who has an ownership interest in a ME. The term
includes an individual who holds a ME license, a general partner of a partnership, an owner or
officer of a corporation, and a member of a limited liability company and its subsidiaries who
holds a ME license.3
A “designated establishment manager” is a MT who holds a clear and active, unrestricted
massage therapy license, and who is responsible for the operation of a ME, and designated as the
manager of the practices at the ME.4
1
Section 480.035, F.S.
2
Section 480.033(7), F.S.
3
Section 480.033(8), F.S.
4
Section 480.033(6), F.S.
BILL: CS/CS/SB 1338 Page 3
A massage “ownership entity” is an entity to whom a ME license is issued and may be a sole
proprietor, a partnership, a limited liability company, or another entity formed under the law of
the jurisdiction in which the entity resides.5
For purposes of the crimes of obscenity, under ch. 847, F.S., an “adult entertainment
establishment” is, among other things, an “unlicensed massage establishment” which is any
business or enterprise that offers, sells, or provides, or that holds itself out as offering, selling, or
providing, massages that include bathing, physical massage, rubbing, kneading, anointing,
stroking, manipulating, or other tactile stimulation of the human body by either male or female
employees or attendants, by hand or by any electrical or mechanical device, on or off the
premises. The term “unlicensed massage establishment” does not include a ME licensed under s.
480.043, F.S., which routinely provides medical services by licensed health care practitioners
and MTs licensed under s. 480.041, F.S.6
Licensure of Massage Establishments
Each ME must obtain a license from the department by submitting a department form and a fee
set by the BMT, along with proof of property damage and bodily injury liability insurance for the
proposed ME.7 A ME license may not be issued until the ME passes a department inspection
which demonstrates that the proposed ME is to be used for “massage” and that the proposed ME
is in compliance with the requirements of chs. 456 and 480, F.S., and the rules of the BMT.8
A ME owner must undergo a Federal Bureau of Investigations (FBI) background screening,
which includes electronically submitting finger prints to the Florida Department of Law
Enforcement (FDLE).9 If a corporation submits proof of having more than $250,000 in business
assets in Florida, the department must require the ME owner, the designated ME manager, and
each individual directly involved in the management of the ME to comply with the background
screening requirements.10 The department must provide all investigative services required in
carrying out the provisions of ch. 480, F.S.11
Massage Establishment Operations
The Legislature requires the BMT to adopt rules to govern the operation of MEs and their
facilities, personnel, safety and sanitary requirements, financial responsibility, insurance
coverage, and the license application and granting process.12
Florida Administrative Code Rule 64B7-26.003(2022), requires each ME to:
 Carry current property damage and bodily injury liability insurance, and a copy of the policy
must be kept at the ME;
5
Fla. Admin. Code R. 64B7-26.001(2022).
6
Section 847.001(2)(d), F.S.
7
Section 480.043(1), F.S.; Fla. Admin. Code R. 64B7-26.002(2022).
8
Section 480.043, F.S.
9
See 456.0135, F.S. for general background screen details.
10
Section 480.043(2), F.S.
11
Section 480.039, F.S.
12
Section 480.043(3),F.S.
BILL: CS/CS/SB 1338 Page 4
 Comply with all municipal building and zoning requirements;
 Maintain all equipment used to administer massage therapy treatment in a safe and sanitary
condition;
 Conspicuously display the current ME license in the ME in open public view;
 Conspicuously display, in open public view, the license or a photocopy, of each MT
practicing in the ME;
 Conspicuously display the required human trafficking signage in compliance with ss.
456.0341(3) and 480.043(13), F.S., which requires a sign at least 11 inches by 15 inches,
printed in a clearly legible font and in at least a 32-point type, which substantially states in
English and Spanish the following:
“If you or someone you know is being forced to engage in an activity and cannot
leave, whether it is prostitution, housework, farm work, factory work, retail work,
restaurant work, or any other activity, call the National Human Trafficking
Resource Center at 888-373-7888 or text INFO or HELP to 233-733 to access help
and services. Victims of slavery and human trafficking are protected under United
States and Florida law.”
 Have a procedure for reporting suspected human trafficking to the National Human
Trafficking Hotline or to a local law enforcement agency and have a sign posted in a
conspicuous place which is accessible to employees with the relevant reporting procedures
posted.13
A massage establishment must provide restroom facilities that include:14
 One functioning toilet and one sink with running water;
 Toilet tissue;
 Soap dispenser with soap or other hand sanitizing agent;
 Sanitary towels for hand drying, or other hand drying device, such as a wall-mounted electric
blow dryer; and
 One waste receptacle; or
 A centralized restroom facility within 300 feet of the ME for MTs who reside in buildings
that are so equipped.
There are additional requirements for ME with whirlpool baths, sauna, steam cabinet or steam
room, (including wet, dry and infrared), which include shower facilities with further
specification. Lavatory facilities are required within 20 feet of each treatment room and must
include either:
 A sink with running water, soap dispenser with soap, and sanitary towels for hand drying or
another hand drying device, such as a wall-mounted electric blow dryer; or
 Hand sanitizer or another chemical germicidal designed to disinfect without the use of
running water.15
13
See ss. 456.0341(3) and 480.043(13), F.S.
14
Fla. Admin. Code R. 64B7-26.003(2) (2022).
15
Id.
BILL: CS/CS/SB 1338 Page 5
Massage establishment facilities must be kept in good repair, be well-lit and properly ventilated.
Each ME must:16
 Maintain a fire extinguisher on premises;
 Provide for safe storage and removal of flammable materials;
 Provide for the removal of refuse; and
 Provide pest control.
Massage establishment required equipment and supplies includes:17
 Massage table(s) made of, or covered by, a non-porous, non-absorbent material that is free
from rips or tears;
 Disinfect;
 Massage table coverings for each patient; and
 Sufficient quantity of sheets, towels, or clean drapes for each patient.
For massage establishments where massage therapists perform colonic irrigation, the ME must:18
 Maintain colonic irrigation equipment in safe and sanitary condition; and
 Maintain sterilization equipment if non-disposable colonic attachments are used.
Massage Establishment Advertising
Section 480.0465. F.S., and Florida Administrative Code Rule 64B7-33.001 (2022), require that
all MEs advertising in a newspaper, on the airways, in telephone directory listings other than an
in a column listing consisting of only a name, address, and telephone number, computer
transmission, business card, handbill, flyer, or sign, or other advertising medium, must include:
 The license number of each licensed MT and each licensed ME whose name appears in the
advertisement, though the license number of a licensed MT who is an owner or principal
officer may be used in lieu of the ME’s license number; and
 Pending licensure of a new ME, the license number of a licensed MT who is an owner or
principal officer of the ME may be used in lieu of the license number for the ME.
Documents Required While Working in a Massage Establishment
A person employed by a ME, and any person performing massage therapy in an ME, must have
with them while in the ME a valid government identification (ID). A valid government ID
includes:
 A valid, unexpired U.S. driver license;
 A valid, unexpired U.S. ID card;
 A valid, unexpired U.S. passport;
 A naturalization certificate issued by the U.S. Department of Homeland Security (DHS);
 A valid, unexpired alien registration receipt card (green card); or
 A valid, unexpired employment authorization card issued by the U.S. DHS.19
16
Id.
17
Id.
18
Id.
19
Section 480.0535, F.S.
BILL: CS/CS/SB 1338 Page 6
A person operating a ME must:
 Immediately present, upon the request of a department investigator or a law enforcement
officer:
o A valid government identification while in the ME; and
o A copy of a U.S. driver’s license for each employee and any person performing massage
therapy in the ME; and
 Ensure that each employee and any person performing massage therapy in the ME is able to
immediately present, upon the request of a department investigator or law enforcement
officer, a valid government ID while in the ME.20
A person who violates the work documents requirement in s. 480.0535, F.S., commits:
 A misdemeanor of the second degree for a first violation, punishable as provided in s.
775.082 or s. 775.083;
 A misdemeanor of the first degree for a second violation, punishable as provided in s.
775.082 or s. 775.083; or
 A felony of the third degree for a third or any subsequent violation, punishable as provided in
s. 775.082, s. 775.083, or s. 775.084.21
Prohibited Practices in a Massage Establishment
A person may not operate a ME between the hours of midnight and 5:00 a.m.; unless the ME is:
 Located on the premises of a health care facility;22
 A health care clinic;23
 A hotel, motel, or bed and breakfast inn;24
 A time share property;25
20
Id.
21
Id.
22
Section 408.07, F.S., defines a “health care facility” as an ambulatory surgical center, a hospice, a nursing home, a hospital,
a diagnostic-imaging center, a freestanding or hospital-based therapy center, a clinical laboratory, a home health agency, a
cardiac catheterization laboratory, a medical equipment supplier, an alcohol or chemical dependency treatment center, a
physical rehabilitation center, a lithotripsy center, an ambulatory care center, a birth center, or a nursing home component
licensed under ch. 400, F.S., within a continuing care facility licensed under ch. 651, F.S.
23
Section 400.9905(4), F.S., defines “health care clinic” as an entity where health care services are provided to individuals
and which tenders charges for reimbursement for such services, including a mobile clinic and a portable equipment provider.
24
Section 509.242, F.S., defines: 1) a “hotel” as any public lodging establishment containing sleeping room accommodations
for 25 or more guests and providing the services generally provided by a hotel and recognized as a hotel in the community in
which it is situated or by the industry; 2) a “motel” as a public lodging establishment which offers rental units with an exit to
the outside of each rental unit, daily or weekly rates, off street parking for each unit, a central office on the property with
specified hours of operation, a bathroom or connecting bathroom for each rental unit, and at least six rental units, and which
is recognized as a motel in the community in which it is situated or by the industry; or 3) a bed and breakfast inn as a family
home structure, with no more than 15 sleeping rooms, which has been modified to serve as a transient public lodging
establishment, which provides the accommodation and meal services generally offered by a bed and breakfast inn, and which
is recognized as a bed and breakfa