ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 1 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 1 An act relating to health care practitioners and 2 massage therapy; amending s. 456.026, F.S.; requiring 3 the Department of Health to report specified data; 4 amending s. 456.074, F.S.; authorizing the department 5 to immediately suspend the license of certain health 6 care practitioners and massage establishments in 7 certain circumstances; amending s. 480.033, F.S.; 8 revising and providing definitions; amending s. 9 480.035, F.S.; revising quorum requirements for the 10 Board of Massage Therapy; amending s. 480.043, F.S.; 11 revising certain rules the board is required to adopt; 12 revising the timeframe in which establishment owners 13 must report specified information to the depa rtment; 14 prohibiting sexual activity and certain devices in 15 massage establishments; specifying prohibited conduct 16 by establishment owners and employees; providing 17 requirements for outside windows and signs in massage 18 establishments; providing exceptions; pr oviding 19 employee dress code requirements; requiring 20 establishments to maintain certain employment records 21 in English or Spanish; requiring that specified 22 information be recorded before an employee may provide 23 services or treatment; requiring massage 24 establishments to conspicuously display a photo and 25 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 2 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S specified information for each employee; requiring 26 that such photos and information be displayed before 27 an employee may provide services or treatment; 28 providing for such requirements in massage 29 establishments within public lodging establishments; 30 requiring massage establishments to maintain customer 31 and patient records for services and treatment 32 provided in the massage establishment in English or 33 Spanish; providing that medical records satisfy 34 certain requirements; requiring massage establishments 35 to maintain such records for a specified timeframe; 36 requiring massage establishments to collect and record 37 specified information; requiring massage 38 establishments to confirm the identification of a 39 customer or patient b efore providing services or 40 treatment; amending s. 480.0465, F.S.; revising 41 advertising requirements for massage therapists and 42 massage establishments; amending s. 480.0475, F.S.; 43 prohibiting establishments from sheltering or 44 harboring, or being used as sl eeping quarters for, any 45 person; amending s. 480.0535, F.S.; requiring 46 Department of Health investigators to request valid 47 government identification from all employees while in 48 a massage establishment; specifying additional 49 documents a person operating a m assage establishment 50 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 3 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S must immediately present, upon request, to department 51 investigators and law enforcement officers; requiring 52 the department to notify a federal immigration office 53 if specified persons fail to provide valid government 54 identification; amending s. 823.05, F.S.; conforming a 55 cross-reference; providing an appropriation; providing 56 an effective date. 57 58 Be It Enacted by the Legislature of the State of Florida: 59 60 Section 1. Section 456.026, Florida Statutes, is amended 61 to read: 62 456.026 Annual report concerning finances, administrative 63 complaints, disciplinary actions, and recommendations. — 64 (1) The department is directed to prepare and submit a 65 report to the President of the Senate and the Speaker of the 66 House of Representatives by Novemb er 1 of each year. In addition 67 to finances and any other information the Legislature may 68 require, the report shall include statistics and relevant 69 information, profession by profession, detailing: 70 (a)(1) The revenues, expenditures, and cash balances for 71 the prior year, and a review of the adequacy of existing fees. 72 (b)(2) The number of complaints received and investigated. 73 (c)(3) The number of findings of probable cause made. 74 (d)(4) The number of findings of no probable cause made. 75 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 4 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (e)(5) The number of administrative complaints filed. 76 (f)(6) The disposition of all administrative complaints. 77 (g)(7) A description of disciplinary actions taken. 78 (h)(8) A description of any effort by the department to 79 reduce or otherwise close any investigation or disciplinary 80 proceeding not before the Division of Administrative Hearings 81 under chapter 120 or otherwise not completed within 1 year after 82 the initial filing of a complaint under this chapter. 83 (i)(9) The status of the development and implementation of 84 rules providing for disciplinary guidelines pursuant to s. 85 456.079. 86 (j)(10) Such recommendations for administrative and 87 statutory changes necessary to facilitate efficient and cost -88 effective operation of the department and the various boards. 89 (2) The report shall separately categorize all complaints, 90 investigations, probable cause, and disciplinary actions against 91 a massage therapist or massage establishment licensed under 92 chapter 480 related to a violation of: 93 (a) Section 480.043(12). 94 (b) Section 480.043(13). 95 (c) Section 480.043(14)(a) -(f). 96 (d) Section 480.0465. 97 (e) Section 480.0475. 98 (f) Section 480.0485. 99 (g) Section 480.0535. 100 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 5 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Section 2. Subsection (4) of section 456.074, Florida 101 Statutes, is amended, and subsection (7) is ad ded to that 102 section, to read: 103 456.074 Certain health care practitioners; immediate 104 suspension of license. — 105 (4) The department shall issue an emergency order 106 suspending the license of a massage therapist and or 107 establishment as those terms are defined in chapter 480 upon 108 receipt of information that the massage therapist ;, the 109 designated establishment manager as defined in chapter 480; an 110 employee of the establishment; a person with an ownership 111 interest in the establishment ;, or, for a corporation that h as 112 more than $250,000 of business assets in this state, the owner, 113 officer, or individual directly involved in the management of 114 the establishment has been arrested for committing or 115 attempting, soliciting, or conspiring to commit, or convicted or 116 found guilty of, or has entered a plea of guilty or nolo 117 contendere to, regardless of adjudication, a violation of s. 118 796.07 s. 796.07(2)(a) which is reclassified under s. 796.07(7) 119 or a felony offense under any of the following provisions of 120 state law or a simila r provision in another jurisdiction: 121 (a) Section 787.01, relating to kidnapping. 122 (b) Section 787.02, relating to false imprisonment. 123 (c) Section 787.025, relating to luring or enticing a 124 child. 125 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 6 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (d) Section 787.06, relating to human trafficking. 126 (e) Section 787.07, relating to human smuggling. 127 (f) Section 794.011, relating to sexual battery. 128 (g) Section 794.08, relating to female genital mutilation. 129 (h) Former s. 796.03, relating to procuring a person under 130 the age of 18 for prostitution. 131 (i) Former s. 796.035, relating to the selling or buying 132 of minors into prostitution. 133 (j) Section 796.04, relating to forcing, compelling, or 134 coercing another to become a prostitute. 135 (k) Section 796.05, relating to deriving support from the 136 proceeds of prostitution. 137 (l) Section 796.07(4)(a)3., relating to a felony of the 138 third degree for a third or subsequent violation of s. 796.07, 139 relating to prohibiting prostitution and related acts. 140 (m) Section 800.04, relating to lewd or lascivious 141 offenses committed upon or in the presence of persons less than 142 16 years of age. 143 (n) Section 825.1025(2)(b), relating to lewd or lascivious 144 offenses committed upon or in the presence of an elderly or 145 disabled person. 146 (o) Section 827.071, relating to sexual performa nce by a 147 child. 148 (p) Section 847.0133, relating to the protection of 149 minors. 150 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 7 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (q) Section 847.0135, relating to computer pornography. 151 (r) Section 847.0138, relating to the transmission of 152 material harmful to minors to a minor by electronic device or 153 equipment. 154 (s) Section 847.0145, relating to the selling or buying of 155 minors. 156 (7) The department shall issue an emergency order 157 suspending the license of any licensee upon a finding of the 158 State Surgeon General that probable cause exists to believe tha t 159 the licensee has committed sexual misconduct as defined and 160 prohibited in s. 456.063(1), or the applicable practice act, and 161 that such violation constitutes an immediate danger to the 162 public. 163 Section 3. Subsections (1) through (6) of section 480.033, 164 Florida Statutes, are renumbered as subsections (2) through (7), 165 respectively, subsections (7) through (12), are renumbered as 166 subsections (9) through (14), respectively, present subsection 167 (6) is amended, and new subsections (1), (8), and (15) are added 168 to that section, to read: 169 480.033 Definitions. —As used in this act: 170 (1) "Advertising medium" means any newspaper; airwave or 171 computer transmission; telephone directory listing, other than 172 an in-column listing consisting only of a name, physical 173 address, and telephone number; business card; handbill; flyer; 174 sign, other than a building directory listing all building 175 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 8 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S tenants and their room or suite numbers; or any other form of 176 written or electronic advertisement. 177 (7)(6) "Designated establishment manager" means a massage 178 therapist who holds a clear and active license without 179 restriction; a health care practitioner licensed under chapter 180 457; or a physician licensed under chapter 458, chapter 459, or 181 chapter 460, who is responsible for the operation of a massage 182 establishment in accordance with the provisions of this chapter, 183 and who is designated the manager by the rules or practices at 184 the establishment. 185 (8) "Employee" means any person, including, but not 186 limited to, independent contractors or lessees of a massage 187 establishment, whose duties involve any aspect or capacity of 188 the massage establishment, including, but not limited to, 189 preparing meals and cleaning regardless of whether such person 190 is compensated for the per formance of such duties. The term does 191 not include a person who is exclusively engaged in the repair or 192 maintenance of the massage establishment or the delivery of 193 goods to the establishment. 194 (15) "Sexual activity" means any direct or indirect 195 contact by any employee or person, or between any employees or 196 persons, with the intent to abuse, humiliate, harass, degrade, 197 or arouse, or gratify the sexual desire of, any employee or 198 person, or which is likely to cause such abuse, humiliation, 199 harassment, degradation, or arousal, or sexual gratification: 200 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 9 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (a) With or without the consent of the employee or person. 201 (b) With or without verbal or nonverbal communication that 202 the sexual activity is undesired. 203 (c) With or without the use of any device or object. 204 (d) With or without the occurrence of penetration, orgasm, 205 or ejaculation. 206 (e) Including, but not limited to, intentional contact 207 with the genitalia, groin, femoral triangle, anus, buttocks, 208 gluteal cleft, breast or nipples, mouth, or tongue. 209 (f) Including, but not limited to, the intentional removal 210 of any drape without specific written informed consent of the 211 patient. 212 Section 4. Subsection (5) of section 480.035, Florida 213 Statutes, is amended to read: 214 480.035 Board of Massage Therapy. — 215 (5) The board shall hold such meetings during the year as 216 it may determine to be necessary, one of which shall be the 217 annual meeting. The chair of the board shall have the authority 218 to call other meetings at her or his discretion. A quorum of the 219 board shall consist of not less than a majority of the current 220 membership of the board four members. 221 Section 5. Subsection (14) of section 480.043, Florida 222 Statutes, is renumbered as subsection (15), subsection (3) and 223 present subsection (14) are amended, and a new sub section (14) 224 is added to that section, to read: 225 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 10 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 480.043 Massage establishments; requisites; licensure; 226 inspection; human trafficking awareness training and policies. — 227 (3) The board shall adopt rules governing the operation of 228 massage establishments and their facilities, employees 229 personnel, safety and sanitary requirements, financial 230 responsibility, insurance coverage, and the license application 231 and granting process. 232 (14) In order to provide the department and law 233 enforcement agencies the means to mo re effectively identify 234 persons engaging in human trafficking at massage establishments, 235 the following apply: 236 (a) Sexual activity in a massage establishment is 237 prohibited. An establishment owner or employee may not engage in 238 or allow any person to engage in sexual activity in the 239 establishment or use the establishment to make arrangements to 240 engage in sexual activity in another location. Used or unused 241 condoms are prohibited in a massage establishment. 242 (b) If there is an outside window or windows into t he 243 massage establishment's reception area, the outside window or 244 windows must allow for at least 35 percent light penetration and 245 no more than 50 percent of the outside window or windows may be 246 obstructed with signage, blinds, curtains, or other 247 obstructions, allowing the public to see the establishment's 248 reception area. A sign must be posted on the front window of the 249 establishment that includes the name and license number of the 250 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 11 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S massage establishment and the telephone number that has been 251 provided to the department as part of licensure of the 252 establishment. This paragraph does not apply to: 253 1. A massage establishment within a public lodging 254 establishment as defined in s. 509.013(4). 255 2. A massage establishment located within a county or 256 municipality that has an ordinance that prescribes requirements 257 related to business window light penetration or signage 258 limitations if compliance with this paragraph would result in 259 noncompliance with such ordinance. 260 (c) All employees within the massage establishment mu st be 261 fully clothed and such clothing must be fully opaque and made of 262 nontransparent material that does not expose the employee's 263 genitalia. This requirement does not apply to an employee, 264 excluding a massage therapist, of a public lodging 265 establishment, as defined in s. 509.013(4), that is licensed as 266 a clothing-optional establishment and chartered with the 267 American Association for Nude Recreation. 268 (d) A massage establishment must maintain a complete set 269 of legible records in English or Spanish, which m ust include 270 each employee's start date of employment, full legal name, date 271 of birth, home address, telephone number, and employment 272 position and a copy of the employee's government identification 273 required under s. 480.0535. All information required under this 274 paragraph must be recorded before the employee may provide any 275 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 12 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S service or treatment to a client or patient. 276 (e) A massage establishment must conspicuously display a 2 277 inch by 2 inch photo for each employee, which, for massage 278 therapists, must be att ached to the massage therapist's license. 279 Such display must also include the employee's full legal name 280 and employment position. All information required under this 281 paragraph must be displayed before the employee may provide any 282 service or treatment to a c lient or patient. A massage 283 establishment within a public lodging establishment as defined 284 in s. 509.013(4) may satisfy this requirement by displaying the 285 photos and required information in an employee break room or 286 other room that is used by employees, bu t is not used by clients 287 or patients. 288 (f) A massage establishment must maintain a complete set 289 of legible records in English or Spanish, which must include the 290 date, time, and type of service or treatment provided; the full 291 legal name of the employee who provided the service or 292 treatment; and the full legal name, home address, and telephone 293 number of the client or patient. Medical records may satisfy 294 this requirement if the records include the specified 295 information. A copy of the client's or patient's photo 296 identification may be used to provide the full legal name and 297 home address of the client or patient. Records required under 298 this paragraph must be maintained for at least 1 year after a 299 service or treatment is provided. All information required under 300 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 13 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S this paragraph must be collected and recorded before any service 301 or treatment is provided to a client or patient. The 302 establishment must confirm the identification of the client or 303 patient before any service or treatment is prov ided to the 304 client or patient. 305 (15)(14) Except for the requirements of subsection (13), 306 this section does not apply to a practitioner physician licensed 307 under chapter 457 or a physician licensed under , chapter 458, 308 chapter 459, or chapter 460 who employs a licensed massage 309 therapist to perform massage therapy on the practitioner's or 310 physician's patients at her or his the physician's place of 311 practice. This subsection does not restrict investigations by 312 the department for violations of chapter 456 or this chapter. 313 Section 6. Section 480.0465, Florida Statutes, is amended 314 to read: 315 480.0465 Advertisement ; prohibitions.— 316 (1) Each massage therapist or massage establishment 317 licensed under this act shall include the number of the license 318 in any advertisement of massage therapy services appearing in 319 any advertising medium, including, but not limited to, a 320 newspaper, airwave transmission, telephone directory, Internet, 321 or other advertising medium. The advertisement must also include 322 the physical address of the massage establishment and the 323 telephone number that has been provided to the department as 324 part of the licensing of the establishment. However, the 325 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 14 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S inclusion of the physical address and telephone number is not 326 required for an advertisement by a massage establishment whose 327 establishment owner operates more than five locations in this 328 state. 329 (2) A massage therapist, an establishment owner, an 330 employee, or any third party directed by the establishment owner 331 or employee, may not place, publish, or distrib ute, or cause to 332 be placed, published, or distributed, any advertisement in any 333 advertising medium which states prostitution services, escort 334 services, or sexual services are available. 335 (3) A massage therapist, an establishment owner, an 336 employee, or any third party directed by the massage therapist, 337 establishment owner, or employee may not place, publish, or 338 distribute, or cause to be placed, published, or distributed, 339 any online advertisement on any website known for advertising 340 prostitution services, e scort services, or sexual services. 341 Pending licensure of a new massage establishment under s. 342 480.043(7), the license number of a licensed massage therapist 343 who is an owner or principal officer of the establishment may be 344 used in lieu of the license number for the establishment. 345 Section 7. Subsection (2) of section 480.0475, Florida 346 Statutes, is amended to read: 347 480.0475 Massage establishments; prohibited practices. — 348 (2) A person operating a massage establishment may not use 349 or permit the establishm ent to be used as a principal or 350 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 15 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S temporary domicile for, to shelter or harbor, or as sleeping or 351 napping quarters for any person unless the establishment is 352 zoned for residential use under a local ordinance. 353 Section 8. Section 480.0535, Florida Statutes, is amended 354 to read: 355 480.0535 Documents required while working in a massage 356 establishment; penalties; reporting .— 357 (1) In order to provide the department and law enforcement 358 agencies the means to more effec tively identify, investigate, 359 and arrest persons engaging in human trafficking, an employee a 360 person employed by a massage establishment and any person 361 performing massage therapy in a massage establishment therein 362 must immediately present, upon the request of an investigator of 363 the department or a law enforcement officer, valid government 364 identification while in the establishment. An investigator of 365 the department must request valid government identification from 366 all employees while in the establishment. A valid government 367 identification for the purposes of this section is: 368 (a) A valid, unexpired driver license issued by any state, 369 territory, or district of the United States; 370 (b) A valid, unexpired identification card issued by any 371 state, territory, or d istrict of the United States; 372 (c) A valid, unexpired United States passport; 373 (d) A naturalization certificate issued by the United 374 States Department of Homeland Security; 375 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 16 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (e) A valid, unexpired alien registration receipt card 376 (green card); or 377 (f) A valid, unexpired employment authorization card 378 issued by the United States Department of Homeland Security. 379 (2) A person operating a massage establishment must: 380 (a) Immediately present, upon the request of an 381 investigator of the department or a law en forcement officer: 382 1. Valid government identification while in the 383 establishment. 384 2. A copy of the documentation specified in paragraph 385 (1)(a) for each employee and any person performing massage 386 therapy in the establishment. 387 3. A copy of the document s required under s. 388 480.043(14)(d) and (f). 389 (b) Ensure that each employee and any person performing 390 massage therapy in the massage establishment is able to 391 immediately present, upon the request of an investigator of the 392 department or a law enforcement of ficer, valid government 393 identification while in the establishment. 394 (3) A person who violates any provision of this section 395 commits: 396 (a) For a first violation, a misdemeanor of the second 397 degree, punishable as provided in s. 775.082 or s. 775.083. 398 (b) For a second violation, a misdemeanor of the first 399 degree, punishable as provided in s. 775.082 or s. 775.083. 400 ENROLLED CS/CS/HB 197 2024 Legislature CODING: Words stricken are deletions; words underlined are additions. hb0197-03-er Page 17 of 17 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (c) For a third or subsequent violation, a felony of the 401 third degree, punishable as provided in s. 775.082, s. 775.083, 402 or s. 775.084. 403 (4) The department shall notify a federal immigration 404 office if a person operating a massage establishment, an 405 employee, or any person performing massage therapy in a massage 406 establishment fails to provide valid government identification 407 as required under this section. 408 Section 9. Subsection (3) of section 823.05, Florida 409 Statutes, is amended to read: 410 823.05 Places and groups engaged in certain activities 411 declared a nuisance; abatement and enjoinment. — 412 (3) A massage establishment as defined in s. 48 0.033 which 413 operates in violation of s. 480.043(14)(a) or (f), s. 480.0475, 414 or s. 480.0535(2) is declared a nuisance and may be abated or 415 enjoined as provided in ss. 60.05 and 60.06. 416 Section 10. For the 2024-2025 fiscal year, eight full -time 417 equivalent positions, with associated salary rate of 593,954, 418 are authorized and the sums of $925,080 in recurring and 419 $108,952 in nonrecurring funds from the Medical Quality 420 Assurance Trust Fund are appropriated to the Department of 421 Health for the purpose of implem enting this act. 422 Section 11. This act shall take effect July 1, 2024. 423