A group of San Francisco massage therapists and business owners has begun the process of drafting new legislation that would revise local rules and better serve the legitimate massage therapy community.

It’s an unfortunate reality that massage therapy is a largely misunderstood profession — and an even more unfortunate reality that illegal massage businesses are often used as a front for human trafficking or other criminal activities.

In November 2018, in an effort to shut down human traffickers, San Francisco’s city supervisors passed an ordinance that amended the health code to make it more difficult for illegal massage businesses. However, some massage therapists have concerns about the effects the new rules may have on their legitimate massage establishments — and many have received violation notices from the health department since the ordinance’s new rules took effect.

Now, they are pushing back.

What’s in the Ordinance?

The ordinance, passed on Nov. 20, 2018, went into effect Jan. 1, 2019, revised the regulation of massage therapy businesses, including outcall businesses. It has several rules, including prohibiting a massage business from operating a massage school on the same premises as a massage establishment; eliminating temporary massage practitioner permits; and establishing a massage establishment reinspection fee of $191 per hour;

The full list of provisions is here on the City and County of San Francisco’s Board of Supervisors’ website.

Some of these rules have created challenges — and additional expenses — for legitimate massage practitioners, and caused them to receive violation notices from the city.

Land Use and Licensing

Land use issues are one of the potential problems small business owners, including owners of massage establishments, face under the ordinance. To operate a massage therapy business in many areas in San Francisco, an owner must apply for conditional use — meaning the specific use of the property must be approved by the city, typically involving a public hearing. A property that has been approved for one use must be re-approved when sold to a new owner, even if the same type of business will exist there.

On top of the existing conditional use rules, the ordinance added provisions to the health code that a business’s permit expires when the business is sold, meaning whoever buys a business will have to go through the permitting process again.

Issues with Infrastructure

The ordinance also added rules concerning the space in which a massage business is located. It requires applicants for a massage establishment permit to, in addition to previous requirements, submit a floor plan of the business showing treatment locations and employees-only areas.

It also added more rules for hygiene and pest control, and stipulates that treatment room doors may not have locks on them. With exceptions for sole practitioners, the exterior doors of businesses will now be required to remain unlocked while the business is open.

No one can reside on the premises, and the ordinance added a list of items, such as raw grocery items and sleepwear, that are considered evidence of residential use.

Article 29 had already contained language prohibiting massage services at night, between 10:00 p.m. and 7:00 a.m.; the new ordinance added that no customers or non-employees may be on the premises during that period of time.

It also barred businesses from advertising illegal massage services, and prohibits operating a massage school on the premises of a massage business.

Fighting Illegal Massage “Parlors”

Candace Combs, CMT, owns In-Symmetry Spa in San Francisco and has been in business for 18 years. While she, like most legitimate massage therapists, cares about dealing with the issue of human trafficking, she is also concerned about the effect legislation like this has on small businesses in general — and on female entrepreneurs in particular, since the massage industry has a high percentage of female therapists.

“There’s a lot of illicit parlors; they’re all over San Francisco,” Combs told MASSAGE Magazine during a 2018 interview, after the ordinance passed but before it took effect. “The massage community, more than any other community, wants to see it all shut down. No one wants human trafficking.”

Despite the growth of her business, Combs had been unwilling to add more locations in San Francisco due to the expense and time involved.

“We franchise, because I can’t grow here,” she said. “I’d have to have two million dollars in order to open a second location.” She also believes that, due to the land-use issue, she won’t be able to sell her business when it’s time to move on.

In addition to startup expenses, it can take months, Combs said, for a new business owner to actually begin operation, during which time the owner must pay rent on a space that isn’t yet generating income. Most small-business owners can’t afford to wait that long.

Creating Change

Combs was re-contacted for comment in December of this year, and told MASSAGE Magazine that since Jan. 1, 2019, about 200 massage therapists in the city have received notices that they are in violation of the new rules. To start effecting change, she and several other massage therapists have formed a board called the San Francisco Massage Community Council, which is working with San Francisco’s Office of Small Business on common-sense legislation that would help relieve the burden on legitimate massage therapists.

The council’s Facebook page unites massage therapists who have been affected by this change, and explains how they can write to their district’s supervisors about it. It also provides updates on the new legislation being written.

A big goal of the group’s work is to allow what she calls a “311 letter” instead of applying for conditional use, Combs said. “You don’t have to go through public hearings; you literally send out a letter [to the community] saying, ‘Hey guys, we’re in the neighborhood. Come and see us, this is what we’re going to be doing.’”

Combs believes educating the public is ultimately the key to stopping massage therapy from being lumped in with criminal activity such as prostitution and human trafficking.

“People have to be educated on this,” Combs said. “Massage is about health and wellness. People need massage. Cancer patients need massage. Doctors need massage therapists in their office. Chiropractors need massage therapy.

“It’s about health and wellness — the end.”

MASSAGE Magazine will continue to update this story with any new developments.

About the Author

Allison M. Payne is the associate editor of MASSAGE Magazine and Chiropractic Economics.

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