>> in the ordinance, it says that if the revenue exceeds the operating costs, the controller can reduce the fees. so it says specifically in the ordinance. >> commissioner ortiz? >> i just going back in to the cosmetics tattoos i just think that the body art communities are fairly well informed and advocating their cause but there is an overlap and to another community that is hugely impacted fwhi and i just want to see the out reach, like you said get ahead of it, instead of like i got this tremendous fee now that we did not have and so that is my only recommendation. >> i don't have a problem with it frankly and i don't like being under pressure now because it is going before the board of supervisors in july 11th. and we must take it because it is going before. i don't like that.

and to have, i really have misgivings about that. i am not saying that it is wrong, i am not saying that it is too expensive. but, i just don't feel comfortable with just the way that it is right now. i am going to have a hard time supporting something that is worded the way that it is now. >> commissioner dwight? >> if you consider this sort of a trial balloon i would expect the board of supervisors to request the same thing that i would request and that would be that you detail out not here today, perhaps, but you detail out, here is what it cost to administer the program and the entities and both exist under the current scenario and the past and then the new ones that we are include and here is what we think the budget is required to address. all of these, here is how we have set all of the fees and the number is balanced. because as you say, if there is a surplus it gets rebated, would i like to see the math done that shows that you have

made every attempt to zero it out so there is no surplus or shortage. >> and then that is the best effort that you can do today. and as the time goes on, you can verify where the assumptions that you made as to the population of these entities is correct or not. and then, you can adjust your fees over time up or down depending on what it takes to administer this new, you know the new set up here. but i think that the board of supervisors would require the same thing. >> so, maybe take this as advice to refine your presentations to address the issues.

>> you can take the policy and the rules and the reg, and the need for health and safety reasons and say that what we can support and if there are budgetary issues and then to say that we can't make a full recommendation now we support this, but here is where the concerns are around the budgetary component and that gets articulated and so you are advising the board of supervisors about what you would like to see about out reach and the out reach in terms of the policy and also in terms of the budget and one time, and ongoing, over a period of time. so, you can sort of separate it

out that way if that makes sense to you >> commissioner dwight? >> so, do we want a motion for position on this? >> presume that you do, mr. president? >> yes. if i may be so bold to take a crack at it. i move that we support the health department, the department of public health in the spirit of health and safety, compliance with the state law and regulation and balancing the budget. these are all requirements. and i recommend, as part of this motion, that you come prepared to the presentation with the supervisors with a transparent and detailed budget analysis, which explains each of these fees and it is not a huge menu so you should be able to go through how you have allocated your expenses against these fees and how that

represents to your analysis of a balanced budget. >> so that the community can feel assured that has been done thoroughly and transparently and that we can then check the math as the years go by and hopefully that satisfies all parties, your needs and the needs of the community. >> i second that. >> do you want to read that back? >> before, i am sorry, could we make a recommendation that one of you also make a motion about out reach to also put in there? >> and that, dot, dot, dot, that there be a concerted effort by the department to prepare an out reach program to explain to the community just exactly what you present to the board of supervisors and so detailing your obligations to

the public, for health and safety and your obligations to the state with the compliance of the rules and regulations that they have enacted and your obligation to balance your budget. >> i am sorry, apologize. >> also for the permanent tattoo, and the cosmetics tattooing, with commissioner ortiz, do we want to make sure that we also encourage the department do language competency or out reach so that everything just is not in english so there are going to be a high number of individuals that... >> absolutely. >> and i think that we should say that for all of those that will be now put into this category, that are permanent make-up artists that significant out reach needs to

be made and bi lingually >> and that the out reach be conducted in the languages prevalent in this profession, which may include, english, spanish and chinese and maybe others that i don't know, vietnamese and that the out reach be done multilingually to the new and existing constituents affected. >> commissioners. i will probably watch this again on tv so that i could make sure that i write this out properly over the next couple of days. but to summarize your motion, that you are, i guess, would this be recommending approval subject to the criteria that you have spelled out? >> yeah. >> which will be to support the department of public health in compliance with the state law

recommending that they come prepared to the board of supervisors with a detailed budget and accounting to justify the rates that they are recommending. and that the department of public health perform out reach in particular to the permanent cosmetics community which will include the multiple languages prior to the ordinance taken effect. and this was motioned by commissioner dwight and he coulded by commissioner white. >> editor. >> thank you. >> that was good. >> and i think that the emphasis, i think that there was some general consensus that the out reach to the tattoo and piercing community maybe there already is at a level of awareness, but that the emphasis will be the out reach to the permanent tattooing industry. >> okay. >> and then, i believe that

captures your motion? >> i'm good with it. >> would you like the roll call? >> yes. >> on that motion, president adams? >> yes. >> commissioner dooley. >> yes. >> commissioner dwight. >> yes. >> commissioner o'brien >> yes. >> commissioner ortiz. >> yes. >> vice president white. >> yes. >> yee riley? >> yes >> that passes 7-0. >> item six, discussion and possible action to make recommendations to the board of subpoenaers on the board and supervisors file number 1 30400, health code massage practitioners and ordinance amending the health code to exempt the massage practitioners who are certificated by the state of california and massage establishment and employ only the state certificated massage practitioners from the requirements of obtaining a permit. and making the environmental findings. this includes the file along with the legislative digest and

once again we have richard lee with the department of public health >> welcome again. >> i think that this may be a little less controversial. >> previously, we are actually one of the few and the only in the health department in california that actually permits the massage establishments, and massage practitioners. but, california, started a licensing program through the california massage therapy council and now, practitioners can get licensed through that agency. and the state passed a regulation that says that if the practitioners go through the state and get licensed through them, they don't have to get permitted through the local agency. so right now, our practitioners in san francisco can either get licensed through us or they can go through the state.

>> now, one additional is that if they have all of the practitioners licensed through the state, they don't need to get permitted at the establishment in san francisco. so that is a big factor for us. that is what the change is and so what we are trying to do now is just adopt what the state says, so we will put it there for what they are saying is that if you are at an establishment now and if all of your practitioners are licensed of the state you don't need a permit in san francisco. >> we are just adopting that. >> that is an easy one. >> sure. >> commissioner dwight? >> so you are just coming into compliance with the state. >> yes. >> the new state regulations? >> yes. >> and these things are actually pretty decent. >> there are no changes, they are either going to pay the state or pay the city. >> yes. >> in terms of the

establishment though. they do not have to get permitted through the state. >> so, in terms of before, they would permit through us as an establishment, and now if all of the practitioners are permitted through the state they don't need to get a permit. >> it will save money. >> that is right. >> commissioner o'brien? >> so, the process of getting a certificate identification. >> with the state it is a little bit more difficult and easier. in san francisco we administer a test which they don't do with the state >> what drives the decision that they qualify for a state certification? if there is no test? >> there is a lot more training

that they have to verify >> so there is no laxation in the standards. >> the only thing that su go through the state you don't have to take a test. >> we actually have a test that we give out at the health department for the city practitioners. and but that is not required if you go through the state. >> those are my favorite classs in college. >> so there is no, yeah, i am just wondering with the test that will act as a insurancing the people that are... >> yes. >> know their stuff better than not having to do the test. >> yes. >> and are you saying also that hey, this is we have to do this with the state law again. >> yes. >> okay, all right. thank you. >> director? >> so, commissioners i want to apologize, the draft is in your binder and since we had the conversation with director lee, that we realized that there was

a mistake under on page 23 of what is in your binder and says section 1919 and also the numbering of the sections also had to be corrected but, what it does say, this has been corrected and we have seen the legislation that has been corrected. and it does say every person unless certified as a massage practitioner or therapist by the state. >> so, as it was initially reading was that it was saying that whether you are state certified or not, you would have to have become a certified establishment with the city and that, and the state law says, that is counter active to the state law. so i just want to make sure that you know that has been amended and has been corrected in the legislation has been submitted. but, we ended up getting the wrong. >> and actually we want to thank the small business commission staff for actually finding that mistake. >> commissioner ortiz?

>> just especially being san francisco, and the reputations some massage establishments have, i mean what is the take with the sfpd? this seems like this is state law and we have to comply and is there any potential for the loop holes? >> we are concerned. >> because some of those establishments may not be what you would say, probably legitimate. >> that we know that massage parlors are not legitimate. and before, we would be doing routine inspections of those facilities now that they become exempt, we would not be doing the regular inspections of those facilities. we still may do the task forces and go in and do, and inspect them, but then because they are not permitted now through the city, there are certain regulations which we can't impose on them. so for instance one thing that we would have and one

regulation is practitioners wearing, you know the proper attire, okay? right now, if we go to a permitted facility, we can actually fine that practitioner for wearing something provo cotiv,. >> and if it is not permitted we will not be able to do that. it will decrease our ability for enforcement. >> could i ask another question, in other counties in the state, was the state legislation actually furthering the process like making it a better situation and it seems like in san francisco, it is actually the opposite, is that accurate? >> i would say that san francisco, we are probably one of the toughest if not the toughest jurisdictions in terms of inspections and enforcement when it gets to the massage parlors but i think that in general it is not improving

enforcement state wide. >> okay. >> commissioner riley? >> yes, you mentioned earlier that if they are not permitted there is not much that you can do, can you shut them down? >> no. >> let's see. >> you know, i am going to have to... we have been looking at some of these violations of what we can do or not do, and i certainly, if they are not permitted we can't take the permits because they don't have a permit. there are actions that we can take if there was prostitution. and i want to grab inspector walsh. >> if we find out there is prostitution or human trafficking going on in a facility that is exempt. the police and the health department will go in there and close it down and see them as a bad business and with the city attorney and the health of the district attorney. >> okay. >> so, the health department cannot do anything but you can work with the law enforcement.

>> correct. >> our biggest enforcement ability is to take away a permit so that they cannot operate any more. if we don't have a requirement for a permit for that establishment, we lose that enforcement ability. >> and also, what is the difference, is there a difference between the fee of the state and the city? >> in terms of the cost for... >> the license's? >> license fee for the different facilities? >> the facilities or the practitioners? >> all of them. >> is there a difference? >> we have a fee for permitting in or of the massage establishment in san francisco. and i think that it is like around $1100. >> there is no fee for exempt establishment, if there is state certified, they are all state certified. >> do they have to pay the state a fee? >> no. >> no? >> all right.

, thank you. >> commissioner ortiz? >> and just some director, you know that we don't want to group massage facilities that are doing everything and most likely, you know, the small business or i want to be very delicate with the question that i am about to ask, does the state legislation mandate that there is no parallel city ordinance or permit fee or not even a fee but actually a permit process that can be imposed by a county? >> >> the state legislation allows the city to give a license. every practitioner has a state certification and all that they can do is issue a business license nae. is it. >> that is it. >> and now, there is a proposed legislation going through the

assembly that may be changing some of this, but we don't know where it is, we know that the mayor's office supports that change such that we make it tougher now for these exempt establishments. >> commissioner dwight? >> so by that last comment, i would presume that the state in its wisdom has recognized some of these issues. and that you know we really don't have a choice here we need to comply what the state is mandating and maybe they will make changes that favor the way that we have been doing the business because we can set a precedent for them. i also would suggest that or hope that if an establishment is in violation of prostitution and trafficking laws that we would sue them any way and simply taking away their permit, frankly if in that great of a violation they don't care if they have a permit or not. you are going to go after them any way, and i don't think that

this really changes anything in the most agregious cases that you may check the permits but i think that we will carry on as we have protecting the rights of the workers and anyone who might be subject to trafficking. so, i'm not concerned that this is going to effect our ability to protect people's rights. >> commissioner o'brien? >> is there any mechanism whereby you can go to the state and advise them that the businesses state permit should be revoked? >> well, like, for instance, let's say that some of these exempt businesses they wind up actually, say that they are exempt and actually hire

practitioners who did not have a state license. >> we are going to go and tell the state that they basically don't deserve the exemption. sxf then they are going to... and then they are going to tell us that we are no longer going to get the exemption. >> and so there is a mechanism that you can enlist the state to enforce it so then, and any situation, just being hypothetical for a second not just by where someone was not exempt or anything that they did that if you have the power locally you will revoke the permit and resumably for any violation that you will consider it appropriate to revoke that and if you had that power you could go to the state and advise the state that they do not deserve to have that permit. >> the state does not actually permit. >> so they don't have a permit from the state.

>> the establishments themselves. now they get a permit from the practitioners but not from the establishments. >> so have we made a distinction when we were talking about this earlier what san francisco was giving was an establishment permit? >> yes and, we still do. >> and you still do? >> yes >> and we will not be able to do it now if all of the practitioners are licensed through the state. >> all right, so the state... so the state doesn't they give... >> they give the practitioners a license not the establishment. >> i see, okay. >> commissioner dooley. >> i have a question about that generally and, the requirements at the state level for practitioner in your opinion how stringent are they, are they able to go in and out of the people that are not masseuses, is it enough of a requirement that is involved?

>> just so you are asking me opinion now. >> right. >> and they are they are supposed to provide the training records, especially of the classes that they take and i think that they have to have 250 are 500? >> 250 hours, or up to 500 hours, of training so they have to send in and get that they are supposed to verify that they have received that training. >> ours is like 100. yeah, we have 100 hours of training plus a test. >> is there any requirement for the training to be from... >> yes. >> an accredited. >> yes. >> any other commissioner comments before we go to public comment? >> seeing none, do we have public comment on item number 6? >> do i have one speaker card. would you like me to read that off. >> beverly may.

>> welcome. >> hello, i'm beverly may and i am the director of governmental affairs and i would like to correct the inaccuracies and camtc is not a state agency and it is a private and a non-profit that was set up by the legislature with the legislative oversight to regulate the profession to issue certificates to qualified individual massage therapists as mr. lee cited we don't certificate establishments, it is voluntary and not mandatory, there is a bill in the sacramento, ab 1147 that would require an exam, and it will also authority the cities to issue revocable registrations and i see in the proposal that you have and you are proposing that the establishment where everyone was certified, and would register that everyone was certified. you could take this a step

further and many cities already doing this, and even though it is not a statute and the cmatc is not opposing issuing city ordinances requiring a revocable registration and talk to ogo before he was transferred and had called to me one day about an establishment that the city went into and found several and they had opened under the premises that they were exempt from the establishment regulation and the city went in and had the people working there who were not certified and the owner said that we will get them certified now. well with an establishment or with a revocable registration, we could have refused to allow that person to open. and so cities are using that, that is in the statute, and no city that has been challenged on that yet. and it is, there is a number of cities that have already passed it and i can give you a list of them. >> and the city still has full

authority over health and safety issues including charging fees for the health inspections and you can charge the fees for citations and you know, penalties, to recover costs. and if, we revoke the people all of the time for on an officer's declaration that he walked in and a woman was dressed in a neglesha >> and so we deal with unprofessional conduct all of the time. it took me four months to track down a police officer to share the arrest report on a woman who had been arrested for prostitution, no charges were filed, and we were able to take the arrest report and his

declaration sworn, declaration of what occurred and refuse to recertify her, and meanwhile we were getting calls constantly from the state legislator who she had called to advocate on her behalf and we were able to deny it and it would have happened a lot sooner, if we had had more cooperation with the police department. >> great. >> thank you very much. >> you are welcome n. >> any other members of the public? >> thank you. >> say my name? >> it is not required but it is appreciated. >> marry anne smith and i am a certified massage therapist and i kind of wanted to request a question of mr. lee what is the difference these days between a spa and what are the requirements for a spa to open, or, because some of these

massage parlors, i have noticed have that were shut down, a year or two ago by the board of health have reopened and are no longer calling themselves massage parlors they are calling themselves spas and i kind of wonder what the regulations are for those, as far as permits, or regulations for the people that are working in there. and also, i just wanted to say as the point of clarification, in order to get the certification with the state we have to graduate from an accredited school and the cost has increased tremendously since i went to school in 1989 to become a certified massage therapist and it is not an easy way to make a living, we don't make a lot of money, that is beside the point. but applying for that and we take a lot of tests before we

are allowed to graduate from the schools, and the amount of hours to graduate from schools are many more are more than 500 hours and you have to have at least that much to be able to become a therapist with the state certification. but mostly i am kind of wondering about the regulations for these spas and how they are maneuvering around the state certification, and there is one right across the street from where i live that has reopened and now they are applying to be and have no services listed on their website and just have their name and now they are applying to be a public bathhouse and i don't think that it is going to enhance our neighborhood at all. we have worked a long time to clear up this corner at geary and hide and so there is the public hearing about that in the next couple of weeks, so i kind of wanted to ask, you. what is