CE INSTITUTE LLC BLOG

by: Selena Belisle, Founder/Instructor, CE Institute LLC

To provide the department and law enforcement agencies the means to more effectively identify, investigate, and arrest persons engaging in human trafficking, an employee or any person performing massage therapy in a massage establishment therein must immediately present, upon the request of an investigator of the department or a law enforcement officer, valid government identification while in the establishment. An investigator of the department must request valid government identification from all employees while in the establishment. A valid government identification includes:

• A valid, unexpired driver’s license issued by any state, territory, or district of the United States;
• A valid, unexpired identification card issued by any state, territory, or district of the United States;
• A valid, unexpired United States passport;
• A naturalization certificate issued by the United States Department of Homeland Security;
• A valid, unexpired alien registration receipt card (green card); or
• A valid, unexpired employment authorization card issued by the United States Department of Homeland Security. 

A massage establishment operator must immediately present a valid government identification while in the establishment when requested by the investigator. A documented copy of each employee and any person performing massage therapy in the establishment must be maintained by the establishment. 

The department shall notify a federal immigration office if a person operating a massage establishment, an employee, or any person performing massage therapy in a massage establishment fails to provide valid government identification as required under this section. 

Violations of these requirements could result in criminal misdemeanor or felony charges, punishable by law. If you would like legal details for any of these newly installed and/or revised rules, it is recommended to consult a licensed attorney for their legal opinion.

The State Surgeon General is the government office, or board, which can make a legal determination when safety to the public is jeopardized. A massage establishment that operates in violation of certain laws and rules is declared a nuisance and may be abated or enjoined, in addition to possible criminal charges.

These are just some of the highlights of Florida's House Bill 197 to require better identification practices amongst massage therapy establishments to help prevent human trafficking within the massage industry.  To learn more rules, laws, human trafficking prevention and more, please visit: https://ceinstitute.com/collections/mandatory 

by Selena Belisle, Founder/Instructor, CE Institute LLC

Massage therapy establishments are required to have a Designated Establishment Manager (DEM), even if there is only one self-employed individual working in a licensed establishment, that one person would be the DEM. All licensed maassage therapy establishments must name and perpetually maintain a DEM by January 1, 2020. 

A DEM must be:

• A licensed Massage Therapist with a clear and active license without restriction.
• Practice at the establishment (and replaced if they leave the establishment).
• Be responsible for the operation of the establishment in accordance with the laws and rules.

Being a DEM for a licensed massage therapy establishment is serious business.  The Florida board of massage could hold the DEM responsible if they found unlicensed practitioners working at the establishment, or other Florida laws or rules violations! If you are considering becoming a DEM for your establishment, it would be a good idea to brush up on your Florida laws and rules requirements before doing so!

The Florida Board of Massage requires that a Florida Licensed Massage Establishments develop a plan to report suspected human trafficking.  Massage establishment owners must develop this reporting plan on their own, with their manager, DEM or another professional such as a:

• Human resources professional or department
• Legal department or business lawyer
• Business advisor
• Any trusted professional business consultant who can advise in business operations

It is recommended to print your plan to report suspected human trafficking and keep it in an accessible place available to all massage establishment staff.  The plan should also be available for an inspector if requested during a massage establishment inspection. Your plan should include a list of available agencies to report any suspected human trafficking, any safety issues that might be of concern with reporting and all other appropriate matters advised by those writing the plan. 

To learn more about Florida laws or human trafficking prevention, please register for one of our courses at: https://ceinstitute.com/collections/mandatory

by: Selena Belisle, Founder/Instructor, CE Institute LLC

The Florida Board of Massage is has enforced several measures to address the catastrophic human trafficking problem we face in the State of Florida's massage therapy industry.  All of these new measures are addressed in this course – they include:

1. Florida Licensed Massage Therapists must complete a 1 CE Hour course in Human Trafficking (this is the course).
2. Florida Licensed Massage Establishments must post signage about Human Trafficking (instructions and links for these FREE signs are included in this course).
3. Florida Licensed Massage Establishments must appoint a Designated Establishment Manager (also known as a DEM).
4. Florida Licensed Massage Establishments must have a plan for reporting suspected human trafficking (a list of agencies to report suspected trafficking are included in this course).
5. HB197 was passed with greater laws to help prevent trafficking abuses.

Florida is now requiring Human Trafficking prevention training for the following healthcare professionals as part of their CE requirement to relicense: 

•    Massage Therapy
•    Physical Therapy
•    Acupuncture
•    Medicine
•    Osteopathic Medicine
•    Chiropractic Medicine
•    Podiatric Medicine
•    Optometry
•    Pharmacy
•    Dentistry
•    Nursing Home Administration
•    Occupational Therapy
•    Dietetics and Nutrition
•    Respiratory Care 

The Florida Board of Massage requires that ALL Florida Licensed Massage Establishments post a sign about human trafficking in a conspicuous place accessible to staff by January 1, 2021. The sign must be at least 11 x 15 inches and in at least 32-point type. The sign must contain statutorily required language and be posted in English and Spanish. The Florida Board of Massage provided Mandarin translations of these signs for use in massage establishments where the Mandarin language is used. If the Mandarin language is spoken in your massage establishment, then you must post the version of this sign that includes English, Spanish & Mandarin languages.

At the end of this paragraph is a website URL to the Human Trafficking sign that is available in English & Spanish languages.  Please remember, when printing the sign, the sign must be at least 11 x 15 inches and in at least 32-point type and it must be posted in a conspicuous place accessible to massage establishment staff by January 1, 2021:  http://flhealthsource.gov/humantrafficking/docs/HumanTraffickingPoster-Eng-Span.pdf

At the end of this paragraph is a website link to a Human Trafficking sign that is available in in English, Spanish & Mandarin languages. If the Mandarin language is spoken or used in your establishment, then you must post a sign that includes the Mandarin language as well as English & Spanish.  Please remember, when printing the sign, the sign must be at least 11 x 15 inches and in at least 32-point type and it must be posted in a conspicuous place accessible to staff by January 1, 2021:  http://flhealthsource.gov/humantrafficking/docs/HumanTraffickingPoster-All.pdf

To learn more about human trafficking prevention, please register for one of our courses at: https://ceinstitute.com/collections/mandatory

by: Selena Belisle, Founder/Instructor, CE Institute LLC

On May 6, 2024, Florida Gov. Ron DeSantis signed Florida House Bill (HB)197 into law. It took effect July 1, 2024. The bill appears to have been unanimously passed by both the Florida Senate and House of Representatives.

The new law is designed to strengthen legal cases against human trafficking and other abuses within the Florida massage therapy industry. Some of this law’s rules, updates, and changes are critical to understand while working in the Florida massage therapy industry. 
Violations of some of these rules could result in disciplinary action or misdemeanor or felony criminal charges. If you would like legal details for any of these newly installed and/or revised rules, it is recommended to consult a licensed attorney for their legal opinion.

While these new rules will be applicable for licensed massage therapists, establishment owners and designated managers, we will review HB197 in a condensed and perhaps more comprehensible manner for massage therapists throughout our HB197 laws and rules lessons. If you’d like to review the bill, and its various proposed versions, you can do so by visiting flsenate.gov/Session/Bill/2024/197. This HB197 information is available on various government websites, including those of the Florida House, Senate and Board of Massage.

According to HB 197, a massage establishment must maintain a complete set of legible records in English or Spanish, which must include each employee’s start date of employment, full legal name, date of birth, home address, telephone number, employment position and a copy of the employee’s government identification.
 
All required employee information must be recorded before the employee may provide any service or treatment to a client or patient. A massage establishment must conspicuously display a 2-inch-by-2-inch photo of each employee, which, for massage therapists, must be attached to the massage therapist’s license. Such a display must also include the employee’s full legal name and  employment position before providing services or treatments.

A massage establishment must maintain a complete set of legible records in English or Spanish, which must include the date, time, and type of service or treatment provided; the full legal name of the employee who provided the service or treatment; and the full legal name, home address, and telephone number of the client or patient.  Medical records may satisfy this requirement if the records include specified information. A copy of the client’s or patient’s photo identification may be used to provide the full legal name and home address of the client or patient. 

These required client records must be collected prior to providing service and maintained for at least one year after a service or treatment is provided. The establishment must confirm the identification of the client or patient before any service or treatment is provided to the client or patient.

The State Surgeon General is the government office, or board, which can make a legal determination when safety to the public is jeopardized. A massage establishment that operates in violation of certain laws and rules is declared a nuisance and may be abated or enjoined, in addition to possible criminal charges.

These are just some of the highlights of Florida's House Bill 197 to help prevent trafficking victims with the massage therapy industry.  To learn more rules, laws, human trafficking prevention and more, please visit: https://ceinstitute.com/collections/mandatory

The Florida Board of Health and MQA (Medical Quality Assurance) departments no longer mail licenses to healthcare professionals.  Healthcare professionals must download, carry and post their own licenses as required by law.

In this video, CE Institute LLC founder Selena Belisle will demonstrate where and how a Florida licensee can download their own e-license from Florida state's website. She will use a Florida massage therapist license as an example; however, this example can be used with almost any healthcare license or provider within Florida State:

According to the American Medical Association (AMA), scope of practice is defined as the activities a licensed health professional is authorized to perform, as determined by state laws and regulations established by relevant licensing bodies.  Healthcare practitioners (and others) are susceptible to lawful medical malpractice claims when they do not operate within their licensed scope of practice

Medical malpractice claims where a healthcare provider worked outside of their licensed scope of practice include the following examples:

• Providing a medical diagnosis when not licensed and/or trained to do so.
• Administering medication,including over-the-counter (OTC) medication when not licensed and/or trained to administer medication.
• Providing medical procedures without proper medical licensure or authorization to do so, such as removing an IV line without medical direction that was originally inserted on doctor’s orders.

There is a relatively new term in healthcare called SCOPE CREEP. Scope creep refers to medical procedures that are increasingly practiced by healthcare professionals that are not doctors.

There is great debate that scope creep improves a patient’s accessibility to healthcare with better/effective timelines; however, the AMA states allowing other healthcare providers beyond doctors to perform doctor-related care can compromise a client’s safety plus increase the risks of medical error, and the associated costs.

Despite today’s modern scope creep practices, to minimize risks and prevent medical errors, it is critical to only practice within your licensed scope, because medical malpractice can be proven when a provider operates outside of their licensed scope and the client is injured as a result of that treatment.

For greater healthcare laws and medical errors prevention training, please register for training with us at: https://ceinstitute.com/collections/mandatory

Anyone can join in the fight against human trafficking. The U.S. Department of State has published an online resource entitled “20 Ways You Can Help Fight Human Trafficking,” which outlines their recommended strategies:

Learn the indicators of human trafficking on the TIP Office’s website or by taking a training.  Human trafficking awareness training is available for individuals, businesses, first responders, law enforcement, educators, and federal employees, among others.

If you are in the United States and believe someone may be a victim of human trafficking, call the 24-hour National Human Trafficking Hotline  at 1-888-373-7888 or report an emergency to law enforcement by calling 911. Trafficking victims, whether or not U.S. citizens, are eligible for services and immigration assistance.

Be a conscientious and informed consumer. Find out more about who may have picked your tomatoes or made your clothes at ResponsibleSourcingTool.org , or check out the Department of Labor’s List of Goods Produced by Child Labor or Forced Labor. 

Encourage companies to take steps to prevent human trafficking in their supply chains and publish the information, including supplier or factory lists, for consumer awareness.

Volunteer and support anti-trafficking efforts in your community.

Meet with and/or write to your local, state, and federal elected officials  to let them know you care about combating human trafficking and ask what they are doing to address it.

Be well-informed. Set up a web alert to receive current human trafficking news. Also, check out CNN’s Freedom Project  for more stories on the different forms of human trafficking around the world.

Organize a fundraiser and donate the proceeds to an anti-trafficking organization .

Encourage your local schools or school district to include human trafficking in their curricula and to develop protocols for identifying and reporting a suspected case of human trafficking or responding to a potential victim.

Use your social media platforms to raise awareness about human trafficking, using the following hashtags: #endtrafficking, #freedomfirst.

Think about whether your workplace is trauma-informed and reach out to management or the Human Resources team to urge implementation of trauma-informed business practices.

Parents and Caregivers: Learn how human traffickers often target and recruit youth  and who to turn to for help in potentially dangerous situations. Host community conversations with parent teacher associations, law enforcement, schools, and community members regarding safeguarding children in your community.

Businesses: Provide jobs, internships, skills training, and other opportunities to trafficking survivors. 

Take steps to investigate and prevent trafficking in your supply chains by consulting the Responsible Sourcing Tool and Comply Chain to develop effective management systems to detect, prevent, and combat human trafficking.

Health Care Providers: Learn how to identify the indicators of human trafficking and assist victims. With assistance from local anti-trafficking organizations, extend low-cost or free services to human trafficking victims. Resources from the Department of Health and Human Services can be found on their website.

Human Trafficking Prevention Educational Materials

The Blue Campaign is a national public awareness campaign designed to educate the public, law enforcement, and other industry partners to recognize the indicators of human trafficking, and how to appropriately respond to possible cases. 

January 11, is National Human Trafficking Awareness Day, aka #WearBlueDay. Why blue? It’s the international color of human trafficking awareness.

The Blue Campaign provided training on identifying indicators of human trafficking and reporting suspected cases to over 23,000 individuals. 

Additionally, more than 280,000 people received training through Blue Lightning Initiative partnerships. Online Blue Campaign shipped more than 2.2 million pieces of outreach materials to requestors across the United States.

The Protocol Toolkit is a vital resource for healthcare institutions seeking to develop protocols to respond to human trafficking. This tool is designed for a variety of healthcare settings.

The PEARR Tool—Provide privacy, Educate, Ask, Respect, and Respond—is a robust, evidence-based framework designed to equip healthcare professionals with the skills to assess trafficking and interpersonal violence. 

PEARR fosters safe environments where patients feel empowered to share their experiences naturally, thereby opening doors to essential support. This trauma-informed, person-centered approach strengthens patient-provider relationships and enhances health, safety, and overall well-being.

Additional information about human trafficking, including resources available to trafficking victims can be found at various private, state and federal organizations.  To learn more about human trafficking, please visit:

 The Florida Department of Health (https://www.floridahealth.gov/programs-and-services/prevention/human-trafficking/index.html)

 The FBI (https://www.fbi.gov/investigate/violent-crime/human-trafficking)

The US Department of Homeland Security (https://www.dhs.gov/topics/human-trafficking)

If you think you are a victim of human trafficking, or have information regarding suspected human trafficking of a person in Florida, contact:  Florida Abuse Hotline 1-800-96-ABUSE (1-800-962-2873).

If you believe you have been a victim of trafficking or have information regarding suspected human trafficking of an adult anywhere in the U.S., or of a child outside Florida, call the National Human Trafficking Resource Center at 1-888-373-7888, text HELP to 233733 (BEFREE), or visit the National Human Trafficking Hotline online at:  https://humantraffickinghotline.org/en

Some healthcare providers might want to provide medical intervention during emergencies, but are afraid of doing so for liability reasons such as committing a medical error due to the emergency circumstances, such as when a person is unconscious and unable to provide dialog that led to their medical condition. Unless you're a trained emergency medical professional, it's possible that things could go wrong during an emergency, even if you had the proper training!

As such, it’s important to know that there is something called Good Samaritan Law, which can be different from state-to-state, and even internationally. On a recent airline flight, a flight attendant in international airspace loudly proclaimed the good samaritan law when no one volunteered to provide urgent medical care to an individual in need. The flight attendant proclaimed a caregiver cannot be held accountable for providing emergency medical assistance to that individual if any harm is done during a reasonable effort to provide care.

This Good Samaritan Law is important to know because in September 2025, Javier's restaurant in the Aria Resort & Casino and MGM Resort International was sued for wrongful death when no life saving medical care measures were attempted which they claim resulted in well-known actor Mike Heslin’s death. The wrongful death lawsuit claims:
Staff "stood by, took no immediate lifesaving action, and failed to initiate or support efforts that could have saved Michael’s life."

• Failed to perform CPR and did not retrieve an automated external defibrillator (AED).
• Failed to keep a stock and inventory of emergency response equipment, including, but not limited to, an automated external defibrillator (AED), or failed to train their staff on where the AEDs were stored.
• It was also stated that a woman allegedly attempted to perform CPR on Heslin at one point. However, the complaint alleged that an employee “forcefully interfered” and removed her from the scene.

If an attorney can sue waiters and a restaurant for failure to provide emergency medical assistance, can you imagine what they would do if a healthcare worker did not provide the same?

While it’s important to always work within your own licensed scope of practice, emergency life threatening situations when other more qualified healthcare providers are not available can become exceptions to what can be practiced. All healthcare providers should know basic emergency life saving measures. These include:

• Learn the heimlich maneuver for choking patients.
• Learn or update CPR certifications and install or locate the nearest AED device to your workplace, especially if you work on cardiovascularly compromised patients, which includes more vulnerable populations such amongst retirement villages or hospice care.
• It would also be important to learn of any medical equipment requirements that are required by law at your healthcare practice, and to ensure you are properly trained to use anything within your scope of practice that could provide life saving measures to anyone in need.

Florida's Good Samaritan Law provides immunity from civil liability for individuals who provide emergency assistance in good faith, protecting them from lawsuits if their actions are not grossly negligent or malicious, even if the aid doesn't succeed or causes minor harm. The law's purpose is to encourage people to help in emergencies without fear of legal repercussions for good-faith efforts or resulting medical errors.

A good samaritan law would generally apply to private citizens, although it could also extend to medical professionals acting in an emergency outside of their usual healthcare setting or scope of practice. 

Exceptions to the good samaritan law are, it should not to be regularly used to operate a medical facility without sufficient medical staff. For example, if patients are regularly coding in the medical facility, then there should be a doctor on staff and other trained medical professionals to run the codes. Consistently operating outside of one’s licensed scope under the good samaritan law is a manipulative abuse of practice and likely punishable by law when proper licensed healthcare is not being provided by medical staff.

Good samaritan laws usually do not protect individuals from liability if their actions involve gross negligence, manipulative conduct, complete recklessness, or malicious intent. 
An example of this would be cutting a person’s abdomen open on an airplane, without proper training, sanitation or reason to do so. There must be some good faith in your emergency medical care for the good samaritan law to apply.

To learn more about healthcare laws and medical errors prevention, please register for one of our courses at:  https://ceinstitute.com/collections/mandatory

Understanding human trafficking is crucial for several reasons. Recognition can save lives with the following purposes: 

• Being able to identify trafficking situations can lead to intervention.
• Effective support: Knowledge helps you support anti-trafficking efforts in your community.
• Awareness creates change: Raising awareness promotes societal change to combat this crime.

By learning about human trafficking as a healthcare worker, you contribute to creating a safer, more informed community that can help prevent exploitation and support survivors.  

Types of Human Trafficking

The United States Department of State recognizes two primary forms of trafficking in persons which are forced labor and sex trafficking. 

Forced Labor sometimes also referred to as labor trafficking, includes activities involved when a person uses force, fraud, or coercion to exploit the labor or services of another person. 

Sex trafficking encompasses the range of activities involved when a trafficker uses force, fraud, or coercion to compel another person to engage in a commercial sex act or causes a child (person under 18) to engage in a commercial sex act. Sex trafficking occurs in various settings, such as fake massage establishments, escort services, brothels, city streets, truck stops, strip clubs, hostess clubs, hotels, and motels.  

Perpetrators of human trafficking span all racial, ethnic, and gender demographics and are as diverse as survivors. Some use their privilege, wealth, and power as a means of control while others experience the same socio-economic oppression as their victims. 

Physical transportation is not required for this crime; a trafficker can control a victim mentally, compelling them to act on the trafficker’s behalf. According to the United Nations’ International Labour Organization, human traffickers victimize an estimated 27.6 million people worldwide.

77% of all victims are in forced labor

23% of all victims are in sex trafficking

57% are men and boys  

43% are women and girls

Within Sex Trafficking the Statistics are:

78% are women and girls and 22% are men and boys

92% are adults and 8% are children

Within forced labor the Statistics are:

33% are women and girls and 67% men and boys

73% are adults and 27% are children

The US Department of Homeland Security states Human trafficking has been reported in all 50 states and the District of Columbia, on Tribal land, and within U.S. territories. In FY 2024, DHS agencies helped over 800 human trafficking victims, provided protections to more than 24,000 people, and made 2,500+ related arrests. DHS supported 914 indictments, 405 convictions, and trained thousands in identifying and reporting human trafficking.   

Identifying Victims of Human Trafficking

There are several physical, behavioral and environmental indicators to consider.  These indicators may appear alone or in combination, and not all victims will show every sign.  

There is no single profile of a human trafficking victim as traffickers may target anyone who can earn them a profit regardless of age, sex, socioeconomic background, nationality, or immigration status. 

The following are examples of groups who may be at increased risk:

• Individuals who have experienced childhood abuse or neglect
• Children and youth involved in the foster care and juvenile justice systems
• People experiencing homelessness
• Individuals living in poverty
• Survivors of violence such as intimate partner or domestic violence
• Unaccompanied alien children
• Individuals displaced due to political instability, war, and disaster
• Individuals working in industries with fewer legal protections
•  Physical Indicators 
• Delayed care or an unexplained progression of an illness
• Evidence of severe workplace injuries, including prolonged and unprotected exposure to toxic chemicals or hazardous conditions
• History of multiple STIs/STDs, multiple pregnancies, or frequent requests for STI/STD testing, substance use and/or poor hygiene
• Physical signs of injury or mistreatment, including
• Long-term trauma
• Bruises in various stages of healing
• Signs of physical or sexual abuse
• Malnourishment
• Severe exhaustion
• Behavioral Indicators Include:
• Overly fearful or nervous behavior
• Use of scripted answers and/or stories about their condition
• Talk that minimizes abuse or the state of their injuries
• Being unwilling or hesitant to answer questions
• Being unaware of their location or the date/time
• Symptoms related to depression or PTSD
• Refusal of care or the need to leave despite medical advice

Environmental Indicators Include:

• An individual consistently speaks on behalf of the patient or requests to be present during examinations
• A person who may be in possession of the patient’s ID or money and/or insists on filling out all paperwork
• A person who lacks essential information about the patient’s medical history or identity, despite claiming to be related
• Reports of experiencing high-risk environmental factors, such as living at a workplace, sleeping in crowded conditions, or not having a fixed home address 

Traffickers’ methods of control

Not all control is physical – it can be mental as well.  Traffickers use force, fraud, and coercion to compel labor or services and commercial sex. Force may involve threats or acts of physical assault and sexual violence directed at the victim, others present, or family members, which makes the threat even more credible.

Controlling victims through fraud is often false promises – of education, a relationship, a specific job, good pay and days off, paying off a debt, sending money home to support the family, or generally of a new more secure life – but the reality is something different and inescapable.

A traffickers coercion with victims can be subtle or overt. Some common tactics include taking identity documents and threatening arrest and/or deportation, inhumane treatment, blackmail, shaming, isolation, addiction, and economic coercion, which can be taking advantage of existing debt or creating a debt.

To learn more about human trafficking prevention, please register for one of our courses at:  https://ceinstitute.com/collections/mandatory