Washington

On July 21, 2023, the Washington State Board of Physical Therapy (board) authorized board staff to file a CR-101 to open WAC chapter 246-915 regarding the intramuscular needling endorsement, which was filed under WSR number 23-16-028. The board and Department of Health (department) are considering rulemaking in chapter 246-915 WAC, Physical Therapists and Physical Therapist Assistants, to clarify statutory requirements for education and training and define an intramuscular needling endorsement. The board and department may consider associated training and education requirements, updating definitions, establishing a fee for the intramuscular needling endorsement, and creating a process to apply for the endorsement. The rulemaking process will take approximately 12-18 months to complete. Intramuscular needling may not take place in Washington until rulemaking is complete, and the endorsement has been established. The department is planning to begin rulemaking mid to late summer 2023.

On May 23, 2023, Allyson McIver (Clayborn), Program Manager at the Office of Health Professions, Health Systems Quality Assurance, Washington State Department of Health, shared with Dr. Jan Dommerholt, that " training programs can legally teach dry needling once the bill becomes effective in July...." However, she also mentioned that "until the rulemaking process is complete, dry needling will still be outside the scope of practice for physical therapists and that is likely to pose difficulties for the hands-on training portion of any course or program given the timing requirements outlined in the bill."

On February 13, 2023, the bill was referred to the Rules Committe.

On May 1, 2023, Governor Jay Inslee of Washington State signed Second Substitute House Bill No. 1039 into law, which will allow physical therapists to perform intramuscular needling! The Primary Sponsor of the bill was Rep. Macri.

On April 13, 2023, the House concurred in Senate amendments and passed final passage with yeas, 96; nays, 1; absent, 0; excused, 1. The House Speaker signed the bill on April 14, 2023, followed by the President of the Senate on April 17, 2023. On April 18, 2023, the bill was delivered to the Governor of Washington State Jay Inslee.

On Mar 20, 2023, the bill was passed to the Rules Committee for second reading, which passed the bill on April 6, 2023 with yeas, 47; nays, 0; absent, 0; excused, 2

On March 4, 2023,Senate bill SB 5288 was introduced to the Senate Health & Long Term Care Committee, which passed the bill on 17, 2023.

On February 27, 2023, the bill passed the House with yeas, 94; nays, 1; absent, 0; excused, 3.

On January 24, 2023, the bill was referred to the House Committee on Appropriations, which passed the bill on February 8, 2023.

On January 9, 2023, House Bill 1039, which concerns physical therapists performing intramuscular needling, was referred to the Health Care & Wellness Committee, which passed the bill on January 20, 2023. The bill was sponsored by Macri, Harris, Corry, Duerr, Riccelli, Chambers, Goodman, Reed, Fitzgibbon, Pollet, Ryu, Paul, Thai, Springer, Stonier, Kloba, Santos, and Ormsby.

On March 14, 2022, Rep Eileen Cody announced her retirement. The PTWA plans to reintroduce "intramuscular needling" legislation in 2023.

During the 2022 legislative session, House bill HB 1662 - Physical therapists performing intramuscular needling - again did not receive a hearing and did not pass.

During the 2019 Legislative session, the Vice Chair of the House Healthcare and Wellness Committee, Representative Nicole Macri sponsored HB 1260 in support of "intramuscular needling" by physical therapists. The corollary bill in the Senate, SB 5642, was sponsored by the Chair of the Health and Long Term Care Committee, Senator Annette Cleveland. A key point in the bill is that Washington State would have the most rigorous continuing education requirement in the country at 300 hours (this includes 75 hours of direct needle instruction, 75 hours of related content instruction and 150 hours of supervision), compared to other states that have either no minimum hour requirements, such as North Carolina and Virginia, or require on between 27-80 hours. Even so, the Chair of the Health & Wellness committee, Sen. Eileen Cody refused to put the bill on the committee hearing calendar, with the rationale that patients are not asking their legislators for this service.

In May and September 2018, the Physical Therapy Association of Washington (PTWA) met with the Washington East Asian Medical Association (WEAMA), through a legislative mediation group “Center for Dialog & Resolution." The PTWA did concede the term "dry needling," and instead put the term “intramuscular needling” into a bill, since this was a particular “sticking point” for WEAMA. As a side note, the term "intramuscular needling" does not comprise the entire scope of dry needling as it negates scar tissue and fascial needling, periosteall needling, etc. (Myopain Seminars).

On August 2, 2016, Jan Dommerholt and other dry needling experts testified on behalf of PTs competence to perform dry needling as part of a Physical Therapy Sunrise Review. The Sunrise Review committee concluded that with adequate training, “dry needling may fit within the physical therapist’s scope of practice” and agreed that the evidence demonstrated a “low rate of serious adverse events” from physical therapists performing dry needling in other states, the US military and Canada.

On April 15, 2016, the Attorney General of Washington State concluded that “the definition of the practice of physical therapy indicates that the legislature did not intend to include dry needling within the scope of practice. We have been informed of many reasons for including dry needling in the practice of physical therapy and arguments to the contrary, but our role is not to resolve such public policy disputes. We conclude only that RCW 18.74, as currently written and implemented, does not encompass dry needling in the practice of physical therapy”.

On March 31, 2015, a Washington State Senate Committee killed a proposed bill HB 1042, which would have prevented physical therapists from using dry needling in Washington State.

In January 2015, Representative Eileen Cody and Chair of the House Health and Wellness Committee sponsored a bill that would prohibit PTs from performing dry needling.

On October 10, 2014, the Honorable Laura C. Inveen, judge at the Superior Court for the State of Washington, County of King, ruled that dry needling is considered the practice of medicine in Washington State and outside the scope of physical therapy practice. Kinetacore, a continuing education company based in Colorado, was enjoined from holding any workshops, classes or similar trainings in the State of Washington by physical therapists. The ruling was the outcome of a lawsuit filed by the State of Washington ex rel South Sound Acupuncture Association, a State of Washington non-profit corporation, vs. Kinetacore, a Colorado LLC doing business in the State of Washington, Edo Zylstra, CEO and owner of Kinetacore, Kerry Maywhort, a Kinetacore instructor, Emerald City Physical Therapy Services, LLC doing business as Salmopn Bay Physical Therapy. LLC, a limited liability company, John Does 1-10 and Jane Does 1-10, No. 13-2-04894-9 SEA.

In 2011, dry needling was put on the agenda of the licensing board, the Washington State Board of Physical Therapy (WBPT), however the licensing board took no action and remained silent. In 2012, WBPT looked at the issue again and agreed that PTs performing dry needling need to be properly trained; however, they still took no action.