House Bill 457
By: Representatives Horner of the 3rd, Powell of the 33rd, Carpenter of the 4th, Ridley of the
22nd, and Jasperse of the 11th
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 28 of Title 43 of the Official Code of Georgia Annotated, relating to
occupational therapists, so as to authorize occupational therapists to perform dry needling
as a physical agent modality if certain training and education requirements are met; to
provide for definitions; to provide for related matters; to repeal conflicting laws; and for
other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Chapter 28 of Title 43 of the Official Code of Georgia Annotated, relating to occupational
therapists, is amended in Code Section 43-28-3, relating to definitions, by revising
paragraph (12) and by adding a new paragraph to read as follows:
<ins>"(1.1) 'Dry needling' means a skilled technique that uses a thin filiform needle to
penetrate the skin and stimulate underlying neural, muscular, and connective tissues for
the management of neuromusculoskeletal conditions, pain, and movement impairments.
Such term shall not include the teaching or application of acupuncture."
</ins> "(12) 'Physical agent modalities' means occupational therapy treatment techniques, both
superficial and deep tissue, which may, but are not required to utilize the following
agents: thermal, mechanical, electromagnetic, water, <del>and</del> light, <ins>and dry needling</ins> for a
specific therapeutic effect to promote functional outcomes."
SECTION 2.
Said chapter is further amended by revising Code Section 43-28-8, relating to license
requirements for therapy techniques involving physical agent modalities, as follows:
"43-28-8.
(a) No person shall utilize occupational therapy techniques involving physical agent
modalities unless such person:
(1) Is licensed according to this article; and
(2) Has successfully completed a minimum of 90 hours of instruction or training
approved by the board which covers the following subjects:
(A) Principles of physics related to specific properties of light, water, temperature,
sound, or electricity, as indicated by selected modality;
(B) Physiological, neurophysiological, and electrophysiological, as indicated, changes
which occur as a result of the application of the selected modality;
(C) The response of normal and abnormal tissue to the application of the modality;
(D) Indications and contraindications related to the selection and application of the
modality;
(E) Guidelines for treatment or administration of the modality within the philosophical
framework of occupational therapy;
(F) Appropriate selection and practical application of physical agent modalities,
including determining treatment parameters based on existing pathology, impairments,
functional limitations, and expected outcomes;
(G) Guidelines for educating the patient, including instructing the patient as to the
process and possible outcomes of treatment, including risks and benefits;
(H) Safety rules and precautions related to the selected modality;
(I) Methods for documenting the effectiveness of immediate and long-term effects of
treatment; and
(J) Characteristics of the equipment, including safe operation, adjustment, and care of
the equipment.
<ins>(b)(1) No occupational therapist shall perform dry needling unless he or she:
(A) Is certified to use physical agent modalities;
(B) Has a minimum of three years of clinical experience as a licensed occupational
therapist; provided, however, that the board may, in its discretion, accept a lesser
amount of clinical experience if the board receives documentation of completion of
courses specifically in dry needling taken while in attendance at an occupational
therapy program recognized by the board; and
(C) Has documented successful completion of coursework in dry needling acceptable
to the board that includes study of musculoskeletal and neuromuscular systems; the
anatomical basis of pain mechanisms, chronic pain, and referred pain; myofascial
trigger point theory; and universal precautions. Such coursework shall also include
postgraduate instruction in:
(i) Anatomical review for safety and effectiveness;
(ii) Indications and contraindications for dry needling;
(iii) Management of adverse effects; and
(iv) Evidence based instruction in the theory of dry needling.
(2) Except for remote study or self-study required as a part of postgraduate coursework
in dry needling, online instruction shall not be considered appropriate training.
(3)(A) In order to perform dry needling on a patient's upper extremities, an
occupational therapist shall have successfully completed a minimum of 28 hours of
postgraduate instruction, of which a minimum of 22 hours shall have been in-person
postgraduate instruction in dry needling on upper extremities in a course acceptable to
the board.
</ins>
<ins>(B) In order to perform dry needling on a patient's lower extremities, an occupational
therapist shall meet the requirements of subparagraph (A) of this paragraph and shall
have successfully completed a minimum of an additional 40 hours of in-person
postgraduate instruction in dry needling on lower extremities in a course acceptable to
the board.
(4) An occupational therapist shall not perform dry needling unless the patient has signed
an informed consent, which shall be maintained in the patient's medical record. The
written informed consent shall clearly state the risks and benefits of dry needling, the
occupational therapist's level of education and training in dry needling, and any other
information required by the board.
</ins> <del>(b)(c)</del> The board shall promulgate rules and regulations specifically pertaining to the use
of physical agent modalities by a person licensed under this article."
SECTION 3.
All laws and parts of laws in conflict with this Act are repealed.