Senate Commerce Committee Statement to Senate, No. 867 — State of New Jersey (June 16, 2021)

Summary

The Senate Commerce Committee of the State of New Jersey, in a statement dated June 16, 2021, reports favorably and with amendments Senate Bill No. 867, which permits a physical therapist to perform dry needling under set conditions. The therapist must complete a program approved by the New Jersey State Board of Physical Therapy Examiners, have two or more years of clinical experience in the State and hold a current CPR certification. Approved programs must include at least 40 hours of academic instruction and a minimum of 40 hours of practical hands-on instruction. Written informed consent is required, and dry needling may not be delegated to a physical therapist assistant or student. The amendments require communication with the referring physician first.

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SENATE COMMERCE COMMITTEE

STATEMENT TO

SENATE, No.
867

with
committee amendments

STATE
OF NEW JERSEY

DATED: JUNE 16,
2021

The Senate Commerce Committee reports favorably and
with amendments Senate Bill No. 867.

As amended, this bill permits a physical therapist to
perform dry needling if the physical therapist has successfully completed a dry
needling continuing education and competency program approved by the New Jersey
State Board of Physical Therapy Examiners, has two or more years of clinical
experience treating patients as a licensed physical therapist in this State,
holds either a doctorate in physical therapy or a current and unrestricted
license to practice physical therapy in this State that was issued prior to
2003, and has a current CPR certification issued by the American Red Cross,
American Heart Association, National Safety Council, or any other agency or
organization approved by the board.

The bill defines “dry needling” as a physical
intervention that uses a dry, filiform needle, without medication or other
deliverable, to penetrate the skin and stimulate underlying muscular tissue,
connective tissues, or myofascial trigger points for the management of
neuromusculoskeletal pain and movement impairments. The bill provides that
“dry needling” does not mean the stimulation of auricular or distal points or
the practice of acupuncture.

The bill establishes requirements for board-approved
dry needling continuing education and competency programs, which must include
at least 40 hours of academic instruction, attendance in person by a physical
therapist, and the ability to complete the program in no more than two years.
The programs must also include a minimum of 40 hours in practical hands-on
instruction, under the direct supervision of a licensed physical therapist or
physician, in the application and technique of dry needling. The required dry
needling instruction must be taught by a licensed physical therapist who has a
minimum of five years of clinical experience in the performance of dry needling
or by a physician licensed to practice medicine and surgery in this State. A
physical therapist who meets the bill’s requirements and is approved by the board
to offer dry needling must complete 10 credits of continuing education and
competency in dry needling during each biennial license renewal period, if the
therapist chooses to continue offering dry needling.

The bill provides that dry needling will only be
performed by a physical therapist who meets the requirements of the bill, and
the performance of dry needling may not be delegated to a physical therapist
assistant or student physical therapist. A physical therapist who meets the
requirements to perform dry needling may only utilize the specific dry needling
techniques for which the physical therapist has completed instruction and
demonstrated competency.

The bill also stipulates that if a patient is ordered,
prescribed, or referred to physical therapy by a New Jersey-licensed physician,
osteopathic physician, or podiatric physician, the physical therapist licensed
in New Jersey to perform dry needling can only perform the dry needling service
on that patient after communicating with the physician who made the order,
prescription, or referral to physical therapy for that patient. This
communication is to address the physical therapy diagnosis of the patient, the
specific dry needling technique that the physical therapist intends to utilize
in the treatment of the patient, the proposed number, size, and insertion
points of the needles, and any elevated risk factors that the patient may have.
The physical therapist is to make note of this communication in the patient’s
record. Dry needling cannot proceed if the physician, who made the order,
prescription, or referral determines and communicates to the physical therapist
that dry needling is contraindicated or clinically inappropriate for the
patient.

The bill also requires a physical therapist to obtain
written informed consent from each patient prior to the provision of dry
needling. The patient must receive a copy of the written informed consent and
the physical therapist must retain a copy of the informed consent in the
patient’s record. The informed consent must include, at a minimum, the
following:

(1) the patient’s signature;

(2) the risks, benefits, and possible complications
of dry needling;

(3) the treatment alternatives to dry needling;

(4) the physical therapist’s level of education regarding
supervised hours of training in dry needling;

(5) the importance of consulting with the patient’s
physician regarding the patient’s condition; and

(6) a clearly and conspicuously written statement
that the patient is not receiving acupuncture.

The bill provides that a physical therapist may only
use filiform needles labeled in accordance with the United States Food and Drug
Administration guidelines when performing dry needling and must perform dry
needling in a manner that is consistent with generally accepted standards of
practice, including clean needle techniques, safe disposal of sharp objects,
and the Occupational Safety and Health Administration’s blood borne pathogens
standard.

Under the bill, a physical therapist must maintain
documentation in the patient record of each dry needling session. The
documentation must include the treatment performed, the patient’s response to
the treatment, and any adverse reactions or complications to the treatment.

Finally, the bill provides that, upon request of the
board or a member of the general public, a physical therapist practicing dry
needling must provide documentation of the education and training completed by
the physical therapist as required by the provisions of the bill. The failure
to provide documentation in response to a request by the board or a member of
the general public will be deemed prima facie evidence that the physical
therapist has not received the required training and will not be permitted to
perform dry needling.

COMMITTEE AMENDMENTS

The committee amended the bill by adding a requirement
that the physical therapist who is to perform dry needling on a patient
communicate to the physician, osteopathic physician, or podiatric physician who
ordered, prescribed or referred the patient to physical therapy the following
information:

(1) the physical therapy diagnosis of the patient;

(2) the specific dry needling technique that the
physical therapist intends to utilize in the treatment of the patient;

(3) the proposed number, size, and insertion points
of the needles; and

(4) any elevated risk factors the patient may have.

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