This bill reenacts and amends RCW 18.59.020 and adds a new section to chapter 18.59 RCW to create an intramuscular needling endorsement for occupational therapists, and it adds an explicit statutory definition of "intramuscular needling" (dry needling) and lists performing intramuscular needling among occupational therapy services. It directs the secretary of health, with approval from the board of occupational therapy practice, to issue the endorsement when specified education, clinical experience, and practice experience requirements are met. The endorsement requires a total of 325 hours of instruction and clinical experience: 100 hours of didactic instruction, 75 hours of in-person intramuscular needling instruction, and a minimum of 150 individual intramuscular needling treatment sessions subject to a successful clinical review by a qualified provider. Applicants have up to 18 months after completing the didactic and in-person portions to finish the treatment sessions. Applicants may document equivalent education or clinical review completed in other jurisdictions, and may apply for endorsement before one year of clinical practice in limited circumstances if specified prelicensure coursework and other chapter requirements are met. The bill imposes practice restrictions and procedural requirements: intramuscular needling cannot be delegated and the occupational therapist must remain in constant attendance during the procedure; practitioners must make reasonable efforts to coordinate care if the patient is being treated by an acupuncturist for the same diagnosis; all patients must sign informed consent that includes a definition of the procedure, risks, benefits, potential side effects, and a statement differentiating it from acupuncture; and intramuscular needling may not be a stand-alone treatment within an occupational therapy care plan. The text cross-references other health professions and OSHA bloodborne pathogens protocol and affects the Department of Health, the board of occupational therapy practice, occupational therapy practitioners, and various licensed providers named in the statute. The extracted material does not show an effective date, detailed procedures for how the secretary and board will process and verify endorsement applications (forms, fees, timelines beyond the 18-month limit), the precise meaning of "all other requirements set forth in this chapter," the manner in which instruction and clinical experience must be approved as acceptable to the board, or any enforcement, disciplinary, or penalty provisions.

If enacted, the bill creates a new endorsement that allows occupational therapists to add intramuscular needling (dry needling) to their practice but only after completing a substantial preset training and clinical workload: 100 hours of classroom work, 75 hours of in-person instruction, and at least 150 individual treatment sessions reviewed by a qualified provider (with an 18‑month window to finish the clinical sessions). In practice this means many OTs who want to provide dry needling will need to invest time and money in training and in arranging supervised clinical cases, document prior out‑of‑state or military experience where applicable, and secure board/department approval to get the endorsement. The people most affected are licensed occupational therapists and their employers, who will likely face training costs, scheduling and staffing changes because the therapist must personally perform and remain present for each procedure and cannot delegate it, and added administrative duties to obtain the specific informed consent and to coordinate care when an acupuncturist is treating the same diagnosis. The board and Department of Health will have new responsibilities to grant endorsements and review clinical affidavits. Important implementation details are missing from the provided text, including the law’s effective date, application fees and timelines, how the board will verify training and approve reviewers, and any enforcement or disciplinary procedures.