Welcome to the Washington East Asian Medicine Association website!
The Washington East Asian Medicine Association (WEAMA) is the acupuncture profession's primary voice in representing and promoting acupuncture and East Asian medicine in Washington state. WEAMA was created for practitioners, the general public, students and allied professionals and legislators. 

All East Asian Medical Practitioners in Washington State are automatically subscribed to our blog to have access to the most important information and resources impacting the industry!

  • February 09, 2018 12:34 PM | Shelley Dahle (Administrator)

    "This bill, which we support, is still in the Rules Committee. If you haven't called your Senator yet, please take the time right now to make the call."

    WEAMA Supports SB 6157 Prior Authorization. Please call your local Senator ASAP! The bill prohibits a health carrier from requiring prior authorization for an initial evaluation and management visit and up to twelve consecutive treatment visits with a contracting provider in a new episode of care of certain therapies (East Asian Medicine, Chiropractic, PT and OT) that meet standards of medical necessity and are subject to quantitative treatment limits of the health plan. The bill has bi-partisan support. Here are the bill sponsors: Sponsors: ShortKudererRiversClevelandPalumboNelsonBeckerWalshWarnickVan De Wege

    The bill had a public hearing in the Senate Health Care Committee earlier this week. WEAMA provided the attached testimony at the public hearing on the bill. We hear that the Chair of the Senate Health Care Committee plans to schedule an Executive Session vote on the bill in this week. The bill will then go to the Senate Rules Committee and wait to be pulled to the floor of the Senate for a vote. There is no House companion bill, so only call your Senator at this time.

    Please call your local Senator and let them know that you support SB 6157!

    To find out who your Senator is in your legislative district go to: Find Your District

    Enter your home address, not your workplace, and your state legislative district will pop up. The website will also provide their contact information. Please send them an email or call and speak with their legislative assistant.

    Please ONLY CONTACT YOUR STATE SENATOR as there is no bill in the House yet. When it passes the Senate, we will do another legislative alert to contact your state House of Representative members.

    Talking Points

    PLEASE SUPPORT SB 6157, re. Prior-Authorization 

    Short, Kuderer, Rivers, Cleveland, Palumbo, Nelson, Becker, Walsh, Warnick, Van De Wege

    For every day of delay, an opioid is prescribed in its place!

    • Every service listed in this bill is a non-pharmacological option to an opioid.
    • This bill gives patients access to up to eight visits of care without having to seek prior authorization. 
    • This bill does NOT require additional benefits be covered. 
    • This bill does NOT remove medical necessity. 
    • This bill does NOT remove prior-authorization completely! 
    • Prior authorizations drive up costs by requiring unnecessary evaluation visits at intervals that are too soon 
    • Prior authorizations shift administrative burden to providers and delay care.

    This bill simply gives patients up to 8 consecutive visits of their already existing benefits, for the same episode of care, without going through the administrative burden of prior authorization.

    Third party companies from out-of-state, who are unregulated, are hired by insurers to interfere with the DrPatient relationship.

    This bill follows a House Health Care work session from the 2017 session. Insurers had several years to correct the issues related to this process and have taken no action. The administrative shifts continue and the delays get longer.

    PLEASE VOTE YES ON SB 6157

    Lori Grassi, Washington State Chiropractic Association, 253-988-0500 Melissa Johnson, Physical Therapy Association of Washington, WA Speech Language and Hearing Association, 360-2806429 Kate White Tudor, WA Occupational Therapy Association, 360-402-1272 Melanie Stewart, American Massage Therapy Association-Washington Chapter, 360-556-8280 Leslie Emerick, East Asian Medicine Association, 360-280-6142


  • February 08, 2018 9:35 PM | Brit Kramer (Administrator)

    The Journal of Acupuncture & Oriental Medicine.  In this issue... Treatment of Long-Term Migraine Utilizing Balance Acupuncture:: A Case Report; Pain Management Using Acupuncture and Herbs for Rheumatoid Arthritis; Acupuncture’s Role in Solving the Opioid Epidemic – White Paper 2017; and more. View this issue

  • February 01, 2018 8:31 AM | Shelley Dahle (Administrator)

    WEAMA Supports SB 6157 Prior Authorization. Please call your local Senator ASAP! The bill prohibits a health carrier from requiring prior authorization for an initial evaluation and management visit and up to twelve consecutive treatment visits with a contracting provider in a new episode of care of certain therapies (East Asian Medicine, Chiropractic, PT and OT) that meet standards of medical necessity and are subject to quantitative treatment limits of the health plan. The bill has bi-partisan support. Here are the bill sponsors: Sponsors: Short, Kuderer, Rivers, Cleveland, Palumbo, Nelson, Becker, Walsh, Warnick, Van De Wege

    The bill had a public hearing in the Senate Health Care Committee earlier this week. WEAMA provided the attached testimony at the public hearing on the bill. We hear that the Chair of the Senate Health Care Committee plans to schedule an Executive Session vote on the bill in this week. The bill will then go to the Senate Rules Committee and wait to be pulled to the floor of the Senate for a vote. There is no House companion bill, so only call your Senator at this time.

    Please call your local Senator and let them know that you support SB 6157!

    To find out who your Senator is in your legislative district go to: Find Your District

    Enter your home address, not your workplace, and your state legislative district will pop up. The website will also provide their contact information. Please send them an email or call and speak with their legislative assistant.

    Please ONLY CONTACT YOUR STATE SENATOR as there is no bill in the House yet. When it passes the Senate, we will do another legislative alert to contact your state House of Representative members.

    Talking Points

    Dear Senator _________,

    My name is ____________ and I live in your legislative district. I am a licensed East Asian Medicine Practitioner (EAMP). I am requesting that you please support SB 6157 Prior Authorization.

    Prior authorizations block access to medically necessary health care services. Some insurers, using third party administrators, authorize a very small number of initial visits and require repeated reauthorizations for medically necessary additional visits. Both factors compromise the integrity and value of the very services that insurers are paying for by creating a “start/stop” treadmill that hinders patient progress and adds a substantial and unnecessary administrative burden on providers.

    You can add a short personal story here if you have one related to problems with prior authorizations.

    This bill would protect patients’ ability to get an initial evaluation and up to twelve consecutive treatment visits, if those treatments were medically necessary and within the quantitative limits of the health plan.

    Thank you for your support! Feel free to contact me if you have any questions.

    Sincerely,


  • January 22, 2018 9:40 AM | Shelley Dahle (Administrator)

    The February 9, 2018 meeting of the East Asian Medicine Advisory Committee has been rescheduled to Friday, March 2, 2018. The meeting location will be the Department of Health offices at Center Point in Kent. The meeting will be in room 307 and start at 9:00 a.m. and go until approximately 2:00 p.m. If there are any questions or concerns regarding this change, feel free to contact this office.

    Vicki Brown, Program Manager
    East Asian medicine practitioner program
    P. O. Box 47852
    Olympia, WA 98504-7852
    Voice: 360-236-4865
    Fax: 360-236-2901
    vicki.brown@doh.wa.gov
    http://www.doh.wa.gov/hsqa/
    Public Health - Always Working for a Safer and Healthier Washington


  • January 18, 2018 9:44 AM | Shelley Dahle (Administrator)

    Prepared by Leslie Emerick, Lobbyist

    Legislative Overview
    Washington state’s 2018 legislative session started on Monday, January 8th. The week got off to a fast start with pre-filed bills that were introduce on day one and had public hearings all week. Since we have a biennial legislature, some bills from last session are moving forward from where the left off last session.

    They will also be working on the Supplemental Operating budget this session. It’s a 60-day “short” session this year and they will also have to contend with the Supreme Court McCleary decision to improve the education budget by $1 billion, court ordered improvements to the mental health system, a debate over the Capital budget and more!

    Democrats have a new majority in the state Senate. The party recently won a special election in the Redmond/Issaquah area, ending a half-decade of Republican control in the chamber. They already controlled the House and Governor’s Office. The win gives them total control of state government. Their lead is just one vote in the Senate, but they will still have considerably more sway to push through legislation and write a supplemental state budget than they had in past years.

    The states Capital Budget funding construction projects statewide for schools, colleges and other state institutions has also been on hold due to the Hirst Decision in the Supreme Court. The Democrats may have a majority, but to sign bonds for the state they need 60 votes, so they will still have to negotiate with the Republicans to pay for the bonds.

    Governor Jay Inslee has requested a “carbon tax” in his budget creating a plan to charge polluters as the centerpiece of an effort to increase state revenue for education and environmental issues, but he hasn’t offered details on the size and scope of the plan yet. The Olympian states that “Such a tax is unlikely to win the hearts and minds of many Republicans, who have objected to carbon taxes. Many say taxing carbon emissions would not provide enough help to the environment to justify the job losses they predict would result from the implementation of the tax.” Inslee has proposed using reserves to meet the McCleary court order, with a promise to refill state coffers with a carbon tax later on.

    WEAMA Legislative Priorities

    Support Acupuncture as an Alternative to Opioids

    On January 15, WEAMA was invited to present to the Senate Health Care Committee as part of a panel on Alternatives to Opioids. Jason Taylor, WEAMA Board member presented to the committee and sharing the “Acupunctures Role in Solving the Opioid Epidemic” that was presented to Congress last fall. Jason did a fabulous job and can be seen on TVW: www.tvw.org/watch/?clientID=9375922947&eventID=2018011155&eventID=2018011155&startStreamAt=781&stopStreamAt=1091&autoStartStream=true

    If you would like to see the entire presentation start at the beginning of the hearing on TVW:

    https://www.tvw.org/watch/?eventID=2018011155

    WEAMA has been working on Acupuncture as an Alternative to Opioids for a number of years. We sent Governor Inslee the attached letter on September 26, 2017 and within a week had a meeting scheduled with Jason McGill, Governor’s Health Policy Staff and the Medical Directors from the Health Care Authority, Medicaid and the Department of Health to discuss how to integrate acupuncture into the Medicaid insurance program in WA State. A policy analyst was assigned to research the issue. Out of that discussion came a section in two bills (companion bills) that have been introduced by Governor Inslee to address opioid abuse:

    WEAMA Supports Governor Inslee’s Opioid bills, HB 2489/SB 6150 Concerning opioid use disorder treatment, prevention, and related services.

    Here is Curt Eschels, WEAMA Legislative Chair, testimony on SB 6150: www.tvw.org/watch/?clientID=9375922947&eventID=2018011155&eventID=2018011155&startStreamAt=4720&stopStreamAt=4798&autoStartStream=true

    These bills have bi-partisan support. WEAMA is very supportive of Section 14 of the bill that starts a pilot project at the Health Care Authority and will be testifying in support of these two bills next week. It is essentially a pilot project to start using EAMPs and acupuncture treatment with Medicaid in WA State. The standards are very similar to L & I for evidence based medicine.

    NEW SECTION. Sec. 14. A new section is added to chapter 74.09 RCW to read as follows: (1) By October 2018, the health care authority shall develop and recommend for coverage nonpharmacologic treatments for chronic noncancer pain and shall report to the governor and the appropriate committees of the legislature, including any requests for funding6necessary to implement the recommendations under this section. The recommendations must contain the following elements: (a) A list of chronic conditions for which nonpharmacologic treatments will be covered; (b) A list of which nonpharmacologic treatments will be covered for each chronic condition specified as eligible for coverage; (c) Recommendations as to the duration, amount, and type of treatment eligible for coverage by condition; (d) A financial model that is scalable based on the types of conditions covered and the amount of allowed services per condition; (e) Guidance on the type of providers eligible to provide these treatments; and (f) Recommendations regarding the need to add any provider types to the list of currently eligible medicaid provider types. (2) The health care authority shall ensure only treatments that are supported by evidence for the treatment of the specific chronic pain conditions listed will be eligible for coverage recommendations.

    Support SB 6157 Prior Authorization

    WEAMA has been working with the chiropractors and PTs on a prior authorization bill for about 3 years now. The bill states “A health carrier may not require prior authorization for an initial evaluation and management visit or an initial, and up to 12 consecutive treatment visits with a contracting provider in a new episode of care of chiropractic, physical therapy, occupational therapy, East Asian medicine, massage therapy, or speech and hearing therapies within the benefit limits of the health plan.” The bill has not been scheduled for a public hearing yet.

    State Agency Regulatory Update

    Acupuncture and ARNPs Medical Acupuncture Advisory Opinion with NCQAC

    WEAMA is consulting with our attorney regarding our official position and will provide talking points soon. We wanted to make sure our membership was aware of this meeting in case you would like to attend in person. We will send out the talking points as soon as we get legal counsel on our options to repeal this decision. We also plan to contact the Governor’s Office in the near future with our concerns.

    Background: Fujio McPherson, a former member of the EAMAC and a dual licensed EAMP and ARNP, submitted a proposal to the NCQAC to allow advanced registered nurse practitioners (ARNPs) in Washington state to be able to do “medical acupuncture” similar to what the medical doctors and osteopaths are allowed to do for 300 hours. He intends to teach this class to ARNPs. The NCQAC prepared an Advisory Opinion that supported Fujio’s request and passed it out of the Advanced Registered Nurses Advisory Committee. It then went to the NCQAC for approval.

    NCQAC approved the Advanced Registered Nurse Practitioner (ARNP) Medical Acupuncture Advisory Opinion at their November 17th, 2018 meeting. WEAMA strongly protested the passage of this Advisory Opinion due to lack of clarity over how they would enforce it and training standards. Dr. Yang and Curt Eschels testified before the commission in opposition.

    The East Asian Medicine Advisory Committee (EAMAC) also petitioned the NCQAC to begin agency rulemaking to insure adequate public review and input from stakeholders on ARNPs Practicing Medical Acupuncture. At the November 17th meeting the NCQAC denied the petition to provide rulemaking and approved the ARNP Advisory Opinion. The NCQAC sent a response back to the EAMAC denying their request for rulemaking. The last words in the response were, “they had sufficiently addressed the concerns raised by EAMAC”. WEAMA strongly disagrees.

    WEAMA is concerned that the Advisory Opinion would seem to set a precedent for sharply reduced training for acupuncture by other professions. Furthermore, the opinion fails to specify any required content for acupuncture training. Not containing any substantive standards would seem to make the allowance arbitrary and leave the Commission without a sound basis to regulate nurse acupuncturists. The Opinion recommends a model “similar to the AAAOM model”, which has only vague qualitative attributes, but no quantitative standards.

    WEAMA attended the NCQAC meeting on Friday, January 12th, 2018 with testimony by Curt Eschles and Dr. Yang with 12 Chinese acupuncturists introduced in the audience.

    Open microphone is for public presentation of issues to the NCQAC. This is a very short comment period and any testimony should be 2-3 minutes.

    We ask that you contact the Nursing Commission and submit written testimony or attend in person. Please ask that they submit your concerns into the NCQAC official record for the January 15, 2018 meeting. Send comments to: Deborah Carlson, MSN, RN, Associate Director of Nursing Practice debbie.carlson@doh.wa.gov or nursing@doh.wa.gov.

    East Asian Medicine Advisory Committee at DOH

    The East Asian Medicine Advisory Committee (EAMAC) requested rulemaking on the Advisory Opinion on ARNPs practicing Medical Acupuncture and submitted it to the NCQAC. As stated above, the request was denied by the NCQAC. We need further discussion about this with the EAMAC. Their next meeting is February 9, 2018 at the Department of Health. Creekside Two Center Point, Room 307, 20425 72nd Ave. S., Bldg 2, Ste. 310 Kent, WA.

    Please support WEAMA’s PAC!

    2018 is an election year and WEAMA has a Political Action Committee to make contributions to legislative campaigns for candidates that support East Asian Medicine and Acupuncture. WEAMA sends a lot of time educating state legislators about your issues and we need to help keep them in office. Political campaigns are expensive, and our PAC is an investment in your future legislative success. To donate go to: https://weama.info/WEAMA-PAC

    In a democracy, “the squeaky wheel gets the grease.” There is power in numbers and your voice counts! WEAMA needs your support and involvement to advocate for your profession to either promote or stop regulations and bills that profoundly impact acupuncture and East Asian Medicine.


  • January 15, 2018 8:50 AM | Shelley Dahle (Administrator)

    WEAMA representatives testified Friday, January 12, at the Nursing Care Quality Assurance Commission meeting. The Commission (NCQAC) had adopted an advisory opinion that ARNPs have “medical acupuncture” within their scope of practice and should take a 300-hour class. The Commission also recommended a 1500 hour EAMP course for ARNPs who wish to practice East Asian Medicine. It denied a request from the East Asian Medicine Advisory Committee to conduct rulemaking before adopting the opinion.

    Four speakers addressed the Commission, and about a dozen EAMPs attended. Dr. Ying Wang testified first, about the extensive training EAMPs receive and how its depth and breadth constitute the foundation for diagnosis and treatment. Dr. Yang testified next, emphasizing how acupuncture is part of a system of medicine, how it is more than simply “inserting needles,” and how acupuncturists in China receive many years of training before practicing. Kathleen Beaufait, a speech pathologist visiting from California who added acupuncture to her practice, testified how she realized after her first 300 hours of training that she had nowhere near the knowledge needed to practice acupuncture. Curt Eschels testified about the process the Commission followed, which failed to define “medical acupuncture” and therefore would not allow proper regulation of ARNPs who needle. WEAMA also submitted over thirty letters signed by members of the Chinese medical community.

    In addition the NCCAOM submitted a letter expressing serious concerns about allowing ARNPS to practice any form of acupuncture without the proper training and assessment. NCCAOM also observed that no state or national regulator has developed or adopted competency standards of “medical acupuncture.”

    All the testifiers and letter writers requested that the NCQAC rescind its adoption of the opinion and begin rule-making. At the meeting the Commission took no action on the requests.

    Stay tuned for further developments.


  • January 12, 2018 4:49 PM | Shelley Dahle (Administrator)

    On January 15, WEAMA has been invited to present to the Senate Health Care Committee as part of a panel on Alternatives to Opioids. Jason Taylor, WEAMA Board member will be presenting to the committee and sharing the “Acupunctures Role in Solving the Opioid Epidemic” that was presented to Congress last fall.

    Washington State is in the middle of an Opioid Epidemic. In 2015, 718 Washingtonians died from opioid overdose, more than from car accidents. The majority of drug overdose deaths — more than six out of ten — involve an opioid. Nationwide, 1 in 4 people who receive prescription opioids for chronic pain in primary care settings struggle with addiction.

    WEAMA has been working on Acupuncture as an Alternative to Opioids for a number of years. We sent Governor Inslee the attached letter on September 26, 2017 and within a week had a meeting scheduled with Jason McGill, Governor’s Health Policy Staff and the Medical Directors from the Health Care Authority, Medicaid and the Department of Health to discuss how to integrate acupuncture into the Medicaid insurance program in WA State. A policy analyst was assigned to research the issue. Out of that discussion came a section in two bills (companion bills) that have been introduced by Governor Inslee to address opioid abuse: 

    HB 2489 - 2017-18  Concerning opioid use disorder treatment, prevention, and related services. 

    Sponsors: Cody, Rodne, Harris, Caldier, Macri, Robinson, Jinkins, Muri, Kagi, McBride, Wylie, Peterson, Slatter, Hayes, Sawyer, Pollet, Doglio, Kloba, Tharinger, Ormsby, Johnson, Kilduff 

    SB 6150 - 2017-18   Concerning opioid use disorder treatment, prevention, and related services. 

    Sponsors: Cleveland, Rivers, Carlyle, Kuderer, Fain, Hasegawa, Mullet, Saldaña, Conway, Van De Wege, Chase, Keiser, Liias

    These bills have bi-partisan support. WEAMA is very supportive of Section 14 of the bill that starts a pilot project at the Health Care Authority and will be testifying in support of these two bills next week. It is essentially a pilot project to start using EAMPs and acupuncture treatment with Medicaid in WA State. The standards are very similar to L & I for evidence based medicine.

    NEW SECTION. Sec. 14. A new section is added to chapter 74.09 RCW to read as follows: (1) By October 2018, the health care authority shall develop and recommend for coverage nonpharmacologic treatments for chronic noncancer pain and shall report to the governor and the appropriate committees of the legislature, including any requests for funding6necessary to implement the recommendations under this section. The recommendations must contain the following elements: (a) A list of chronic conditions for which nonpharmacologic treatments will be covered; (b) A list of which nonpharmacologic treatments will be covered for each chronic condition specified as eligible for coverage; (c) Recommendations as to the duration, amount, and type of treatment eligible for coverage by condition; (d) A financial model that is scalable based on the types of conditions covered and the amount of allowed services per condition; (e) Guidance on the type of providers eligible to provide these treatments; and (f) Recommendations regarding the need to add any provider types to the list of currently eligible medicaid provider types. (2) The health care authority shall ensure only treatments that are supported by evidence for the treatment of the specific chronic pain conditions listed will be eligible for coverage recommendations.

    If you live in one of these state legislator’s districts, please send them a note in support of the bill. To find your district and state legislator, go to: http://app.leg.wa.gov/DistrictFinder/, put in your home address and open links to your two House of Representative and one Senators contact information. If you are free that day, feel free to come to Olympia and watch the proceedings or watch on TVW at: https://www.tvw.org/

    Senate Health & Long-Term Care

    1/15/18 10:00 am 

    Senate Hearing Rm 2, J.A. Cherberg Building, Olympia, WA 

    Work Session:

    1. Emergency Department perspective in the opioid crisis. 
    2. Conversation on alternative therapies to pain management. Panelist Jason Taylor, will be presenting for WEAMA. 
    3. Medically-assisted treatment for opioid abuse.

    Public Hearing:

    SB 6150 - Concerning opioid use disorder treatment, prevention, and related services.

    Health Care & Wellness (House) - HHR A, JLOB - 1/19 @ 10:00am

    HB 2489 - Public Hearing - Concerning opioid use disorder treatment, prevention, and related services.

    See attachments below:

    Gov Inslee Lettter Acupuncture Alt Opiods 9-26-17.pdf

    Acupunctures Role in Solving the Opioid Epidemic _Final_September_20_2017-1 (1).pdf

  • January 08, 2018 3:24 PM | Shelley Dahle (Administrator)

    ARNP Medical Acupuncture Advisory Opinion Approved by NCQAC without Agency Rulemaking! WEAMA requests NCQAC Repeal Decision!

    We need your support and participation for an upcoming Nursing Care Quality Assurance Commission (NCQAC) Friday, January 12, 2018 8:30 AM – 2:00 PM at the Department of Health, 310 Israel Road SE, Point Plaza East, Room 152/153, Tumwater, WA 98501. To attend via webinar, please register for the meeting at: https://attendee.gotowebinar.com/register/7768581101889235203

    WEAMA is consulting with our attorney regarding our official position and will provide talking points soon. We wanted to make sure our membership was aware of this meeting in case you would like to attend in person. We will send out the talking points as soon as we get legal counsel on our options to repeal this decision. We also plan to contact the Governor’s Office in the near future with our concerns.

    Background: Fujio McPherson, a former member of the EAMAC and a dual licensed EAMP and ARNP, submitted a proposal to the NCQAC to allow advanced registered nurse practitioners (ARNPs) in Washington state to be able to do “medical acupuncture” similar to what the medical doctors and osteopaths are allowed to do for 300 hours. He intends to teach this class to ARNPs. The NCQAC prepared an Advisory Opinion that supported Fujio’s request and passed it out of the Advanced Registered Nurses Advisory Committee. It then went to the NCQAC for approval.

    NCQAC approved the Advanced Registered Nurse Practitioner (ARNP) Medical Acupuncture Advisory Opinion at their November 17th, 2018 meeting. WEAMA strongly protested the passage of this Advisory Opinion due to lack of clarity over how they would enforce it and training standards. Dr. Yang and Curt Eschels testified before the commission in opposition.

    The East Asian Medicine Advisory Committee (EAMAC) also petitioned the NCQAC to begin agency rulemaking to insure adequate public review and input from stakeholders on ARNPs Practicing Medical Acupuncture. At the November 17th meeting the NCQAC denied the petition to provide rulemaking and approved the ARNP Advisory Opinion. The NCQAC sent a response back to the EAMAC denying their request for rulemaking. The last words in the response were, “they had sufficiently addressed the concerns raised by EAMAC”. WEAMA strongly disagrees.

    WEAMA is concerned that the Advisory Opinion would seem to set a precedent for sharply reduced training for acupuncture by other professions. Furthermore, the opinion fails to specify any required content for acupuncture training. Not containing any substantive standards would seem to make the allowance arbitrary and leave the Commission without a sound basis to regulate nurse acupuncturists. The Opinion recommends a model “similar to the AAAOM model”, which has only vague qualitative attributes, but no quantitative standards.

    NCQAC recently released the agenda for their upcoming meeting this Friday, January 12th, 2018. On the agenda is:

    VII. 10:45 AM – 11:30 AM Sub-committee Report – DISCUSSION/ACTION

    A. Advanced Practice – Laurie Soine, Chair 1. Acupuncture

    a. Petition to write rules

    b. Response

    c. Advisory Opinion

    There is a public comment period from:

    IX. 1:00 PM – 1:15 PM Open Microphone

    Open microphone is for public presentation of issues to the NCQAC. This is a very short comment period and any testimony should be 2-3 minutes.

    We ask that you contact the Nursing Commission and submit written testimony or attend in person. Please ask that they submit your concerns into the NCQAC official record for the January 15, 2018 meeting. Send comments to:

    Deborah Carlson, MSN, RN, Associate Director of Nursing Practice debbie.carlson@doh.wa.gov or nursing@doh.wa.gov.

    Sincerely,

    Curtis Eschels, WEAMA Legislative Chair


  • January 02, 2018 8:31 PM | Shelley Dahle (Administrator)

    Legislative overview by Leslie Emerick, Lobbyist
    In the November election the Democrats took control of the state Senate starting January 8th, 2018 when the Legislative session starts. This means that the Governor, House and Senate will all be under Democratic control in January. The upcoming session is the 60-day short-session of the legislature where they work on the Supplemental Budget. As a reminder, the WA State Legislature is biennial. The 2-year state operating, capital and transportation budgets are determined during the long, 120-day legislative session in odd years such as 2015, 2017…supplemental budgets are created during the short session in even years to fix the larger biennial budgets. This also means that bills live for two years and some bills that we followed last session will be back in 2018.

    Some big issues from two state budgets remain on the table. The state Supreme Court does not think the legislature has accomplished their goal of fulling funding education under the McCleary Decision. They are required to have a funding solution by September 2018. The states Capital Budget funding construction projects statewide for schools, colleges and other state institutions has also been on hold due to the Hirst Decision in the Supreme Court. The Democrats may have a majority, but to sign bonds for the state they need 60 votes, so they will still have to negotiate with the Republicans to pay for the bonds.

    The Governor has suggested a Carbon Tax in his initial budget as a way of funding education. No one wants a Special Session in 2018 because it’s an election year and the entire House of Representatives are up for reelection and half of the Senate. This is a good year to invest in your WEAMA Political Action Committee (PAC) to keep legislators who support your profession in office by financially supporting their campaigns!

    I met with key legislators on the House and Senate Health Care Committees during the 2017 Fall Legislative Days over November 13-17th this year to discuss issues related to East Asian Medicine. I met with some in their home districts prior to that time such as the new chair of the Senate Health Care Committee, Senator Annette Cleveland from Vancouver and Rep Eileen Cody, the chair of the House Health Care committee in West Seattle.

    WEAMA Legislative Team

    During the 2018 legislative session, Curt Eschels, Jason Taylor and I will meet weekly to review upcoming legislation that might impact EAMPs and make a determination whether we need to sign in or testify on a bill. I will begin preparing weekly reports for the WEAMA Board of Directors to review during the legislative session. Typically, over 2,000 bills are introduced each session and WEAMA tracks about 30-40 bills with potential impacts to EAMPs, insurance or general health care related issues.

    WEAMA Legislative Priorities

    East Asian Medicine Scope of Practice and Training Requirements

    WEAMA has been considering a bill for 2018 that clarifies East Asian Medicine Scope of Practice and Training Requirements. The WEAMA Board decided at the last meeting that the bill needs additional legal review and stakeholder work. They decided to hold off on running legislation in 2018 that would clarify some definitions and get legislative authority for potential future CE’s. We are also reviewing closing some loopholes regarding other professions practicing acupuncture in our statute, RCW 18.06, and will receive legal advice to rework portions of the bill.

    Opposing Dry Needling

    One of the elements of our clarification bill is that trigger points are included in the definition of acupuncture. This has turned out to be very controversial for the physical therapists (PTs). The PTs were considering running their dry needling bill again in 2018. PTs will not run their dry needling bill if EAMPs does not run our bill with trigger points in 2018. Although this was a consideration, it was not the only reason the board decided to postpone running the bill in 2018.

    What I found in my meetings with legislators is that they are not very interested in a scope of practice fight between the PTs and the EAMPs over dry needling and trigger points and were reluctant to sign onto our legislation if that is not worked out ahead of time. As I understand it, the PT’s got the same feedback from legislators regarding dry needling and they would not be successful unless they work it out with EAMPs.

    WEAMA has been debating the pros and cons of an invitation by PTWA for a facilitated discussion. This would not be the first time WEAMA has met with the Physical Therapy of Washington (PTWA) association to discuss dry needling related issues, so this is nothing new. The board has decided to participate in one facilitated discussion with PTWA in May 2018 to see if we can find any common ground. Participating in this conversation does not commit WEAMA to any position or agreement on the issue of dry needling.

    Support Acupuncture as an Alternative to Opioids

    WEAMA submitted a letter to Governor Inslee on acupuncture as an alternative to opioids and included recent evidence based data on the report. Within a week of submitting the letter, WEAMA was invited to attend a meeting with the medical directors of the Health Care Authority, Medicaid and the Dept. of Health. They were very interested in our request for a pilot project for Medicaid to include acupuncturists, chiropractors, PTs and massage therapists. Although the Governor did not include funding for adding acupuncture and other therapies such as chiropractic, massage and PT to Medicaid, there is a lot of interest among legislators to promote these therapies as alternatives to opioids in the state’s largest insurance program.

    In the private insurance market, acupuncture treatments for chemical dependency are not limited under the Essential Health Benefits WAC 284-43-5642(5)(a) (vi) Acupuncture treatment visits without application of the visit limitation requirements, when provided for chemical dependency.

    Support Prior Authorization Revisions

    WEAMA has been working with the chiropractors and PTs on a prior authorization bill for about 3 years now. A new bill will be proposed this session. The draft bill states “A health carrier may not require prior authorization for an initial evaluation and management visit or an initial, and up to 12 consecutive treatment visits with a contracting provider in a new episode of care of chiropractic, physical therapy, occupational therapy, East Asian medicine, massage therapy, or speech and hearing therapies within the benefit limits of the health plan.” We will be following this bill closely this session.

    State Agency Regulatory Update

    Acupuncture and ARNPs Medical Acupuncture Advisory Opinion with NCQAC

    Fujio McPherson, a former member of the EAMAC and a dual licensed EAMP and ARNP, submitted a proposal to the Nursing Care Quality Assurance Commission (NCQAC) to allow advanced registered nurse practitioners (ARNPs) in Washington state to be able to do “medical acupuncture” similar to what the medical doctors and osteopaths are allowed to do for 300 hours.

    He was successful in his request and the NCQAC approved the ARNP Medical Acupuncture Advisory Opinion at their November 17th, 2018 meeting. Dr. Yang and Curt Eschels, WEAMA Board members, testified in opposition at the public portion of the meeting. They each had 3 minutes to speak. NCQAC determined that acupuncture is within their current scope of practice. The Commission said an ARNP should obtain training through a national or international accredited program.

    The NCQAC recommended the following amounts of training:

    • For those practicing acupuncture and East Asian medicine: 1500 hours
    • For those adding medical acupuncture techniques: not less than 300 hours
    • For those practicing a medical acupuncture protocol (e.g., NADA or battlefield acupuncture: variable)

    The NCQAC also denied a request by the East Asian Medicine Advisory Committee (EAMAC) to carry out rulemaking regarding ARNPs performing medical acupuncture. The NCQAC has 60 days from November 17, 2018 to respond to the EAMAC’s request for rulemaking. WEAMA will monitor how the EAMAC responds to the NCQAC denial for rulemaking.

    WEAMA is concerned that the Advisory Opinion would seem to set a precedent for sharply reduced training for acupuncture by other professions. Furthermore, the opinion fails to specify any required content for acupuncture training. Not containing any substantive standards would seem to make the allowance arbitrary and leave the Commission without a sound basis to regulate nurse acupuncturists. The Opinion recommends a model “similar to the AAAOM model”, which has only vague qualitative attributes, but no quantitative standards.

    The Commission implies that it can allow nurse practitioners to practice a substantively and legally different system of medicine without adopting specific standards for training and competence and standard of care.

    The Advisory Opinion would allow undefined “medical acupuncture” but does not differentiate it from acupuncture regulated under Chapter 18.06 RCW. Therefore, the Commission would have no clear legal basis to decide if an action by a nurse practitioner constitutes “medical acupuncture” within the scope of practice, or if it constitutes acupuncture defined in Chapter 18.06 RCW,

    There was no nationally accredited program for “medical acupuncture” training available to nurses when the Advisory Opinion was adopted. Not long after adoption, Helms started offering a 200-hour “medical acupuncture” training to ARNP and physician assistants of mostly online classes. It is unclear whether the new offering is accredited by any accrediting body.

    WEAMA testified at the meeting about our concerns for consistent standards for the practice of acupuncture in WA State. The NCQAC claim they have the statutory authority to determine what is in their scope of practice. They decided that they will not do rulemaking in relation to the advisory opinion and WEAMA and the public will not have additional opportunity to comment. WEAMA will evaluate the legality of this decision and the board will be reviewing options to address their concerns regarding the adopted ARNP Advisory Opinion on Medical Acupuncture.

    East Asian Medicine Advisory Committee at DOH

    The East Asian Medicine Advisory Committee (EAMAC) requested rulemaking on the Advisory Opinion on ARNPs practicing Medical Acupuncture and submitted it to the NCQAC. As stated above, the request was denied by the NCQAC. We need further discussion about this with the EAMAC. Their next meeting is February 9, 2018 at the Department of Health. Creekside Two Center Point, Room 307, 20425 72nd Ave. S., Bldg 2, Ste. 310 Kent, WA.

    DOH Rule making: Chapter 246-803 WAC East Asian Medicine Practitioner.

    DOH is considering revising the East Asian medicine practitioner rules consistent with statutorily authorized five-year rule review. They have not set a date yet for the initial stakeholder meetings.

    This rule review is being done consistent with the five-year rule review under RCW 43.70.041. As part of the review, the department will be looking at areas to consolidate and clarify requirements to better reflect best practices and complete general housekeeping. In the process, the department is also considering adding new rules for record keeping, infection control and expired licenses. Rulemaking maybe necessary to update, clarify, and modernize rule language to assure alignment with current practice and increase patient safety. Establishing clear record keeping and infection control rules will provide guidance to practitioners, potentially reducing the number and cost of disciplinary actions related to East Asian medicine practitioners.

    The rules hearings will be held with the East Asian Medicine Advisory Committee meetings in the future. If you are aware of any changes that need to be made in the existing WAC 246-803 East Asian medicine practitioner, please let us know.

    Labor & Industries (L & I) Update

    WEAMA was successful in 2017 gaining approval from the Washington State Department of Labor & Industries (L&I) to begin the Acupuncture Pilot Project in October 2017. L&I will use the pilot rulemaking process to allow and pay for acupuncture services during this pilot (RCW 34.05.313 Feasibility studies – Pilot projects). The exceptions to allow payment for acupuncture are effective throughout a two-year pilot period or as otherwise specified and will apply only to pilot participants. The CR-102 will be filed when there is sufficient data to assess and evaluate the provision of acupuncture treatment within the workers’ compensation setting. At that time, pilot program results will be considered in developing proposed rule language, medical coverage decisions and/or payment policy.

    http://lni.wa.gov/ClaimsIns/Providers/TreatingPatients/ByCondition/Acupuncture/default.asp

    http://lni.wa.gov/Main/Listservs/LNI-Acupuncture.asp

    Please support your profession by supporting WEAMA!

    In a democracy, “the squeaky wheel gets the grease.” There is power in numbers and your voice counts! WEAMA needs your support and involvement to advocate for your profession to either promote or stop regulations and bills that profoundly impact acupuncture and East Asian Medicine. We will be sending legislative alerts to our members and interested EAMPs in the state as the 2018 legislative session progresses. Please help WEAMA support and impact legislation and issues at state agencies impacting your profession.





  • November 15, 2017 8:12 AM | Shelley Dahle (Administrator)

    Legislative Overview by Leslie Emerick, Lobbyist  
    The election was held on November 7th and it is now determined that the Senate will be controlled by the Democrats in 2018 because of the Senate race in the 45th district, formerly held by Senator Andy Hill (R), who passed away from cancer last year leaving an open seat this fall. As of Tuesday night, Democrat Manka Dhingra held a double-digit lead over her 45th District Senate opponent. This means that both houses of the legislature and the Governor’s Office will be controlled by the Democrats. Read More...

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PT dry needling Sunrise Review Draft Report

WA DOH:  "The department does not support the applicant’s proposal to add dry needling to the physical therapy scope of practice. The proposal as submitted does not meet the sunrise criteria for increasing a profession’s scope of practice."  Download DOH Draft Report

WA State Attorney General's Opinion

The WA State Attorney General has issued his opinion stating that dry needling is not within the PT's scope of practice. Read the full opinion

Point Injection Clarification
SHB 2448 Bill Signed

Governor Jay Inslee signed our bill, SHB 2448, which helped clarify over 30 years of ambiguity. Read the Senate Bill Report

Meridians Journal Issues Available

Members can access the latest issue of Meridians Journal.  Login to your account above first.Member Benefits section

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