Health Professions


(Process updated in 2020)

Beginning the review process

The Department of Health doesn't initiate a sunrise review unless requested by the legislature. To initiate a review:

  • A group or organization interested in creating or changing a health profession credential (applicant group) works with the legislature to draft legislation.
  • The chair of the House Health Care and Wellness Committee or the Senate Health Care Committee formally requests a review and provides draft legislation.
  • The applicant group submits a complete applicant report explaining how the proposed legislation meets the criteria in RCW 18.120.010(2) including the factors listed in RCW 18.120.030. The actual review process doesn't begin until the applicant group submits this report.
  • The applicant report must be received by the department by June 1 to complete our review and report to the legislature before the next legislative session.
The applicant report

The department recommends the applicant group incorporate evidence from studies or other sources, with citations, to ensure accurate analysis of the proposal. An attached annotated bibliography with citations or links to source material and that highlights your evidence may be an effective tool to focus attention to that evidence. However, it's not a requirement of the applicant report.

New Health Profession

The department is legally required to evaluate the applicant report according to the criteria in RCW 18.120.010 when making recommendations. This law says a health profession should be regulated only when:

  • Unregulated practice can clearly harm or endanger the public health, safety or welfare. The potential for the harm must be easily recognizable and not remote or dependent on a tenuous argument;
  • The public needs to, and can reasonably be expected to, benefit from an assurance of initial and continuing professional ability; and
  • The public cannot be effectively protected by other means in a more cost-beneficial manner.

The applicant group must also explain the factors in RCW 18.120.030. Please use this Applicant Report Outline/Instructions Form (PDF).

Increased Scope of Practice

Chapter 18.120 RCW also applies to proposals to increase an existing profession's scope of practice. However, the statute doesn't contain specific criteria for these types of reviews. The department requests applicant groups focus their proposals on the criteria in RCW 18.120.010 by demonstrating that proposals:

  • Protect the public from harm;
  • Provide assurance of professional ability to perform the increased scope of practice (such as education and training); and
  • Provide the most cost-beneficial option to protect the public.

The applicant group must also explain the factors in RCW 18.120.030 that are relevant to increases in scopes of practice.

Please use this Applicant Report Outline/Instructions Form (PDF).

After receipt of the applicant report

The department:

  • Asks questions of the applicant group as needed throughout the review and posts the responses on the web page.
  • Sends notice to interested parties inviting them to submit written comments on the proposal
  • Drafts an initial report and posts it to our webpage, inviting the applicant group and interested parties to provide comments on the draft.
    • The department considers the comments on the draft report and incorporates any appropriate changes into the report.
    • The comments are summarized in the sunrise report.
Department report

The final report must be reviewed within the department, and then sent to the Office of Financial Management (OFM) for review. OFM provides fiscal and policy support to the governor, legislature, and state agencies, and must approve all legislative reports. The conclusion of the department's process is the final report to the legislature, which is advisory only. The legislature may take the report under advisement, introduce legislation, or do nothing.

Once the final report has been submitted to the legislature, the department posts it to our webpage and shares it with interested parties.

Please note: Written materials developed in the course of a sunrise review, including public comments, are subject to public inspection and copying under Chapter 42.56 RCW – Public Records Act.