Rule-Making Activity

The Washington State Department of Health (DOH) or designee should use the criteria in this policy to identify a water system that meets the criteria for a Same Farm Exemption (SFE), and their eligibility for the SFE. These include water systems that have four or fewer connections, all of which serve residences on the same farm. Filed April 24, 2025, as WSR 25-10-006.

Interpretive Statement – Health Equity Continuing Education for Dental Hygienists, HSQA OHP DH2301

Health equity continuing education (CE) requirements for Dental Hygienists under chapter 246-815 WAC. Training requirements in WAC 246-12-800 through WAC 246-12-
830 will apply to a Dental Hygiene licensee starting January 1, 2024. Filed December 22, 2023.

Interpretive Statement – Health Equity Continuing Education for Licenses Behavior Analysts and Licensed Behavior Analysts, ABA 23-01

Health equity continuing education (CE) requirements for LBA’s and LABA’s under chapter 246-805 WAC. Training requirements in WAC 246-12-800 through WAC 246-12-830 will apply to a LBA and LABA licensee starting January 1, 2024. Filed December 22, 2023.

The Washington State Department of Health (DOH) is proposing a new chapter of rules to implement Engrossed Second Substitute House Bill (E2SHB) 1477 (chapter 302, Laws of 2021). The rules establish standards for designation of crisis call centers as crisis hubs within the 988 national suicide prevention and mental health crisis hotline system.

The Pharmacy Quality Assurance Commission (commission) is proposing to amend WAC 246-945-090, WAC 246-945-091, WAC 246-945-092, and WAC 246-945-093 to include manufacturers and wholesalers of dialysis devices and approved legend drugs, including dialysate, in home dialysis program rules under the commission’s jurisdiction. This supplemental proposal further amends WAC 246-945-090 to add the word "may" and list the dialysis devices manufacturers and wholesalers may sell, deliver, possess, or dispense to home dialysis patients, and to amend WACs 246-945-091, 246-945-092, and 246-945-093 to conform to the list of dialysis devices. 

The Pharmacy Quality Assurance Commission adopted amendments to WAC 246-945-090, 246-945-091, 246-945-092, and 246-945-093 to include manufacturers and wholesalers of dialysis devices and approved legend drugs, including dialysate, in home dialysis program rules under the commission’s jurisdiction.

The Washington State Department of Health (DOH) amended chapter 246-822 WAC to clarify, streamline, and modernize rules for dietitians and nutritionists. The adopted amendments include updated rules that align with national professional standards for dietitians, clear standards for education, experience, and supervision requirements, rules that reflect current department processes, the removal of redundant mandatory reporting language, and updates and cross references for clarification.

The Department of Health is proposing to clarify, streamline, update, and modernize rules for licensing dietitians and nutritionists in chapter 246-822 WAC. This is a supplemental proposal and includes an additional definition in WAC 246-822-010, clarification of application and education requirements for both dietitians and nutritionists, updates requirements for dietitian qualified supervisors, and removes unnecessary terms in rules regarding providing services.

The Washington State Department of Health (DOH) is considering creating a new section in chapter 246-822 WAC and making amendments to dietitians and nutritionists application requirements in WAC 246-822-120, 246-822-132, and other related sections.

To ensure safe drinking water, water must be tested for contaminants. The State Board of Health (SBOH) establishes state action levels (SAL) and maximum contaminant levels (MCL) to ensure contaminate levels are below a certain threshold. SBOH sets criteria for the adoption of SALs and MCLs in WAC 246-290-315 and includes criteria that would apply upon federal adoption of MCLs. WAC 246-290-315(8) states that upon federal adoption of a MCL, the MCL will supersede a less stringent SAL and associated requirements, including monitoring and public notice.

SBOH adopted an emergency rule to amend WAC 246-290-315 such that the criteria would apply on the effective date of an MCL as set in the federal standard, not the adoption date, in order to maintain vital public health protections for drinking water safety. This third emergency rule continues the emergency rule originally filed on June 24, 2024, as WSR 24-14-016, without change and extended on October 22, 2024 as WSR 24-21-138, without change.

The Washington State Department of Health (DOH) is proposing rule amendments to incorporate the federal requirements of the Bipartisan Infrastructure Law (BIL) – Public Law 117-58 – Bipartisan Infrastructure Investment and Jobs Act in chapter 246-296 WAC. The proposed rules redefine the definition of a disadvantaged community and change the state revolving fund priority point system for project rating and ranking proportionate with need.

The Washington State Department of Health (DOH) adopted rule amendments to incorporate the federal requirements of the Bipartisan Infrastructure Law (BIL) – Public Law 117-58 – Bipartisan Infrastructure Investment and Jobs Act. The adopted rules redefine the definition of a disadvantaged community and change the state revolving fund priority point system for project rating and ranking proportionate with need.

The department adopted emergency rules on August 30, 2023 (WSR# 23-18-044) and a second emergency rule December 29, 2023 (WSR# 24-02-060) to amend chapter 246-296 WAC to redefine the term disadvantaged community, update loan terms, update application requirements, and clarify loan rating and ranking criteria to conform with requirements in the BIL. This emergency rule is being adopted to extend the existing emergency rule without making changes to the previous emergency rules.

The Pharmacy Quality Assurance Commission is proposing to amend WAC 246-945-455 to allow unlicensed employees or contractors of a health care facility to access certain drugs that are stored outside of the pharmacy in a designated area when they are acting within their scope of employment.

This policy clarifies the Pharmacy Quality Assurance Commission's approach to enforcing timely transfers for initial dispensing of an electronic prescription for a controlled substance, if the failure to comply results from the licensee's use of National Council for Prescription Drug programs (NCPDP) SCRIPT standard version 2023011, as it relates to WAC 246-945-346.

Effective Date: December 26, 2024. Filed November 26, 2024.

The Washington State Department of Health issued a policy statement regarding health requirements for hospitals providing emergency services to provide immediate access to abortion services or secure transfer to another hospital. Effective Date: June 17, 2024.

The Washington State Department of Health (DOH) is considering amendments to WAC 246-320-010 and 246-320-281 to comply with recently passed legislation and Governor Directive 25-01 to ensure access to treatment, including abortion care, for emergency medical conditions in hospital emergency departments.

The Washington State Department of Health (DOH) updated and revised existing rules and added new sections to ensure regulations and standards are clear, concise, and reflect current standards of care and best practice for the benefit and safety of the public. This update will satisfy the requirements of RCW 43.70.041, enacted, and codified in 2013, which directs DOH to establish a formal review process of existing rules every five years.

The Department of Health is proposing amendments to update and align requirements with current national standards, make rules more clear, concise, and organized, propose changes to address barriers to initial and renewal application processes, and respond to new legislative requirements. WAC 246-976-010 through 246-976-182, 246-976-260 through 246-976-310, 246-976-330 through 246-976-395, 246-976-920, 246-976-960, 246-976-970 and proposing new WAC 246-976-026, 246-976-139, and 246-976-261.

The Department of Health is proposing amendments to existing sections and the addition of two new sections to chapter 246-976 WAC relating to EMS Data Systems reporting to the Washington EMS Information System (WEMSIS) system to meet the requirements of Section 19 of Substitute Senate Bill 5380 (chapter 314, Laws of 2019).

The Washington State Department of Health (DOH) adopted amendments to WAC 246-976-001, 246-976-430, and 246-976-910 and two new sections, WAC 246-976-445 and 246-976-455, to comply with Substitute Senate Bill 5380 (chapter 314, Laws of 2019). The adopted rules establish requirements for submitting patient data using the Washington EMS Information System (WEMSIS) and make housekeeping changes to implement these amendments.

Postponing enforcement of data reporting requirements using the Washington Emergency Medical Services Information System (WEMSIS) for licensed ambulance and aid services (RCW 70.168.090, WAC 246-976-455).

Effective Date: September 30, 2024. Filed September 9, 2024, as WSR 24-19-030.

The Washington State Department of Health (DOH) adopted emergency rules amending WAC 246-320-281 to maintain access to emergency care, including abortion services, while permanent rulemaking is in progress. These emergency rules align with newly enacted Senate Bill 5557 (chapter 182, Laws of 2025) and preserve protections for emergency medical care.

The Washington State Department of Health (DOH), and the Orthotics and Prosthetics Advisory Committee, is proposing to amend 246-850 WAC to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023). DOH is proposing to amend the jurisprudence examination as a requirement for licensure and incorporating knowledge of professional jurisprudence into continuing competency requirements for orthotists and prosthetists.

The Dental Quality Assurance Commission (commission) is considering amending WAC 246-817-195 to allow the amalgam clinical patient requirement to be optional. The commission may consider amendments to other relevant licensure requirement rule sections in chapter 246-817 WAC.

The Pharmacy Quality Assurance Commission adopted amendments to WAC 246-945-455 to allow access to drugs stored outside of the pharmacy by unlicensed staff in health care facilities for the purposes of supply chain management.

This policy clarifies the Pharmacy Quality Assurance Commission’s renewal extension process for pharmacy interns who have reached the renewal limitation set in WAC 246-945-155(3). Policy number: P012. Effective Date: February 1, 2024.

The Washington State Department of Health (DOH) is proposing amendments to chapter 246-780 WAC to include requirements for the use of electronic benefit payments.

The Washington State Department of Health (DOH) has adopted amendments in chapter 246-780 WAC which transitions the Farmers Market Nutrition Program (FMNP) to use electronic benefit payments (e-FMNP). Women, Infants, and Children (WIC) program participants can also use their Cash Value Benefits (CVB) for fresh fruits and vegetables at authorized farmers markets and farm stores, in addition to the seasonal FMNP benefits.

The Pharmacy Quality Assurance Commission is proposing to add a new subsection to WAC 246-945-055 to delete fenfluramine from Schedule IV in accordance with RCW 69.50.201. The commission is also proposing to create a new section, WAC 246-945-05001, to establish a list of exempted substances from RCW 69.50.204, 69.50.206, 69.50.208, 69.50.210, and 69.50.212, including fenfluramine.

The Department of Health is considering amendments to genetic counselor licensure requirements in WAC 246-825-080 Licensure by endorsement, to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023) to make disciplining authorities review and adjust licensure requirements to remove barriers to entering and remaining in the health care workforce, and to streamline and shorten the credentialing process.

The Washington State Department of Health (DOH) amended WAC 246-825-080 to remove licensure barriers, updating rules to waive education, training, experience, and examination requirements for applicants that qualify for licensure by endorsement.

The Washington State Department of Health (DOH) is proposing amendments to WAC 246-825-080 to remove barriers to entering and remaining in the health care workforce. The updates will streamline and shorten the credentialing process for genetic counselors. DOH is proposing to waive existing education and exam requirements

The Washington State Board of Nursing adopted amendments WAC 246-840-930 and WAC 246-840-940 and adopted new rules, WAC 246-840-835 and WAC 246-840-935, to change the amount of time required for RN supervision and evaluation of the delegated task of insulin injections as well as established new sections of rule regarding nurse delegation of blood glucose monitoring and testing, in response to Substitute House Bill (SHB) 1124 (chapter 14, Laws of 2022).

The Washington State Department of Health (DOH) is considering rulemaking in response to new legislative requirements under Substitute Senate Bill 5986 (chapter 218, Laws of 2024) regarding out-of-network health care charges (balance billing) for ground ambulance services. WAC 246-976-260 and 246-976-270 may be amended as necessary.

The State Board of Health adopted changes to WAC 245-500-050, WAC 246-500-053, and WAC 246-500-055 to align with changes in statute. These rules establish the requirements for remains reduced through cremation, alkaline hydrolysis, and natural organic reduction. The amendment also added counties to the list of entities that may lawfully dispose of human remains after the holding period.

The Washington State Department of Health (DOH) is implementing legislation reducing licensure barriers for hearing and speech professions and clarifying requirements for speech-language pathology assistant certification in chapter 246-828 WAC.

The Board of Hearing and Speech adopted amendments to implement section 8 of Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023), codified as RCW 18.130.077 to reduce barriers to entering and remaining in the hearing and speech workforce and to shorten the credentialing process. This rule adopts revisions to WAC 246-828-020, 246-828-510, and creates a new section, WAC 246-828-035.

The Board of Hearing and Speech is considering amendments to WAC 246-828-020, WAC 246-828-510, and WAC 246-828-617 to update requirements for speech-language pathology assistant certification. The board may also consider making related updates or new sections to clarify and streamline licensure in chapter 246-828 WAC.

The Department of Health continues rules to establish alternate certification time frames for individuals working toward certification as a home care aide or nursing assistant. This emergency rule continues the previous emergency rule (WSR 24-02-051) without change. Due to lasting impacts caused by the coronavirus disease 2019 (COVID-19) pandemic, many long-term care workers are still unable to obtain training and certification as home care aides or NA-Cs within statutory time frames.

The Washington State Department of Health (DOH) has adopted a sixth emergency rule to continue without change rules established alternate certification time frames for two different groups of long-term care workers: individuals working toward certification as a home care aide and individuals working toward certification as an NA-C. This includes amending WAC 246-980-025, 246-980-030, 246-980-040, 246-980-065 and adopting a new rule section, WAC 246-980-011. Rules impacting home care aides were developed in collaboration with the Department of Social and Health Services (DSHS), while rules impacting NA-Cs were developed in collaboration with DSHS and the Washington State Board of Nursing (WABON).

The Washington State Department of Health (DOH) adopted without change emergency rules which establish alternate certification time frames for individuals working toward certification as a home care aide or nursing assistant-certified (NA-C), due to impacts of the COVID-19 pandemic. This includes adopting new rule WAC 246-980-011 and amending WAC 246-980-025, 246-980-030, 246-980-040, and 246-980-065 to allow additional time for long-term care workers to complete training, testing, and credentialing.

The Washington State Department of Health (DOH) established alternate certification time frames for individuals working toward certification as a home care aide or nursing assistant-certified. This includes amending WAC 246-980-025, 246-980-030, 246-980-040, 246-980-065 and adopting a new rule, WAC 246-980-011. The rules allow workers impacted by the coronavirus disease 2019 pandemic more time to complete requirements while training, testing, and credentialing capacity issues are being resolved. This is the seventh and anticipated final emergency rule.

The Washington State Department of Health (DOH) adopted rules to implement legislation to increase the home care aide workforce in Chapter 246-980 WAC to align with statutory changes and implement Engrossed Second Substitute House Bill (E2SHB) 1694(chapter 424, Laws of 2023) and Engrossed Second Substitute Senate Bill (E2SSB) 5278 (chapter 323, Laws of 2023). These rules address the date of hire, the home care aide workforce, certification examinations, certification process, and other aspects of the profession. 

The Department of Health is considering amending chapter 246-980 WAC to implement Engrossed Second Substitute House Bill 1694, (chapter 424, Laws of 2023) and Engrossed Second Substitute Senate Bill 5278, (chapter 323, Laws of 2023). These laws reduce barriers to hire home care aides.

The Washington State Department of Health (DOH) proposes to implement Senate Bill 5811 (chapter 322, Laws of 2024), which expands criteria for exemptions from the requirement to obtain home care aide certification.

The Pharmacy Quality Assurance Commission is proposing to amend WAC 246-945-090, 246-945-091, 246-945-092, and 246-945-093 to include manufacturers and wholesalers of dialysis devices and approved legend drugs, including dialysate, in home dialysis program rules under the commission’s jurisdiction. The amendments are proposed in response to statutory changes made by Substitute House Bill (SHB) 1675 (chapter 23, Laws of 2022). 

The Washington State Department of Health (DOH) is considering establishing standards for hospital at-home services to implement Substitute House Bill (SHB) 2295 (chapter 259, Laws of 2024). DOH is considering amending chapter 246-320 WAC to add hospital at-home services as a type of service that can be offered by hospitals, establish standards, and consider creating a fee to cover costs.

The Washington State Department of Health (DOH) adopted permanent rules establishing standards and fees in WAC 246-320-278 and 246-320-199 for hospital at-home programs. These adopted rules implement recent legislation codified as RCW 70.41.550.

The Washington State Department of Health (DOH) is proposing rules to establish operating standards and fees for hospital at-home services. Proposing amendments to WAC 246-320-199 and creating a new rule, WAC 246-320-278, to add hospital at-home services as a type of service offered by hospitals. The rules establish operating standards and create a fee to cover the costs of reviewing applications for the hospital at-home program.