Rule-Making Activity

The Dental Quality Assurance Commission is proposing amendments to WAC 246-817-187, Temporary practice permit - Military spouse eligibility and issuance, to update language changes made by Second Substitute House Bill (2SHB) 1009 (chapter 165, Laws of 2023).

The Washington State Department of Health (DOH) adopted amendments to WAC 246-12-051 to align with recent legislation to expedite the issuance of professional licenses for military spouses who hold a license in another state by removing the need to first leave employment. 

The Department of Health is proposing amendments to WAC 246-12-051 to update language changes made by Second Substitute House Bill (2SHB) 1009 (chapter 165, Laws of 2023). The proposed changes will align the rules with statutory changes regarding licensure of military spouses who hold a license in another state.

Outlines the Washington State Department of Health’s (DOH) process to enforce RCW 70.54.500, Motor carriers – Access to restroom facilities. RCW 70.54.500 requires a shipper or consignee to provide access to a restroom to a motor carrier delivering goods to or picking goods up during normal business hours.

Effective Date: July 1, 2024. Filed November 6, 2024.

The Department of Health in consultation with the Washington State Board of Nursing (board), adopted amendments to WAC 246-840-990 to establish the multistate nursing license fee and increase the nursing center surcharge fee as directed by Substitute Senate Bill (SSB) 5499 (chapter 123, Laws of 2023).

The Washington State Department of Health (DOH) adopted rules necessary to create a licensure program for music therapists. Individuals working as a music therapist are required to be licensed by January 1, 2025. The adopted rules establish the new profession’s licensure requirements which include education, training, and examination requirements for initial licensure; continuing education requirements; fees for licensing, examination, and renewal; and other qualifications as determined by the secretary.

This emergency rule filing allows for the 3mg and 4mg dosage versions of naloxone spray to be prescribed as Over-The-Counter (OTC) products. This rule is unchanged from the previous emergency rule under WSR 24-01-021 filed on December 8, 2023. This emergency rule will be continued until the permanent rulemaking is effective.

To combat the ongoing opioid epidemic, The Pharmacy Quality Assurance Commission has adopted an emergency rule amending WAC 246-945-030 and adding a new section, WAC 246-945-034. These rules classify the 3mg and 4mg naloxone hydrochloride nasal spray as approved by the FDA for OTC distribution in Washington state. This filing reflects an FDA update which broadened the classification of allowed Naloxone products as OTC status. Filed as WSR 24-01-021 (PDF).

In March 2023, the United States Food and Drug Administration (FDA) approved the first 4 mg naloxone hydrochloride nasal spray as an over-the-counter (OTC) drug and has approved other naloxone nasal sprays since that time. Naloxone is an opioid antagonist used for the emergency treatment of known or suspected opioid overdose. Currently, WAC 246-945-030 incorporates the 39th edition of the Approved Drug Products with Therapeutic Equivalence Evaluations, or "Orange Book," which has naloxone listed as a prescription drug. The Pharmacy Quality Assurance Commission (commission) considers the ongoing opioid epidemic to be a public health emergency in Washington state. In order to combat this epidemic in Washington, the commission is amending WAC 246-945-030 and adding a new section, WAC 246-945-034, classifying the 3mg and 4mg naloxone hydrochloride nasal spray as approved by the FDA for OTC distribution as an OTC drug in Washington state.

The timeline for the availability of naloxone nasal spray is set by the manufacturers, although some are already available.

This emergency rule prepares Washington state for the moment that the drug becomes available by manufacturers. The proposed new section of chapter 246-945 WAC would also allow for expansion of different formularies if the FDA makes further changes. This preparation would allow for a faster release of the drug throughout the state, meaning this life saving drug would be in the hands of Washingtonians faster. Increasing patient access to the drug is critical to reduce opioid overdoses.

This emergency rule filing allows for the 3mg and 4mg dosage versions of naloxone spray to be prescribed as over-the-counter products. The previous emergency rule filing on this topic, filed as WSR 23-17-059 on August 11, 2023, only allowed the 4 mg nasal spray under the brand name Narcan to be prescribed as an OTC product, but the FDA broadened the classification of allowed naloxone products since that previous filing.

The Board of Naturopathy is considering amendments to licensure requirements relating to the jurisprudence examination as a condition for licensure and to clarify, update, and simplify rules to comply with Second Substitute House bill (2SHB) 1724, (chapter 425, Laws of 2023) codified as RCW 18.130.077.

The Board of Naturopathy has adopted amendments to WAC 246-836-020, Requirements for licensure, and WAC 246-836-040, Jurisprudence examinations to clarify, update, and simplify rules to align with RCW 18.130.077. To account for changes to the credentialing system the board is delaying the effective date to September 1, 2025.

The Washington State Department of Health (DOH) in consultation with the Board of Naturopathy, is considering removing the jurisprudence examination fee from WAC 246-836-990 to align with the recent changes to the naturopathic licensure requirements.

The Board of Naturopathy adopted amendments to WAC 246-836-080, to clarify continuing education (CE) requirements pertaining to pharmacology CE and to implement health equity CE requirements mandated by Engrossed Substitute Senate Bill (ESSB) 5229 (chapter 276, Laws of 2021), codified as RCW 43.70.613. The adopted amendments clarify acceptable forms of documentation to verify the pharmacology CE requirements and implement the Department of Health’s model health equity CE requirements.

The Board of Naturopathy is proposing amendments to licensure requirements in WAC 246-836-020 and WAC 246-836-040 relating to jurisprudence examinations as a condition for licensure for naturopathic physicians and to clarify, update, and simplify rules to comply with RCW 18.130.077.

The Washington Medical Commission is considering amending WAC 246-919-601 to exempt the use of nitrous oxide in office-based surgical settings under certain circumstances. Additionally, the commission is considering adding a new subsection to further address the use of nitrous oxide in such settings.

The State Board of Health (SBOH) is considering amending the reporting requirements for COVID-19 in chapter 246-101 WAC, in response to feedback from local health jurisdictions and changes in the national notifiable condition designation by the Council for State and Territorial Epidemiologists. SBOH will not consider other changes to these rules at this time.

The Washington State Board of Nursing (board) is considering amendments to education and experience requirements in WAC 246-840-517 and other related sections in chapter 246-840 WAC for nurse administrators of baccalaureate nursing education programs in response to E2SSB 5582 (Chapter 126, Laws of 2023) codified as RCW 18.79.150.

The Board of Nursing is considering amendments to nursing assistant rules to implement skills testing in training programs, make changes to the specialty curricula rule requirements, and other related rules as appropriate.

The Washington State Board of Nursing withdrew the CR-101 for nursing assistant skills testing, chapter 246-841A WAC, which was filed on September 27, 2024, and published as WSR 24-20-087. The board withdrew this CR-101 because its scope is limited to integrating skills testing to nursing assistant training programs. However, additional critical topics must be addressed, including changes to the specialty curricula rule requirements in WAC 246-841A-440(1)(c). 

The Washington State Board of Nursing is proposing a new section of rule, WAC 246-840-5341, and amendments to WAC 246-840-534 to implement Engrossed Second Substitute Senate Bill (E2SSB) 5582 (chapter 126, Laws of 2023).

The Washington State Board of Nursing adopted a new section of rule, WAC 246-840-5341 to establish the requirements for use of simulation-based learning experiences as a substitute for required clinical and direct patient care experiences in licensed practical nurse (LPN), registered nurse (RN), or RN to Bachelor of Science in Nursing (BSN) education programs. The board also adopted amendments to the current simulation rule, WAC 246-840-534, to clarify the use of simulation at a 1:1 ratio.

The Washington State Board of Nursing proposed amendments to education and experience requirements for nurse administrators of baccalaureate nursing education programs in WAC 246-840-517 in response to RCW 18.79.150.

The Washington State Department of Health (DOH) in consultation with the Washington State Board of Nursing, permanently adopted amendments to WAC 246-840-990 to make a housekeeping change to correct fee total amounts. There is no change to the fees being charged. The changes only correct a technical error in the total lines. 

The Washington State Department of Health (DOH), in consultation with the Washington State Board of Nursing, is proposing amendments to WAC 246-840-990 to make a housekeeping change to correct fee total amounts.

The Department of Health adopted a retired active fee for the nursing home administrator license. Concurrently, the Board of Nursing Home Administrators adopted a retired active status to allow an individual to practice in emergent or intermittent circumstances and pay a reduced renewal fee. This will allow individuals to fill in at nursing homes that need a temporary administrator while recruiting a new administrator to assist in emergency circumstances such as a pandemic.

The Board of Nursing Home Administrators adopted rule amendments and a new rule to expand and clarify licensure requirement for licensure and temporary practice permits by correcting and updating continuing education requirements, language and citations, and correcting a typographical error. The rule no longer requires HIV/AIDS education. The rules add health equity continuing education.

Rescission of interpretive statement NCIS2.00 for WAC 246-840-4659 because a permanent rule has been adopted in its place. The rule clarifies the application of the advanced practice pain management rules in nursing homes and long-term acute care hospitals and incorporated the interpretive statement into permanent rule. Filed on January 31, 2024.

The board engaged in rulemaking to clarify the application of the advanced practice pain management rules in nursing homes and long-term acute care hospitals and incorporated the interpretive statement into permanent rule. The proposed rule was adopted by the board in a rule hearing on May 12, 2023. The permanent rule was filed on June 29, 2023 as WSR 23-14-082.

The Washington State Department of Health (DOH) issued a policy statement providing clarity about the reporting requirements outlined in Substitute Senate Bill 5547, Nursing Pool Transparency. Effective Date: June 12, 2024.

Filed on August 1, 2024.

The Washington State Board of Nursing adopted rules amending WAC 246-840-750 through 246-840-780 and adding WAC 246-840-790 to establish new definitions, update existing terms, and add application requirements for a stipend for the substance use disorder monitoring program for nursing professionals in response to Substitute House Bill 1255 (chapter 141, Laws of 2023) codified in RCW 18.79.440.

The Washington State Board of Nursing adopted rules amending WAC 246-840-750 through 246-840-780 and adding WAC 246-840-790 to establish new definitions, update existing terms, and add application requirements for a stipend for the substance use disorder monitoring program for nursing professionals in response to Substitute House Bill 1255 (chapter 141, Laws of 2023) codified in RCW 18.79.440.

The Occupational Therapy Practice Board (board) adopted rule amendments to implement legislation to reduce barriers to entering and remaining in the occupational therapy workforce. Additionally, the board updated the continuing education requirements to align with national standards and the code of ethics requirements for consistency and clarity in occupational therapy services.

The Occupational Therapy Practice Board and the Washington State Department of Health adopted amendments to the temporary permit and fee rules in response to legislation.

The Occupational Therapy Practice Board and Washington State Department of Health (DOH) jointly are proposing rule amendments to WAC 246-847-117 to reduce barriers for military spouses holding a temporary practice permit while entering and remaining in the occupational therapy workforce. Additionally, amendments are proposed to WAC 246-847-990 to create a new fee to cover the cost of the temporary permit.

The Occupational Therapy Practice Board and the Department of Health are considering amending rules and establishing fees for temporary practice permits in response to the Washington Military Spouse Employment Act.

The Occupational Therapy Practice Board is proposing rule amendments to reduce barriers to entering and remaining in the occupational therapy workforce and to streamline and shorten the credentialing process. The board is proposing revisions to WAC 246-847-051, 246-847-068, 246-847-070, 246-847-080, 246-847-125, and adding a new section, 246-847-127. Additionally, the proposal amends WAC 246-847-065 to adjust continuing education requirements so they align with the national certifying board and WAC 246-847-170 to ensure care is provided ethically and professionally.

The Department of Health is considering adopting a new chapter to Title 246 that establishes general administrative procedures and fees for non-potable water systems.

The Washington Medical Commission is proposing amendments to the commission’s opioid prescribing rules for allopathic physicians and physician assistants to exclude patients with sickle cell disease, to clarify tapering considerations, and to clarify the use of biological specimen testing. Amending WAC 246-918-801, WAC 246-918-870, WAC 246-918-900, WAC 246-919-851, WAC 246-919-920, and WAC 246-919-950.

This is a supplemental notice. The first CR-102 was filed March 30, 2024, as WSR 24-07-106.

The Washington State Department of Health (DOH) in consultation with the Dental Quality Assurance Commission added facility types to the list of opioid prescribing exclusions for dentists. Amendments to WAC 246-817-905 expand the types of patients who are exempt from opioid prescribing rules.

The Washington Medical Commission is considering amending opioid prescribing rules to modernize the language, add clarity, and bring the rules in line with current practice in WAC 246-919-850 through 246-919-985 and WAC 246-918-800 through 246-918-935.

The Board of Optometry is proposing amendments to reduce barriers for optometrists to enter and remain in the health care workforce. The proposed amendments remove the jurisprudence (JP) exam requirement from initial licensure in WAC 246-851-490 and add the JP exam as a requirement for a licensed optometrist’s first full CE reporting period in WAC 246-851-090 to be included within the existing CE hour requirement. The JP exam will no longer be a requirement prior to licensure by endorsement. Additionally, the proposed amendments clarify the minimum number of CE credit hours that must be obtained through synchronous and in-person learning and the maximum number of CE hours that may be earned through asynchronous learning.

The Board of Optometry adopted new WAC 246-851-515 and amendments to WACs 246-851-400, 246-851-410, and 246-851-570 through 246-851-600 to expand optometrist scope of practice to include advanced procedures an optometrist may perform with an advanced procedures license endorsement.

The Board of Optometry is proposing amendments to WAC 246-851-400, 246-851-410, 246-851-570 through 246-851-600 and establishing a new section WAC 246-851-515 to expand the optometrist scope of practice to include certain advanced procedures and establishes requirements for a license endorsement.

The Board of Optometry is considering amendments to optometrist continuing education and examination requirements in WAC 246-851-090 through 246-851-230 and WAC 246-851-490 to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023) and to consider increasing the number of allowable online credits.

The Washington State Department of Health (DOH) is proposing a new rule in response to legislative requirements under Substitute House Bill (SHB) 1271 (chapter 290, Laws of 2023) to establish the minimum standards for organ transport vehicles and equipment in WAC 246-976-360.

The Washington State Department of Health (DOH) adopted a new rule establishing minimum requirements for vehicle and equipment standards, as well as establishes the licensing process to obtain an organ transport license.

The Washington State Department of Health (DOH), along with the Orthotics and Prosthetics Advisory Committee, is considering amendments to comply with recent legislation. To align chapter 246-850 WAC with 2SHB 1724 (chapter 425, Laws of 2023), DOH is considering amending the jurisprudence examination as a requirement for licensure and possibly incorporating knowledge of professional jurisprudence into continuing competency requirements for orthotists and prosthetists. DOH will consider amending WACs 246-850-060, 246-850-140, 246-850-150 and other related sections, along with the establishment of potential new WAC sections. 

The Board of Osteopathic Medicine and Surgery is considering amending WAC 246-853-080 to update the continuing education (CE) requirements for licensure renewal of osteopathic physicians to clarify Washington-specific mandated CE requirements.

The Washington Medical Commission is proposing amendments to WAC 246-918-895 and WAC 246-919-945—Pain management specialist—Chronic pain, to align rule language with currently accepted language.

The Board of Osteopathic Medicine and Surgery is proposing amendments to WAC 246-853-080 to update the continuing education (CE) requirements for licensure renewal of osteopathic physicians to clarify Washington-specific mandated CE requirements.

The Board of Osteopathic Medicine and Surgery has adopted amendments to WAC 246-853-080 to update the continuing education (CE) requirements for licensure renewal of osteopathic physicians to clarify Washington-specific mandated CE requirements.

The Board of Osteopathic Medicine and Surgery is considering amendments to update the examination requirements for licensure of osteopathic physicians in response to Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023) and to reduce potentially unnecessary licensure barriers.

2SHB 1724 requires regulatory authorities to review licensure standards for health professionals in other states to determine substantial equivalency to Washington licensure standards in order to streamline and expedite credentialing processes. In response to this requirement, and to reduce potentially unnecessary licensure barriers, the board is considering amendments to the osteopathic physician examination requirements.