Rule-Making Activity

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 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.

The Board of Osteopathic Medicine and Surgery is proposing amendments to update the examination requirements for licensure of osteopathic physicians in WAC 246-853-020.

The Board of Osteopathic Medicine and Surgery and the Washington State Department of Health (DOH) are proposing amendments to WAC 246-853-045 and WAC 246-853-21, and to repeal WAC 243-853-060, as a result of the review to clarify and update language.

The Board of Osteopathic Medicine and Surgery is considering amending WAC 246-853-661 Exclusions, WAC 246-853-730 Periodic review, and WAC 246-853-755 Tapering requirements, to modernize the language, add clarity, and align rules with the Washington Medical Commission (WMC).

The Board of Osteopathic Medicine and Surgery has adopted amendments to WAC 246-853-290, 246-853-300, 246-853-310, and 246-853-320 to update the rules regarding health profession monitoring programs. The adopted changes align existing rule language with the changes made in Substitute Senate Bill (SSB) 5496 (chapter 43, Laws of 2022). These changes align the rules with currently accepted language for substance use disorders and related monitoring programs.

The Board of Osteopathic Medicine and Surgery (board) conducted a review of all sections in chapter 246-853 WAC that have not been reviewed in the last five years and identified that WAC 246-853-045 and 246-853-210 contain outdated language. The board adopted amendments to update the term "practitioner" to "osteopathic physician" to be consistent with the entire chapter. The board has also identified that WAC 246-853-060 does not contain any rule language content and is repealing this section.

The Washington Medical Commission adopted amendments to WAC 246-918-895 and 246-919-945 to align rule language with currently accepted language.

Becky McElhiney
360-236-4766

The Board of Hearing and Speech adopted rules to reflect federal changes for over-the-counter (OTC) hearing aids. To align with changes in federal regulation, the board’s adopted amendment removes requirements in WAC 246-828-100 for medical clearance as a condition for sale of OTC hearing aids. The adopted changes to WAC 246-828-100 only remove requirements no longer permitted by federal rule and do not otherwise change licensure requirements.

The Board of Hearing and Speech is proposing amendments to WAC 246-828-100 (Hearing instruments fitting and dispensing – Minimum standards of practice) to reflect changes to relevant federal rules by the Food and Drug Administration (FDA) regarding the sale of over-the-counter (OTC) hearing aids (21 C.F.R. Parts 800, 801, 808, and 874 (2022)).

Nina Helping
360-236-3065

The State Board of Health (SBOH) is considering amending WAC 246-290-315, State Action Levels (SALs) and State Minimum Contaminant Levels (MCLs), and WAC 246-290-71006, Public notice for contaminants with a SAL and other unregulated contaminants, to align with the federal Environmental Protection Agency’s (EPA) new federal standards for PFAS. The SBOH adopted an emergency rule and is now considering permanent rule amendments. 

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-480 and creating new sections in chapter 246-945 WAC to improve notifications and prescription transfer directions provided to patients when the facility closes permanently.

The Pharmacy Quality Assurance Commission adopted health equity continuing education requirements to meet the requirements of the Department of Health’s equity model rules in WAC 246-12-800 through 246-12-830. The adopted rules add one hour of health equity education every two years, coinciding with the license renewal cycles for both pharmacists and pharmacy technicians.

In 2020, the Pharmacy Quality Assurance Commission consolidated multiple chapters of rules into chapter 246-945 WAC that covers the practice of pharmacy. This adopted rule amends WAC 246-945-040(1) to incorporate Title 21 of the CFR by reference for the purpose of capturing any changes made to Title 21 after WAC 246-945-040 went into effect on July 1, 2020. Language was also added to the rule for the purpose of providing individuals directions for acquiring copies of the reference material listed for public inspection.

Updating reference to United States Pharmacopeia (USP) General Chapters 795 and 797. The Pharmacy Quality Assurance Commission (commission) is proposing a revision to WAC 246-945-100, Compounding minimum standards, to update the rule to the most recent version of the USP – National Formulary <795> and <797>.

Purpose of the proposal and its anticipated effects, including any changes in existing rules: The proposed rule amends WAC 246-945-100 to update the rule to the most recent versions of the USP <795> and <797>. USP <795> and <797> were adopted into rule by reference effective on July 1, 2020. Since then, USP <795> and <797> have been updated.

Reasons supporting proposal: The existing reference in WAC 246-945-100 does not account for changes made to USP <795> and <797> that are official as of November 1, 2023 by USP. The proposed rule updates the references to the most recent versions. The proposed rule language qualifies for expedited rulemaking under RCW 34.05.353(1)(b) as the language incorporates by reference national standards without material change.

 IF YOU OBJECT TO THIS USE OF THE EXPEDITED RULE-MAKING PROCESS, YOU MUST EXPRESS YOUR OBJECTIONS IN WRITING AND THEY MUST BE SENT TO Haleigh Mauldin, Pharmacy Quality Assurance Commission, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-890-0720, fax 360-236-2901, email https://fortress.wa.gov/doh/policyreview, AND RECEIVED BY April 17, 2023.

The Pharmacy Quality Assurance Commission is proposing to amend WAC 246-945-155 to grant additional renewals to pharmacy interns. Additionally, the commission proposes to amend WAC 246-945-156 to extend the duration of pharmacy intern temporary practice permits to 180 days which stems from compliance with Second Substitute House Bill (2SHB) 1009 (chapter 165, Laws of 2023).

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-155, WAC 246-945-156, and adding a new section to chapter 246-945 WAC. These changes would grant renewal extensions to pharmacy interns and would extend temporary pharmacy intern practice permits for spouses of military personnel in accordance with Second Substitute House Bill 1009 (chapter 165, Laws of 2023).

Notice of Adoption: This policy Issued by the Pharmacy Quality Assurance Commissions clarifies the Commission’ approach to United States Pharmacopeia General chapters 795, 797, 800, and 825 as it relates to WAC 246-945-100 and RCW 18.64.270(2). Policy PO-10. Effective Date: November 1, 2023.

Rescission of Policy Statement P004, Regulatory Standards Applicable to Remote Dispensing Sites. Filed February 8, 2024.

The pharmacy quality assurance commission (commission) is rescinding the policy statement Regulatory Standards Applicable to Remote Dispensing Sites, which was filed on July 2, 2020, and published as WSR 20-15-011.

The department of health is rescinding this policy statement because rulemaking was completed allowing a pharmacy to extend its pharmacy license to a remote dispensing site where technology is used to dispense medications used for the treatment of opioid use disorder or its symptoms. The CR-103P was filed under WSR 24-01-098 and went into effect on January 18, 2024.

Individuals requiring information on this rule should contact Joshua Munroe, rules and legislative consultant, phone 360-502-5058, email PharmacyRules@doh.wa.gov. 

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-051 and adding new sections to chapter 246-945 WAC to add kratom and its active compounds to the list of Schedule I substances.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-001, 246-945-315, 246-945-317, 246-945-320, and potentially adding a new section in chapter 246-945 WAC to clarify the utilization of pharmacy ancillary personnel and technology within the pharmacy.

The Pharmacy Quality Assurance Commission adopted updates to references, made grammar corrections, and made other technical changes that do not affect implementation of the rule.

Citation of rules amended by this order: WACs 246-945-001, 246-945-011, 246-945-014, 246-945-018, 246-945-063, 246-945-156, 246-945-170, 246-945-173, 246-945-175, 246-945-200, 246-945-217, 246-945-230, 246-945-417, and 246-945-590.

This proposal will remove citations to repealed WAC chapters, update citations to the current governing WAC chapter or specific rule(s) and make general grammatical corrections without making any material changes.

Joshua Munroe

The Pharmacy Quality Assurance Commission is considering amending existing rules and establishing a new section in chapter 246-945 WAC to implement a uniform enforcement tool for pharmaceutical firms. The rules will implement Engrossed Substitute Senate Bill (ESSB) 5271 (chapter 121, Laws of 2024).

The Board of Physical Therapy is considering amendments to update initial licensure and endorsement requirements in consideration of Second Substitute House Bill (2SHB) 1724, (chapter 425, Laws of 2023). The board will also consider making general updates to the licensing and endorsement process, examine the jurisprudence examination requirement, and review for housekeeping changes.

The Board of Physical Therapy is considering amendments to update initial licensure and endorsement requirements in consideration of Second Substitute House Bill (2SHB) 1724, (chapter 425, Laws of 2023). The board will also consider making general updates to the licensing and endorsement process, examine the jurisprudence examination requirement, and review for housekeeping changes.

Section 8 of 2SHB 1724 requires boards and commissions to waive any examination requirements in an effort to expedite the licensing process for applicants who meet the requirements under 2SHB 1724. The board will review the initial licensure and endorsement requirements to bring them into alignment with 2SHB 1724, and review the current license requirements for consistency and relevancy. The board will consider additional housekeeping updates.

Agency: Department of Health and the Board of Physical Therapy
Subject of possible rule making: Physical Therapists intramuscular needling requirements. The Board of Physical 
Therapy (board) and Department of Health (department) are considering rulemaking in chapter 246-915 WAC, Physical 
Therapists and Physical Therapist Assistants, to clarify statutory requirements for education and training and define an 
intramuscular needling endorsement. The board and department may consider associated training and education 
requirements, updating definitions, establishing a fee for the intramuscular needling endorsement, and creating a process 
to apply for the endorsement.
Statutes authorizing the agency to adopt rules on this subject: Second Substitute House bill (2SHB) 1039 (chapter 
198, Laws of 2023), RCW 18.74.023, 43.70.110, 43.70.250, and 43.70.280
Reasons why rules on this subject may be needed and what they might accomplish: 2SHB 1039 expands the 
scope of practice of physical therapists to perform intramuscular needling, also known as dry needling. Rules may be 
needed to clarify statutory requirements for education and training to receive an initial endorsement to perform 
intramuscular needling. The board and the department will also consider establishing the steps to apply for the 
endorsement, including establishing a fee.
Identify other federal and state agencies that regulate this subject and the process coordinating the rule with 
these agencies: None
Process for developing new rule (check all that apply):
☐ Negotiated rule making
☐ Pilot rule making
☐ Agency study
☒ Other (describe) Collaborative rulemaking
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule 
before publication by contacting:
(If necessary)
Name: Allyson McIver Name:
Address: PO Box 47852, Olympia, WA 98504-7852 Address:
Phone: 360-236-2878 Phone:
Fax: 360-236-2901 Fax:
TTY: 711 TTY:
Email: physical.therapy@doh.wa.gov Email:
Web site: doh.wa.gov Web site:
Other: Other:
Additional comments: Interested parties can participate in the drafting of the proposed rules. The department and the
board will be conducting rules workshops with interested parties and subject matter experts. The department will use 
existing GovDelivery lists and other known contact information to inform interested parties of opportunities to provide input
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on proposed rule language. To find out more information about our rulemaking, visit www.doh.wa.gov. To subscribe to 
GovDelivery, please visit www.doh.wa.gov, and select the "Subscribe" button at the bottom of the page, select Health 
Professions, and then Physical Therapy Program. You may also check the box next to one or more of the other 
professions listed to receive information related to that specific profession.
Date: July 18, 2023
Name: Kathryn Dale, PT, DSc and Kristin Peterson, JD for 
Umair A. Shah, MD, MPH
Title: Chair, Physical Therapy Board and Chief of Policy 
for Secretary of Health

The Board of Physical Therapy (board) is proposing amendments to WAC 246-915-030, 246-915-040, 246-915-085, and 246-915-120 in order to comply with Section 8 of 2SHB 1724 (chapter 425, Laws of 2023), codified as RCW 18.130.077 and to make general and housekeeping updates to these sections. Additionally, the board is proposing amendments to WAC 246-915-040 to further expand upon the endorsement pathway required under 2SHB 1724 and amendments to WAC 246-915-120 to streamline the foreign educated applicant application process.

The Board of Physical Therapy and the Washington State Department of Health (DOH) adopted amendments to chapter 246-915 WAC, Physical Therapists and Physical Therapist Assistants, to clarify statutory requirements included in Second Substitute House Bill (2SHB) 1039 (chapter 198, Laws of 2023) for obtaining an intramuscular needling endorsement and to establish a fee to cover the cost of the endorsement. The adopted rules clarify and set standards to ensure that physical therapists who are seeking the endorsement are prepared with the skills and education needed to provide safe intramuscular needling services to the public.

The Board of Physical Therapy and Department of Health are proposing amendments to clarify statutory requirements for education and training and define the endorsement for intramuscular needling, and to amend fees and renewal cycle, to implement Second Substitute House Bill 1039, (chapter 198, Laws of 2023) which expands the scope of practice of physical therapists to perform intramuscular needling.

The Board of Physical Therapy is proposing to update the effective date in WAC 246-915A-010 for the Physical Therapy Compact per RCW 18.74.500 Article IX(2), updating the reference date to the most recent physical therapy licensure compact rules. This proposed rule will update the compact effective date to June 27, 2023. 

The Board of Physical Therapy has updated WAC 246-915A-010 to comply with RCW 18.74.500, Article IX (2), which mandates that the board adopt the most recent version of the compact commission rules to participate in the compact in the state of Washington. The adopted changes to WAC 246-915A-010 complies with the statute by incorporating by reference.

The Board of Physical Therapy is proposing to update the effective date in WAC 246-915A-010 to match the date of the most recent Physical Therapy Compact rules per RCW 18.74.500 Article IX(2). This proposed amendment will update the effective date in rule to June 17, 2024.

Amelia Boyd

PO Box 47866

Olympia, WA 98504

360-918-6336

amelia.boyd@doh.wa.gov

The Washington Medical Commission adopted amendments to chapter 246-918 WAC to implement Engrossed Substitute House Bill (ESHB) 2041 (chapter 62, Laws of 2024) which aims to establish clear guidelines and requirements for the collaboration between physician assistants and supervising physicians. The commission also adopted amendments that clarify and update terms.

The Washington Medical Commission is proposing amendments to chapter 246-918 WAC to implement Engrossed Substitute House Bill (ESHB) 2041 (chapter 62, Laws of 2024) which aims to establish clear guidelines and requirements for the collaboration between physician assistants (PAs) and supervising physicians.