Rule-Making Activity

The Department of Health is rescinding this policy statement because the content was permanently incorporated into WAC 246-828-100 as published in WSR 24-01-087 on December 18, 2023. The policy statement is no longer needed. Filed April 23, 2024.

The Washington State Department of Health (department), Health Systems Quality Assurance Division, Office of Community Health Systems, Emergency Medical Services (EMS) Section is rescinding Policy Number EMS 20-01 | EMS Providers and Emergency Vaccinations, which was filed October 23, 2020, and published in WSR 20-22-030.

The policy is being rescinded because it is no longer needed. The department adopted permanent rules under WSR 24-15-104 on July 22, 2024, for chapter 246-976 WAC Emergency Medical Services and Trauma Care Systems. The rules became effective on September 30, 2024.

Filed January 9, 2025, as WSR 25-03-048.

The Washington State Department of Health (the department), Health Systems Quality Assurance Division, Office of Community Health Systems, Emergency Medical Services (EMS) Section is rescinding Policy Number EMS 21-01 | EMS Providers and Emergency Administration of Monoclonal Antibodies, which was filed December 7, 2021, and published in WSR 22-01-043.

The policy is being rescinded because it is no longer needed. The department adopted permanent rules under WSR 24-15-104 on July 22, 2024, for chapter 246-976 WAC Emergency Medical Services and Trauma Care Systems. The rules became effective on September 30, 2024. The amendments to the rule and updates to the scope of practice include requirements for EMS providers listed in the policy statement to administer monoclonal antibodies.

Filed January 9, 2025, as WSR 25-03-047.

This statement allowed currently operating organ transport services and organ transport vehicles in Washington state to continue operating while permanent rules were in development to implement the department’s licensing requirements under Substitute House Bill (SHB) 1271, chapter 290, Laws of 2023.

This policy is being rescinded because the department officially filed a CR-103P in WSR 24-17-005 on August 8, 2024, for chapter 246-976 WAC Organ transport service and vehicle license. The rules became effective on September 30, 2024, therefore the policy statement is no longer needed. Organ transport vehicle and service license requirements are established in WAC 246-976-360.

Filed December 20, 2024 as WSR 25-02-058.

This policy statement provided guidance to donor milk banks and insurance carriers consistent with RCW 43.70.645 until the department adopted permanent rules. The policy statement served as the milk bank safety standards established by the department for inpatient use for the purpose of RCW 43.70.645 and 48.43.815, clarified and added a definition addressing donor human milk obtained from a milk bank for the purposes of ensuring inclusion of donor milk provided by renumerated donors and ensuring inclusive language use.

The department is rescinding this policy statement because it is superseded by permanent rules that were adopted August 22, 2023, filed as WSR 23-17-149 with an effective date of September 22, 2023, making the policy statement obsolete.

Individuals requiring information on this should contact Me'kyel Bailey, lead policy advisor, email mekyel.bailey@doh.wa.gov, or phone 360-754-9161. Filed February 5, 2024.

The Washington Medical Commission is rescinding this policy statement because the state of Washington became the first state to enact ESSB 5481, the Uniform Telemedicine Act, and this statute just recently went into effect on June 6, 2024. As such, the commission’s Telemedicine policy, POL2021-02, became superseded by statutory law. Filed December 20, 2024.

The Washington State Department of Health (DOH) is considering amendments to RTF regulations in WAC 246-337-010 and WAC 246-337-990 along with private psychiatric hospital regulations in WAC 246-322-020 and WAC 246-322-990 to implement Substitute House Bill (SHB) 2075 (chapter 204, Laws of 2024). SHB 2075 directs DOH to issue RTF and private psychiatric hospital licenses to Indian health care providers by July 1, 2025, if the provider submits a tribal attestation and an attestation processing fee. Amendments may include other necessary changes to licensing regulations in chapters 246-322 and 246-337 WAC. DOH may also consider amending the Behavioral Health Agency (BHA) regulations in WAC 246-341-0367 regarding tribal attestation fees to align with RTF and private psychiatric hospital tribal attestation fees.

The Washington State Department of Health (DOH) is proposing a new rule in chapter 246-337 WAC and a new rule in chapter 246-322 WAC to establish fees necessary to receive and process an attestation that a tribal residential treatment facility or tribal private psychiatric hospital meets state minimum standards for licensure. The proposed rule also amends WAC 246-337-010 to clarify that the licensure process described in each section does not apply to tribes seeking licensure via attestation. Finally, DOH is proposing to update WAC 246-341-0367 regarding BHA tribal attestation fees to align with the proposed RTF and private psychiatric hospital tribal attestation fees.

The Washington State Department of Health (DOH) increased RTF fees in April 2025, filed as WSR 25-08-069, to adequately fund inspection, investigation, and licensing programs to protect patients. An error was found in the adopted amendment, where the updated renewal fee was not reflected. The proposed rule amends the error.

The Washington State Department of Health (DOH) corrected a renewal fee error in WAC 246-337-990.

The Washington State Department of Health (DOH) and Pharmacy Quality Assurance Commission is proposing housekeeping amendments to the following WAC sections to fix incorrect references: WAC 246-320-211 pharmaceutical services for Hospital licensing regulations; WAC 246-330-200 pharmaceutical services for ambulatory surgical facilities; WAC 246-335-310 definition; WAC 246-335-722 pharmaceutical services; WAC 246-335-738 pharmaceutical services area sections for In-home services agencies; and WAC 246-337-105 medication management for residential treatment facilities. 

The Washington State Department of Health (DOH) is proposing rule amendments to reduce barriers to entering and remaining in the respiratory care practitioner (RCP) workforce and to streamline and shorten the credentialing process. This will also include amendments to the temporary permit rules to reduce barriers for military spouses entering and remaining in the RCP workforce and proposed amendments to WAC 246-928-560, 246-928-570, and adding a new section, WAC 246-928-575, for applicants with a current national certification.

The Department of Health is considering amending requirements for respiratory care practitioner application, examination licensure, and out of state credentialing and temporary practice permits.

The Washington State Department of Health (DOH) amended WAC 246-928-560 and adopted a new section, WAC 246-928-575, for applicants with a current national certification to align licensure and endorsement requirements with recent legislation. The rules reduce barriers to entering and remaining in the respiratory care practitioner workforce and reduce barriers for military spouses entering and remaining in the workforce.

The Department of Health adopted amendments regarding Safe Medication Return to update rules about multiple program operators. Amendments also set a fee for proposal review and provide transparency for the department’s method of calculating program operator annual fees.

The Washington State Department of Health (DOH) is proposing to amend WAC 246-282-005(1)(a) to adopt by reference the 2023 version of the National Shellfish Sanitation Program’s (NSSP) Guide for the Control of Molluscan Shellfish (guide). This rulemaking is necessary to update the publication date of the NSSP guide adopted by reference from 2019 to the 2023 version.

The Washington State Department of Health (DOH) amended WAC 246-282-005(1)(a) to adopt by reference the 2023 version of the National Shellfish Sanitation Program’s Guide for the Control of Molluscan Shellfish to ensure that the most current health and safety requirements are in rule as required by the statute.

The State Board of Health changed to the effective date of the Environmental Health and Safety Standards for Primary and Secondary Schools, for one year due to legislative direction in the supplemental state operating budget Engrossed Substitute Senate Bill (ESSB) 5187 prohibiting implementation until the legislature acts to formally fund implementation of the standards. The effective date of the rules is now September 1, 2025.

The Washington State Department of Health (DOH) is proposing to create a new chapter of rule that establishes radiation safety standards for the use of ionizing radiation for security purposes, while making every reasonable effort to maintain exposures to radiation as low as reasonably achievable to protect public health and safety. 

The Washington State Department of Health (DOH) adopted a new chapter of rules, chapter 246-230 WAC, that establishes radiation safety standards for the use of ionizing radiation for security purposes, while making every reasonable effort to maintain exposures to radiation as low as reasonably achievable to protect public health and safety.

The Washington State Department of Health (DOH) adopted emergency rules amending WAC 246-282-006 to shift the 2025 start date for stricter harvest control measures to June 6, 2025, in response to early heat and low tides.

The Washington State Department of Health (DOH) is proposing rule changes to update WIC vendor agreements and remove some restrictions against A-50 vendors in order to establish their eligibility to join the WIC program.

The State Board of Health is proposing amending WAC 245-500-050, WAC 246-500-053, and WAC 246-500-055 to align with changes in Substitute House Bill 1974 (chapter 57, Laws of 2024), codified in RCW 68.50.230. These rules establish the requirements for remains reduced through cremation, alkaline hydrolysis, and natural organic reduction.

The State Board of Health has adopted amendments to chapter 246-272A WAC to implement changes to existing requirements. The adopted rule establishes new requirements, including requirements for field verification of proprietary products, property transfer inspections, remediation, and product supply chain issues and makes clarification updates. 

The Occupational Therapy Practice Board is considering amendments to implement Second Substitute House Bill (2SHB) 1724 (Chapter 425, Laws of 2023) to remove barriers to licensure and endorsement. Additionally, the board will consider amendments to align with the national certifying board and standards of ethics and professional conduct.

Section 8 of 2SHB 1724 directs boards and commissions to waive certain requirements to licensure for specific types of applicants. The intent of the bill was to change licensure requirements to remove barriers to entering and remaining in the health care workforce, and to streamline and shorten the credentialing process. Rulemaking may be necessary to amend licensure requirements to align with the new legislation. Additionally, the board consistently receives inquiries on whether an OT can work off the evaluation of another profession such as a physical therapist. The board is considering adding rule language that makes it clear that an OT must complete their own evaluation of the client, and will consider adding language that aligns continued competency rules with the national certifying board.

The Board of Osteopathic Medicine and Surgery is proposing 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 proposed changes reflect updated language changes made by Substitute Senate Bill 5496 (chapter 43, Laws of 2022). In partnership with the Secretary of Health, technical amendments are also being proposed to WAC 246-853-990 to reflect changes to the updated rules and statute.

The Washington State Board of Nursing proposes amendments and an addition to rules relating to the board’s substance use disorder (SUD) monitoring program in response to Substitute House Bill (SHB) 1255 (chapter 141, Laws of 2023) including application requirements for a stipend.

The Department of Health is considering updates to chapter 246-811 WAC to lower barriers to entering and remaining in the SUDP workforce and to streamline and shorten the credentialing process.

The Washington State Department of Health (DOH) is proposing updates to reduce barriers to entering and remaining in the substance use disorder profession (SUDP) workforce and to streamline and shorten the credentialing process. Amending chapter 246-811 WAC, including repealing sections and creating new sections.

The Washington State Department of Health (DOH) adopted amendments to reduce barriers to entering and remaining in the workforce and to streamline and shorten the credentialing process. The adopted rule amended chapter 246-811 WAC, including repealing sections and creating new sections.

The Department of Health adopted amendments to reduce barriers to certification for Substance Use Disorder Professionals and Substance Use Disorder Professional Trainees. Changes include removing the requirement to verify educational coursework for applicants with a national certification in WAC 246-811-070, making pharmacists eligible for the alternative training pathway in WAC 246-811-076, and removing osteopathic physician assistants pursuant to Substitute House Bill 2378 (chapter 80, Laws of 2020). The rule also removes the obsolete AIDS training from the list of probationary license requirements pursuant to Engrossed Substitute House Bill 1551 (chapter 76, Laws of 2020).

The Washington State Department of Health (DOH) amended the substance use disorder professionals and substance use disorder professional trainees rules in chapter 246-811 WAC to reduce barriers to entering and remaining in the behavioral health workforce, to streamline the substance use disorder professional and trainee credentialing process, and to implement recent legislation.

The Washington State Department of Health (DOH) is adopting these emergency rules to reduce barriers to entering and remaining in the behavioral health workforce, to streamline the substance use disorder professional and trainee credentialing process, and to implement recent legislation. DOH is amending WACs 246-811-010, 246-811-025, 246-811-030, 246-811-035, 246-811-045, 246-811-046, 246-811-048, 246-811-049, 246-811-060, 246-811-070, 246-811-220, 246-811-240, 246-811-260, 246-811-990 and, creating WAC 246-811-310. These emergency rules are being continued while permanent rulemaking filed under WSR 24-10-011 on April 18, 2024, are in progress.

The Department of Health is considering implementing recent legislation by establishing a directory to help mental health counselor, marriage and family therapist, and social worker associates find supervisors; standards for supervision of associates a stipend program to offset some costs of supervision; and other changes.

The Washington State Board of Nursing (board) adopted amendments to WAC 246-840-095, reducing the length of time a temporary practice permit is effective and updating criteria to issue a temporary practice permit in order to align the internal board process with rule language and implement Second Substitute House Bill (2SHB) 1009 (chapter 165, Laws of 2023).

This policy clarifies the Pharmacy Quality Assurance Commission’s issuance of temporary practice permits to pharmacy interns who are spouses of military personnel. Policy number: P011. Effective Date: February 1, 2024.

The Department of Health is considering amending fees in WAC 246-358-990 to cover operating costs in the Temporary Worker Housing program. The department will consider updating or restructuring existing fees and creating new fees. Rulemaking is being considered because the department conducted an initial assessment of the program and determined the current fee is not generating sufficient revenue to cover the program’s costs.

The Washington State Department of Health (DOH) is considering amending wastewater treatment requirements in WAC 246-272A-0110, Table I, Category 2 to add NSF/ANSI 40 testing for Category 2 products.

The Washington State Department of Health (DOH) adopted a requirement for Category 2 products, listed in WAC 246-272A-0110, Table I to be tested according to NSF/ANSI 40 - Residential Wastewater Treatment Systems (versions dated between January 2009 and May 31, 2021).

The Pharmacy Quality Assurance Commission is proposing revisions to update references to regulations from other entities that have been incorporated into chapter 246-945 WAC and to make other clarifying changes that do not change the effect of the rule.

The Washington State Department of Health (DOH) has adopted changes to replace the term “honorable discharge” with “qualifying discharge” in WAC 246-12-530 and 246-12-560 in accordance with Second Substitute House Bill (2SHB) 2014 (chapter 146, Laws of 2024).

The Veterinary Board of Governors is considering updates to licensure, reactivation, continuing education, and examination requirements, which may include adding a new section in chapter 246-933 WAC and chapter 246-935 WAC to implement Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023) and Second Substitute House Bill (2SHB) 1009 (chapter 165, Laws of 2023).

The Veterinary Board of Governors adopted health equity continuing education requirements in WAC 246-933-437 and WAC 246-935-307 for licensed veterinarians and veterinary technicians to implement Engrossed Substitute Senate Bill (ESSB) 5229 (chapter 276, Laws of 2021.)

The Veterinary Board of Governors is proposing amendments to chapters 246-933 and 246-935 WAC to reduce barriers to education, examination, and licensure requirements and proposing general housekeeping amendments by repealing the licensure examination rules that are no longer relevant.

The Veterinary Board of Governors has adopted amendments to physician health monitoring programs for substance use disorders of veterinarian professions to update language changes made by Substitute Senate Bill (SSB) 5496 (chapter 43, Laws of 2022). Amendments include terminology and definitions for currently accepted language and replacing "substance abuse" with "substance use disorder." The board also made amendments to correct citations and other general housekeeping changes.

The Veterinary Board of Governors is refiling proposed amendments to WAC 246-933-010 and WAC 246-933-200. This supplemental CR-102 is being filed without changes to the original proposal and is intended to hold a second public hearing, allowing the board to reconsider the proposal and provide additional opportunity for public comment. The proposed rules include relevant definitions and clarify the appropriate use and limitations of telehealth in providing veterinary services.

In response to three rules petitions received in 2022, the Veterinary Board of Governors is proposing changes to WAC 246-933-010 and 246-933-200 to establish additional standards for use of telehealth. The proposed rules add relevant definitions and specify boundaries on the use of telehealth in veterinary services.

The Veterinary Board of Governors adopted amendments to chapters 246-933 and 246-935 WAC to remove outdated exam requirements and reduce barriers.

The Washington State Department of Health (DOH) is considering amending WAC 246-491-350 to implement a new birth certificate fee waiver process authorized by Substitute Senate Bill 5030.

The Washington State Department of Health (DOH) continued without change the previous emergency rules, which require acute care hospitals to report hospital maintenance and operation data to DOH through Washington’s Healthcare and Emergency and Logistics Tracking Hub (WA HEALTH) in accordance with the WA HEALTH User Guide. The existing emergency rule was originally filed on August 31, 2022, as WSR 22-18-060.