Rule-Making Activity

Effective November 11, 2024, rescission of WSR 24-16-085, CR-103E, emergency rules for naloxone nasal spray as over-the-counter status, WAC 246-945-030 and 246-945-034. The commission is rescinding these emergency rules because permanent rulemaking has been completed to update these rules. The permanent rule was filed as WSR 24-21-069 on October 11, 2024, and becomes effective November 11, 2024. Memo to rescind emergency rule filed as WSR 24-21-081.

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.

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The department is rescinding this policy statement because it is superseded by permanent rules that were adopted August 22, 2023, filed as WSR 23-17-149 with an effective date of September 22, 2023, making the policy statement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

Jocelyn W. Jones
360-236-3020

Stuart Glasoe
360-236-4111

Peter Beaton
 

The Washington State Board of Health (Board) is considering adding Guanidinoacetate methyltransferase deficiency (GAMT) and Arginase 1 deficiency (ARG1-D) to the list of mandatory conditions for newborn screening conducted by the Department of Health (Department).

The Board has the authority under RCW 70.83.050 to define and adopt rules for screening Washington-born infants for hereditary conditions. WAC 246-650-010 defines the conditions, and WAC 246-650-020 lists the conditions for which all Washington-born newborns are to be screened. GAMT deficiency and ARG1-D are rare inherited metabolic conditions that can result in severe disability and in some cases death if not detected and treated early. Early diagnosis of GAMT deficiency and ARG1-D through newborn screening is essential to save lives and to improve the quality of life for impacted infants and their families.

To be added to the listserv for notifications regarding this rulemaking, email Molly.Dinardo@sboh.wa.gov with the subject line "Newborn Screening – GAMT & ARG1-D."

Stuart Glasoe
 

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 Department of Health (department) is considering amending chapter 246-790 WAC to increase flexibility in allowed vendor types and update program requirements for vendors. The department is also considering amendments to the Participant Compliance rules to reflect virtual service options.

WSBOH@sboh.wa.gov

Samantha Pskowski
360-789-2358
 

The Washington State Board of Health is considering amending the auditory screening sections of chapter 246-760 WAC, Auditory and Visual Standards – School Districts, to align with current national evidence-based practices and assess potential options regarding whether to include otoacoustic emission (OAE) screening technology in the Board’s rules. The Board may also consider other technical or editorial changes as needed.

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 is proposing amendments to address changes to existing requirements, including requirements governing local management plans, repairs, registration of proprietary treatment products, minimum lot sizes, treatment levels, and licensing of operations and maintenance providers. The proposed rule establishes new requirements, including requirements for field verification of proprietary products, property transfer inspections, remediation, and product supply chain issues. The proposed rule also makes several editorial updates to improve clarity and repeals obsolete rules.

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 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) 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 Board of Optometry amended WAC 246-851-440 through 246-851-470 to align with technical changes made by Substitute Senate Bill (SSB) 5496 (Chapter 43, Laws of 2022). Changes align the rules with currently accepted language for substance use disorders and related monitoring programs, and include technical clarifications as needed without changing the rule’s effect.

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.

Submit Written Comments to: Nina Helpling, DOH, P.O. Box 47820, Olympia, WA 98504-7820, email tempworkerrule@doh.wa.gov, by July 7, 2023.

Assistance for Persons with Disabilities: Contact Nina Helpling, phone 360-236-3065, TTY 711, email nina.helpling@doh.wa.gov, by June 13, 2023.

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.

RCW 70.114A.065 directs the Department of Health (DOH) and the Department of Labor and Industries (L&I) to adopt joint rules for the licensing, operation, and inspection of temporary worker housing. DOH and L&I have assessed the emergency rule requirements, along with input from interested parties and adopted key provisions to address prevention of future outbreaks and the spread of any airborne infectious disease.

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 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 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 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.

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 is considering updates and revisions to WAC 246-935-050 animal health care tasks, WAC 246-935-040 responsibilities of a Veterinarian supervising a licensed Veterinary Technician or unregistered assistant, WAC 246-935-010 definitions (Veterinary Technicians), and WAC 246-937-010 definitions (registered Veterinary Medication Clerks).

WAC 246-282-006, Washington state Vibrio parahaemolyticus control plan. Vibrio parahaemolyticus (Vp) is a naturally occurring bacteria found in marine waters. Molluscan bivalve shellfish acquire Vp through filter feeding. Humans who consume raw or undercooked shellfish containing Vp can develop an intestinal disease called vibriosis. Chapter 246-282 WAC establishes the minimum performance standards for growing, harvesting, processing, packing, storage, transporting, and selling of shellfish for human consumption.

These rules do not apply to persons who conduct activities limited to retail food service, personal use, and transporting as a common carrier of freight. WAC 246-282-006 establishes the control plan for the months of May 1st through September 30th and are an extension of the NSSP Model Ordinance (U.S. Food and Drug Administration National Shellfish Sanitation Program, Guide for the Control of Molluscan Shellfish). Due to current early season high temperatures, this emergency rule making is necessary to protect public health by modifying the existing strictest harvest control requirements which currently start July 1st by setting even more protective measures immediately.

The State Board of Health (board) filed a Preproposal Statement of Inquiry (CR-101) on February 23, 2022, WSR 22-06-034 regarding permanent amendments to the existing rules to address harvest control measures and may also include updating definitions, seed size and other technical and editorial changes as needed. Until permanent rule making can be completed, the board has delegated emergency rule making authority to the Department of Health if heat-wave conditions occur prior to July 1To reduce the threat to public health, amending the “time of harvest to cooling requirements” to a more protective control season immediately is necessary.

The current Vp Control Plan, last revised in 2015, establishes a control season between May 1st and September 30th and authorizes enforcement of the rule’s strictest time-to cooling requirements for harvested oysters starting July 1 of the Vp control season. However, recent events demonstrate the need for more flexible rules.

From June 26 to July 2, 2021, the National Weather Service in Seattle reported a long-duration, unprecedented heat wave throughout the Pacific Northwest. Shellfish-related Vp illnesses increased sharply. Therefore, due to current early season temperatures and mid-day low tides, this emergency rule is necessary to protect public health.

The Washington State Department of Health (DOH) is extending an emergency rule to continue to require acute care hospitals in Washington state, licensed under chapter 70.41 RCW, 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. This emergency rule continues without change, the existing emergency rule originally filed on August 31, 2022, as WSR 22-18-060.

The Department of Health is considering requiring acute care hospitals to report hospital maintenance and operation data to the department through the Washington Healthcare Emergency and Logistics Tracking Hub (WA HEALTH), a statewide data management system. The department will also consider requiring behavioral health agencies and facilities to report hospital maintenance and operation data to the department through WA HEALTH.

Amelia Boyd

Notice of Adoption: This statement Issued by The Washington Medical Commission establishes the use of Nitrous Oxide in Office-Based Settings Under WAC 246-919-601, and regulates the use of analgesia, anesthesia, and sedation in office-based settings to exempt the use of nitrous oxide from the requirements of WAC 246-919-601. Interpretive Statement INS2023-02. Effective Date: October 20, 2023.

The Pharmacy Quality Assurance Commission adopted amendments to WAC 246-945-507 to add four intramammary antibiotics to the list of approved legend drugs in chapter 246-945 WAC in response to a petition request from a veterinarian at Washington Department of Fish and Wildlife.

The Washington State Department of Health (DOH) withdrew the CR-101 filed as WSR 21-23-082 filed November 16, 2021, concerning hospital systems of accounting, financial reporting, budgeting, and cost allocation in WAC 246-454-010, 246-454-020, 246-454-090, 246-454-110. The CR-101 is being withdrawn because amendments are necessary that were not included in the filing. DOH intends to file a new CR-101 to address this topic.

The Examining Board of Psychology is withdrawing a preproposal statement of inquiry amending psychology licensing requirements in chapter 246-924 WAC filed February 23, 2023, and published as WSR 23-06-041 because additional legislation requires the board to adopt rules on additional topics. The board will engage in rulemaking under a new rule package. 

Recent legislation substantially amended the structure of the planned stipend program. The department filed a new CR-101 to give appropriate notice to all impacted interested parties. Filed April 18, 2024.