Rule-Making Activity

The Dental Quality Assurance Commission is adopting amendments to update rules regarding out-of-state licensure in line with Senate Bill 5113 (chapter 89, Laws of 2023) to include any institution of higher education in Washington state accredited by the Commission on Dental Accreditation (CODA) for faculty licensure.

The Department of Health is considering establishing a new chapter of rules, chapter 246-819 WAC, for the dental therapist profession to implement Engrossed Substitute House Bill (ESHB) 1678 (Chapter 460, Laws of 2023).

The Dental Quality Assurance Commission is proposing amendments to WAC 246-817-905 to expand the types of patients who are exempt from opioid prescribing rules.

The Dental Quality Assurance Commission and the Washington State Department of Health (DOH) are considering adding new section(s) to chapter 246-817 WAC to implement provisions of ESHB 1576 (chapter 297, Laws of 2023), codified as chapter 18.33 RCW, which creates a new interstate compact for dentists and gives member states the discretion to charge a fee for granting compact privileges.

The Board of Denturists (board) is considering updates to jurisprudence exam and examination requirements to reduce barriers for Denturists. The board is considering adopting substantial equivalency standard rules within WAC 246-812-120, WAC 246-812-125, WAC 246-812-159, and other rules to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023). 

The Board of Denturist adopted requirements in WAC 246-812-462 for the use of placement of prefabricated implant abutments. The adopted rule establishes the requirements that are to be followed for a licensed denturist to place a prefabricated implant abutment on an implant for the purpose of fabricating, repairing, relining, or rebasing a denture. The board also amended WAC 246-812-501 to ensure that a licensed denturist develop and maintain written infection control policies, procedures, and requirements for infection prevention and control that are appropriate for the denturist services provided by the facility.

The Board of Denturists (board) is proposing a new section of rule, WAC 246-812-462 - Prefabricated implant abutments, to set out the requirements for the placement of prefabricated implant abutments. The board is also proposing amending the infection control standards purpose statement in WAC 246-812-50 to ensure written policies and procedures are maintained.

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 is considering amending and creating new sections in chapter 246-945 WAC to include manufacturers and distributors of dialysate and dialysis devices in home dialysis program rules under the commission’s jurisdiction. The amendments under consideration are in response to statutory changes made by Substitute House Bill (SHB) 1675 (chapter 23, Laws of 2022).

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 Department of Health is proposing amending, repealing, and creating new rule sections in chapter 246-822 WAC, Dietitians and Nutritionists, to clarify, streamline, update, and modernize rules for licensing dietitians and nutritionists.

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.

Purpose: Engrossed Second Substitute Senate Bill (E2SSB) 5702 (chapter 236, Laws of 2022) requires the Department of Health (department) to develop minimum standards to ensure milk bank safety for donor human milk and human milk derived products. Milk banks are organizations that engage in the procurement, processing, storage, distribution or use of human milk contributed by donors. To ensure the safety of donor human milk and human milk derived products, the department is adopting safety standards in chapter 246-720 WAC to include donor screening, testing, milk handling and processing, and record keeping as required by the statute.

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.

Emergency Rule

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) 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 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 Department of Health is considering updates to rules regarding acute care and private psychiatric hospital fees to address funding needs under WAC 246-322-990. An update may be necessary to adequately fund the hospital inspection, investigation, and licensing programs to protect patients.

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 Pharmacy Quality Assurance Commission is considering amending WAC 246-945-055 to remove fenfluramine from the list of Schedule IV substances and adding a new section to chapter 246-945 WAC to establish a list of schedule IV exemptions. Fenfluramine is a medication used in the treatment of seizures associated with certain syndromes and as an appetite suppressant and was removed from the Drug Enforcement Administration’s (DEA) federal Controlled Substances Act (CSA) in December of 2022.

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 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.