Rule-Making Activity

The Podiatric Medical Board has adopted sections WAC 246-922-300 and WAC 246-922-310 to comply with RCW 43.70.163. The board adopted the Department of Health’s health equity model rules, WAC 246-12-800 through 246-12-830, for podiatric physicians and surgeons. The adopted rule adds two hours of health equity education, as required in the model rules, to be completed as part of the current continuing competency requirements every four years. In addition, the board also adopted amendments that correct some confusing rule language to clarify that a resident in an approved postgraduate residency training program is not required to participate in podiatric continuing medical education. 

The Podiatric Medical Board (board) adopted amendments to WAC 246-922-400, WAC 246-922-405, WAC 246-922-410, and WAC 246-922-415 to update language regarding health profession monitoring programs to align with changes made by Substitute Senate Bill (SSB) 5496 (chapter 43, Laws of 2022).

The Board of Hearing and Speech (board) adopted a new rule, WAC 246-828-505, and amended WAC 246-828-510 to implement Engrossed Substitute Senate Bill (ESSB) 5229 (chapter 276, Laws of 2021). The board adopted and exceeded the health equity model rule minimum standards. The board’s adopted rules require two hours of health equity education to be completed every three years as part of the current CE requirements for the professions. The adopted rules do not increase total CE hours but require two hours of health equity CE be absorbed into the existing CE hour requirements. This exceeds the minimum two hours of health equity education required every four years in the model rules.

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.

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.

The Dental Quality Assurance Commission adopted health equity continuing education requirements to meet the requirements of the Department of Health’s equity model rules, WAC 246-12-800 through 246-12-830. The amended rules add two hours of health equity education, to be completed as part of the current continuing education requirements every three years.

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.

Substitute Senate Bill (SSB) 6086, passed in 2020, allows a pharmacy to extend its pharmacy license to a remote dispensing site where technology is used to dispense medications for the treatment of Opioid Use Disorder (OUD) or its symptoms. The Pharmacy Quality Assurance Commission adopted rules that establish the minimum standards for OUD medication remote dispensing sites. Adopted rules reflect standards, restrictions and requirements set in statute.

The minimum standards must address who may access medications at the remote dispensing site pursuant to a valid prescription or chart order. The minimum standards must also require that the pharmacy is responsible for stocking and maintaining a perpetual inventory of the OUD medications stored in or at the remote dispensing site (referred to as the “supplying pharmacy” in the rule language).

Current rules in chapter 246-945 WAC cover requirements for drugs stored outside of a pharmacy but restrict their location to a facility that is otherwise able to store and possess drugs (i.e., a licensed pharmaceutical firm). The adopted rule, WAC 246-945-457, is necessary to establish enforceable minimum standards as directed by SSB 6086 for OUD medication remote dispensing sites. As the statute specifically requires rulemaking, no other alternatives were considered.

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 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 Dental Quality Assurance Commission is adopting amendments to requirements for the administration of anesthetic agents for dental procedures to reflect changes in patient care standards since the rule was adopted. The amendment includes changes and additions to pediatric protocols, emergency and on-call protocols, education, training, and medications including prescribing, administration and dosage.

Standards of care have changed since the current rule was adopted and a complete review was necessary. Creating a pediatric sedation endorsement is necessary to provide safeguards for the unique sedation needs of pediatric patients.

The adopted rule amendments require 24 hour on-call availability, update basic life support education requirements, add requirements for emergency protocols and training, clarify requirements for record keeping and emergency medications, establish requirements for self-inspections for all dentists when anesthetic is administered, update requirements for on-site inspections for dentists with moderate sedation with parenteral agents or general anesthesia permits, create a pediatric sedation endorsement, require vital sign monitoring for pediatric patients, clarify the requirement to obtain vital signs on American Society of Anesthesiologist classification ASA I age 13 and under will be at the dentist’s discretion, clarify requirements for prescribing for patient dosage prior to the appointment and specify that electrocardiogram (EKG) monitoring is not required when a pediatric patient is uncooperative or the emotional condition means monitoring is not possible or the patient does not tolerate the monitoring pads.

The commission made the following edits upon adoption:

• The date in WAC 246-817-765 (1) was changed from “January 1, 2024” to “January 1, 2025”.
• The word “and” was added to WAC 246-817-765(3)(c)(ii)(B)(V). 
• The word “or” was removed from WAC 246-817-740(1)(a) and (1)(b).

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 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.

The Washington Medical Commission (commission) adopted health equity continuing education requirements in new sections, WAC 246-918-195 and WAC 246-919-445. The commission has adopted the Department of Health’s health equity model rules, WAC 246-12-800 through 246-12-830, to adopt rules requiring a licensee to complete health equity CE training at least once every four years. The adopted rule does not change the total CE hours but requires two hours in health equity CE every four years which is absorbed into the existing number of CE hours required. The health equity CE requirement is counted under existing, unspecified CE requirements for the profession.

Department of Health adopted amendments to WAC 246-930-410 to establish health equity continuing education (CE) requirements. The adopted rule does not change the total CE hours required for SOTPs. It requires two hours in health equity CE every four years, which is absorbed into the existing number of CE hours required. Additionally, because an individual must hold an SOTP credential in addition to a credential for their primary health profession, the adopted rule does not require an SOTP to take an additional health equity CE training if they have already completed the training for their primary credential.

Describe any changes other than editing from proposed to adopted version: On its own initiative, the department has made minor edits to update formatting and increase clarity, including: (1) discontinuing the use of “and/or”; (2) removing bold formatting from rule text; (3) dividing subsection (4) into paragraphs for clarity; and (4) relocating a paragraph for greater visibility.
 
If a preliminary cost-benefit analysis was prepared under RCW 34.05.328, a final cost-benefit analysis is available by contacting:

Lana Crawford 
P.O. Box 47852
Olympia, WA 98504-7852 

Phone: 564-669-1455 
TTY: 711

Email: Lana.Crawford@doh.wa.gov

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."

The Washington State Board of Nursing (board) adopted health equity continuing education requirements in WAC 246-840-220 and WAC 246-840-222 to comply with RCW 43.70.613. The board’s adopted rule adds two hours of health equity education to be completed as part of the current continuing education requirements every year. This exceeds the two hours of health equity education to be completed every four years required in the Department of Health’s model rules. The proposed rule requires two hours in health equity CE every year which can be counted under existing CE requirements for the profession. 

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.

The Department of Health adopted amendments to WAC 246-809-095, 246-809-110, 246-809-130, 246-809-210, 246-809-310, 246-809-320, 246-809-330, 246-809-610, 246-809-630, 246-809-632, 246-809-650, and 246-809-730 to establish two hours of health equity continuing education (CE) requirements every four years for substance use disorder professionals. The adopted rules do not change the total CE hours. The hours are counted under existing, unspecified CE requirements for the profession.

The Department of Health amended WAC 246-850-140 to adopt the health equity model rules, WAC 246-12-800 through 246-12-830, for orthotists and prosthetists to comply with RCW 43.70.613. WAC 246-850-140 was amended to include at minimum two hours of CE in health equity every four years for orthotists and prosthetists. The health equity CE requirement will be added to the existing number of CE hours required for orthotists and prosthetists without changing the existing total number of required CE hours. The health equity CE requirement is counted under existing, unspecified CE requirements for the profession.

Amending the definition of mental health professional and creating certified agency affiliated counselor and licensed agency affiliated counselor credentials. Amending WACs 246-341-0200 and 246-341-0515 in chapter 246-341 WAC, Behavioral Health Agency Licensing and Certification Requirements, and WACs 246-810-010, 246-810-015, and 246-810-990 in chapter 246-810 WAC, Counselors. 

Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023) made several immediate changes impacting behavioral health agencies, including amending the definition of “mental health professional” (MHP) and creating two new agency affiliated counselor (AAC) credentials. Because 2SHB 1724’s amendments to the MHP definition and AAC credentials went into effect immediately and were designated as necessary for the immediate preservation of the public health, safety, or general welfare, the Department of Health (department) implemented these changes by emergency rule under WSR 23-16-031, filed on July 21, 2023.

This emergency rules continues without change the original emergency rule. The emergency rule:

• Amends chapter 246-341 WAC to address language that conflicts with 2SHB 1724, deleting an outdated definition of MHP requirements and updating an incorrect cross-reference.
• Amends chapter 246-810 WAC to expand existing language to establish two new credentials, the certified agency affiliated counselor (C-AAC) and the licensed agency affiliated counselor (L-AAC). The amendments align rule language with statute and revise the registered AAC fees to apply to all AAC types.

The emergency rules will be continued while permanent rule making is in progress under WSR 23-16-044, filed on July 25, 2023.

Reasons for this finding: The legislature established in 2SHB 1724, Section 33 that many sections of the bill are “necessary for the immediate preservation of the public peace, health, or support of the state government and its existing public institutions and take effect immediately.” Sections 13 through 20, which create the new AAC credentials and amends the definition of MHP, are among the sections that became effective immediately.

Under 2SHB 1724, RCW 71.05.020 was amended to define an MHP as an individual practicing within their credential’s scope of practice. Qualifying credentials include the certified and licensed AAC credential, but not the current AAC registration. Prior to the passage of 2SHB 1724, many MHPs performed assessments and made diagnoses with only a registration. After 2SHB 1724 became effective, however, they were required to obtain an AAC certification, AAC license, or other qualifying credential in order to continue providing these services. Establishing the new AAC credentials immediately by emergency rule and continuing these emergency rules allows MHPs to transition into the new credentials and continue providing essential behavioral health services while permanent rules are in progress.

If the department had waited to make these amendments through standard rule making, MHPs with an AAC registration would be both unable to continue assessing and diagnosing due to the changed MHP definition and unable to obtain a higher AAC credential that would allow them to continue that work. Continuing these emergency rules will allow MHPs who are AACs to continue serving Washington residents with behavioral health needs.

Policy Number: AAC-23-01. The Department of Health clarified their position on implementation of new agency affiliated counselor credentials. Effective Date: July 23, 2023. Filed as WSR 23-23-116.

The Department of Health is considering establishing chapter 246-385 WAC as a new chapter of rules to set inspection and operational standards for private detention facilities, health and safety standards for detained persons, and issuance of civil penalties pursuant to Second Substitute House Bill 1470 (2SHB 1470), chapter 419, Laws of 2023.

The Board of Osteopathic Medicine and Surgery adopted a new rule, WAC 246-873-045, to establish health equity continuing education (CE) requirements. The adopted rules do not change the total CE hours. They require two hours in health equity CE every four years, which is absorbed into the existing number of required CE hours. The health equity CE requirement is counted under existing, unspecified CE requirements for the profession.

The Board of Naturopathy adopted new rules that identify Botulinum Toxin (Botox) as a legend approved drug, clarify procedures that are within the scope of practice of naturopathic medicine, set training requirements, and establish minimum standards for the performance of nonsurgical cosmetic procedures by naturopathic physicians licensed in Washington state. The adopted rules also amend WAC 246-836-210 by removing the current exclusion for the use of Botox for cosmetic purposes.

The Dental Quality Assurance Commission is proposing amending WAC 246-817-150 to remove specific references about granting licenses to University of Washington faculty and replacing this with a reference to a faculty of any institution of higher education in Washington state accredited by the Commission on Dental Accreditation (CODA).

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-345 and potentially establishing a new section in chapter 246-945 WAC to clarify the expectation of pharmacies related to prescription transfers upon patient request. Other amendments to facilitate the timely transfer of prescription may also be considered.

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.

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.

The Department of Health adopted amendments to WAC 246-811-220, 246-811-240, and 246-811-280 and adopts a new rule section, WAC 246-811-290, to establish two hours of health equity continuing education (CE) requirements every four years for substance use disorder professionals. The adopted rules do not change the total CE hours. The hours are counted under existing, unspecified CE requirements for the profession. Additionally, the department adopts minor amendments to update and clarify rule language.

The Department of Health adopted amendments to WACs 246-810-027 and 246-810-0298 and creating a new section, WAC 246-810-0299, to establish two hours of health equity continuing education (CE) requirements every four years for certified counselors and certified advisers. The health equity CE requirement is counted under existing, unspecific CE requirements for the profession and does not change the total number of CE hours required. Additionally, clarify and streamline rule language without changing its effect.

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.

This memo serves as notice that the Department of Health is withdrawing CR-101, filed January 8, 2021, published under WSR 21-03-011, and CR-102 filed on May 24, 2023, published under WSR 23-11-166. The department is withdrawing this CR-101 and CR-102 because the comments received from interested parties during the public comment process indicated substantial opposition to the rule as proposed.

As a result, the department will continue to use its existing authority and rules to determine the need for new trauma centers and the optimal distribution of trauma services to ensure equitable access to trauma care. Individuals requiring information on this rule should contact Anthony Partridge, Program Manager, at anthony.partridge@doh.wa.gov.

The Department of Health is adopting an amendment to WAC 246-916-060 to implement Engrossed Substitute Senate Bill (ESSB) 5229 (chapter 276, Laws of 2021), codified as RCW 43.70.613. The department is adopting the health equity model rules, WAC 246-12-800 through 246-12-830, for the athletic trainer profession to comply with the statute.

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 Department of Health (department) is adopting an increase in fees to cover the costs of operating the Radiation Machine Facility Program. The department is also adopting changes to machine categories within the fee schedule to allow the department to better track and manage X-ray machines across Washington. This will allow the department to be more efficient in regulatory and inspection processes.

The Department of Health (department) is proposing to establish a retired active fee for the nursing home administrator license in WAC 246-843-990.

Clarifying terms and information about prescription history for the PMP. The Department of Health (department) is considering clarifying that prescribers can request the history of prescriptions they have written. The department is considering changes to WAC 246-470- 010, 246-470-030, and 246-470-050 and potentially other related sections in chapter 246-470 WAC to help clarify rules including terms and definitions relating to the Prescription Monitoring Program.

The Board of Optometry adopted changes to WAC 246-851-090 and WAC 246-851-125 through 246-851-230 related to CE requirements for licensed optometrists. Adopted amendments include online continuing education, new definitions, limits on types and categories of CE hours, reference to other required trainings, CE documentation requirements, clarifying self-study requirements, and certain allowances during a declared state of emergency.

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 Board of Optometry adopted WAC 246-851-225, a new section requiring two hours of health equity continuing education (CE) every four years for licensed optometrists. Health equity CE programs must meet the standards created in the Department of Health model rules in WAC 246-12-800 through 246-12-830. The adopted rule does not add to the total CE hours required to renew the license.

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 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.

The Department of Health in consultation with the Board of Nursing, formerly known as the Nursing Care Quality Assurance Commission, is proposing to increase the nursing center surcharge fee and proposing to create a new fee for a multistate nursing license in WAC 246-840-990. The proposed rule implements Substitute Senate Bill (SSB) 5499, Multistate Nurse Licensure Compact (Chapter 123, Laws of 2023).

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).

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.

The Department of Health is considering creating a new chapter of rules under Title 246 WAC to establish licensing regulations for music therapists, including fees. The department will consider any necessary rules for an advisory committee.

The Dental Quality Assurance Commission is considering adding residential habilitation centers, nursing homes, and long-term hospitals to the list of opioid prescribing exclusions in WAC 246-817-905 Exclusions.

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.