Rulemaking Activity

The Washington State Department of Health (DOH) adopted a new chapter of rules to implement legislation. The rules establish standards for the designation of crisis centers as contact hubs within the 988 national suicide prevention and mental health crisis hotline system.

The Washington State Department of Health (DOH) rescinded an interpretive statement on abbreviated coordinated water system plans because it was outdated. Filed January 15, 2026, as WSR 26-03-053.

The Washington State Department of Health (DOH) in consultation with the Acupuncture and Eastern Medicine Advisory Committee (committee) is considering amending WAC 246-803-103 and WAC 246-803-240 to allow the acceptance of the Occupational English Test providing Acupuncture and Eastern medicine practitioner licensing applicants who have completed the required National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM) examinations in languages other than English. Other amendments relevant to application and examination requirements in chapter 246-803 WAC may also be considered.

The Washington State Department of Health (DOH) withdrew the Administrative Procedures and Requirements for Credentialed Health Care Providers CR-101 for chapter 246-12 WAC, which was filed April 20, 2017, and published in WSR 17-10-007 and will consider amending the rules at a future date.

Filed February 20, 2025 as WSR 25-06-011.

The Washington State Department of Health (DOH) adopted amendments to rules related to the Certificate of Need (CN) requirements for Percutaneous Coronary Intervention (PCI) programs in Chapter 246-310 WAC. These amendments update, modernize, and develop progressive enforcement tools for the adult elective PCI CN requirements.

The Washington State Board of Nursing (board) adopted amendments to the education requirements in WAC 246-840-010, 246-840-340, and 246-840-342 in response to the Joint Administrative Rules Review Committee’s (JARRC) recommendation. The board adopted amendments to define the term "graduate degree" as a master's or doctoral degree, for technical edits, and to provide for exemptions to education requirements for advanced registered nurse practitioner (ARNP) licensure as outlined in existing board procedures.

The Washington State Department of Health (DOH) adopted rules establishing a new agency affiliated counselor credential and made other updates or amendments to chapter 246-810 WAC pursuant to E2SHB 1504, 2SHB1724, and E2SHB 2247.

The Washington State Department of Health (DOH) continues without changing the previously adopted emergency rules, which align the rule language with statute and revise fees. This rule amends WACs 246-810-010, 246-810-015, and 246-810-990 in chapter 246-810 WAC to amend the definition of mental health professional (MHP) and create two new AAC credentials. DOH implemented changes by emergency rule originally under WSR 23-16-031, filed on July 21, 2023, and has continued without change these same amendments. These emergency rules will be in effect until the permanent rules adopted on February 20, 2025, under WSR 25-06-010 become effective on July 1, 2025, which will permanently create the new agency affiliated counselor credentials.

The Pharmacy Quality Assurance Commission rescinded policy statement P005 filed as WSR 20-17-018 on enforcement of AIDS education and training requirements because recent legislation repealed those requirements in law. Filed as WSR 25-16-046.

The Washington State Department of Health (DOH) is proposing an amendment to the federal rule publication date to conform to U.S. Environmental Protection Agency (EPA) requirements.

The Washington Medical Commission adopted amendments to the opioid prescribing rules to exclude patients with sickle cell disease, to clarify tapering considerations, and to clarify the use of biological specimen testing. The rules amend WAC 246-918-801 Exclusions, WAC 246-918-870 Periodic Review - Chronic pain, and WAC 246-918-900 Tapering considerations - Chronic pain for physician assistants, as well as WAC 246-919-851 Exclusions, WAC 246-919-920 Periodic Review - Chronic pain, and WAC 246-919-950, Tapering considerations - Chronic pain for allopathic physicians.

The Washington Medical Commission is considering amending WAC 246-919-010 through 246-919-520 and WAC 246-919-602 through 246-919-700 to modernize language, add clarity, and align with current practice.

The Washington State Department of Health (DOH) rescinded a policy statement addressing the provision of alternative water supplies because it was superseded by updated guidance. Filed January 15, 2026, as WSR 26-03-051.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-410 to clarify that only pharmacies may submit an AUP, per RCW 18.64A.040 and 18.64A.060, for approval by the commission to utilize pharmacy ancillary personnel as defined in RCW 18.64A.010(5).

The Washington Medical Commission adopted new chapter 246-921 WAC, creating a licensure framework and practice standards for anesthesiologist assistants.

The Washington State Department of Health (DOH) in consultation with the Washington Medical Commission adopted a new section of rule, WAC 246-921-990, to implement the licensing and regulation fees for the new anesthesiologist assistant (AA) profession.

The Washington State Department of Health (DOH) in consultation with the Washington Medical Commission proposes amendments to WAC 246-922-990 to establish fees for anesthesiologist assistants following recent rule changes authorizing licensure for this profession.

The Washington Medical Commission is proposing a new chapter of rule, chapter 246-921 WAC Anesthesiologist Assistants, to implement Senate Bill (SB) 5184 (chapter 362, Laws of 2024) codified under chapter 18.71D RCW, which created the new anesthesiologist assistant license.

The Washington State Department of Health (DOH), in consultation with the Washington State Applied Behavior Analysis Advisory Committee, is considering amendments to WAC 246-805-210, 246-805-240, and 246-805-330 to remove barriers for education and update the requirements for continuing supervision for certified behavior technicians (CBT) and licensed assistant behavior analysts (LABA).

The Washing State Department of Health (DOH) is proposing reducing licensure barriers and updating current rules to align with recent legislation. The proposed amendments to WAC 246-916-010 and 246-916-030 align with RCW 18.130.077.

The Washington State Department of Health (DOH) adopted amendments to WAC 246-916-010 and 246-916-030 to align with RCW 18.130.077, reducing barriers to licensure for out-of-state applicants and to increase clarity.

The Washington State Board of Health proposes updating hearing screening standards for schools in chapter 246-760 WAC. The changes would allow school districts to use otoacoustic emission devices as an alternative screening tool for students, clarify rule language, ensure consistency with vision screening sections, and align with current national standards.

The Washington State Department of Health (DOH) is proposing amendments to WAC 246-341-1108 to implement Second Substitute Senate Bill 6228 (chapter 366, Laws of 2024), that requires BHAs providing voluntary substance use disorder treatment services to report to DOH specific data on individuals who are voluntarily or involuntarily released from treatment early.

The Washington State Department of Health (DOH) is proposing rule amendments to update behavioral health agency fees in WAC 246-341-0365 and residential treatment facility fees in WAC 246-337-990. DOH is also proposing changes to clarify and standardize language.

The Washington State Department of Health (DOH) adopted amendments to Behavioral Health Agency (BHA) fees in WAC 246-341-0365 and Residential Treatment Facility (RTF) fees in WAC 246-337-990 to address funding requirements for inspection, investigation and licensing programs.

The Washington State Department of Health (DOH) adopted updates to chapter 246-341 WAC to provide greater access to care by streamlining the approval and certification process to operate an Opioid Treatment Program (OTP) and aligning state regulations with federal certification and treatment standards for OTPs. DOH also adopted updates to implement legislature that allows licensed OTPs to operate a mobile or fixed-site medication unit as part of, but geographically separate from, their existing licensed OTP. Amendments were also made to correct two internal citations from a previous rules project.

The Washington State Department of Health (DOH) adopted updates to WAC 246-341-1108 concerning reporting information about early release of individuals receiving substance use disorder (SUD) treatment to support treatment program compliance. These adopted rules implement legislative mandates and finalize rule language.

The Washington State Department of Health (DOH) adopted rules in chapter 246-809 WAC to implement recent legislation, including provisions of Second Substitute House Bill 1724 (chapter 425, Laws of 2023) and Engrossed Second Substitute House Bill 2247 (chapter 371, Laws of 2024), which establish an optional supervisor directory, set minimum supervision standards, create an optional stipend program, and allow applicants to practice under supervision for up to 120 days after submitting a completed application.

The Washington State Department of Health (DOH) adopted amendments to WAC 246-835-010 and 246-835-025 to update the definition of "culturally congruent care" and to clarify education and training requirements related to culturally congruent care.

The Washington State Department of Health (DOH) adopted amendments to WAC 246-835-040 to waive education, training, experience, and examination requirements for applicants that qualify for certification by endorsement to implement RCW 18.130.077.

The Washington State Department of Health (DOH) is proposing amendments to WAC 246-329-990 to update existing licensure and renewal fees for birthing centers and to establish a fee structure that incorporates accreditation status. The proposed changes are intended to comply with RCW 43.70.250, ensure program sustainability, and create an enforceable and transparent fee schedule.

The Washington State Department of Health (DOH) is considering amendments to WAC 246-329-990 regarding initial license, renewal, and other charges for birthing centers to address funding requirements. Recent legislation directs the department to make changes to inspection standards for state licensure. An update may be needed to restructure and adequately fund the birthing center inspection, investigation, and licensing programs to protect patients. The requirement in RCW 43.70.250 states that fees must cover regulatory program expenses which necessitates the program to be self-funding and changes to rules are the only way to make fee adjustments. 

The Washington State Department of Health (DOH) is considering rulemaking to implement and align with statutory changes under Substitute House Bill (SHB) 1824 (chapter 69, Laws of 2025). This rulemaking will consider amendments to Chapter 246-329 WAC to update inspection requirements for birthing centers and make other necessary updates.

Rescission of Interpretive Statement BON 21-01, Continuing Education Pharmacology Documentation. Filed February 8, 2024.

The board is rescinding this interpretive statement because the board has adopted amendments to WAC 246-836-080 Continuing competency program, that clarify what forms of documentation are acceptable to verify meeting the pharmacology continuing education requirements. Thus, the interpretive statement is no longer necessary.

Individuals requiring information on this rule should contact Rachel Phipps, program manager, phone 564-233-1277, email naturopathy@doh.wa.gov.

Clarifying that the Washington State Department of Health and the Board of Nursing Home Administrators consider the terms "Administrator-in-Training (AIT) program" and "administrator residency" to mean the same thing.

Effective Date: July 15, 2025. Filed July 8, 2025, as WSR 25-15-025.

Policy Number: OD 24-01. Allowances for in-person continuing education for licensed optometrists who have a continuing education reporting date in year 2024. Effective Date: March 1, 2024.

The Board of Optometry filed an expedited proposal to update citations in WAC 246-851-490 related to examination and licensure requirements.

Board of Osteopathic Medicine and Surgery rescinded policy statement OP22-01 filed as WSR 22-15-061 on telemedicine because it has been superseded by recent legislation. Filed July 31, 2025, as WSR 25-16-061.

The Washington State Department of Health (DOH) proposes expanding the applicability of brief adjudicative proceedings under the authority of DOH in WAC 246-10-501 and in Model Procedural Rules for Boards in WAC 246-11-420 to new category types eligible for Brief Adjudicated Proceedings.

The Washington State Department of Health (DOH) filed a CR-101 to consider changes to brief adjudicative proceedings (BAP) rules, which expand applicability to new category types for department rules and board and commission rules.

The Washington State Department of Health (DOH) rescinded CR101 filed as WSR 24-08-043, considering rulemaking on application of brief adjudicated proceedings for the DOH to combine and expand the scope of the amendment. Filed as WSR 25-12-004.

The Washington State Department of Health (DOH) rescinded CR101 filed as WSR 21-21-105, considering rulemaking on Application of Brief Adjudicated Proceedings for Boards and Commissions to combine and expand the scope of the amendment. Filed as WSR 25-12-003.

The Washington State Department of Health (DOH) adopted amendments to brief adjudicative proceedings rules in WAC 246-10-501 (DOH) and WAC 246-11-420 (Health Profession Boards and Commissions). The amendments expand the category types eligible for brief adjudicated proceedings.

The Washington State Department of Health (DOH) is considering a new section of chapter 246-310 WAC to establish requirements for nursing homes to provide in-home dialysis services under the Certificate of Need program.

The Washington State Department of Health (DOH) is considering an update to Certificate of Need (CN) review fees in WAC 246-310-990 and may also consider changes to clarify and standardize language.

The Washington State Department of Health (DOH) in consultation with the Washington Medical Commission proposes amending chapter 246-310 WAC to revise requirements related to percutaneous coronary intervention (PCI) programs, ensuring alignment with updated standards of care.

The Washington State Department of Health (DOH) proposes to create a new section and amend existing rules in chapter 246-926 WAC to implement Substitute House Bill 2355 (chapter 94, Laws of 2024), establishing certification requirements for MRI technologists. Housekeeping edits and updates are also proposed.

The Washington State Department of Health (DOH) adopted certification standards in chapter 246-929 WAC for the new certified peer specialist and trainee credentials establishing: the application process; education and examination requirements; supervised experience requirements; approved supervisor requirements; professional standards; continuing education requirements; and fees.

The Washington State Department of Health (DOH) adopted amendments to implement Second Substitute House Bill (2SHB) 1427 (chapter 360, Laws of 2025). The adopted rule amendments change the name of the credentials from Certified Peer Specialist and Certified Peer Specialist Trainee to Certified Peer Support Specialist and Certified Peer Support Specialist Trainee.

The Washington State Department of Health (DOH) proposes to update training and supervision standards in chapter 246-341 WAC to better support workforce development for certified peer support specialists.