Rulemaking Activity

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.

The Washington State Department of Health (DOH) is implementing legislation reducing licensure barriers for hearing and speech professions and clarifying requirements for speech-language pathology assistant certification in chapter 246-828 WAC.

The Board of Hearing and Speech adopted amendments to implement section 8 of Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023), codified as RCW 18.130.077 to reduce barriers to entering and remaining in the hearing and speech workforce and to shorten the credentialing process. This rule adopts revisions to WAC 246-828-020, 246-828-510, and creates a new section, WAC 246-828-035.

The Board of Hearing and Speech is considering amendments to WAC 246-828-020, WAC 246-828-510, and WAC 246-828-617 to update requirements for speech-language pathology assistant certification. The board may also consider making related updates or new sections to clarify and streamline licensure in chapter 246-828 WAC.

The State Board of Health (SBOH) adopted standards for hearing screening standards for school districts which establish requirements for annual preventative hearing and vision screenings.

The Department of Health continues rules to establish alternate certification time frames for individuals working toward certification as a home care aide or nursing assistant. This emergency rule continues the previous emergency rule (WSR 24-02-051) without change. Due to lasting impacts caused by the coronavirus disease 2019 (COVID-19) pandemic, many long-term care workers are still unable to obtain training and certification as home care aides or NA-Cs within statutory time frames.

The Washington State Department of Health (DOH) has adopted a sixth emergency rule to continue without change rules established alternate certification time frames for two different groups of long-term care workers: individuals working toward certification as a home care aide and individuals working toward certification as an NA-C. This includes amending WAC 246-980-025, 246-980-030, 246-980-040, 246-980-065 and adopting a new rule section, WAC 246-980-011. Rules impacting home care aides were developed in collaboration with the Department of Social and Health Services (DSHS), while rules impacting NA-Cs were developed in collaboration with DSHS and the Washington State Board of Nursing (WABON).

The Washington State Department of Health (DOH) adopted without change emergency rules which establish alternate certification time frames for individuals working toward certification as a home care aide or nursing assistant-certified (NA-C), due to impacts of the COVID-19 pandemic. This includes adopting new rule WAC 246-980-011 and amending WAC 246-980-025, 246-980-030, 246-980-040, and 246-980-065 to allow additional time for long-term care workers to complete training, testing, and credentialing.

The Washington State Department of Health (DOH) established alternate certification time frames for individuals working toward certification as a home care aide or nursing assistant-certified. This includes amending WAC 246-980-025, 246-980-030, 246-980-040, 246-980-065 and adopting a new rule, WAC 246-980-011. The rules allow workers impacted by the coronavirus disease 2019 pandemic more time to complete requirements while training, testing, and credentialing capacity issues are being resolved. This is the seventh and anticipated final emergency rule.

The Washington State Department of Health (DOH) adopted amendments to WAC 246-980-025 and 246-980-110 allowing expanded exemptions from certification requirements for home care aides.

The Washington State Department of Health (DOH) adopted rules to implement legislation to increase the home care aide workforce in Chapter 246-980 WAC to align with statutory changes and implement Engrossed Second Substitute House Bill (E2SHB) 1694(chapter 424, Laws of 2023) and Engrossed Second Substitute Senate Bill (E2SSB) 5278 (chapter 323, Laws of 2023). These rules address the date of hire, the home care aide workforce, certification examinations, certification process, and other aspects of the profession. 

The Department of Health is considering amending chapter 246-980 WAC to implement Engrossed Second Substitute House Bill 1694, (chapter 424, Laws of 2023) and Engrossed Second Substitute Senate Bill 5278, (chapter 323, Laws of 2023). These laws reduce barriers to hire home care aides.

The Washington State Department of Health (DOH) proposes to implement Senate Bill 5811 (chapter 322, Laws of 2024), which expands criteria for exemptions from the requirement to obtain home care aide certification.

The Pharmacy Quality Assurance Commission is proposing to amend WAC 246-945-090, 246-945-091, 246-945-092, and 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. The amendments are proposed in response to statutory changes made by Substitute House Bill (SHB) 1675 (chapter 23, Laws of 2022). 

The Washington State Department of Health (DOH) is considering establishing standards for hospital at-home services to implement Substitute House Bill (SHB) 2295 (chapter 259, Laws of 2024). DOH is considering amending chapter 246-320 WAC to add hospital at-home services as a type of service that can be offered by hospitals, establish standards, and consider creating a fee to cover costs.

The Washington State Department of Health (DOH) adopted permanent rules establishing standards and fees in WAC 246-320-278 and 246-320-199 for hospital at-home programs. These adopted rules implement recent legislation codified as RCW 70.41.550.

The Washington State Department of Health (DOH) is proposing rules to establish operating standards and fees for hospital at-home services. Proposing amendments to WAC 246-320-199 and creating a new rule, WAC 246-320-278, to add hospital at-home services as a type of service offered by hospitals. The rules establish operating standards and create a fee to cover the costs of reviewing applications for the hospital at-home program.

In accordance with Governor Directive 25-01, the Washington State Department of Health (DOH) amended WAC 246-320-010 and WAC 246-320-281to ensure access to treatment, including abortion care, for emergency medical conditions in hospital emergency departments and protection of a pregnant person’s right to exercise informed consent in prioritizing their health and safety when receiving treatment for emergency medical conditions in hospital emergency departments. These requirements are subject to applicable protections of conscience and the free exercise of religion under state and federal law.

The Washington State Department of Health (DOH) is considering amendments to the accounting and reporting manual requirements for the uniform, hospital financial reporting system in Chapter 246-454 WAC to implement requirements in Engrossed Second Substitute House Bill (E2SHB)1272 (chapter 162, Laws of 2021) and additional sections to update language that contains references to Chapter 246-454 WAC.

The Washington State Department of Health (DOH) is proposing amendments to chapter 246-454 WAC to simplify existing rules regarding the uniform system for hospitals for accounting, financial reporting, budgeting, and cost allocation. Also proposed are amendments to update outdated language within chapter 246-454 WAC, and two sections of Hospitals-Assessments and Related Reports, WAC 246-451-010 and 246-451-050.

The Washington State Department of Health (DOH) is refiling to correct a clerical error when filing original proposal. Amendments to chapter 246-454 WAC. 

The Washington State Department of Health (DOH) adopted amendments to simplify existing requirements regarding the uniform system for hospitals for accounting, financial reporting, budgeting, and cost allocation. Additionally, the adopted amendments update outdated language within chapter 246-454 WAC, and two sections of Hospitals-Assessments and Related Reports in WAC 246-451-010 and 246-451-050.

The Washington State Department of Health (DOH) is proposing amendments to WACs 246-320-500, 246-320-505, and 246-320-600 to align hospital licensing construction standards with the 2022 editions of the Guidelines for Design and Construction of Hospitals and the Guidelines for Design and Construction of Outpatient Facilities. Additionally, DOH is proposing to increase the construction cost threshold for projects that require a pre-submission conference from $250,000 to $500,000. For clarity and readability, DOH is proposing to reformat WAC 246-320-600 by adopting the 2022 Guidelines by reference and publishing a separate document outlining Washington’s amendments to the 2022 Guidelines. 

The Washington State Department of Health (DOH) aligned existing rules with Nationally Recognized Industry Standards in chapter 246-320 WAC. The updates also increase the cost threshold for projects that require a pre-submission conference with DOH and, for readability purposes, adopted the 2022 Guidelines by reference.

Interpreting the requirements of RCW 70.41.420, which describes the establishment, composition, and responsibilities of hospital staffing committees. Interpretive Statement CHS-01-17-24. Effective Date: January 1, 2024

The Washington State Department of Health's interpretation of RCW 70.41.420, as it relates to the establishment, composition, and responsibilities of hospital staffing committees. Effective Date: June 21, 2024.

The Washington State Department of Health (DOH) is considering rule amendments to update fees for in-home services agencies and to clarify and standardize language in WAC 246-335-990.

The Washington State Department of Health (DOH) proposed a technical correction to WAC 246-335-540, updating the citation to RCW 74.09.325 regarding audio-only telemedicine services.

The Pharmacy Quality Assurance Commission adopted revisions to WAC 246-945-010, 246-945-013, 246-945-030, 246-945-550, and 246-945-565 to update various references incorporated throughout the rules. The new section adopted as WAC 246-945-034 incorporates updates to FDA drug classifications. When effective, the amendments to WAC 246-945-030 and adoption of WAC 246-945-034 will supersede emergency rules filed as WSR 24-16-085 on August 1, 2024.

The Washington State Department of Health (DOH) adopted new and amended rules in WAC 246-322, 246-337, and 246-341 to establish administrative fees for attestations that a Tribal RTF or tribal private psychiatric hospital meets state minimum standards for licensure, and to align those fees with proposed attestation fees for Tribal BHAs. The amended rules also clarify that the standard licensure process does not apply to Tribes seeking licensure via attestation.

The Washington State Board of Nursing is proposing amendments to clarify specific licensing requirements for out-of-state Registered Nurse (RN) and Licensed Practical Nurse (LPN) applicants.

The Washington State Board of Nursing adopted amendments to WAC 246-840-030 and WAC 246-840-090 clarifying specific licensing requirements for out-of-state registered nurse and licensed practical nurse applicants.

The Washington State Department of Health (DOH) amended chapter 246-562-WAC to rewrite the rule for better organization, clarity, and modernization. The adopted amendments better reflect the purpose and intent of the J-1 Visa Waiver Program and clarify the changes in physician practice and the need for physicians across Washington state. The adopted amendments address the applicant criteria, the application review process, and the need for more available specialist waivers slots earlier in the fiscal year. The rule adoption implements a scoring methodology to allow DOH to prioritize waiver placements based on physician practices, employers, and communities that are in highest need across the state. DOH created two new sections in the rule adoption to include requirements for requesting letters attestation and letters of completion.

The Washington State Department of Health (DOH) is proposing a rewrite and reorganization of chapter 246-562 WAC to clarify and update rules about J-1 physician visa waivers. 

Withdrawal of WSR 23-12-089, for chapter 246-562 WAC Physician Visa Waivers. The department is expanding the scope of the rule making project under a new CR-101.

The Department of Health is proposing a new section, WAC 246-310-825 kidney disease treatment centers — temporary emergency situation exemption, and amending existing kidney disease treatment center rules, WAC 246-310-800 through 246-310-833, to implement Substitute Senate Bill (SSB) 5569 (chapter 48, Laws of 2023).

The Washington State Department of Health (DOH) adopted a new section, WAC 246-310-825 and adopted amendments to existing kidney disease treatment center rules, WAC 246-310-800 through 246-310-806, and 246-310-812 through 246-310-833, to implement Substitute Senate Bill (SSB) 5569 (chapter 48, Laws of 2023), codified in RCW 70.38.280. DOH also adopted amendments to address impacts to the need methodology based upon new temporary emergency situation exemption, as well as clean-up language to ensure consistency in kidney disease treatment center rules.

The Washington State Department of Health (DOH) is proposing to establish a civil penalty schedule for violations of a law or rule regulating large on-site sewage systems. This proposed rule is necessary to clarify DOH penalties based on significance of the violation, previous compliance record, and the presence of aggravating or exacerbating circumstances. 

The Washington State Department of Health (DOH) is considering amending chapter 246-272B WAC to add a penalty schedule for the issuance of civil penalties. RCW 70A.115.050 gives DOH the ability to assess a penalty of not more than ten thousand dollars per day for every violation of a law or rule regulating large onsite sewage systems. Rules that establish a penalty schedule will clarify DOH’s penalties based on the severity of the violation.

The Washington State Department of Health (DOH) adopted updated certification requirements to reduce barriers, clarify requirements, and update continuing health equity and AIDS continuing education and training requirements. Fees were added and updated to support the new rule changes.

Citation of rules affected by this order:

New: WACs 246-805-025, 246-805-110, 246-805-120, 246-805-130, 246-805-250, 246-805-325, 246-805-340, 246-805-401, 246-805-402, 246-805-510, and 246-805-520

Repealed: WAC 246-805-020

Amended: WACs 246-805-010, 246-805-100, 246-805-200, 246-805-220, 246-805-230, 246-805-240, 246-805-300, 246-805-310, 246-805-320, 246-805-330, 246-805-400, 246-805-410, and 246-805-990

The Washington State Department of Health (DOH) adopted rules in chapter 246-809 WAC to streamline the licensure process for mental health counselors, marriage and family therapists, and social workers. Changes include updates to education, supervision, and credentialing standards, as well as reducing barriers for associate-level and out-of-state applicants.

The Washington State Department of Health (DOH) is proposing permanent rules to implement new requirements in chapter 246-809 WAC. The proposed rules establish standards for the licensed counselor supervisor directory program, supervision, practice on a pending license, and the supervision stipend program.

The Board of Optometry adopted an amendment to WAC 246-851-490 that removes the jurisprudence (JP) examination requirement from initial licensure. The board is also adopting amendments to WAC 246-851-090 that adds the JP exam as a requirement for a licensed optometrist’s first full CE reporting period, allowing it to count for a maximum of three hours within the existing CE hour requirements.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-230 and potentially establishing a new section in chapter 246-945 WAC to clarify when facilities need to submit a modification or remodel application and what constitutes a modification or remodel.

The Washington State Department of Health (DOH) is considering adding new sections to and updating sections of chapter 246-926 WAC, Radiologic imaging professionals, to implement Substitute House Bill (SHB) 2355 (chapter 94, Laws of 2024), which establishes certification of MRI technologists. DOH will also consider minor housekeeping edits and or updates related specifically to establishing and regulating MRI technologists.

The Washington State Department of Health (DOH) adopted rules creating a new section and amending chapter 246-926 WAC to implement SHB 2355, establishing certification requirements for MRI technologists and making related updates.

The Washington State Department of Health (DOH) is considering rule amendments and adding new sections to chapter 246-827 WAC, Medical Assistants, to implement Substitute Senate Bill (SSB) 5940 (chapter 217, Laws of 2024) establishing the MA-EMT credential for individuals holding a current EMT, advanced EMT, or paramedic credential. DOH will also consider fees for the new credentials.

The Washington State Department of Health (DOH) adopted amendments to chapter 246-827 WAC and related sections to establish the new credential of MA-EMT to implement Substitute Senate Bill 5940.

The Washington State Department of Health (DOH) adopted amendments to WAC 246-827-0010, 246-827-0200, and 246-827-0240 and adopted a new section, WAC 246-827-0340. The adopted amendments ensure that the rules are current and align with best practices, and include updating and clarifying definitions, updating credentialing requirements, and aligning medication administration and supervision requirements to the recently enacted statutes.

The Washington State Department of Health (DOH) is considering rule amendments to WAC 246-827-0010, 246-827-0200, and 246-827-0240 to align with Engrossed Substitute House Bill (ESHB) 1073 (chapter 134, Laws of 2023) and Engrossed Substitute Senate Bill (ESSB) 5983 (chapter 248, Laws of 2024) to ensure that the rules are current and align with best practices. DOH will also consider adding a new section, WAC 246-827-0340, to address the medication administration requirements for the medical assistant-registered credential.