Rulemaking Activity

The Washington State Department of Health (DOH) is proposing new rules in chapter 246-827 WAC and proposing an amendment to WAC 246-827-990 to implement this new credential type.

The Washington State Department of Health (DOH) is proposing rule amendments to WAC 246-827-0010, 246-827-0200, and 246-827-0240 to align rules with updated statutes and best practices. DOH is also proposing a new section, WAC 246-827-0340, to address the medication administration requirements for the medical assistant-registered credential.

The Washington State Department of Health (DOH) withdrew a CR101 impacting chapter 246-827 WAC; CR-101 titled “Medical Assistants— Various Provisions” filed October 3, 2023, published as WSR 23-20-118. DOH filed a new CR101 to accommodate Engrossed Substitute Senate Bill (ESSB) 5983 (chapter 248, Laws of 2024) which impacts the same sections of rule. 

The Washington State Department of Health (DOH) adopted amendments to sections WAC 246-338-022, 246-338-040, 246-338-050, 246-338-060, 246-338-070, 246-338-080, and 246-338-090 to incorporate existing minimum standards that are missing, make technical corrections to rules, and adopt new federal requirements.

To align with federal rules, the Washington State Department of Health (DOH) removed the professions of naturopath licensed under chapter 18.36A RCW and midwife licensed under chapter 18.50 RCW from the list of licensed professionals that may perform a provider performed microscopic procedure (PPMP) in WAC 246-338-020. DOH clarified that both the laboratory director and testing personnel of PPMP must be licensed professionals. A technical citation amendment was also made to a definition in WAC 246-338-010.

The Washington State Department of Health (DOH) is proposing amendments to sections WAC 246-338-022, 246-338-040, 246-338-050, 246-338-060, 246-338-070, 246-338-080, and 246-338-090 to incorporate existing minimum standards that are missing, make technical corrections to rules, and adopt new federal requirements.

To align with federal rules, the Department of Health (department) is proposing removing the professions of naturopath licensed under chapter 18.36A RCW and midwife licensed under chapter 18.50 RCW from the list of licensed professionals that may perform a provider performed microscopic procedure (PPMP) in WAC 246-338-020. The department is proposing to clarify that both the laboratory director and testing personnel of PPMP must be licensed professionals. The department is also proposing a technical citation adjustment to a definition in WAC 246-338-010. 

The Washington State Department of Health (DOH) adopted amendments to establish criteria for medication assistance in community-based and in-home care settings in accordance with chapter 69.41 RCW.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-714 regulating medication assistance provided by nonpractitioners to bring the rule line with changes made to RCW 69.41.010(15) following the passage of Substitute House Bill (SHB) 1720 (chapter 26, Laws of 2025).

The Pharmacy Quality Assurance Commission and Washington State Department of Health (DOH) are jointly proposing adding five new sections, WACs 246-945-710, 246-945-712, 246-945-714, 246-945-716, and 246-945-718, to establish standards for the practice of medication assistance. The proposed rules describe definitions, actions, and restrictions pertaining to the provision of medication assistance in accordance with chapter 69.41 RCW. 

The Department of Health rescinded the CR103E filed as WSR 24-07-062 amending behavioral health agency licensing and certification requirements because it was incomplete. The emergency rule was refiled correctly under WSR 24-07-100. Filed March 20, 2024.

The Washington State Board of Nursing (WABON) rescinded emergency rules in WAC 246-840-030 and WAC 246-840-090 filed as WSR 24-10-096 which clarified licensing requirements for registered nurse (RN) and licensed practical nurse (LPN) out of state applicants because the amendments have been adopted in permanent rule, making the emergency rule unnecessary.

The Department of Health is rescinded the CR-103E for the Sixth Emergency rule for proprietary treatment products and the use of substitution products under WAC 246-272A-0110, published as WSR 24-04-071 because a permanent rule WSR 24-06-046 filed on March 1, 2024 makes the emergency rule redundant.

The Washington State Department of Health (DOH) is proposing permanent rules to reduce barriers for entering and remaining in the behavioral health care workforce and streamline and shorten the credentialing process by removing renewal limits for associate-level credentials, allowing professional experience to substitute for clinical practicum experience, and by lowering continuing education requirements, chapter 246-809 WAC. 

The Department of Health is considering rule amendments to reduce barriers to licensure and streamlining the credentialing process in chapter 246-809 WAC.

The Washington State Department of Health (DOH) rescinded the sixth emergency rule filed as WSR 25-11-057 related to the licensed counselor supervisory directory because permanent rules on the topic have become effective. Filed as WSR 25-13-039.

The Washington State Department of Health (DOH) rescinded emergency rule WSR 25-11-057 for Mental Health Counselors, Marriage and Family Therapists, and Social Worker Associates because permanent rulemaking on the topic has been completed.

The Washington State Department of Health (DOH) issued interpretive statement EHS-01-2024 advising local health officers on the application of chapter 64.44 RCW when personal use of methamphetamine is suspected in transient accommodations. Effective June 1, 2024. Filed as WSR 24-12-032 on May 29, 2024.

The Department of Health (department) adopted amendments to chapter 246-834 WAC implementing Substitute Senate Bill (SSB) 5765 (chapter 289, Laws of 2022), which created two levels of limited prescriptive license extensions for midwives to prescribe, obtain, and administer medications and certain therapies. The department also adopted amendments to chapter 246-834 WAC to implement Engrossed Substitute Senate Bill (ESSB) 5229 (chapter 276, Laws of 2021) regarding health equity CE requirements. The adopted amendments additionally replace gendered language with gender-neutral terms to make the chapter more inclusive.

The Department of Health (department) is proposing amendments to chapter 246-834 WAC to implement Substitute Senate Bill 5765 (chapter 289, Laws of 2022), which created two levels of limited prescriptive license extension for midwives to prescribe, obtain, and administer medications and therapies for the prevention and treatment of common prenatal and postpartum conditions, family planning methods, medical devices and implants. This bill also gave the Secretary of Health the authority to establish education requirements in the chapter. The department is also proposing amendments to implement Engrossed Substitute Senate Bill 5229 (chapter 276, Laws of 2021) regarding health equity continuing education requirements.

The Washington Medical Commission is amending WAC 246-918-076 (physician assistants) and WAC 246-919-397 (physicians) to align with the provisions of the Military Spouse Employment Act.

The Dental Quality Assurance Commission is proposing amendments to WAC 246-817-187, Temporary practice permit - Military spouse eligibility and issuance, to update language changes made by Second Substitute House Bill (2SHB) 1009 (chapter 165, Laws of 2023).

The Washington State Department of Health (DOH) adopted amendments to WAC 246-12-051 to align with recent legislation to expedite the issuance of professional licenses for military spouses who hold a license in another state by removing the need to first leave employment. 

The Department of Health is proposing amendments to WAC 246-12-051 to update language changes made by Second Substitute House Bill (2SHB) 1009 (chapter 165, Laws of 2023). The proposed changes will align the rules with statutory changes regarding licensure of military spouses who hold a license in another state.

Outlines the Washington State Department of Health’s (DOH) process to enforce RCW 70.54.500, Motor carriers – Access to restroom facilities. RCW 70.54.500 requires a shipper or consignee to provide access to a restroom to a motor carrier delivering goods to or picking goods up during normal business hours.

Effective Date: July 1, 2024. Filed November 6, 2024.

The Department of Health in consultation with the Washington State Board of Nursing (board), adopted amendments to WAC 246-840-990 to establish the multistate nursing license fee and increase the nursing center surcharge fee as directed by Substitute Senate Bill (SSB) 5499 (chapter 123, Laws of 2023).

The Washington State Department of Health (DOH) adopted rules necessary to create a licensure program for music therapists. Individuals working as a music therapist are required to be licensed by January 1, 2025. The adopted rules establish the new profession’s licensure requirements which include education, training, and examination requirements for initial licensure; continuing education requirements; fees for licensing, examination, and renewal; and other qualifications as determined by the secretary.

This emergency rule filing allows for the 3mg and 4mg dosage versions of naloxone spray to be prescribed as Over-The-Counter (OTC) products. This rule is unchanged from the previous emergency rule under WSR 24-01-021 filed on December 8, 2023. This emergency rule will be continued until the permanent rulemaking is effective.

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 Naturopathy is considering amendments to licensure requirements relating to the jurisprudence examination as a condition for licensure and to clarify, update, and simplify rules to comply with Second Substitute House bill (2SHB) 1724, (chapter 425, Laws of 2023) codified as RCW 18.130.077.

The Board of Naturopathy has adopted amendments to WAC 246-836-020, Requirements for licensure, and WAC 246-836-040, Jurisprudence examinations to clarify, update, and simplify rules to align with RCW 18.130.077. To account for changes to the credentialing system the board is delaying the effective date to September 1, 2025.

The Washington State Department of Health (DOH) in consultation with the Board of Naturopathy, is considering removing the jurisprudence examination fee from WAC 246-836-990 to align with the recent changes to the naturopathic licensure requirements.

The Washington State Department of Health (DOH) in consultation with the Board of Naturopathy proposes removing the jurisprudence exam fee from the naturopathic physician licensure fees in WAC 246-836-990 to align with the recent changes to the naturopathic licensure requirements.

The Board of Naturopathy adopted amendments to WAC 246-836-080, to clarify continuing education (CE) requirements pertaining to pharmacology CE and to implement health equity CE requirements mandated by Engrossed Substitute Senate Bill (ESSB) 5229 (chapter 276, Laws of 2021), codified as RCW 43.70.613. The adopted amendments clarify acceptable forms of documentation to verify the pharmacology CE requirements and implement the Department of Health’s model health equity CE requirements.

The Board of Naturopathy is proposing amendments to licensure requirements in WAC 246-836-020 and WAC 246-836-040 relating to jurisprudence examinations as a condition for licensure for naturopathic physicians and to clarify, update, and simplify rules to comply with RCW 18.130.077.

The Washington Medical Commission is considering amending WAC 246-919-601 to exempt the use of nitrous oxide in office-based surgical settings under certain circumstances. Additionally, the commission is considering adding a new subsection to further address the use of nitrous oxide in such settings.

The State Board of Health (SBOH) is considering amending the reporting requirements for COVID-19 in chapter 246-101 WAC, in response to feedback from local health jurisdictions and changes in the national notifiable condition designation by the Council for State and Territorial Epidemiologists. SBOH will not consider other changes to these rules at this time.

The Washington State Board of Nursing (board) is considering amendments to education and experience requirements in WAC 246-840-517 and other related sections in chapter 246-840 WAC for nurse administrators of baccalaureate nursing education programs in response to E2SSB 5582 (Chapter 126, Laws of 2023) codified as RCW 18.79.150.

The Board of Nursing is considering amendments to nursing assistant rules to implement skills testing in training programs, make changes to the specialty curricula rule requirements, and other related rules as appropriate.

The Washington State Board of Nursing withdrew the CR-101 for nursing assistant skills testing, chapter 246-841A WAC, which was filed on September 27, 2024, and published as WSR 24-20-087. The board withdrew this CR-101 because its scope is limited to integrating skills testing to nursing assistant training programs. However, additional critical topics must be addressed, including changes to the specialty curricula rule requirements in WAC 246-841A-440(1)(c). 

The Washington State Board of Nursing is proposing a new section of rule, WAC 246-840-5341, and amendments to WAC 246-840-534 to implement Engrossed Second Substitute Senate Bill (E2SSB) 5582 (chapter 126, Laws of 2023).

The Washington State Board of Nursing adopted a new section of rule, WAC 246-840-5341 to establish the requirements for use of simulation-based learning experiences as a substitute for required clinical and direct patient care experiences in licensed practical nurse (LPN), registered nurse (RN), or RN to Bachelor of Science in Nursing (BSN) education programs. The board also adopted amendments to the current simulation rule, WAC 246-840-534, to clarify the use of simulation at a 1:1 ratio.

The Washington State Board of Nursing proposed amendments to education and experience requirements for nurse administrators of baccalaureate nursing education programs in WAC 246-840-517 in response to RCW 18.79.150.

The Washington State Department of Health (DOH) in consultation with the Washington State Board of Nursing, permanently adopted amendments to WAC 246-840-990 to make a housekeeping change to correct fee total amounts. There is no change to the fees being charged. The changes only correct a technical error in the total lines. 

The Washington State Department of Health (DOH), in consultation with the Washington State Board of Nursing, is proposing amendments to WAC 246-840-990 to make a housekeeping change to correct fee total amounts.

The Department of Health adopted a retired active fee for the nursing home administrator license. Concurrently, the Board of Nursing Home Administrators adopted a retired active status to allow an individual to practice in emergent or intermittent circumstances and pay a reduced renewal fee. This will allow individuals to fill in at nursing homes that need a temporary administrator while recruiting a new administrator to assist in emergency circumstances such as a pandemic.

The Board of Nursing Home Administrators adopted rule amendments and a new rule to expand and clarify licensure requirement for licensure and temporary practice permits by correcting and updating continuing education requirements, language and citations, and correcting a typographical error. The rule no longer requires HIV/AIDS education. The rules add health equity continuing education.

The Board of Nursing Home Administrators are proposing amendments to WAC 246-843-090, 246-843-095, and 246-843-230 to reduce barriers for licensure and align with RCW 18.130.077. 

Rescission of interpretive statement NCIS2.00 for WAC 246-840-4659 because a permanent rule has been adopted in its place. The rule clarifies the application of the advanced practice pain management rules in nursing homes and long-term acute care hospitals and incorporated the interpretive statement into permanent rule. Filed on January 31, 2024.

The board engaged in rulemaking to clarify the application of the advanced practice pain management rules in nursing homes and long-term acute care hospitals and incorporated the interpretive statement into permanent rule. The proposed rule was adopted by the board in a rule hearing on May 12, 2023. The permanent rule was filed on June 29, 2023 as WSR 23-14-082.

The Washington State Department of Health (DOH) issued a policy statement providing clarity about the reporting requirements outlined in Substitute Senate Bill 5547, Nursing Pool Transparency. Effective Date: June 12, 2024.

Filed on August 1, 2024.