Rulemaking Activity

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 Washington State Department of Health (DOH) is considering amending WAC 246-976-022 and 246-976-041 to expand initial enrollment for Emergency Medical Responder (EMR) and Emergency Medical Technician (EMT) training to students who are 16 years of age. Consideration is in response to Bill (HB) 1722 (chapter 98, Laws of 2025). Other amendments to sections or adding a new section in chapter 246-976 WAC may also be considered to address this specific topic.

The Washington State Department of Health (DOH) continued emergency rules to ensure that state law protects access to treatment, including abortion care, for emergency medical conditions in hospital emergency departments.

The Washington State Department of Health (DOH) proposes permanent amendments to WAC 246-320-010 and 246-320-281 in accordance with recently passed legislation and Directive of the Governor 25-01 to ensure hospital compliance with EMTALA, including abortion care requirements.

The Washington State Department of Health (DOH) adopted emergency rules amending WAC 246-320-281 to maintain access to emergency care, including abortion services, while permanent rulemaking is in progress. These emergency rules align with newly enacted Senate Bill 5557 (chapter 182, Laws of 2025) and preserve protections for emergency medical care.

The Washington State Department of Health (DOH) filed a CR-101 to evaluate and potentially revise fees for: 

• Decontamination of Illegal Drug Manufacturing or Storage Sites  
• Water Recreation Facilities  
• Onsite Sewage Systems  
• Large Onsite Sewage Systems  
• Commercial Shellfish  
• Temporary Worker Housing  
• Transient Accommodations  
• Food Service  

Fees may be revised in order to cover operating costs of the program.

The Washington State Department of Health (DOH), and the Orthotics and Prosthetics Advisory Committee, is proposing to amend 246-850 WAC to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023). DOH is proposing to amend the jurisprudence examination as a requirement for licensure and incorporating knowledge of professional jurisprudence into continuing competency requirements for orthotists and prosthetists.

The Examining Board of Psychology rescinded EBOP-20-01.2, Use of Telepsychology to Fulfill Experience Requirements during and following the COVID-19 Declared Emergency.

Filed September 26, 2025.

The Examining Board of Psychology rescinded EBOP-22-01, Requirements for Educational Meetings Completed in lieu of Doctoral Residency - Applicants for psychology license.

Filed September 26, 2025.

The Examining Board of Psychology rescinded EBOP-20-02.2, Virtual Supervision for Psychology Internships and Pre-internships during and following the COVID-19 Declared Emergency.

Filed September 26, 2025.

The Examining Board of Psychology rescinded EBOP-21-01, Application of Supervised Experience Hours for Applicants of a Psychologist License When Only Partial Credit Applies.

Filed September 26, 2025.

The Examining Board of Psychology rescinded EBOP-22-02, Supplemental Information Requirement for Applicants for Psychology License from Hybrid or Online Graduate Programs

Filed September 26, 2025.

The Examining Board of Psychology rescinded interpretive statement WSR 12-08-020, Allowable coursework taken outside of the doctoral degree program, because rulemaking on this topic was recently completed. Filed October 8, 2025, as WSR 25-21-038.

The Dental Quality Assurance Commission proposed rules for expanded function dental auxiliaries to allow the amalgam clinical patient requirement to be optional.

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 Washington State Department of Health (DOH) has adopted amendments in chapter 246-780 WAC which transitions the Farmers Market Nutrition Program (FMNP) to use electronic benefit payments (e-FMNP). Women, Infants, and Children (WIC) program participants can also use their Cash Value Benefits (CVB) for fresh fruits and vegetables at authorized farmers markets and farm stores, in addition to the seasonal FMNP benefits.

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 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 Washington State Department of Health (DOH) proposed amendments to WAC 246-976-260 and 246-976-270 to implement new laws prohibiting balance billing by out-of-network ground ambulance services.

The Washington State Department of Health (DOH) is considering rulemaking in response to new legislative requirements under Substitute Senate Bill 5986 (chapter 218, Laws of 2024) regarding out-of-network health care charges (balance billing) for ground ambulance services. WAC 246-976-260 and 246-976-270 may be amended as necessary.

The Washington State Department of Health (DOH) adopted amendments to WAC 246-976-260 and 246-976-270 in response to Substitute Senate Bill (SSB) 5986 (chapter 218, Laws of 2024) regarding out of network health care charges for ground ambulance services, and licensed ground emergency medical services.

The State Board of Health (SBOH) is proposing amendments to WAC 246-290-315, State Action Levels (SALs) and State Minimum Contaminant Levels (MCLs) and WAC 246-290-71006, Public notice for contaminants with a SAL and other unregulated contaminants, to align with the federal Environmental Protection Agency’s (EPA) new standards for per- and polyfluoroalkyl substances (PFAS).

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) is considering amendments to chapter 246-980 WAC implementing legislation to reflect standardized basic training requirements for exempt workers and increase the home care aide workforce.

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) established emergency rules to extend the timeline for individuals applying for Home Care Aide certification that was mandated by Senate Bill 5672 (chapter 341, Laws of 2025).

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.