Rules in Progress

Rule making is the process the Department of Health uses when proposing to create, change, or delete rules in order to protect public health. To learn more, see the department’s “What is Rule Making?” webpage.

To get updates about rule-making projects and other topics, select "Subscribe for Updates" at the bottom of the page.

Current rules in progress

Hospital Emergency Services

On May 12, 2025, the department filed an emergency rule (PDF) continuing the provision of emergency rules initially adopted (PDF) by the department on January 13, 2025, under WSR 25-03-056, that incorporated the federal Emergency Medical Treatment and Labor Act (EMTALA) into state law, with modifications. This rule rescinds other provisions of the previously adopted emergency rule because substantively identical provisions were codified in the recently enacted Engrossed Substitute Senate Bill (ESSB) 5557 (PDF). These provisions include those revising the definition of “Emergency medical condition” in RCW 70.41.020, imposing requirements related to hospital transfers, and imposing requirements related to emergency medical care for pregnant persons. The emergency rules will continue while permanent rulemaking is in progress.

Hospital at Home

The Department of Health filed a CR-102 on March 10, 2025 (PDF), to propose rules to establish operating standards and fees for hospital at-home services. You can comment on the proposed rules by email (ochsfacilities@doh.wa.gov). You can also provide public comment at a virtual public hearing that is scheduled on April 22, 2025, at noon.

Interested in receiving email updates with hospital-related information? Subscribe to GovDelivery! Enter your email address and under Facilities, select Hospitals.

Acute Care and Psychiatric hospitals - Fees

On June 25, 2024, at 11 a.m., the Department of Health held a public rule hearing related to initial and annual licensing fees for hospitals to generate the revenue needed to license, perform inspections and investigations, and complete other regulatory work required to protect patient safety. The CR-102 for Acute Care and Psychiatric Hospital Fees was filed on May 21, 2024, as WSR 24-11-118 (PDF) to propose amendments to WACs 246-320-199 and 246-322-990.

The Department of Health is adopting amendments to WAC 246-320-199 and 246-322-990 to update fees for acute care hospitals licensed under chapter 246-320 WAC and private psychiatric hospitals licensed under chapter 246-322 WAC.

These changes address funding needs and to clarify and standardize the language.

To comply with this direction, the Department of Health has issued CR-103P (PDF) and an accompanying concise explanatory statement (PDF) to highlight the necessity for the updated fees. These updates are intended to ensure adequate funding for hospital inspections, investigation, and licensing programs to protect patients.

For additional information, see our hospitals webpage or fees webpage or email the facilities program. 

Supporting Materials:

Acute Care hospitals – 23-hour crisis relief centers

The Department is considering amending the Acute Care Hospital regulations in chapter 246-320 WAC to implement Second Substitute Senate Bill 2SSB 5120 (PDF) relating to 23-hour crisis relief centers, a new type of facility that will provide mental health and substance use crisis response to adults.

CR-101(PDF) - Amending the Acute Care Hospital regulations in chapter 246-320 WAC to establish rules prohibiting hospitals licensed under 70.41 RCW from discharging or transferring a patient to a 23-hour crisis relief center unless the hospital has a formal relationship with the 23-hour crisis relief center.

Updating references to pharmacy rules within WAC chapters for hospitals, ambulatory surgical facilities, in-home services agencies, and residential treatment facilities

The Department of Health has filed a CR-102 (PDF) to do expedited rulemaking with proposed language amending WAC 246-320-211 Pharmaceutical services for Hospital licensing regulations in addition to WAC sections for other facility types. The purpose of this rulemaking is to correct references to outdated pharmacy rule citations.

You may provide comments on the proposed rule using one of the following options:

Public Rules Hearing Registration Information for May 6, 2025, at noon.

This public hearing will be held virtually:

Register for the virtual Public Rules Hearing Webinar.