Rules in Progress

Rules are created through a public process involving open public meetings and hearings. While each rule is in various stages of rule writing, you're welcome to comment at any time.

Rules are also known as regulations, Washington Administrative Code, or WAC.

The Washington Chiropractic Quality Assurance Commission (CQAC) has authority (RCW18.25) to update and change chapter 246-808 WAC.

Current rules in progress

Rule	Filing Information
Subject of possible rule making:
Rulemaking is necessary to achieve the statute’s goals and objectives by providing updated requirements that are clear, concise, and necessary to ensure patient safety. Rulemaking establishes enforceable credentialing requirements and safety mechanisms for patients receiving chiropractic services.
Chiropractic Credentialing Requirements. The Chiropractic Quality Assurance Commission is considering revisions to WAC 246-808-010, 246-808-105 through 246-808-140, 246-808-190, 246-808-510, 246-808-535, and 246-808-801 through 246-808-830 to clarify, streamline, and modernize the rule language to be consistent with current laws and practice standards. The commission is also considering technical amendments to implement Substitute Senate Bill (SSB) 5496 (Chapter 43, Laws of 2022). SSB 5496 updated terminology, definitions, and references for chiropractors. SSB 5496 also made clarifications to confidentiality protections in RCW 18.130.070 for health professional monitoring programs.	CR101 23-05-053 Filed February 10, 2023 (PDF)
Chiropractic fees and renewal cycle updates. The Department of Health is considering revisions to WAC 246-808-990 to update chiropractic and chiropractic X-ray technician licensure, registration, renewal, and other fees including clarifying updates.	CR-102 25-12-015 Filed May 22, 2025 (PDF)
Classification of Chiropractic Procedures and Instrumentation. The Chiropractic Quality Assurance Commission is considering amending WAC 246-808-505, Classification of chiropractic procedures and instrumentation, to better align the rule language with the statutory language and to modernize and streamline current language. The commission may also consider further amendments based on research and interested party input.	CR-101 25-10-041 Filed April 30, 2025 (PDF)

Workshops

Rules	Date and Location
The commission is considering revisions to WAC 246-808-010, 246-808-105 through 246-808-140, 246-808-180, 246-808-190, 246-808-510, 246-808-535 and WAC 246-808-801 through 246-808-830 to clarify, streamline, and modernize the rule language, and to be consistent with current laws and practice standards. The commission is also considering technical amendments to implement Substitute Senate Bill (SSB) 5496 (Chapter 43, Laws of 2022). SSB 5496 updated terminology, definitions, and references for chiropractors, and also made clarifications to confidentiality protections in RCW 18.130.070 for health professional monitoring programs. Except for the revision of individual rule sections, a comprehensive review of chapter 246-808 WAC has not been conducted since 1996. The commission will review WAC 246-808-130, Temporary permit: Issuance and duration; WAC 246-808-133, Background Check Temporary Practice Permit; WAC 246-808-140, Thirty-Day Permit; WAC 246-808-051, Military spouse or military-related temporary practice permit (New Section); and WAC 246-808-010, Definitions.	May 8, 2025 Department of Health TC2 Room 166/167 111 Israel Rd. S.E. Tumwater, WA 98501 This meeting is also available via MS Teams.

Hearings

Rules	Filing Information	Hearing Details
The hearings are open to the public and will be announced here, as well as through GovDelivery. To get announcements subscribe to GovDelivery.
Title of rule and other identifying information: Chiropractic fees and renewal cycle updates. The Department of Health (department) in collaboration with the Chiropractic Quality Assurance Commission (commission) is proposing amendments to WAC 246-808-990 to update chiropractic and X-ray technician licensure, registration, renewal, and other fees including clarifying updates.	WSR -25-12-015 Filed May 22, 2025 Access proposed rules (PDF) Fee Narrative (PDF)	Date: July 8, 2025 Time: 11 a.m. The meeting will be held in virtual format. Virtual link: Register in advance for this webinar. After registering, you will receive a confirmation email. Written comments can be submitted via email (cqac@doh.wa.gov or hsqafeerules@doh.wa.gov)

Rules Recently Filed

Rule	Filing Information
CR-103 Permanent Rule Announcement The Chiropractic Quality Assurance Commission (commission) is adopting changes to chapter 246-808 WAC pertaining to chiropractic X-ray technicians. The adopted changes amend WAC 246-808-201, create new sections WAC 246-808-203, 246-808-205, 246-808-207, 246-808-209, 246-808-211, and repeal WAC 246-808-215. In general, the adopted rules: Create new sections: WAC 246-808-203 Definitions WAC 246-808-205 Registration of chiropractic X-ray technicians, WAC 246-808-207 Course requirements and approval WAC 246-808-209 Continuing education for chiropractic X-ray technicians WAC 246-808-211 Expired credential – Requirements for reactivating a chiropractic X-ray technician. Repeal WAC 246-808-215 Registration of chiropractic X-ray technicians Clarify that a chiropractor may also employ another chiropractor to operate X-ray equipment. Amend the number of training hours to obtain the credential from 48 hours to 72 total hours, only 30 of which must be completed in person. Amend the examination requirements to include a written and practical proficiency examination. Create additional exceptions for who may obtain the chiropractic X-ray technician without obtaining the required training or examination. Clarify when the first continuing education (CE) period is due. Adopt the health equity CE model rules. The commission is adopting the health equity model rules, WAC 246-12-800 through 246-12-830, for chiropractic X-ray technicians to comply with RCW 43.70.631. The rule as adopted does not change the total hours, it adopts the model health equity CE rules by adding the required two hours in health equity CE every four years to the existing number of CE hours required for chiropractic X-ray technicians without changing the existing total number of CE hours required. The goal of health equity CE is to equip health care workers with the skills to recognize and reduce health inequities in their daily work. The content of health equity trainings includes instruction on skills to address structural factors such as bias, racism, and poverty, that manifest as health inequities. Provide clarity about what is required to renew an expired chiropractic X-ray technician. Propose additional training requirements for chiropractic X-ray technicians who have allowed their credential to expire for five years or longer. The adopted rules are different from the text of the proposed rule as it was published in the Washington State Register 23-20-026. The following clarifying and non-substantive changes were made to the proposed rules upon adoption: 1. The proposed rule language was updated to include the repeal of WAC 246-808-215. The commission’s intent and the public’s understanding since the beginning of this rule making was that WAC 246-808-215 would be repealed and replaced with the new rules. 2. Editorial changes were made to WAC 246-808-207, Course requirements and approval, as follows for consistency with the rule language: WAC 246-808-207(c) A qualified instructor. A qualified instructor must verify that during the preceding five years their license has not been suspended, revoke, or otherwise conditioned or restricted and: (i) Be a diplomate of the American Chiropractic Board of Radiology; (ii) Be a chiropractor who has been licensed for five years, with at least five years in practice that includes the taking of X-rays; or (iii) Be a chiropractor who has on-campus or postgraduate faculty status in the field of radiology. The adopted amendments to chapter 246-808 WAC will become effective on July 1, 2024. For more information email the Chiropractic Quality Assurance Commission or call 360-236-2822.	CR-103 Permanent Rule language (PDF) Concise Explanatory Statement (PDF)

Rule

Filing Information

CR-103 Permanent Rule Announcement

The Chiropractic Quality Assurance Commission (commission) is adopting changes to chapter 246-808 WAC pertaining to chiropractic X-ray technicians. The adopted changes amend WAC 246-808-201, create new sections WAC 246-808-203, 246-808-205, 246-808-207, 246-808-209, 246-808-211, and repeal WAC 246-808-215.

In general, the adopted rules:

Create new sections:
- WAC 246-808-203 Definitions
- WAC 246-808-205 Registration of chiropractic X-ray technicians,
- WAC 246-808-207 Course requirements and approval
- WAC 246-808-209 Continuing education for chiropractic X-ray technicians
- WAC 246-808-211 Expired credential – Requirements for reactivating a chiropractic X-ray technician.
Repeal WAC 246-808-215 Registration of chiropractic X-ray technicians
Clarify that a chiropractor may also employ another chiropractor to operate X-ray equipment.
Amend the number of training hours to obtain the credential from 48 hours to 72 total hours, only 30 of which must be completed in person.
Amend the examination requirements to include a written and practical proficiency examination.
Create additional exceptions for who may obtain the chiropractic X-ray technician without obtaining the required training or examination.
Clarify when the first continuing education (CE) period is due.
Adopt the health equity CE model rules. The commission is adopting the health equity model rules, WAC 246-12-800 through 246-12-830, for chiropractic X-ray technicians to comply with RCW 43.70.631.
- The rule as adopted does not change the total hours, it adopts the model health equity CE rules by adding the required two hours in health equity CE every four years to the existing number of CE hours required for chiropractic X-ray technicians without changing the existing total number of CE hours required.
- The goal of health equity CE is to equip health care workers with the skills to recognize and reduce health inequities in their daily work. The content of health equity trainings includes instruction on skills to address structural factors such as bias, racism, and poverty, that manifest as health inequities.
Provide clarity about what is required to renew an expired chiropractic X-ray technician.
Propose additional training requirements for chiropractic X-ray technicians who have allowed their credential to expire for five years or longer.

The adopted rules are different from the text of the proposed rule as it was published in the Washington State Register 23-20-026. The following clarifying and non-substantive changes were made to the proposed rules upon adoption:

1. The proposed rule language was updated to include the repeal of WAC 246-808-215. The commission’s intent and the public’s understanding since the beginning of this rule making was that WAC 246-808-215 would be repealed and replaced with the new rules.

2. Editorial changes were made to WAC 246-808-207, Course requirements and approval, as follows for consistency with the rule language:

WAC 246-808-207(c) A qualified instructor. A qualified instructor must verify that during the preceding five years their license has not been suspended, revoke, or otherwise conditioned or restricted and:

(i) Be a diplomate of the American Chiropractic Board of Radiology;
(ii) Be a chiropractor who has been licensed for five years, with at least five years in practice that includes the taking of X-rays; or
(iii) Be a chiropractor who has on-campus or postgraduate faculty status in the field of radiology.

The adopted amendments to chapter 246-808 WAC will become effective on July 1, 2024.

For more information email the Chiropractic Quality Assurance Commission or call 360-236-2822.

CR-103 Permanent Rule language (PDF)

Concise Explanatory Statement (PDF)

Comment on Rules

The Chiropractic Quality Assurance Commission values your input and we sincerely encourage you to send us your comments on any rule in progress. You may send your comments to:

Department of Health
Attn: Chiropractic Commission Rules
P.O. Box 47858
Olympia, WA 98504-7858

E-mail: cqac@doh.wa.gov
Phone: 360-236-2868

You may also submit comments using the online rules comment page.

Rules in Progress

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