Rulemaking Activity

The Washington State Department of Health (DOH) adopted certification standards for the new profession created by SSB 5189 (chapter 270, Laws of 2023). DOH established requirements including: the application process; education and curriculum; supervised experience; continuing education; professional standards; the educational program approval process; and fees.

The Washington State Department of Health (DOH) is proposing the establishment of certification standards for the new Behavioral Health Support Specialist (BHSS) profession created by Substitute Senate Bill (SSB) 5189 (chapter 270, Laws of 2023). The proposed rules include the application process, education, supervised experience, professional standards, the educational program approval process, and fees.

The Washington State Department of Health (DOH) is proposing amendments to WAC 246-835-010 and WAC 246-835-025 to update the definition of "culturally congruent care" and to clarify education and training requirements related to "culturally congruent care" and "culturally congruent ancestral practices."

The Department of Health is considering amendments to WAC 246-835-010 and WAC 246-835-025 to clarify the definition of “culturally congruent care” and to ensure education and training requirements related to “culturally congruent care” are clear.

The Washington State Department of Health (DOH) adopted amendments to WAC 246-835-010 and 246-835-025 to update the definition of "culturally congruent care" and to clarify education and training requirements related to culturally congruent care.

The Department of Health is considering amendments to the birth doula certification requirements in WAC 246-835-040, Applicants currently certified in other states or territories, to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023).

The Washington State Department of Health (DOH) is proposing amendments to WAC 246-835-040 to implement recent legislation to reduce barriers to entering and remaining in the birth doula workforce and to shorten the credentialing process.

The Washington State Department of Health (DOH) adopted amendments to WAC 246-835-040 to waive education, training, experience, and examination requirements for applicants that qualify for certification by endorsement to implement RCW 18.130.077.

Rescission of Interpretive Statement BON 21-01, Continuing Education Pharmacology Documentation. Filed February 8, 2024.

The board is rescinding this interpretive statement because the board has adopted amendments to WAC 246-836-080 Continuing competency program, that clarify what forms of documentation are acceptable to verify meeting the pharmacology continuing education requirements. Thus, the interpretive statement is no longer necessary.

Individuals requiring information on this rule should contact Rachel Phipps, program manager, phone 564-233-1277, email naturopathy@doh.wa.gov.

Clarifying that the Washington State Department of Health and the Board of Nursing Home Administrators consider the terms "Administrator-in-Training (AIT) program" and "administrator residency" to mean the same thing.

Effective Date: July 15, 2025. Filed July 8, 2025, as WSR 25-15-025.

Policy Number: OD 24-01. Allowances for in-person continuing education for licensed optometrists who have a continuing education reporting date in year 2024. Effective Date: March 1, 2024.

The Board of Optometry filed an expedited proposal to update citations in WAC 246-851-490 related to examination and licensure requirements.

The Washington State Department of Health (DOH) proposes expanding the applicability of brief adjudicative proceedings under the authority of DOH in WAC 246-10-501 and in Model Procedural Rules for Boards in WAC 246-11-420 to new category types eligible for Brief Adjudicated Proceedings.

The Washington State Department of Health (DOH) filed a CR-101 to consider changes to brief adjudicative proceedings (BAP) rules, which expand applicability to new category types for department rules and board and commission rules.

The Washington State Department of Health (DOH) rescinded CR101 filed as WSR 24-08-043, considering rulemaking on application of brief adjudicated proceedings for the DOH to combine and expand the scope of the amendment. Filed as WSR 25-12-004.

The Washington State Department of Health (DOH) rescinded CR101 filed as WSR 21-21-105, considering rulemaking on Application of Brief Adjudicated Proceedings for Boards and Commissions to combine and expand the scope of the amendment. Filed as WSR 25-12-003.

The Washington State Department of Health (DOH) in consultation with the Washington Medical Commission proposes amending chapter 246-310 WAC to revise requirements related to percutaneous coronary intervention (PCI) programs, ensuring alignment with updated standards of care.

The Washington State Department of Health (DOH) proposes to create a new section and amend existing rules in chapter 246-926 WAC to implement Substitute House Bill 2355 (chapter 94, Laws of 2024), establishing certification requirements for MRI technologists. Housekeeping edits and updates are also proposed.

Certification standards in chapter 246-929 WAC: The Washington State Department of Health (DOH) is proposing rules to establish requirements including the application process and education and examination requirements.

The Washington State Department of Health (DOH) adopted certification standards in chapter 246-929 WAC for the new certified peer specialist and trainee credentials establishing: the application process; education and examination requirements; supervised experience requirements; approved supervisor requirements; professional standards; continuing education requirements; and fees.

The Washington State Department of Health (DOH) proposes to update training and supervision standards in chapter 246-341 WAC to better support workforce development for certified peer support specialists.

The Washington State Department of Health (DOH) in collaboration with schools is proposing to update WAC 246-105-060 to remove the school immunization status reporting date and replace it with, "Submit an annual immunization status report under RCW 28A.210.110 at a time and in a manner approved by the department."

The Washington State Department of Health (DOH) adopted amendments in chapter 246-329 WAC updating industry language, licensing requirements, and operational standards for birthing centers.

The Washington State Department of Health (DOH) is proposing updates to birthing center licensing rules in chapter 246-329 WAC to align them with current standards of practice and to implement necessary changes for this facility type, including revising the chapter name from "Childbirth Centers" to "Birthing Centers" to align with chapter 18.46 RCW.

Under delegated authority, the Washington State Department of Health (DOH) adopted rule amendments in WAC 246-105-040 and WAC 246-105-060 to update references to the most recent Advisory Committee on Immunization Practices (ACIP) guidelines. The adopted rule also eliminated the specified data reporting date for schools and childcare centers and in place provides language that will allow flexibility in reporting timelines to better support schools and childcare centers. 

The Washington State Department of Health is considering revisions to WAC 246-808-990 to update chiropractic and X-ray technician licensure, registration, renewal, and other fees including clarifying updates.

The Washington State Department of Health (DOH) and the Chiropractic Quality Assurance Commission proposed to increase clarity and update chiropractic and X-ray technician licensure, registration, renewal, and other fees in WAC 246-808-990.

Identifies the states and territories of the United States, the District of Columbia, Puerto Rico, or providence of Canada with "substantially equivalent" licensing standards, allowing applicants to apply for licensure via endorsement.

Effective Date: July 11, 2024. Filed August 28, 2024, as WSR 24-18-055.

The Chiropractic Quality Assurance Commission (commission) developed this policy statement to address licensing requirements, standard of care and the role of the 
commission in evaluating technology and equipment used to facilitate telehealth services.

Effective Date: July 11, 2024. Filed August 28, 2024, as WSR 24-18-051.

Policy Statement CH-24-03-014 (PDF). The Washington State Chiropractic Quality Assurance Commission issued a policy statement stating that an Individual’s holding a chiropractic license in “inactive” status, and endorsement or expired credential reissuance applicants are not required to take and pass the jurisprudence examination if the applicant holds an active credential recognized as having substantially equivalent standards. Effective Date: March 14, 2023.

The Chiropractic Quality Assurance Commission adopted rules concerning chiropractic X-ray technicians including: updates to course requirements; who can be approved to instruct the course; and set new requirements for obtaining, maintaining and returning from expired status. The commission also adopted health equity continuing education requirements. Amends WAC 246-808-201, creates new sections WAC 246-808-203, WAC 246-808-205, WAC 246-808-207, WAC 246-808-209, and WAC 246-808-211, and repeals WAC 246-808-215.

The Washington State Department of Health (DOH) amended the civil penalty schedule to clarify the penalties based on significance of the violation, previous compliance record, and the presence of aggravating or exacerbating circumstances in WAC 246-272B-08105.

The Dental Quality Assurance Commission is considering amending WAC 246-817-773 to ensure clear CE requirements.

The Chiropractic Quality Assurance Commission is considering amending WAC 246-808-505 to align rule language with statute and to modernize and streamline current language. The commission may also consider further amendments based on research and interested party input.

The Pharmacy Quality Assurance Commission is proposing to amend WAC 246-945-507 to add four intramammary antibiotics to the list of approved legend drugs in chapter 246-945 WAC in response to request from Washington State Department of Fish and Wildlife.

The Department of Health is proposing amending WAC 246-290-100, Water system plans, to add the climate resilience element as a requirement for public water systems with one thousand or more connections. The proposal also makes editorial changes to align with the Code Reviser’s 2023 Bill Drafting Guide.

The Washington State Department of Health (DOH) adopted amendments to WAC 246-290-100, water system plans, to add a climate resilience element to the water system plans as a requirement for public water systems with one thousand or more connections. The adopted amendments also make editorial changes.

The Washington State Department of Health (DOH) withdrew the Closure of Abandoned Incomplete Health Care Credential Applications CR-101, filed on April 28, 2017, and published in WSR 17-10-045, to consider adding a new section to chapter 246-12 WAC.

Filed on February 20, 2025 as WSR 25-06-012.

The Washington State Department of Health (DOH) is considering amendments to chapter 246-804 WAC to update curriculum standards, develop application processes, and clarify definitions for the co-occurring disorder specialist (CODS) enhancement program.

The Washington State Department of Health (DOH) is continuing emergency rules that establish a directory to help mental health counselor marriage and family therapist, and social worker associates find supervisors and setting supervision standards. The emergency rule creates new sections WAC 246-809-020, 246-809-070, 246-809-071, and 246-809-072 in chapter 246-809 WAC, Licensure for Mental Health Counselors, Marriage and Family Therapists, and Social Workers. These emergency rules implement RCW 18.225.180. 

These rules continue without change the initial emergency rules filed on September 28, 2023, under WSR 23-20-055 and continued on January 26, 2024, under WSR 24-04-011 and May 22, 2024, under WSR 24-11-153. The department will continue these emergency rules until directory and supervision standards are adopted through the permanent rule making process. The department filed the Preproposal Statement of Inquiry (CR-101) to begin the permanent rule making on December 27, 2023 under WSR 24-02-038.

WA-DOH is proposing a new chapter of rule, chapter 246-837 WAC, Music Therapists, to implement Substitute House Bill 1247 (chapter 175, Laws of 2023), which creates the music therapist profession. WA-DOH is proposing to establish the education and training, examination and licensure requirements, continuing education, and fees. The proposed rules also implement other recently enacted legislation.

The Washington State Department of Health (DOH) is proposing changes to replace the term "honorable discharge" with "qualifying discharge." Recent legislation amended language adding the term "qualifying discharge" to various benefit programs for veterans, replacing references to "honorable discharge." This term is used in WAC 246-12-530 and 246-12-560. 

The Dental Quality Assurance Commission is proposing amending WAC 246-187-190 to include a minimum age requirement for dental assistant registration.

The Dental Quality Assurance Commission proposed amending WAC 246-817-190 to include a minimum age requirement for dental assistant registration.

The Dental Quality Assurance Commission is considering amending WAC 246-187-190 to include a minimum age requirement for dental assistant registration.

The Washington State Department of Health (DOH) in consultation with the Dental Quality Assurance Commission and Dental Hygiene Examining Committee are considering making amendments to WAC 246-814-020 to include Silver Diamine Fluoride (SDF) to practices authorized in school-based and school linked program settings for dental hygienists and dental assistants, and WAC 246-814-030 to remove requirements for participating in oral health coalition meetings that may be held in the geographical region. 

The Washington State Department of Health (DOH), in consultation with the Dental Hygiene Examining Committee, is considering establishing new section(s) of rule in chapter 246-815 WAC to implement recent legislation which creates a new interstate compact for dental hygienists and gives member states the discretion to charge a fee for granting compact privileges.

The Department of Health is proposing health equity model rules for dental hygienists to comply with RCW 43.70.613. The proposed rule adds two hours of health equity education, as required in the model rules, to be completed as part of the current continuing education requirements every four years. The proposed rule does not change total CE hours but requires two hours in health equity CE every four years which is absorbed into the existing number of CE hours required. The health equity CE requirement is counted under existing, unspecified CE requirements for the profession.

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 include implicit bias trainings to identify strategies to reduce bias during assessment and diagnosis in an effort to address structural factors, such as bias, racism, and poverty, that manifests as health inequities.

Two hours of training allows individuals to gain a foundation in health equity that can have an immediate positive impact on the professional’s interaction with those receiving care. Health equity training enables health care professionals to care effectively for patients from diverse cultures, groups, and communities, varying race, ethnicity, gender identity, sexuality, religion, age, ability, socioeconomic status, and other categories of identity. The two hours of health equity CE credits may be earned as part of the health professional’s existing CE requirements, therefore not requiring completion of additional CE hours. 

The Washington State Department of Health (DOH) adopted a new section of rule to establish health equity continuing education (CE) requirements to implement Engrossed Substitute Senate Bill (ESSB) 5229 (chapter 276, Laws of 2021). The adopted rule adds two hours of health equity education, as required in the model rules, to be completed as part of the current CE requirements every four years. The adopted rule does not change total CE hours but requires two hours in health equity CE every four years which is absorbed into the existing number of CE hours required. The health equity CE requirement is counted under existing, unspecified CE requirements for the profession.

The Dental Quality Assurance Commission (commission) is considering amending WAC 246-817-135 to remove requirements pertaining to federal or state tax numbers when applying for licensure without an examination. The commission is also considering amending WAC 246-817-160 to clarify clinical and didactic education and training requirements for foreign-trained dentists and graduates of non-accredited schools or programs.