Rulemaking Activity

The Dental Quality Assurance Commission amended WAC 246-817-187 by removing the requirement for military spouses who hold a license in another state to first leave employment before applying for a temporary practice permit in Washington state.

The Dental Quality Assurance Commission adopted health equity continuing education requirements to meet the requirements of the Department of Health’s equity model rules, WAC 246-12-800 through 246-12-830. The amended rules add two hours of health equity education, to be completed as part of the current continuing education requirements every three years.

Extending the effective date for when a licensed dentist must have a pediatric sedation endorsement to administer moderate sedation with eternal agents or moderate sedation with parenteral agents to pediatric patients from January 1, 2025, to February 28, 2025.

Effective Date: January 17, 2025. Filed February 3, 2025.

This policy statement extends the effective date for when a licensed dentist must have a pediatric sedation endorsement to administer moderate sedation with eternal agents or moderate sedation with parenteral agents to pediatric patients from February 28, 2025 to June 30, 2025.

Effective Date: February 13, 2025. Filed February 26, 2025 as WSR 25-06-032.

The Dental Quality Assurance Commission is adopting amendments to update rules regarding out-of-state licensure in line with Senate Bill 5113 (chapter 89, Laws of 2023) to include any institution of higher education in Washington state accredited by the Commission on Dental Accreditation (CODA) for faculty licensure.

The Washington State Department of Health (DOH) proposed amendments to establish licensing requirements for dental therapists under newly adopted legislation.

The Dental Quality Assurance Commission is proposing amendments to WAC 246-817-905 to expand the types of patients who are exempt from opioid prescribing rules.

The Dental Quality Assurance Commission and the Washington State Department of Health (DOH) are considering adding new section(s) to chapter 246-817 WAC to implement provisions of ESHB 1576 (chapter 297, Laws of 2023), codified as chapter 18.33 RCW, which creates a new interstate compact for dentists and gives member states the discretion to charge a fee for granting compact privileges.

The Board of Denturists (board) is considering updates to jurisprudence exam and examination requirements to reduce barriers for Denturists. The board is considering adopting substantial equivalency standard rules within WAC 246-812-120, WAC 246-812-125, WAC 246-812-159, and other rules to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023). 

The Board of Denturist adopted requirements in WAC 246-812-462 for the use of placement of prefabricated implant abutments. The adopted rule establishes the requirements that are to be followed for a licensed denturist to place a prefabricated implant abutment on an implant for the purpose of fabricating, repairing, relining, or rebasing a denture. The board also amended WAC 246-812-501 to ensure that a licensed denturist develop and maintain written infection control policies, procedures, and requirements for infection prevention and control that are appropriate for the denturist services provided by the facility.

The Board of Denturists proposed revising WAC 246-812-159 to establish an annual requirement for a jurisprudence examination to maintain licensure.

The Washington State Department of Health (DOH) or designee should use the criteria in this policy to identify a water system that meets the criteria for a Same Farm Exemption (SFE), and their eligibility for the SFE. These include water systems that have four or fewer connections, all of which serve residences on the same farm. Filed April 24, 2025, as WSR 25-10-006.

Interpretive Statement – Health Equity Continuing Education for Dental Hygienists, HSQA OHP DH2301

Health equity continuing education (CE) requirements for Dental Hygienists under chapter 246-815 WAC. Training requirements in WAC 246-12-800 through WAC 246-12-
830 will apply to a Dental Hygiene licensee starting January 1, 2024. Filed December 22, 2023.

Interpretive Statement – Health Equity Continuing Education for Licenses Behavior Analysts and Licensed Behavior Analysts, ABA 23-01

Health equity continuing education (CE) requirements for LBA’s and LABA’s under chapter 246-805 WAC. Training requirements in WAC 246-12-800 through WAC 246-12-830 will apply to a LBA and LABA licensee starting January 1, 2024. Filed December 22, 2023.

The Washington State Department of Health (DOH) is proposing a new chapter of rules to implement Engrossed Second Substitute House Bill (E2SHB) 1477 (chapter 302, Laws of 2021). The rules establish standards for designation of crisis call centers as crisis hubs within the 988 national suicide prevention and mental health crisis hotline system.

The Pharmacy Quality Assurance Commission (commission) is proposing to amend WAC 246-945-090, WAC 246-945-091, WAC 246-945-092, and WAC 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. This supplemental proposal further amends WAC 246-945-090 to add the word "may" and list the dialysis devices manufacturers and wholesalers may sell, deliver, possess, or dispense to home dialysis patients, and to amend WACs 246-945-091, 246-945-092, and 246-945-093 to conform to the list of dialysis devices. 

The Pharmacy Quality Assurance Commission adopted amendments to 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 Washington State Department of Health (DOH) amended chapter 246-822 WAC to clarify, streamline, and modernize rules for dietitians and nutritionists. The adopted amendments include updated rules that align with national professional standards for dietitians, clear standards for education, experience, and supervision requirements, rules that reflect current department processes, the removal of redundant mandatory reporting language, and updates and cross references for clarification.

The Washington State Department of Health (DOH) proposed amendments to WAC 246-822-020 and 246-822-030 to update education and training requirements for certification. These changes provide clarity and alignment with national standards.

The Department of Health is proposing to clarify, streamline, update, and modernize rules for licensing dietitians and nutritionists in chapter 246-822 WAC. This is a supplemental proposal and includes an additional definition in WAC 246-822-010, clarification of application and education requirements for both dietitians and nutritionists, updates requirements for dietitian qualified supervisors, and removes unnecessary terms in rules regarding providing services.

The Washington State Department of Health (DOH) is considering creating a new section in chapter 246-822 WAC and making amendments to dietitians and nutritionists application requirements in WAC 246-822-120, 246-822-132, and other related sections.

The Pharmacy Quality Assurance Commission is considering amendments to WAC 246-945-231 to establish clear timeframes for reporting disciplinary actions against licensees.

To ensure safe drinking water, water must be tested for contaminants. The State Board of Health (SBOH) establishes state action levels (SAL) and maximum contaminant levels (MCL) to ensure contaminate levels are below a certain threshold. SBOH sets criteria for the adoption of SALs and MCLs in WAC 246-290-315 and includes criteria that would apply upon federal adoption of MCLs. WAC 246-290-315(8) states that upon federal adoption of a MCL, the MCL will supersede a less stringent SAL and associated requirements, including monitoring and public notice.

SBOH adopted an emergency rule to amend WAC 246-290-315 such that the criteria would apply on the effective date of an MCL as set in the federal standard, not the adoption date, in order to maintain vital public health protections for drinking water safety. This third emergency rule continues the emergency rule originally filed on June 24, 2024, as WSR 24-14-016, without change and extended on October 22, 2024 as WSR 24-21-138, without change.

The Washington State Department of Health (DOH) is proposing rule amendments to incorporate the federal requirements of the Bipartisan Infrastructure Law (BIL) – Public Law 117-58 – Bipartisan Infrastructure Investment and Jobs Act in chapter 246-296 WAC. The proposed rules redefine the definition of a disadvantaged community and change the state revolving fund priority point system for project rating and ranking proportionate with need.

The Washington State Department of Health (DOH) adopted rule amendments to incorporate the federal requirements of the Bipartisan Infrastructure Law (BIL) – Public Law 117-58 – Bipartisan Infrastructure Investment and Jobs Act. The adopted rules redefine the definition of a disadvantaged community and change the state revolving fund priority point system for project rating and ranking proportionate with need.

The department adopted emergency rules on August 30, 2023 (WSR# 23-18-044) and a second emergency rule December 29, 2023 (WSR# 24-02-060) to amend chapter 246-296 WAC to redefine the term disadvantaged community, update loan terms, update application requirements, and clarify loan rating and ranking criteria to conform with requirements in the BIL. This emergency rule is being adopted to extend the existing emergency rule without making changes to the previous emergency rules.

The Pharmacy Quality Assurance Commission is proposing to amend WAC 246-945-455 to allow unlicensed employees or contractors of a health care facility to access certain drugs that are stored outside of the pharmacy in a designated area when they are acting within their scope of employment.

This policy clarifies the Pharmacy Quality Assurance Commission's approach to enforcing timely transfers for initial dispensing of an electronic prescription for a controlled substance, if the failure to comply results from the licensee's use of National Council for Prescription Drug programs (NCPDP) SCRIPT standard version 2023011, as it relates to WAC 246-945-346.

Effective Date: December 26, 2024. Filed November 26, 2024.

The Washington State Department of Health issued a policy statement regarding health requirements for hospitals providing emergency services to provide immediate access to abortion services or secure transfer to another hospital. Effective Date: June 17, 2024.

The Washington State Department of Health (DOH) is considering amendments to WAC 246-320-010 and 246-320-281 to comply with recently passed legislation and Governor Directive 25-01 to ensure access to treatment, including abortion care, for emergency medical conditions in hospital emergency departments.

The Washington State Department of Health (DOH) updated and revised existing rules and added new sections to ensure regulations and standards are clear, concise, and reflect current standards of care and best practice for the benefit and safety of the public. This update will satisfy the requirements of RCW 43.70.041, enacted, and codified in 2013, which directs DOH to establish a formal review process of existing rules every five years.

The Department of Health is proposing amendments to update and align requirements with current national standards, make rules more clear, concise, and organized, propose changes to address barriers to initial and renewal application processes, and respond to new legislative requirements. WAC 246-976-010 through 246-976-182, 246-976-260 through 246-976-310, 246-976-330 through 246-976-395, 246-976-920, 246-976-960, 246-976-970 and proposing new WAC 246-976-026, 246-976-139, and 246-976-261.

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) 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 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.