Rule-Making Activity

The Washington State Board of Nursing adopted rules amending WAC 246-840-750 through 246-840-780 and adding WAC 246-840-790 to establish new definitions, update existing terms, and add application requirements for a stipend for the substance use disorder monitoring program for nursing professionals in response to Substitute House Bill 1255 (chapter 141, Laws of 2023) codified in RCW 18.79.440.

The Washington State Board of Nursing adopted rules amending WAC 246-840-750 through 246-840-780 and adding WAC 246-840-790 to establish new definitions, update existing terms, and add application requirements for a stipend for the substance use disorder monitoring program for nursing professionals in response to Substitute House Bill 1255 (chapter 141, Laws of 2023) codified in RCW 18.79.440.

Shad Bell
360-236-4711

Shad Bell
360-236-4711

The Occupational Therapy Practice Board (board) adopted rule amendments to implement legislation to reduce barriers to entering and remaining in the occupational therapy workforce. Additionally, the board updated the continuing education requirements to align with national standards and the code of ethics requirements for consistency and clarity in occupational therapy services.

Purpose: WAC 246-847-991 Occupational therapy licensure compact (compact) privilege fees and renewal cycle. The Department of Health (department) is adopting a new section of rule, WAC 246-847-991, to implement Senate Bill (SB) 5518 (Chapter 152, Laws of 2022), which creates a new interstate licensure compact for occupational therapy and gives member states the discretion to charge a fee for granting compact privileges. The department is adopting a new rule to specify the compact fees and renewal cycle.

The Occupational Therapy Practice Board and the Washington State Department of Health adopted amendments to the temporary permit and fee rules in response to legislation.

The Occupational Therapy Practice Board and Washington State Department of Health (DOH) jointly are proposing rule amendments to WAC 246-847-117 to reduce barriers for military spouses holding a temporary practice permit while entering and remaining in the occupational therapy workforce. Additionally, amendments are proposed to WAC 246-847-990 to create a new fee to cover the cost of the temporary permit.

The Occupational Therapy Practice Board and the Department of Health are considering amending rules and establishing fees for temporary practice permits in response to the Washington Military Spouse Employment Act.

The Occupational Therapy Practice Board is proposing rule amendments to reduce barriers to entering and remaining in the occupational therapy workforce and to streamline and shorten the credentialing process. The board is proposing revisions to WAC 246-847-051, 246-847-068, 246-847-070, 246-847-080, 246-847-125, and adding a new section, 246-847-127. Additionally, the proposal amends WAC 246-847-065 to adjust continuing education requirements so they align with the national certifying board and WAC 246-847-170 to ensure care is provided ethically and professionally.

The Department of Health is considering adopting a new chapter to Title 246 that establishes general administrative procedures and fees for non-potable water systems.

The Washington Medical Commission is proposing amendments to the commission’s opioid prescribing rules for allopathic physicians and physician assistants to exclude patients with sickle cell disease, to clarify tapering considerations, and to clarify the use of biological specimen testing. Amending WAC 246-918-801, WAC 246-918-870, WAC 246-918-900, WAC 246-919-851, WAC 246-919-920, and WAC 246-919-950.

This is a supplemental notice. The first CR-102 was filed March 30, 2024, as WSR 24-07-106.

The Board of Optometry is proposing amendments to reduce barriers for optometrists to enter and remain in the health care workforce. The proposed amendments remove the jurisprudence (JP) exam requirement from initial licensure in WAC 246-851-490 and add the JP exam as a requirement for a licensed optometrist’s first full CE reporting period in WAC 246-851-090 to be included within the existing CE hour requirement. The JP exam will no longer be a requirement prior to licensure by endorsement. Additionally, the proposed amendments clarify the minimum number of CE credit hours that must be obtained through synchronous and in-person learning and the maximum number of CE hours that may be earned through asynchronous learning.

The Board of Optometry adopted changes to WAC 246-851-090 and WAC 246-851-125 through 246-851-230 related to CE requirements for licensed optometrists. Adopted amendments include online continuing education, new definitions, limits on types and categories of CE hours, reference to other required trainings, CE documentation requirements, clarifying self-study requirements, and certain allowances during a declared state of emergency.

The Board of Optometry adopted new WAC 246-851-515 and amendments to WACs 246-851-400, 246-851-410, and 246-851-570 through 246-851-600 to expand optometrist scope of practice to include advanced procedures an optometrist may perform with an advanced procedures license endorsement.

The Board of Optometry is proposing amendments to WAC 246-851-400, 246-851-410, 246-851-570 through 246-851-600 and establishing a new section WAC 246-851-515 to expand the optometrist scope of practice to include certain advanced procedures and establishes requirements for a license endorsement.

The Board of Optometry is considering amendments to optometrist continuing education and examination requirements in WAC 246-851-090 through 246-851-230 and WAC 246-851-490 to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023) and to consider increasing the number of allowable online credits.

The Washington State Department of Health (DOH) is proposing a new rule in response to legislative requirements under Substitute House Bill (SHB) 1271 (chapter 290, Laws of 2023) to establish the minimum standards for organ transport vehicles and equipment in WAC 246-976-360.

The Washington State Department of Health (DOH) adopted a new rule establishing minimum requirements for vehicle and equipment standards, as well as establishes the licensing process to obtain an organ transport license.

The Washington State Department of Health (DOH), along with the Orthotics and Prosthetics Advisory Committee, is considering amendments to comply with recent legislation. To align chapter 246-850 WAC with 2SHB 1724 (chapter 425, Laws of 2023), DOH is considering amending the jurisprudence examination as a requirement for licensure and possibly incorporating knowledge of professional jurisprudence into continuing competency requirements for orthotists and prosthetists. DOH will consider amending WACs 246-850-060, 246-850-140, 246-850-150 and other related sections, along with the establishment of potential new WAC sections. 

Purpose: Provides prescribing requirement exemptions in specific circumstances. WAC 246-853-661, Exclusions. The Board of Osteopathic Medicine and Surgery (board) is adopting amendments to expand the types of patients who are exempt from opioid prescribing rules. The adopted language aligns with the Washington Medical Commission's recently adopted rules to ensure consistency and alignment with best practices.

The Board of Osteopathic Medicine and Surgery is considering amending WAC 246-853-080 to update the continuing education (CE) requirements for licensure renewal of osteopathic physicians to clarify Washington-specific mandated CE requirements.

The Washington Medical Commission is proposing amendments to WAC 246-918-895 and WAC 246-919-945—Pain management specialist—Chronic pain, to align rule language with currently accepted language.

The Board of Osteopathic Medicine and Surgery is proposing amendments to WAC 246-853-080 to update the continuing education (CE) requirements for licensure renewal of osteopathic physicians to clarify Washington-specific mandated CE requirements.

The Board of Osteopathic Medicine and Surgery has adopted amendments to WAC 246-853-080 to update the continuing education (CE) requirements for licensure renewal of osteopathic physicians to clarify Washington-specific mandated CE requirements.

The Board of Osteopathic Medicine and Surgery is considering amendments to update the examination requirements for licensure of osteopathic physicians in response to Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023) and to reduce potentially unnecessary licensure barriers.

2SHB 1724 requires regulatory authorities to review licensure standards for health professionals in other states to determine substantial equivalency to Washington licensure standards in order to streamline and expedite credentialing processes. In response to this requirement, and to reduce potentially unnecessary licensure barriers, the board is considering amendments to the osteopathic physician examination requirements.

The Board of Osteopathic Medicine and Surgery is proposing amendments to update the examination requirements for licensure of osteopathic physicians in WAC 246-853-020.

The Board of Osteopathic Medicine and Surgery (board) adopted amendments in WAC 246-853-020 to update the examination requirements for licensure of osteopathic physicians, allowing applicants to select one out of the four nationally approved examination series instead of selecting a combination of two or more examinations to qualify for licensure. Additionally, the board removed the Osteopathic Principles and Practices exam as one of the examination options as this is an underutilized pathway to licensure.

The Board of Osteopathic Medicine and Surgery and the Washington State Department of Health (DOH) are proposing amendments to WAC 246-853-045 and WAC 246-853-21, and to repeal WAC 243-853-060, as a result of the review to clarify and update language.

The Board of Osteopathic Medicine and Surgery is considering amending WAC 246-853-661 Exclusions, WAC 246-853-730 Periodic review, and WAC 246-853-755 Tapering requirements, to modernize the language, add clarity, and align rules with the Washington Medical Commission (WMC).

The Board of Osteopathic Medicine and Surgery has adopted amendments to WAC 246-853-290, 246-853-300, 246-853-310, and 246-853-320 to update the rules regarding health profession monitoring programs. The adopted changes align existing rule language with the changes made in Substitute Senate Bill (SSB) 5496 (chapter 43, Laws of 2022). These changes align the rules with currently accepted language for substance use disorders and related monitoring programs.

The Board of Osteopathic Medicine and Surgery (board) conducted a review of all sections in chapter 246-853 WAC that have not been reviewed in the last five years and identified that WAC 246-853-045 and 246-853-210 contain outdated language. The board adopted amendments to update the term "practitioner" to "osteopathic physician" to be consistent with the entire chapter. The board has also identified that WAC 246-853-060 does not contain any rule language content and is repealing this section.

The Washington Medical Commission adopted amendments to WAC 246-918-895 and 246-919-945 to align rule language with currently accepted language.

Becky McElhiney
360-236-4766

The Board of Hearing and Speech adopted rules to reflect federal changes for over-the-counter (OTC) hearing aids. To align with changes in federal regulation, the board’s adopted amendment removes requirements in WAC 246-828-100 for medical clearance as a condition for sale of OTC hearing aids. The adopted changes to WAC 246-828-100 only remove requirements no longer permitted by federal rule and do not otherwise change licensure requirements.

The Board of Hearing and Speech is proposing amendments to WAC 246-828-100 (Hearing instruments fitting and dispensing – Minimum standards of practice) to reflect changes to relevant federal rules by the Food and Drug Administration (FDA) regarding the sale of over-the-counter (OTC) hearing aids (21 C.F.R. Parts 800, 801, 808, and 874 (2022)).

Nina Helping
360-236-3065

The State Board of Health (SBOH) is considering amending 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 federal standards for PFAS. The SBOH adopted an emergency rule and is now considering permanent rule amendments. 

The Pharmacy Quality Assurance Commission (commission) is proposing to amend WAC 246-945-480 to require additional reporting requirements provided to customers and the commission in advance of permanent closures. The commission is proposing to add WAC 246-945-231 to consolidate the reporting requirement for pharmaceutical firms to report disciplinary action to the commission and add WAC 246-945-592 to establish reporting requirements for permanently closing manufacturers and wholesalers.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-480 and creating new sections in chapter 246-945 WAC to improve notifications and prescription transfer directions provided to patients when the facility closes permanently.

The Pharmacy Quality Assurance Commission adopted health equity continuing education requirements to meet the requirements of the Department of Health’s equity model rules in WAC 246-12-800 through 246-12-830. The adopted rules add one hour of health equity education every two years, coinciding with the license renewal cycles for both pharmacists and pharmacy technicians.

In 2020, the Pharmacy Quality Assurance Commission consolidated multiple chapters of rules into chapter 246-945 WAC that covers the practice of pharmacy. This adopted rule amends WAC 246-945-040(1) to incorporate Title 21 of the CFR by reference for the purpose of capturing any changes made to Title 21 after WAC 246-945-040 went into effect on July 1, 2020. Language was also added to the rule for the purpose of providing individuals directions for acquiring copies of the reference material listed for public inspection.

Updating reference to United States Pharmacopeia (USP) General Chapters 795 and 797. The Pharmacy Quality Assurance Commission (commission) is proposing a revision to WAC 246-945-100, Compounding minimum standards, to update the rule to the most recent version of the USP – National Formulary <795> and <797>.

Purpose of the proposal and its anticipated effects, including any changes in existing rules: The proposed rule amends WAC 246-945-100 to update the rule to the most recent versions of the USP <795> and <797>. USP <795> and <797> were adopted into rule by reference effective on July 1, 2020. Since then, USP <795> and <797> have been updated.

Reasons supporting proposal: The existing reference in WAC 246-945-100 does not account for changes made to USP <795> and <797> that are official as of November 1, 2023 by USP. The proposed rule updates the references to the most recent versions. The proposed rule language qualifies for expedited rulemaking under RCW 34.05.353(1)(b) as the language incorporates by reference national standards without material change.

 IF YOU OBJECT TO THIS USE OF THE EXPEDITED RULE-MAKING PROCESS, YOU MUST EXPRESS YOUR OBJECTIONS IN WRITING AND THEY MUST BE SENT TO Haleigh Mauldin, Pharmacy Quality Assurance Commission, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-890-0720, fax 360-236-2901, email https://fortress.wa.gov/doh/policyreview, AND RECEIVED BY April 17, 2023.