Rule-Making Activity

The Pharmacy Quality Assurance Commission is proposing to amend WAC 246-945-155 to grant additional renewals to pharmacy interns. Additionally, the commission proposes to amend WAC 246-945-156 to extend the duration of pharmacy intern temporary practice permits to 180 days which stems from compliance with Second Substitute House Bill (2SHB) 1009 (chapter 165, Laws of 2023).

The Pharmacy Quality Assurance Commission (commission) adopted amendments to WAC 246-945-155 and WAC 246-945-156 related to pharmacy intern registration requirements. The commission amended WAC 246-945-155 to grant additional renewals to pharmacy interns parties, and amended WAC 246-945-156 to extend the duration of pharmacy intern temporary practice permits to 180 days.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-155, WAC 246-945-156, and adding a new section to chapter 246-945 WAC. These changes would grant renewal extensions to pharmacy interns and would extend temporary pharmacy intern practice permits for spouses of military personnel in accordance with Second Substitute House Bill 1009 (chapter 165, Laws of 2023).

The Pharmacy Quality Assurance Commission adopted amendments to WAC 246-945-345 and a created a new section, WAC 246-945-346, to establish the expectations of pharmacies related to noncontrolled and controlled substance prescription transfers upon patient request.

Notice of Adoption: This policy Issued by the Pharmacy Quality Assurance Commissions clarifies the Commission’ approach to United States Pharmacopeia General chapters 795, 797, 800, and 825 as it relates to WAC 246-945-100 and RCW 18.64.270(2). Policy PO-10. Effective Date: November 1, 2023.

Rescission of Policy Statement P004, Regulatory Standards Applicable to Remote Dispensing Sites. Filed February 8, 2024.

The pharmacy quality assurance commission (commission) is rescinding the policy statement Regulatory Standards Applicable to Remote Dispensing Sites, which was filed on July 2, 2020, and published as WSR 20-15-011.

The department of health is rescinding this policy statement because rulemaking was completed allowing a pharmacy to extend its pharmacy license to a remote dispensing site where technology is used to dispense medications used for the treatment of opioid use disorder or its symptoms. The CR-103P was filed under WSR 24-01-098 and went into effect on January 18, 2024.

Individuals requiring information on this rule should contact Joshua Munroe, rules and legislative consultant, phone 360-502-5058, email PharmacyRules@doh.wa.gov. 

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-051 and adding new sections to chapter 246-945 WAC to add kratom and its active compounds to the list of Schedule I substances.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-001, 246-945-315, 246-945-317, 246-945-320, and potentially adding a new section in chapter 246-945 WAC to clarify the utilization of pharmacy ancillary personnel and technology within the pharmacy.

The Pharmacy Quality Assurance Commission adopted updates to references, made grammar corrections, and made other technical changes that do not affect implementation of the rule.

Citation of rules amended by this order: WACs 246-945-001, 246-945-011, 246-945-014, 246-945-018, 246-945-063, 246-945-156, 246-945-170, 246-945-173, 246-945-175, 246-945-200, 246-945-217, 246-945-230, 246-945-417, and 246-945-590.

This proposal will remove citations to repealed WAC chapters, update citations to the current governing WAC chapter or specific rule(s) and make general grammatical corrections without making any material changes.

Joshua Munroe

The Pharmacy Quality Assurance Commission is considering amending existing rules and establishing a new section in chapter 246-945 WAC to implement a uniform enforcement tool for pharmaceutical firms. The rules will implement Engrossed Substitute Senate Bill (ESSB) 5271 (chapter 121, Laws of 2024).

The Board of Physical Therapy is considering amendments to update initial licensure and endorsement requirements in consideration of Second Substitute House Bill (2SHB) 1724, (chapter 425, Laws of 2023). The board will also consider making general updates to the licensing and endorsement process, examine the jurisprudence examination requirement, and review for housekeeping changes.

The Board of Physical Therapy is considering amendments to update initial licensure and endorsement requirements in consideration of Second Substitute House Bill (2SHB) 1724, (chapter 425, Laws of 2023). The board will also consider making general updates to the licensing and endorsement process, examine the jurisprudence examination requirement, and review for housekeeping changes.

Section 8 of 2SHB 1724 requires boards and commissions to waive any examination requirements in an effort to expedite the licensing process for applicants who meet the requirements under 2SHB 1724. The board will review the initial licensure and endorsement requirements to bring them into alignment with 2SHB 1724, and review the current license requirements for consistency and relevancy. The board will consider additional housekeeping updates.

Agency: Department of Health and the Board of Physical Therapy
Subject of possible rule making: Physical Therapists intramuscular needling requirements. The Board of Physical 
Therapy (board) and Department of Health (department) are considering rulemaking in chapter 246-915 WAC, Physical 
Therapists and Physical Therapist Assistants, to clarify statutory requirements for education and training and define an 
intramuscular needling endorsement. The board and department may consider associated training and education 
requirements, updating definitions, establishing a fee for the intramuscular needling endorsement, and creating a process 
to apply for the endorsement.
Statutes authorizing the agency to adopt rules on this subject: Second Substitute House bill (2SHB) 1039 (chapter 
198, Laws of 2023), RCW 18.74.023, 43.70.110, 43.70.250, and 43.70.280
Reasons why rules on this subject may be needed and what they might accomplish: 2SHB 1039 expands the 
scope of practice of physical therapists to perform intramuscular needling, also known as dry needling. Rules may be 
needed to clarify statutory requirements for education and training to receive an initial endorsement to perform 
intramuscular needling. The board and the department will also consider establishing the steps to apply for the 
endorsement, including establishing a fee.
Identify other federal and state agencies that regulate this subject and the process coordinating the rule with 
these agencies: None
Process for developing new rule (check all that apply):
☐ Negotiated rule making
☐ Pilot rule making
☐ Agency study
☒ Other (describe) Collaborative rulemaking
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule 
before publication by contacting:
(If necessary)
Name: Allyson McIver Name:
Address: PO Box 47852, Olympia, WA 98504-7852 Address:
Phone: 360-236-2878 Phone:
Fax: 360-236-2901 Fax:
TTY: 711 TTY:
Email: physical.therapy@doh.wa.gov Email:
Web site: doh.wa.gov Web site:
Other: Other:
Additional comments: Interested parties can participate in the drafting of the proposed rules. The department and the
board will be conducting rules workshops with interested parties and subject matter experts. The department will use 
existing GovDelivery lists and other known contact information to inform interested parties of opportunities to provide input
Page 2 of 2
on proposed rule language. To find out more information about our rulemaking, visit www.doh.wa.gov. To subscribe to 
GovDelivery, please visit www.doh.wa.gov, and select the "Subscribe" button at the bottom of the page, select Health 
Professions, and then Physical Therapy Program. You may also check the box next to one or more of the other 
professions listed to receive information related to that specific profession.
Date: July 18, 2023
Name: Kathryn Dale, PT, DSc and Kristin Peterson, JD for 
Umair A. Shah, MD, MPH
Title: Chair, Physical Therapy Board and Chief of Policy 
for Secretary of Health

The Board of Physical Therapy (board) is proposing amendments to WAC 246-915-030, 246-915-040, 246-915-085, and 246-915-120 in order to comply with Section 8 of 2SHB 1724 (chapter 425, Laws of 2023), codified as RCW 18.130.077 and to make general and housekeeping updates to these sections. Additionally, the board is proposing amendments to WAC 246-915-040 to further expand upon the endorsement pathway required under 2SHB 1724 and amendments to WAC 246-915-120 to streamline the foreign educated applicant application process.

Continuance of public rules hearing. The Washington State Department of Health (DOH) and the Board of Physical Therapy (board) are proposing amendments to WAC 246-915-030, 246-915-040, 246-915-085, and 246-915-120 to reduce barriers to licensure. Additionally, the board is proposing amendments to WAC 246-915-040 to expand upon the endorsement pathway and amendments to WAC 246-915-120 to streamline the foreign educated applicant application process.

The Board of Physical Therapy and the Washington State Department of Health (DOH) adopted amendments to chapter 246-915 WAC, Physical Therapists and Physical Therapist Assistants, to clarify statutory requirements included in Second Substitute House Bill (2SHB) 1039 (chapter 198, Laws of 2023) for obtaining an intramuscular needling endorsement and to establish a fee to cover the cost of the endorsement. The adopted rules clarify and set standards to ensure that physical therapists who are seeking the endorsement are prepared with the skills and education needed to provide safe intramuscular needling services to the public.

The Board of Physical Therapy and Department of Health are proposing amendments to clarify statutory requirements for education and training and define the endorsement for intramuscular needling, and to amend fees and renewal cycle, to implement Second Substitute House Bill 1039, (chapter 198, Laws of 2023) which expands the scope of practice of physical therapists to perform intramuscular needling.

The Board of Physical Therapy is proposing to update the effective date in WAC 246-915A-010 for the Physical Therapy Compact per RCW 18.74.500 Article IX(2), updating the reference date to the most recent physical therapy licensure compact rules. This proposed rule will update the compact effective date to June 27, 2023. 

The Board of Physical Therapy has updated WAC 246-915A-010 to comply with RCW 18.74.500, Article IX (2), which mandates that the board adopt the most recent version of the compact commission rules to participate in the compact in the state of Washington. The adopted changes to WAC 246-915A-010 complies with the statute by incorporating by reference.

The Board of Physical Therapy is proposing to update the effective date in WAC 246-915A-010 to match the date of the most recent Physical Therapy Compact rules per RCW 18.74.500 Article IX(2). This proposed amendment will update the effective date in rule to June 17, 2024.

The Washington Medical Commission adopted amendments to WAC 246-918-076 and WAC 246-919-397 to align with the provisions of Second Substitute House Bill 1009, also known as the Military Spouse Employment Act, codified under RCW 18.340.020. These amendments streamline the license process for military spouses, ensuring consistency with state legislation and improving overall clarity and efficiency in the application process.

Amelia Boyd

PO Box 47866

Olympia, WA 98504

360-918-6336

amelia.boyd@doh.wa.gov

The Washington Medical Commission adopted amendments to chapter 246-918 WAC to implement Engrossed Substitute House Bill (ESHB) 2041 (chapter 62, Laws of 2024) which aims to establish clear guidelines and requirements for the collaboration between physician assistants and supervising physicians. The commission also adopted amendments that clarify and update terms.

The Washington Medical Commission is proposing amendments to chapter 246-918 WAC to implement Engrossed Substitute House Bill (ESHB) 2041 (chapter 62, Laws of 2024) which aims to establish clear guidelines and requirements for the collaboration between physician assistants (PAs) and supervising physicians.

The Washington Medical Commission is proposing amendments to WAC 246-919-330 to remove two requirements that have become a barrier to licensure. The purpose of this proposal is to amend the rules to align them with current practices and remove barriers to licensure for qualified applicants entering the physician workforce.

The Department of Health is considering a chapter review to reorganize sections and amend rules regarding J-1 Physician Visa waivers. The department is exploring updates to help meet the greatest needs across Washington State. The department will also look for increased clarity in the organizational structure, application criteria, and requirements for letters of support.

Amelia Boyd

PO Box 47866 Olympia, WA 98504-7866

360-918-6336

amelia.boyd@wmc.wa.gov

The Podiatric Medical Board has adopted sections WAC 246-922-300 and WAC 246-922-310 to comply with RCW 43.70.163. The board adopted the Department of Health’s health equity model rules, WAC 246-12-800 through 246-12-830, for podiatric physicians and surgeons. The adopted rule adds two hours of health equity education, as required in the model rules, to be completed as part of the current continuing competency requirements every four years. In addition, the board also adopted amendments that correct some confusing rule language to clarify that a resident in an approved postgraduate residency training program is not required to participate in podiatric continuing medical education. 

The Podiatric Medical Board (board) adopted amendments to WAC 246-922-400, WAC 246-922-405, WAC 246-922-410, and WAC 246-922-415 to update language regarding health profession monitoring programs to align with changes made by Substitute Senate Bill (SSB) 5496 (chapter 43, Laws of 2022).

The Podiatric Medical Board is considering updates to reduce licensure barriers for podiatric physician and surgeons and amending reciprocity requirements in WAC 246-922-055 to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023) codified at RCW 18.130.077.

The Podiatric Medical Board (board) is proposing amendments to WAC 246-922-300 and 246-922-310 to establish health equity continuing education (CE) requirements to implement Engrossed Substitute Senate Bill 5229 (ESSB 5229).

Susan Gragg

PO Box 47852 Olympia, WA 98504-7852

Email:  podiatric@doh.wa.gov

Policy Number: AAC-23-01. The Department of Health clarified their position on implementation of new agency affiliated counselor credentials. Effective Date: July 23, 2023. Filed as WSR 23-23-116.

Policy Statement CHS-04-08-24: The Washington State Department of Health (DOH) issued a policy statement on enforcement discretion of certain requirements in chapter 246-341 WAC applicable to Opioid Treatment Program licensing and certification. Filed as WSR 24-12-021 on May 24, 2024.

The Washington Medical Commission has adopted amendments to WAC 246-919-330 to eliminate the outdated requirement for consecutive years of training in no more than two programs. This change removes a barrier for qualified applicants to obtain licensure. This permanent rule will supersede the emergency rule filed on March 8, 2024, as WSR 24-07-019.

The Washington Medical Commission has adopted amendments to WAC 246-919-330 to eliminate the outdated requirement for consecutive years of training in no more than two programs. This change removes a barrier for qualified applicants to obtain licensure. This permanent rule will supersede the emergency rule filed on March 8, 2024, as WSR 24-07-019.

The Pharmacy Quality Assurance Commission is proposing amendments to WAC 246-945-015 and adding four new sections to chapter 246-945 WAC establishing prescription label accessibility standards to ensure meaningful access to prescription information for patients with visual impairments or print disabilities, and for limited English Proficient patients.

The Pharmacy Quality Assurance Commission is considering creating a new section(s) in chapter 246-945 WAC related to the regulation of the practices of “white bagging” and “brown bagging” or any other transfer of a prescription or drug for the purpose of re-dispensing or subsequent administration to a patient. Concerns have been raised over ensuring the integrity and quality of these medications is maintained if such practices are used by prescribers, hospitals, or patients because these practices can create an unknown chain of custody.

Clarifying terms and information about prescription history for the PMP. The Department of Health (department) is considering clarifying that prescribers can request the history of prescriptions they have written. The department is considering changes to WAC 246-470- 010, 246-470-030, and 246-470-050 and potentially other related sections in chapter 246-470 WAC to help clarify rules including terms and definitions relating to the Prescription Monitoring Program.

The Washington State Department of Health (DOH) is proposing updates to WAC 246-470-010, 246-470-030, and 246-470-050 to add definitions and language consistency, and to clarify prescribers’ ability to request their prescribing history.

The Washington State Department of Health (DOH) adopted clarifying terms and added definitions of "delivery," "dispense," and "ultimate user." DOH also adopted language to clarify a prescriber’s ability to request the history of prescriptions the prescribers have written to decrease confusion regarding requirements of dispensers and prescribers.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-345 and potentially establishing a new section in chapter 246-945 WAC to clarify the expectation of pharmacies related to prescription transfers upon patient request. Other amendments to facilitate the timely transfer of prescription may also be considered.