Technical corrections

AN ACT Relating to making technical corrections and removing 1
obsolete language from the Revised Code of Washington pursuant to RCW 2
1.08.025; amending RCW 1.16.050, 9.94A.507, 18.225.090, 23B.13.200, 3
23B.13.210, 23B.13.220, 66.04.021, 6.15.060, 9.94A.840, 9.94B.020, 4
9.95.040, 9A.56.120, 12.36.020, 18.73.270, 18.330.040, 19.116.040, 5
19.182.040, 28A.600.385, 28B.20.810, 28B.76.730, 35.82.080, 6
35.82.285, 36.32.440, 38.52.020, 38.52.390, 41.32.345, 41.56.465, 7
41.56.492, 43.20B.670, 43.21A.662, 43.70.670, 43.216.152, 43.330.430, 8
43.330.435, 46.18.205, 46.61.100, 48.20.555, 48.21.375, 51.14.150, 9
59.22.020, 64.34.216, 64.34.316, 64.34.324, 64.34.400, 69.25.030, 10
70.14.050, 70.122.020, 71.09.098, 71A.12.210, 71A.12.220, 11
74.04.00511, 74.04.300, 74.04.670, 79A.05.065, 80.70.020, 88.02.610, 12
18.20.230, 18.50.032, 18.79.010, 18.79.040, 18.79.050, 18.79.070, 13
18.79.080, 18.79.090, 18.79.100, 18.79.110, 18.79.150, 18.79.160, 14
18.79.170, 18.79.180, 18.79.190, 18.79.230, 18.79.240, 18.79.250, 15
18.79.260, 18.79.290, 18.79.310, 18.79.340, 18.79.390, 18.79.400, 16
18.79.410, 18.79.430, 18.79.435, 18.79.440, 18.79.800, 18.79.810, 17
18.88A.020, 18.88A.030, 18.88A.060, 18.88A.080, 18.88A.082, 18
18.88A.085, 18.88A.087, 18.88A.088, 18.88A.090, 18.88A.100, 19
18.88A.210, 18.88B.070, 28A.210.275, 28A.210.280, 28A.210.290, 20
28B.115.020, 41.05.180, 48.20.393, 48.21.225, 48.43.087, 48.44.325, 21
48.46.275, 69.45.010, 69.51A.300, 70.128.210, 74.42.230, 7.68.030, 22
7.68.063, 7.68.080, 9.02.110, 9.02.130, 10.77.175, 11.130.290, 23
Z-0001.3
HOUSE BILL 1281
State of Washington 69th Legislature 2025 Regular Session
By Representatives Goodman, Simmons, and Hill; by request of Statute
Law Committee
Read first time 01/14/25. Referred to Committee on Civil Rights &
Judiciary.
p. 1 HB 1281
11.130.390, 11.130.615, 18.16.260, 18.50.005, 18.50.115, 18.57.040, 1
18.59.100, 18.64.253, 18.64.560, 18.71.030, 18.74.200, 18.89.020, 2
18.130.410, 18.134.010, 18.225.010, 18.250.010, 19.410.010, 3
28A.210.090, 28A.210.275, 28A.210.280, 28A.210.290, 28A.210.305, 4
41.05.177, 41.05.180, 41.24.155, 43.70.470, 46.19.010, 46.61.506, 5
46.61.508, 48.20.392, 48.20.393, 48.21.225, 48.21.227, 48.42.100, 6
48.43.094, 48.43.115, 48.44.325, 48.44.327, 48.46.275, 48.46.277, 7
48.125.200, 50A.05.010, 51.04.030, 51.28.010, 51.28.020, 51.28.025, 8
51.28.055, 51.36.010, 51.48.060, 51.52.010, 68.50.105, 69.41.010, 9
69.41.030, 69.43.135, 69.45.010, 69.50.101, 70.02.010, 70.02.230, 10
70.24.115, 70.30.061, 70.41.410, 70.47.210, 70.48.135, 70.48.490, 11
70.54.400, 70.58A.010, 70.122.051, 70.122.130, 70.128.120, 12
70.180.020, 70.180.040, 70.245.010, 71.05.148, 71.05.154, 71.05.210, 13
71.05.215, 71.05.230, 71.05.290, 71.05.300, 71.05.585, 71.12.540, 14
71.32.110, 71.32.140, 71.32.250, 71.34.720, 71.34.750, 71.34.755, 15
71.34.770, 71.34.815, 72.09.588, 74.09.010, 74.09.725, 74.42.010, and 16
74.42.380; amending 2021 c 167 s 1, 2015 c 207 s 1, 2015 c 70 s 2, 17
2013 c 3 s 1, 2017 c 317 s 12, 2015 2nd sp.s. c 4 s 101, 2020 c 236 s 18
1, 2020 c 133 s 1, 2019 c 393 s 1, and 2007 c 371 s 1 (uncodified); 19
reenacting and amending RCW 19.158.020, 43.21B.110, 90.58.090, 20
18.130.175, 43.21B.300, 43.43.842, 70.41.230, 9.02.170, 9.41.010, 21
10.77.010, 18.360.010, 43.70.442, 51.36.110, 69.51A.010, 70.41.230, 22
71.05.217, 71.32.020, 71.32.260, and 71.34.730; reenacting RCW 23
19.09.085, 28B.76.526, 43.03.230, 43.03.240, 43.03.250, 43.03.265, 24
43.79.195, and 70A.65.030; creating a new section; decodifying RCW 25
15.92.105, 28A.300.2851, 28A.300.807, 43.10.300, and 43.280.091; 26
repealing 2023 c 470 s 3013; providing effective dates; and providing 27
expiration dates. 28
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:29
NEW SECTION. Sec. 1. RCW 1.08.025 directs the code reviser, 30
with the approval of the statute law committee, to prepare 31
legislation for submission to the legislature "concerning 32
deficiencies, conflicts, or obsolete provisions" in statutes. This 33
act makes technical, nonsubstantive amendments as follows:34
(1) Section 1001 of this act places legislatively recognized days 35
in calendar order. 36
(2) Section 1002 of this act corrects a cross reference 37
concerning the sentencing of sex offenders. 38
p. 2 HB 1281
(3) Section 1003 of this act corrects a drafting error concerning 1
the number of hours of supervised experience for licensed advanced 2
social workers. 3
(4) Section 1004 of this act renumbers a definition section in 4
order to combine two subsections defining the term "commercial 5
telephone solicitor." 6
(5) Sections 1005 through 1007 of this act correct errors in 7
internal references of the Washington business corporation act.8
(6) Section 1008 of this act removes a duplicative cross 9
reference created by merging multiple amendments. 10
(7) Section 1009 of this act corrects a cross reference 11
concerning the definition of liquor retailers. 12
(8) Section 1010 of this act decodifies sections relating to 13
various groups whose work has concluded. 14
(9) Section 1011 of this act repeals a session law section 15
omitted in error from the repeal of RCW 10.31.115 by chapter 1, Laws 16
of 2023 sp. sess. 17
(10) Sections 2001 through 2051 of this act adjust cross 18
references to reflect recodification of sections and changes in 19
subsection numbering. 20
(11) Sections 3001 through 3011 of this act merge multiple 21
amendments created when sections were amended without reference to 22
other amendments made in the same session. 23
(12) Sections 4001 through 4010 of this act change the term 24
"marijuana" to "cannabis" in uncodified notes published in the 25
Revised Code of Washington. 26
(13) Sections 5001 through 5172 of this act change the term 27
"nursing care quality assurance commission" to "state board of 28
nursing," in accordance with chapter 123, Laws of 2023, and "advanced 29
registered nurse practitioner" to "advanced practice registered 30
nurse," in accordance with chapter 239, Laws of 2024.31
PART I32
GENERAL CORRECTIONS33
Sec. 1001. RCW 1.16.050 and 2024 c 76 s 3 are each amended to 34
read as follows: 35
(1) The following are state legal holidays: 36
(a) Sunday; 37
(b) The first day of January, commonly called New Year's Day;38
p. 3 HB 1281
(c) The third Monday of January, celebrated as the anniversary of 1
the birth of Martin Luther King, Jr.; 2
(d) The third Monday of February, to be known as Presidents' Day 3
and celebrated as the anniversary of the births of Abraham Lincoln 4
and George Washington; 5
(e) The last Monday of May, commonly known as Memorial Day;6
(f) The nineteenth day of June, recognized as Juneteenth, a day 7
of remembrance for the day the African slaves learned of their 8
freedom; 9
(g) The fourth day of July, the anniversary of the Declaration of 10
Independence; 11
(h) The first Monday in September, to be known as Labor Day;12
(i) The eleventh day of November, to be known as Veterans Day;13
(j) The fourth Thursday in November, to be known as Thanksgiving 14
Day; 15
(k) The Friday immediately following the fourth Thursday in 16
November, to be known as Native American Heritage Day; and17
(l) The twenty-fifth day of December, commonly called Christmas 18
Day. 19
(2) Employees of the state and its political subdivisions, except 20
employees of school districts and except those nonclassified 21
employees of institutions of higher education who hold appointments 22
or are employed under contracts to perform services for periods of 23
less than twelve consecutive months, are entitled to one paid holiday 24
per calendar year in addition to those specified in this section. 25
Each employee of the state or its political subdivisions may select 26
the day on which the employee desires to take the additional holiday 27
provided for in this section after consultation with the employer 28
pursuant to guidelines to be promulgated by rule of the appropriate 29
personnel authority, or in the case of local government by ordinance 30
or resolution of the legislative authority. 31
(3) Employees of the state and its political subdivisions, 32
including employees of school districts and those nonclassified 33
employees of institutions of higher education who hold appointments 34
or are employed under contracts to perform services for periods of 35
less than twelve consecutive months, are entitled to two unpaid 36
holidays per calendar year for a reason of faith or conscience or an 37
organized activity conducted under the auspices of a religious 38
denomination, church, or religious organization. This includes 39
employees of public institutions of higher education, including 40
p. 4 HB 1281
community colleges, technical colleges, and workforce training 1
programs. The employee may select the days on which the employee 2
desires to take the two unpaid holidays after consultation with the 3
employer pursuant to guidelines to be promulgated by rule of the 4
appropriate personnel authority, or in the case of local government 5
by ordinance or resolution of the legislative authority. If an 6
employee prefers to take the two unpaid holidays on specific days for 7
a reason of faith or conscience, or an organized activity conducted 8
under the auspices of a religious denomination, church, or religious 9
organization, the employer must allow the employee to do so unless 10
the employee's absence would impose an undue hardship on the employer 11
or the employee is necessary to maintain public safety. Undue 12
hardship shall have the meaning established in rule by the office of 13
financial management under RCW 43.41.109. 14
(4) If any of the state legal holidays specified in this section 15
are also federal legal holidays but observed on different dates, only 16
the state legal holidays are recognized as a paid legal holiday for 17
employees of the state and its political subdivisions. However, for 18
port districts and the law enforcement and public transit employees 19
of municipal corporations, either the federal or the state legal 20
holiday is recognized as a paid legal holiday, but in no case may 21
both holidays be recognized as a paid legal holiday for employees.22
(5) Whenever any state legal holiday: 23
(a) Other than Sunday, falls upon a Sunday, the following Monday 24
is the legal holiday; or 25
(b) Falls upon a Saturday, the preceding Friday is the legal 26
holiday. 27
(6) Nothing in this section may be construed to have the effect 28
of adding or deleting the number of paid holidays provided for in an 29
agreement between employees and employers of political subdivisions 30
of the state or as established by ordinance or resolution of the 31
local government legislative authority. 32
(7) The legislature declares that the following days are 33
recognized as provided in this subsection, but may not be considered 34
legal holidays for any purpose: 35
(a) ((The thirteenth day of January, recognized as Korean-36
American day;37
(b) The twelfth day of October, recognized as Columbus day;38
(c) The ninth day of April, recognized as former prisoner of war 39
recognition day;40
p. 5 HB 1281
(d) The twenty-sixth day of January, recognized as Washington 1
army and air national guard day;2
(e) The seventh day of August, recognized as purple heart 3
recipient recognition day;4
(f) The second Sunday in October, recognized as Washington state 5
children's day;6
(g) The sixteenth day of April, recognized as Mother Joseph day;7
(h) The fourth day of September, recognized as Marcus Whitman 8
day;9
(i) The seventh day of December, recognized as Pearl Harbor 10
remembrance day;11
(j) The twenty-seventh day of July, recognized as national Korean 12
war veterans armistice day;13
(k) The nineteenth day of February, recognized as civil liberties 14
day of remembrance;15
(l) The thirtieth day of March, recognized as welcome home 16
Vietnam veterans day;17
(m) The eleventh day of January, recognized as human trafficking 18
awareness day;19
(n) The thirty-first day of March, recognized as Cesar Chavez 20
day;21
(o) The tenth day of April, recognized as Dolores Huerta day;22
(p) The fourth Saturday of September, recognized as public lands 23
day;24
(q) The eighteenth day of December, recognized as blood donor 25
day;26
(r) The fifteenth day of May, recognized as water safety day;27
(s) The ninth day of March, recognized as Billy Frank Jr. day; 28
and29
(t) The date corresponding with the second new moon following the 30
winter solstice, or the third new moon following the winter solstice 31
should an intercalary month intervene, recognized as the lunar new 32
year)) The eleventh day of January, recognized as human trafficking 33
awareness day;34
(b) The thirteenth day of January, recognized as Korean American 35
day;36
(c) The date corresponding with the second new moon following the 37
winter solstice, or the third new moon following the winter solstice 38
should an intercalary month intervene, recognized as the lunar new 39
year;40
p. 6 HB 1281
(d) The twenty-sixth day of January, recognized as Washington 1
army and air national guard day;2
(e) The nineteenth day of February, recognized as civil liberties 3
day of remembrance;4
(f) The ninth day of March, recognized as Billy Frank Jr. day;5
(g) The thirtieth day of March, recognized as welcome home 6
Vietnam veterans day;7
(h) The thirty-first day of March, recognized as Cesar Chavez 8
day;9
(i) The ninth day of April, recognized as former prisoner of war 10
recognition day;11
(j) The tenth day of April, recognized as Dolores Huerta day;12
(k) The sixteenth day of April, recognized as Mother Joseph day;13
(l) The fifteenth day of May, recognized as water safety day;14
(m) The twenty-seventh day of July, recognized as national Korean 15
war veterans armistice day;16
(n) The seventh day of August, recognized as purple heart 17
recipient recognition day;18
(o) The fourth day of September, recognized as Marcus Whitman 19
day;20
(p) The fourth Saturday of September, recognized as public lands 21
day;22
(q) The second Sunday in October, recognized as Washington state 23
children's day;24
(r) The twelfth day of October, recognized as Columbus day;25
(s) The seventh day of December, recognized as Pearl Harbor 26
remembrance day; and27
(t) The eighteenth day of December, recognized as blood donor 28
day. 29
Sec. 1002. RCW 9.94A.507 and 2008 c 231 s 33 are each amended to 30
read as follows: 31
(1) An offender who is not a persistent offender shall be 32
sentenced under this section if the offender: 33
(a) Is convicted of: 34
(i) Rape in the first degree, rape in the second degree, rape of 35
a child in the first degree, child molestation in the first degree, 36
rape of a child in the second degree, or indecent liberties by 37
forcible compulsion; 38
p. 7 HB 1281
(ii) Any of the following offenses with a finding of sexual 1
motivation: Murder in the first degree, murder in the second degree, 2
homicide by abuse, kidnapping in the first degree, kidnapping in the 3
second degree, assault in the first degree, assault in the second 4
degree, assault of a child in the first degree, assault of a child in 5
the second degree, or burglary in the first degree; or6
(iii) An attempt to commit any crime listed in this subsection 7
(1)(a); or 8
(b) Has a prior conviction for an offense listed in RCW 9
9.94A.030(((31)(b))) (37)(b)(i), and is convicted of any sex offense 10
other than failure to register. 11
(2) An offender convicted of rape of a child in the first or 12
second degree or child molestation in the first degree who was 13
seventeen years of age or younger at the time of the offense shall 14
not be sentenced under this section. 15
(3)(a) Upon a finding that the offender is subject to sentencing 16
under this section, the court shall impose a sentence to a maximum 17
term and a minimum term. 18
(b) The maximum term shall consist of the statutory maximum 19
sentence for the offense. 20
(c)(i) Except as provided in (c)(ii) of this subsection, the 21
minimum term shall be either within the standard sentence range for 22
the offense, or outside the standard sentence range pursuant to RCW 23
9.94A.535, if the offender is otherwise eligible for such a sentence.24
(ii) If the offense that caused the offender to be sentenced 25
under this section was rape of a child in the first degree, rape of a 26
child in the second degree, or child molestation in the first degree, 27
and there has been a finding that the offense was predatory under RCW 28
9.94A.836, the minimum term shall be either the maximum of the 29
standard sentence range for the offense or twenty-five years, 30
whichever is greater. If the offense that caused the offender to be 31
sentenced under this section was rape in the first degree, rape in 32
the second degree, indecent liberties by forcible compulsion, or 33
kidnapping in the first degree with sexual motivation, and there has 34
been a finding that the victim was under the age of fifteen at the 35
time of the offense under RCW 9.94A.837, the minimum term shall be 36
either the maximum of the standard sentence range for the offense or 37
twenty-five years, whichever is greater. If the offense that caused 38
the offender to be sentenced under this section is rape in the first 39
degree, rape in the second degree with forcible compulsion, indecent 40
p. 8 HB 1281
liberties with forcible compulsion, or kidnapping in the first degree 1
with sexual motivation, and there has been a finding under RCW 2
9.94A.838 that the victim was, at the time of the offense, 3
developmentally disabled, mentally disordered, or a frail elder or 4
vulnerable adult, the minimum sentence shall be either the maximum of 5
the standard sentence range for the offense or twenty-five years, 6
whichever is greater. 7
(d) The minimum terms in (c)(ii) of this subsection do not apply 8
to a juvenile tried as an adult pursuant to RCW 13.04.030(1)(e) (i) 9
or (v). The minimum term for such a juvenile shall be imposed under 10
(c)(i) of this subsection. 11
(4) A person sentenced under subsection (3) of this section shall 12
serve the sentence in a facility or institution operated, or utilized 13
under contract, by the state. 14
(5) When a court sentences a person to the custody of the 15
department under this section, the court shall, in addition to the 16
other terms of the sentence, sentence the offender to community 17
custody under the supervision of the department and the authority of 18
the board for any period of time the person is released from total 19
confinement before the expiration of the maximum sentence.20
(6)(a) As part of any sentence under this section, the court 21
shall also require the offender to comply with any conditions imposed 22
by the board under RCW 9.95.420 through 9.95.435. 23
(b) An offender released by the board under RCW 9.95.420 is 24
subject to the supervision of the department until the expiration of 25
the maximum term of the sentence. The department shall monitor the 26
offender's compliance with conditions of community custody imposed by 27
the court, department, or board, and promptly report any violations 28
to the board. Any violation of conditions of community custody 29
established or modified by the board are subject to the provisions of 30
RCW 9.95.425 through 9.95.440. 31
Sec. 1003. RCW 18.225.090 and 2024 c 371 s 14 are each amended 32
to read as follows: 33
(1) The secretary shall issue a license to any applicant who 34
demonstrates to the satisfaction of the secretary that the applicant 35
meets the following education and experience requirements for the 36
applicant's practice area. 37
(a) Licensed social work classifications: 38
(i) Licensed advanced social worker: 39
p. 9 HB 1281
(A) Graduation from a master's social work educational program 1
accredited by the council on social work education or a social work 2
doctorate program at a university accredited by a recognized 3
accrediting organization, and approved by the secretary based upon 4
nationally recognized standards; 5
(B) Successful completion of an approved examination;6
(C) Successful completion of a supervised experience requirement. 7
The supervised experience requirement consists of a minimum of 8
((3,200 [3,000] )) 3,000 hours with supervision by an approved 9
supervisor who has been licensed for at least two years. Of those 10
supervised hours: 11
(I) At least 90 hours must include direct supervision as 12
specified in this subsection by a licensed independent clinical 13
social worker, a licensed advanced social worker, or an equally 14
qualified licensed mental health professional. Of those hours of 15
directly supervised experience at least 40 hours must be in one-to-16
one supervision and 50 hours may be in one-to-one supervision or 17
group supervision; and 18
(II) 800 hours must be in direct client contact; and19
(D) Successful completion of continuing education requirements 20
established in rule by the secretary in consultation with the 21
committee, including a minimum number of hours in professional 22
ethics. 23
(ii) Licensed independent clinical social worker:24
(A) Graduation from a master's level social work educational 25
program accredited by the council on social work education or a 26
social work doctorate program at a university accredited by a 27
recognized accrediting organization, and approved by the secretary 28
based upon nationally recognized standards; 29
(B) Successful completion of an approved examination;30
(C) Successful completion of a supervised experience requirement. 31
The supervised experience requirement consists of a minimum of 3,000 32
hours of experience, over a period of not less than two years, with 33
supervision by an approved supervisor who has been licensed for at 34
least two years and, as specified in this subsection, may be either a 35
licensed independent clinical social worker who has had at least one 36
year of experience in supervising the clinical social work of others 37
or an equally qualified licensed mental health practitioner. Of those 38
supervised hours: 39
(I) At least 1,000 hours must be direct client contact; and40
p. 10 HB 1281
(II) Hours of direct supervision must include: 1
(1) At least 100 hours by a licensed mental health practitioner;2
(2) At least 70 hours of supervision with a licensed independent 3
clinical social worker meeting the qualifications under this 4
subsection (1)(a)(ii)(C); the remaining hours may be supervised by an 5
equally qualified licensed mental health practitioner; and6
(3) At least 60 hours must be in one-to-one supervision and the 7
remaining hours may be in one-to-one supervision or group 8
supervision; and 9
(D) Successful completion of continuing education requirements 10
established in rule by the secretary in consultation with the 11
committee, including a minimum number of hours in professional 12
ethics. 13
(b) Licensed mental health counselor: 14
(i)(A) Graduation from a master's or doctoral level educational 15
program in counseling that consists of at least 60 semester hours or 16
90 quarter hours, or includes at least 60 semester hours or 90 17
quarter hours of graduate coursework that includes the following 18
topic areas: 19
(I) Mental health counseling orientation and ethical practice;20
(II) Social and cultural diversity; 21
(III) Human growth and development; 22
(IV) Career development; 23
(V) Counseling and helping relationships; 24
(VI) Group counseling and group work; 25
(VII) Diagnosis and treatment; 26
(VIII) Assessment and testing; and 27
(IX) Research and program evaluation; or 28
(B) Graduation from a master's or doctoral level educational 29
program in a related discipline from a college or university approved 30
by the secretary based upon nationally recognized standards. An 31
applicant who satisfies the educational requirements for licensure 32
under this subsection (1)(b)(i)(B) is not qualified to exercise the 33
privilege to practice under the counseling compact established in 34
chapter 18.17 RCW unless the master's or doctoral level educational 35
program in a related discipline consists of at least 60 semester 36
hours or 90 quarter hours, or includes at least 60 semester hours or 37
90 quarter hours of graduate coursework that includes the topic areas 38
specified in (b)(i)(A)(I) through (IX) of this subsection;39
(ii) Successful completion of an approved examination;40
p. 11 HB 1281
(iii) Successful completion of a supervised experience 1
requirement. The experience requirement consists of a minimum of 36 2
months full-time counseling or 3,000 hours of postgraduate mental 3
health counseling under the supervision of a qualified licensed 4
mental health counselor or equally qualified licensed mental health 5
practitioner, in an approved setting. The 3,000 hours of required 6
experience includes a minimum of 100 hours spent in immediate 7
supervision with the qualified licensed mental health counselor, and 8
includes a minimum of 1,200 hours of direct counseling with 9
individuals, couples, families, or groups; and 10
(iv) Successful completion of continuing education requirements 11
established in rule by the secretary in consultation with the 12
committee, including a minimum number of hours in professional 13
ethics. 14
(c) Licensed marriage and family therapist: 15
(i) Graduation from a master's degree or doctoral degree 16
educational program in marriage and family therapy or graduation from 17
an educational program in an allied field equivalent to a master's 18
degree or doctoral degree in marriage and family therapy approved by 19
the secretary based upon nationally recognized standards;20
(ii) Successful passage of an approved examination;21
(iii) Successful completion of a supervised experience 22
requirement. The experience requirement consists of a minimum of 23
3,000 hours of marriage and family therapy. Of the total supervision, 24
100 hours must be with a licensed marriage and family therapist with 25
at least two years' clinical experience; the other 100 hours may be 26
with an equally qualified licensed mental health practitioner. Total 27
experience requirements include: 28
(A) 1,000 hours of direct client contact; at least 500 hours must 29
be gained in diagnosing and treating couples and families; plus30
(B) At least 200 hours of qualified supervision with a 31
supervisor. At least 100 of the 200 hours must be one-on-one 32
supervision, and the remaining hours may be in one-on-one or group 33
supervision. 34
Applicants who have completed a master's program accredited by 35
the commission on accreditation for marriage and family therapy 36
education of the American association for marriage and family therapy 37
may be credited with 500 hours of direct client contact and 100 hours 38
of formal meetings with an approved supervisor; and39
p. 12 HB 1281
(iv) Successful completion of continuing education requirements 1
established in rule by the secretary in consultation with the 2
committee, including a minimum number of hours in professional 3
ethics. 4
(2) The department shall establish by rule what constitutes 5
adequate proof of meeting the criteria. Only rules in effect on the 6
date of submission of a completed application of an associate for her 7
or his license shall apply. If the rules change after a completed 8
application is submitted but before a license is issued, the new 9
rules shall not be reason to deny the application.10
(3) In addition, applicants shall be subject to the grounds for 11
denial of a license or issuance of a conditional license under 12
chapter 18.130 RCW. 13
Sec. 1004. RCW 19.158.020 and 2023 c 103 s 4 are each reenacted 14
and amended to read as follows: 15
The definitions in this section apply throughout this chapter 16
unless the context clearly requires otherwise. 17
(1) "Commercial telephone solicitation" means:18
(a) An unsolicited telephone call, initiated by one other than a 19
person described under subsection (((3)(a))) (2)(b)(i) through 20
(((k))) (xi) of this section, for the purpose of encouraging a person 21
to purchase or invest in property, goods, or services, or wrongfully 22
obtaining anything of value; 23
(b) Other communication with a person where: 24
(i) A free gift, award, or prize is offered to a purchaser who 25
has not previously purchased from the person initiating the 26
communication; and 27
(ii) A telephone call response is invited; and28
(iii) The caller intends to complete a sale or enter into an 29
agreement to purchase during the course of the telephone call;30
(c) Other communication with a person which misrepresents the 31
price, quality, or availability of property, goods, or services and 32
which invites a response by telephone or which is followed by a call 33
to the person; 34
(d) For purposes of this section, "other communication" means a 35
written or oral notification or advertisement transmitted through any 36
means. 37
p. 13 HB 1281
(2)(a) A "commercial telephone solicitor" is any person who 1
engages in commercial telephone solicitation, including service 2
bureaus. 3
(((3))) (b) A "commercial telephone solicitor" does not include 4
any of the following: 5
(((a))) (i) A person engaging in commercial telephone 6
solicitation where the solicitation is an isolated transaction and 7
not done in the course of a pattern of repeated transactions of like 8
nature; 9
(((b))) (ii) A person making calls for religious, charitable, 10
political, or other noncommercial purposes; 11
(((c))) (iii) A person soliciting business solely from purchasers 12
who have previously purchased from the business enterprise for which 13
the person is calling; 14
(((d))) (iv) A person soliciting: 15
(((i))) (A) Without the intent to complete or obtain provisional 16
acceptance of a sale during the telephone solicitation; and17
(((ii))) (B) Who does not make the major sales presentation 18
during the telephone solicitation; and 19
(((iii))) (C) Who only makes the major sales presentation or 20
arranges for the major sales presentation to be made at a later face-21
to-face meeting between the salesperson and the purchaser;22
(((e))) (v) A person selling a security which is exempt from 23
registration under RCW 21.20.310; 24
(((f))) (vi) A person licensed under RCW 18.85.101 when the 25
solicited transaction is governed by that law; 26
(((g))) (vii) A person registered under RCW 18.27.060 when the 27
solicited transaction is governed by that law; 28
(((h))) (viii) A person licensed under chapter 48.17 RCW when the 29
solicited transaction is governed by that law; 30
(((i))) (ix) Any person soliciting the sale of a franchise who is 31
registered under RCW 19.100.140; 32
(((j))) (x) A person primarily soliciting the sale of a newspaper 33
of general circulation, a magazine or periodical, or contractual 34
plans, including book or record clubs: (((i))) (A) Under which the 35
seller provides the consumer with a form which the consumer may use 36
to instruct the seller not to ship the offered merchandise; and 37
(((ii))) (B) which is regulated by the federal trade commission trade 38
regulation concerning "use of negative option plans by sellers in 39
commerce"; 40
p. 14 HB 1281
(((k))) (xi) Any supervised financial institution or parent, 1
subsidiary, or affiliate thereof. As used in this section, 2
"supervised financial institution" means any commercial bank, trust 3
company, savings and loan association, mutual savings banks, credit 4
union, industrial loan company, personal property broker, consumer 5
finance lender, commercial finance lender, or insurer, provided that 6
the institution is subject to supervision by an official or agency of 7
this state or the United States; 8
(((l))) (xii) A person soliciting the sale of a prearrangement 9
funeral service contract registered under RCW 18.39.240 and 10
18.39.260; 11
(((m))) (xiii) A person licensed to enter into prearrangement 12
contracts under RCW 68.05.155 when acting subject to that license;13
(((n))) (xiv) A person soliciting the sale of services provided 14
by a cable television system operating under authority of a franchise 15
or permit; 16
(((o))) (xv) A person or affiliate of a person whose business is 17
regulated by the utilities and transportation commission or the 18
federal communications commission; 19
(((p))) (xvi) A person soliciting the sale of agricultural 20
products, as defined in RCW 20.01.010 where the purchaser is a 21
business; 22
(((q))) (xvii) An issuer or subsidiary of an issuer that has a 23
class of securities that is subject to section 12 of the securities 24
exchange act of 1934 (15 U.S.C. Sec. 78l) and that is either 25
registered or exempt from registration under paragraph (A), (B), (C), 26
(E), (F), (G), or (H) of subsection (g) of that section;27
(((r))) (xviii) A commodity broker-dealer as defined in RCW 28
21.30.010 and registered with the commodity futures trading 29
commission; 30
(((s))) (xix) A business-to-business sale where:31
(((i))) (A) The purchaser business intends to resell the property 32
or goods purchased, or 33
(((ii))) (B) The purchaser business intends to use the property 34
or goods purchased in a recycling, reuse, remanufacturing or 35
manufacturing process; 36
(((t))) (xx) A person licensed under RCW 19.16.110 when the 37
solicited transaction is governed by that law; 38
(((u))) (xxi) A person soliciting the sale of food intended for 39
immediate delivery to and immediate consumption by the purchaser;40
p. 15 HB 1281
(((v))) (xxii) A person soliciting the sale of food fish or 1
shellfish when that person is licensed pursuant to the provisions of 2
Title 77 RCW. 3
(((4))) (3) "Free gift, award, or prize" means a gratuity which 4
the purchaser believes of a value equal to or greater than the value 5
of the specific product, good, or service sought to be sold to the 6
purchaser by the seller. 7
(((5))) (4) "Person" includes any individual, firm, association, 8
corporation, partnership, joint venture, sole proprietorship, or any 9
other business entity. 10
(((6))) (5) "Purchaser" means a person who is solicited to become 11
or does become obligated to a commercial telephone solicitor.12
(((7))) (6) "Salesperson" means any individual employed, 13
appointed, or authorized by a commercial telephone solicitor, whether 14
referred to by the commercial telephone solicitor as an agent, 15
representative, or independent contractor, who attempts to solicit or 16
solicits a sale on behalf of the commercial telephone solicitor.17
(((8))) (7) "Seller" means any person who contracts with any 18
service bureau to purchase commercial telephone solicitation 19
services. 20
(((9))) (8) "Service bureau" means a commercial telephone 21
solicitor who contracts with any person to provide commercial 22
telephone solicitation services. 23
(((10))) (9) "Telephone call" includes any communication made 24
through a telephone that uses a live person, artificial voice, or 25
recorded message. 26
(((11))) (10) "Unsolicited" means to initiate contact for the 27
purpose of attempting to sell a person property, goods, or services, 28
where such person provided no previous express interest in 29
purchasing, investing in, or obtaining information regarding the 30
property, goods, or services attempted to be sold.31
Sec. 1005. RCW 23B.13.200 and 2024 c 22 s 23 are each amended to 32
read as follows: 33
(1) If proposed corporate action creating dissenters' rights 34
under RCW 23B.13.020 is submitted for approval by a vote at a 35
shareholders' meeting, the meeting notice must state that 36
shareholders are or may be entitled to assert dissenters' rights 37
under this chapter and be accompanied by a copy of this chapter.38
p. 16 HB 1281
(2) If proposed corporate action creating dissenters' rights 1
under RCW 23B.13.020 would be submitted for approval by a vote at a 2
shareholders' meeting but for the provisions of RCW ((23B.11A.040)) 3
23B.11A.045, the offer made pursuant to RCW ((23B.11A.040)) 4
23B.11A.045 must state that shareholders are or may be entitled to 5
assert dissenters' rights under this chapter and be accompanied by a 6
copy of this chapter. 7
(3) If corporate action creating dissenters' rights under RCW 8
23B.13.020 is submitted for approval without a vote of shareholders 9
in accordance with RCW 23B.07.040, the shareholder consent described 10
in RCW 23B.07.040(1)(b) and the notice described in RCW 11
23B.07.040(3)(a) must include a statement that shareholders are or 12
may be entitled to assert dissenters' rights under this chapter and 13
be accompanied by a copy of this chapter. 14
Sec. 1006. RCW 23B.13.210 and 2024 c 22 s 24 are each amended to 15
read as follows: 16
(1) If proposed corporate action creating dissenters' rights 17
under RCW 23B.13.020 is submitted to a vote at a shareholders' 18
meeting, a shareholder who wishes to assert dissenters' rights must 19
(a) deliver to the corporation before the vote is taken written 20
notice of the shareholder's intent to demand payment for the 21
shareholder's shares if the proposed corporate action is effected, 22
and (b) not vote such shares in favor of the proposed corporate 23
action. 24
(2) If proposed corporate action creating dissenters' rights 25
under RCW 23B.13.020 does not require shareholder approval pursuant 26
to RCW ((23B.11A.040)) 23B.11A.045, a shareholder who wishes to 27
assert dissenters' rights with respect to any class or series of 28
shares: 29
(a) Shall deliver to the corporation before the shares are 30
purchased pursuant to the offer under RCW ((23B.11A.040)) 23B.11A.045 31
written notice of the shareholder's intent to demand payment for the 32
shareholder's shares if the proposed corporate action is effected; 33
and 34
(b) Shall not tender, or cause to be tendered, any shares of such 35
class or series in response to such offer. 36
(3) If proposed corporate action creating dissenters' rights 37
under RCW 23B.13.020 is submitted for approval without a vote of 38
shareholders in accordance with RCW 23B.07.040, a shareholder who 39
p. 17 HB 1281
wishes to assert dissenters' rights must not execute the consent or 1
otherwise vote such shares in favor of the proposed corporate action.2
(4) A shareholder who does not satisfy the requirements of 3
subsection (1), (2), or (3) of this section is not entitled to 4
payment for the shareholder's shares under this chapter.5
Sec. 1007. RCW 23B.13.220 and 2024 c 22 s 25 are each amended to 6
read as follows: 7
(1) If proposed corporate action creating dissenters' rights 8
under RCW 23B.13.020 is approved at a shareholders' meeting, the 9
corporation shall within ten days after the effective date of the 10
corporate action deliver to all shareholders who satisfied the 11
requirements of RCW 23B.13.210(1) a notice in compliance with 12
subsection (6) of this section. 13
(2) If proposed corporate action creating dissenters' rights 14
under RCW 23B.13.020 is approved without a vote of shareholders in 15
accordance with RCW ((23B.11A.040)) 23B.11A.045, the corporation 16
shall within 10 days after the effective date of the corporate action 17
deliver to all shareholders who satisfied the requirements of RCW 18
23B.13.210(2) a notice in compliance with subsection (6) of this 19
section. 20
(3) If proposed corporate action creating dissenters' rights 21
under RCW 23B.13.020 is approved without a vote of shareholders in 22
accordance with RCW 23B.07.040, the notice delivered pursuant to RCW 23
23B.07.040(3)(b) to shareholders who satisfied the requirements of 24
RCW 23B.13.210(3) shall comply with subsection (6) of this section.25
(4) In the case of proposed corporate action creating dissenters' 26
rights under RCW 23B.13.020(1)(a)(ii), the corporation shall within 27
ten days after the effective date of the corporate action deliver to 28
all shareholders of the subsidiary other than the parent a notice in 29
compliance with subsection (6) of this section. 30
(5) In the case of proposed corporate action creating dissenters' 31
rights under RCW 23B.13.020(1)(d) that, pursuant to RCW 32
23B.10.020(4)(b), is not required to be approved by the shareholders 33
of the corporation, the corporation shall within ten days after the 34
effective date of the corporate action deliver to all shareholders 35
entitled to dissent under RCW 23B.13.020(1)(d) a notice in compliance 36
with subsection (6) of this section. 37
(6) Any notice under subsection (1), (2), (3), (4), or (5) of 38
this section must: 39
p. 18 HB 1281
(a) State where the payment demand must be sent and where and 1
when certificates for certificated shares must be deposited;2
(b) Inform holders of uncertificated shares to what extent 3
transfer of the shares will be restricted after the payment demand is 4
received; 5
(c) Supply a form for demanding payment that includes the date of 6
the first announcement to news media or to shareholders of the terms 7
of the proposed corporate action and requires that the person 8
asserting dissenters' rights certify whether or not the person 9
acquired beneficial ownership of the shares before that date;10
(d) Set a date by which the corporation must receive the payment 11
demand, which date may not be fewer than thirty nor more than sixty 12
days after the date the notice in subsection (1), (2), (3), (4), or 13
(5) of this section is delivered; and 14
(e) Be accompanied by a copy of this chapter. 15
Sec. 1008. RCW 43.21B.110 and 2024 c 347 s 5, 2024 c 340 s 4, 16
and 2024 c 339 s 16 are each reenacted and amended to read as 17
follows: 18
(1) The hearings board shall only have jurisdiction to hear and 19
decide appeals from the following decisions of the department, the 20
director, local conservation districts, the air pollution control 21
boards or authorities as established pursuant to chapter 70A.15 RCW, 22
local health departments, the department of natural resources, the 23
department of fish and wildlife, the parks and recreation commission, 24
and authorized public entities described in chapter 79.100 RCW:25
(a) Civil penalties imposed pursuant to chapter 70A.230 RCW and 26
RCW 18.104.155, 70A.15.3160, 70A.300.090, 70A.20.050, 27
((70A.230.020,)) 70A.205.280, 70A.355.070, 70A.430.070, 70A.500.260, 28
70A.505.100, 70A.505.110, 70A.530.040, 70A.350.070, 70A.515.060, 29
70A.245.040, 70A.245.050, 70A.245.070, 70A.245.080, 70A.245.130, 30
70A.245.140, 70A.65.200, 70A.455.090, 70A.550.030, 70A.555.110, 31
70A.560.020, 70A.565.030, 76.09.170, 77.55.440, 78.44.250, 88.46.090, 32
90.03.600, 90.46.270, 90.48.144, 90.56.310, 90.56.330, and 90.64.102.33
(b) Orders issued pursuant to RCW 18.104.043, 18.104.060, 34
18.104.130, 43.27A.190, 70A.15.2520, 70A.15.3010, 70A.15.4530, 35
70A.15.6010, 70A.205.280, 70A.214.140, 70A.300.120, 70A.350.070, 36
70A.245.020, 70A.65.200, 70A.505.100, 70A.555.110, 70A.560.020, 37
70A.565.030, 86.16.020, 88.46.070, 90.03.665, 90.14.130, 90.46.250, 38
90.48.120, 90.48.240, 90.56.330, and 90.64.040. 39
p. 19 HB 1281
(c) Except as provided in RCW 90.03.210(2), the issuance, 1
modification, or termination of any permit, certificate, or license 2
by the department or any air authority in the exercise of its 3
jurisdiction, including the issuance or termination of a waste 4
disposal permit, the denial of an application for a waste disposal 5
permit, the modification of the conditions or the terms of a waste 6
disposal permit, a decision to approve or deny a solid waste 7
management plan under RCW 70A.205.055, approval or denial of an 8
application for a beneficial use determination under RCW 70A.205.260, 9
an application for a change under RCW 90.03.383, or a permit to 10
distribute reclaimed water under RCW 90.46.220. 11
(d) Decisions of local health departments regarding the granting 12
or denial of solid waste permits pursuant to chapter 70A.205 RCW, 13
including appeals by the department as provided in RCW 70A.205.130.14
(e) Decisions of local health departments regarding the issuance 15
and enforcement of permits to use or dispose of biosolids under RCW 16
70A.226.090. 17
(f) Decisions of the department regarding waste-derived 18
fertilizer or micronutrient fertilizer under RCW 15.54.820.19
(g) Decisions of local conservation districts related to the 20
denial of approval or denial of certification of a dairy nutrient 21
management plan; conditions contained in a plan; application of any 22
dairy nutrient management practices, standards, methods, and 23
technologies to a particular dairy farm; and failure to adhere to the 24
plan review and approval timelines in RCW 90.64.026 as provided in 25
RCW 90.64.028. 26
(h) Any other decision by the department or an air authority 27
which pursuant to law must be decided as an adjudicative proceeding 28
under chapter 34.05 RCW. 29
(i) Decisions of the department of natural resources, the 30
department of fish and wildlife, and the department that are 31
reviewable under chapter 76.09 RCW, and the department of natural 32
resources' appeals of county, city, or town objections under RCW 33
76.09.050(7). 34
(j) Forest health hazard orders issued by the commissioner of 35
public lands under RCW 76.06.180. 36
(k) Decisions of the department of fish and wildlife to issue, 37
deny, condition, or modify a hydraulic project approval permit under 38
chapter 77.55 RCW, to issue a stop work order, to issue a notice to 39
p. 20 HB 1281
comply, to issue a civil penalty, or to issue a notice of intent to 1
disapprove applications. 2
(l) Decisions of the department of natural resources that are 3
reviewable under RCW 78.44.270. 4
(m) Decisions of an authorized public entity under RCW 79.100.010 5
to take temporary possession or custody of a vessel or to contest the 6
amount of reimbursement owed that are reviewable by the hearings 7
board under RCW 79.100.120. 8
(n) Decisions of the department of ecology that are appealable 9
under RCW 70A.245.020 to set recycled minimum postconsumer content 10
for covered products or to temporarily exclude types of covered 11
products in plastic containers from minimum postconsumer recycled 12
content requirements. 13
(o) Orders by the department of ecology under RCW 70A.455.080.14
(2) The following hearings shall not be conducted by the hearings 15
board: 16
(a) Hearings required by law to be conducted by the shorelines 17
hearings board pursuant to chapter 90.58 RCW, except where appeals to 18
the pollution control hearings board and appeals to the shorelines 19
hearings board have been consolidated pursuant to RCW 43.21B.340.20
(b) Hearings conducted by the department pursuant to RCW 21
70A.15.3010, 70A.15.3070, 70A.15.3080, 70A.15.3090, 70A.15.3100, 22
70A.15.3110, and 90.44.180. 23
(c) Appeals of decisions by the department under RCW 90.03.110 24
and 90.44.220. 25
(d) Hearings conducted by the department to adopt, modify, or 26
repeal rules. 27
(3) Review of rules and regulations adopted by the hearings board 28
shall be subject to review in accordance with the provisions of the 29
administrative procedure act, chapter 34.05 RCW. 30
Sec. 1009. RCW 66.04.021 and 2012 c 2 s 125 are each amended to 31
read as follows: 32
In this title, unless the context otherwise requires:33
(1) "Retailer" except as expressly defined by RCW 66.28.285(5) 34
with respect to its use in RCW ((6.28.280 [66.28.280])) 66.28.280 35
through 66.28.315, means the holder of a license or permit issued by 36
the board authorizing sale of liquor to consumers for consumption on 37
and/or off the premises. With respect to retailer licenses, "on-sale" 38
p. 21 HB 1281
refers to the license privilege of selling for consumption upon the 1
licensed premises. 2
(2) "Spirits distributor" means a person, other than a person who 3
holds only a retail license, who buys spirits from a domestic 4
distiller, manufacturer, supplier, spirits distributor, or spirits 5
importer, or who acquires foreign-produced spirits from a source 6
outside of the United States, for the purpose of reselling the same 7
not in violation of this title, or who represents such distiller as 8
agent. 9
(3) "Spirits importer" means a person who buys distilled spirits 10
from a distiller outside the state of Washington and imports such 11
spirits into the state for sale or export. 12
NEW SECTION. Sec. 1010. The following sections are decodified:13
(1) RCW 15.92.105 (Commission on integrated pest management —14
Report on activities—Review by legislature); 15
(2) RCW 28A.300.2851 (School bullying and harassment—Work group);16
(3) RCW 28A.300.807 (Task force—Review of federal 2007 race and 17
ethnicity reporting guidelines—Development of state guidelines);18
(4) RCW 43.10.300 (Hate crime advisory working group); and19
(5) RCW 43.280.091 (Statewide coordinating committee on sex 20
trafficking). 21
NEW SECTION. Sec. 1011. 2023 c 470 s 3013 is repealed.22
NEW SECTION. Sec. 1012. Section 1003 of this act takes effect 23
October 1, 2025.24
PART II25
CROSS REFERENCE UPDATES26
Sec. 2001. RCW 6.15.060 and 1993 c 200 s 5 are each amended to 27
read as follows: 28
(1) Except as provided in subsection (2) of this section, 29
property claimed exempt under RCW 6.15.010 shall be selected by the 30
individual entitled to the exemption, or by the husband or wife 31
entitled to a community exemption, in the manner described in 32
subsection (3) of this section. 33
p. 22 HB 1281
(2) If, at the time of seizure under execution or attachment of 1
property exemptible under RCW 6.15.010(((3) (a), (b), or (c))) 2
(1)(d)(i) and (iii), the individual or the husband or wife entitled 3
to claim the exemption is not present, then the sheriff or deputy 4
shall make a selection equal in value to the applicable exemptions 5
and, if no appraisement is required and no objection is made by the 6
creditor as permitted under subsection (4) of this section, the 7
officer shall return the same as exempt by inventory. Any selection 8
made as provided shall be prima facie evidence (a) that the property 9
so selected is exempt from execution and attachment, and (b) that the 10
property so selected is not in excess of the values specified for the 11
exemptions. 12
(3)(a) A debtor who claims personal property as exempt against 13
execution or attachment shall, at any time before sale, deliver to 14
the officer making the levy a list by separate items of the property 15
claimed as exempt, together with an itemized list of all the personal 16
property owned or claimed by the debtor, including money, bonds, 17
bills, notes, claims and demands, with the residence of the person 18
indebted upon the said bonds, bills, notes, claims and demands, and 19
shall verify such list by affidavit. The officer shall immediately 20
advise the creditor, attorney, or agent of the exemption claim and, 21
if no appraisement is required and no objection is made by the 22
creditor as permitted under subsection (4) of this section, the 23
officer shall return with the process the list of property claimed as 24
exempt. 25
(b) A debtor who claims personal property exempt against 26
garnishment shall proceed as provided in RCW 6.27.160.27
(c) A debtor who claims as a homestead, under chapter 6.13 RCW, a 28
mobile home that is not yet occupied as a homestead and that is 29
located on land not owned by the debtor shall claim the homestead as 30
against a specific levy by delivering to the sheriff who levied on 31
the mobile home, before sale under the levy, a declaration of 32
homestead that contains (i) a declaration that the debtor owns the 33
mobile home, intends to reside therein, and claims it as a homestead, 34
and (ii) a description of the mobile home, a statement where it is 35
located or was located before the levy, and an estimate of its actual 36
cash value. 37
(d) A debtor who claims as a homestead, under RCW 6.13.040, any 38
other personal property, shall at any time before sale, deliver to 39
the officer making the levy a notice of claim of homestead in a 40
p. 23 HB 1281
statement that sets forth the following: (i) The debtor owns the 1
personal property; (ii) the debtor resides thereon as a homestead; 2
(iii) the debtor's estimate of the fair market value of the property; 3
and (iv) the debtor's description of the property in sufficient 4
detail for the officer making the levy to identify the same.5
(4)(a) Except as provided in (b) of this subsection, a creditor, 6
or the agent or attorney of a creditor, who wishes to object to a 7
claim of exemption shall proceed as provided in RCW 6.27.160 and 8
shall give notice of the objection to the officer not later than 9
seven days after the officer's giving notice of the exemption claim.10
(b) A creditor, or the agent or attorney of the creditor, who 11
wishes to object to a claim of exemption made to a levying officer, 12
on the ground that the property claimed exceeds exemptible value, may 13
demand appraisement. If the creditor, or the agent or attorney of the 14
creditor, demands an appraisement, two disinterested persons shall be 15
chosen to appraise the property, one by the debtor and the other by 16
the creditor, agent or attorney, and these two, if they cannot agree, 17
shall select a third; but if either party fails to choose an 18
appraiser, or the two fail to select a third, or if one or more of 19
the appraisers fail to act, the court shall appoint one or more as 20
the circumstances require. The appraisers shall forthwith proceed to 21
make a list by separate items, of the personal property selected by 22
the debtor as exempt, which they shall decide as exempt, stating the 23
value of each article, and annexing to the list their affidavit to 24
the following effect: "We solemnly swear that to the best of our 25
judgment the above is a fair cash valuation of the property therein 26
described," which affidavit shall be signed by two appraisers at 27
least, and be certified by the officer administering the oaths. The 28
list shall be delivered to the officer holding the execution or 29
attachment and be annexed to and made part of the return, and the 30
property therein specified shall be exempt from levy and sale, but 31
the other personal estate of the debtor shall remain subject to 32
execution, attachment, or garnishment. Each appraiser shall be 33
entitled to fifteen dollars or such larger fee as shall be fixed by 34
the court, to be paid by the creditor if all the property claimed by 35
the debtor shall be exempt; otherwise to be paid by the debtor.36
(c) If, within seven days following the giving of notice to a 37
creditor of an exemption claim, the officer has received no notice 38
from the creditor of an objection to the claim or a demand for 39
p. 24 HB 1281
appraisement, the officer shall release the claimed property to the 1
debtor. 2
Sec. 2002. RCW 9.94A.840 and 1992 c 45 s 1 are each amended to 3
read as follows: 4
(1)(a) When it appears that a person who has been convicted of a 5
sexually violent offense may meet the criteria of a sexually violent 6
predator as defined in RCW 71.09.020(((1))), the agency with 7
jurisdiction over the person shall refer the person in writing to the 8
prosecuting attorney of the county where that person was convicted, 9
three months prior to the anticipated release from total confinement.10
(b) The agency shall inform the prosecutor of the following:11
(i) The person's name, identifying factors, anticipated future 12
residence, and offense history; and 13
(ii) Documentation of institutional adjustment and any treatment 14
received. 15
(2) This section applies to acts committed before, on, or after 16
March 26, 1992. 17
(3) The agency with jurisdiction, its employees, and officials 18
shall be immune from liability for any good-faith conduct under this 19
section. 20
(4) As used in this section, "agency with jurisdiction" means 21
that agency with the authority to direct the release of a person 22
serving a sentence or term of confinement and includes the department 23
of corrections, the indeterminate sentence review board, and the 24
department of social and health services. 25
Sec. 2003. RCW 9.94B.020 and 2008 c 231 s 52 are each amended to 26
read as follows: 27
In addition to the definitions set out in RCW 9.94A.030, the 28
following definitions apply for purposes of this chapter:29
(1) "Community placement" means that period during which the 30
offender is subject to the conditions of community custody and/or 31
postrelease supervision, which begins either upon completion of the 32
term of confinement (postrelease supervision) or at such time as the 33
offender is transferred to community custody in lieu of earned 34
release. Community placement may consist of entirely community 35
custody, entirely postrelease supervision, or a combination of the 36
two. 37
p. 25 HB 1281
(2) "Community supervision" means a period of time during which a 1
convicted offender is subject to crime -related prohibitions and other 2
sentence conditions imposed by a court pursuant to this chapter or 3
RCW 16.52.200(((6))) (9) or 46.61.524. Where the court finds that any 4
offender has a chemical dependency that has contributed to his or her 5
offense, the conditions of supervision may, subject to available 6
resources, include treatment. For purposes of the interstate compact 7
for out -of-state supervision of parolees and probationers, RCW 8
9.95.270, community supervision is the functional equivalent of 9
probation and should be considered the same as probation by other 10
states. 11
(3) "Postrelease supervision" is that portion of an offender's 12
community placement that is not community custody.13
Sec. 2004. RCW 9.95.040 and 1999 c 324 s 4 are each amended to 14
read as follows: 15
The board shall fix the duration of confinement for persons 16
committed by the court before July 1, 1986, for crimes committed 17
before July 1, 1984. Within six months after the admission of the 18
convicted person to a state correctional facility, the board shall 19
fix the duration of confinement. The term of imprisonment so fixed 20
shall not exceed the maximum provided by law for the offense of which 21
the person was convicted or the maximum fixed by the court where the 22
law does not provide for a maximum term. 23
Subject to RCW 9.95.047, the following limitations are placed on 24
the board or the court for persons committed to a state correctional 25
facility on or after July 1, 1986, for crimes committed before July 26
1, 1984, with regard to fixing the duration of confinement in certain 27
cases, notwithstanding any provisions of law specifying a lesser 28
sentence: 29
(1) For a person not previously convicted of a felony but armed 30
with a deadly weapon at the time of the commission of the offense, 31
the duration of confinement shall not be fixed at less than five 32
years. 33
(2) For a person previously convicted of a felony either in this 34
state or elsewhere and who was armed with a deadly weapon at the time 35
of the commission of the offense, the duration of confinement shall 36
not be fixed at less than seven and one-half years.37
The words "deadly weapon," as used in this section include, but 38
are not limited to, any instrument known as a blackjack, sling shot, 39
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billy, sand club, sandbag, metal knuckles, any dirk, dagger, pistol, 1
revolver, or any other firearm, any knife having a blade longer than 2
three inches, any razor with an unguarded blade, any metal pipe or 3
bar used or intended to be used as a club, any explosive, and any 4
weapon containing poisonous or injurious gas. 5
(3) For a person convicted of being an habitual criminal within 6
the meaning of the statute which provides for mandatory life 7
imprisonment for such habitual criminals, the duration of confinement 8
shall not be fixed at less than fifteen years. 9
(4) Any person convicted of embezzling funds from any institution 10
of public deposit of which the person was an officer or stockholder, 11
the duration of confinement shall be fixed at not less than five 12
years. 13
Except when an inmate of a state correctional facility has been 14
convicted of murder in the first or second degree, the board may 15
parole an inmate prior to the expiration of a mandatory minimum term, 16
provided such inmate has demonstrated a meritorious effort in 17
rehabilitation and at least two-thirds of the board members concur in 18
such action: PROVIDED, That any inmate who has a mandatory minimum 19
term and is paroled prior to the expiration of such term according to 20
the provisions of this chapter shall not receive a conditional 21
release from supervision while on parole until after the mandatory 22
minimum term has expired. 23
An inmate serving a sentence fixed under this chapter, whether or 24
not a mandatory minimum term has expired, may be granted an 25
extraordinary medical placement by the secretary of corrections when 26
authorized under RCW 9.94A.728(((4))) (1)(c). 27
Sec. 2005. RCW 9A.56.120 and 2011 c 336 s 377 are each amended 28
to read as follows: 29
(1) A person is guilty of extortion in the first degree if he or 30
she commits extortion by means of a threat as defined in RCW 31
9A.04.110(((27))) (28) (a), (b), or (c). 32
(2) Extortion in the first degree is a class B felony.33
Sec. 2006. RCW 12.36.020 and 1998 c 52 s 1 are each amended to 34
read as follows: 35
(1) To appeal a judgment or decision in a small claims action, an 36
appellant shall file a notice of appeal in the district court, pay 37
the statutory superior court filing fee, post the required bond or 38
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undertaking, and serve a copy of the notice of appeal on all parties 1
of record within thirty days after the judgment is rendered or 2
decision made. 3
(2) No appeal may be allowed, nor proceedings on the judgment or 4
decision stayed, unless a bond or undertaking shall be executed on 5
the part of the appellant and filed with and approved by the district 6
court. The bond or undertaking shall be executed with two or more 7
personal sureties, or a surety company as surety, to be approved by 8
the district court, in a sum equal to twice the amount of the 9
judgment and costs, or twice the amount in controversy, whichever is 10
greater, conditioned that the appellant will pay any judgment, 11
including costs, as may be rendered on appeal. No bond is required if 12
the appellant is a county, city, town, or school district.13
(3) When an appellant has filed a notice of appeal, paid the 14
statutory superior court filing fee and the costs of preparation of 15
the complete record as set forth in RCW 3.62.060(((7))) (1)(b), and 16
posted the bond or undertaking as required, the clerk of the district 17
court shall immediately file a copy of the notice of appeal, the 18
filing fee, and the bond or undertaking with the superior court.19
Sec. 2007. RCW 18.73.270 and 2009 c 359 s 1 are each amended to 20
read as follows: 21
(1) Except when treatment is provided in a hospital licensed 22
under chapter 70.41 RCW, a physician's trained advanced emergency 23
medical ((service intermediate life support )) technician and 24
paramedic, emergency medical technician, or first responder who 25
renders treatment to a patient for (a) a bullet wound, gunshot wound, 26
powder burn, or other injury arising from or caused by the discharge 27
of a firearm; (b) an injury caused by a knife, an ice pick, or any 28
other sharp or pointed instrument which federal, state, or local law 29
enforcement authorities reasonably believe to have been intentionally 30
inflicted upon a person; (c) a blunt force injury that federal, 31
state, or local law enforcement authorities reasonably believe 32
resulted from a criminal act; or (d) injuries sustained in an 33
automobile collision, shall disclose without the patient's 34
authorization, upon a request from a federal, state, or local law 35
enforcement authority as defined in RCW 70.02.010(((3))), the 36
following information, if known: 37
(i) The name of the patient; 38
(ii) The patient's residence; 39
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(iii) The patient's sex; 1
(iv) The patient's age; 2
(v) The patient's condition or extent and location of injuries as 3
determined by the physician's trained advanced emergency medical 4
((service intermediate life support )) technician and paramedic, 5
emergency medical technician, or first responder; 6
(vi) Whether the patient was conscious when contacted;7
(vii) Whether the patient appears to have consumed alcohol or 8
appears to be under the influence of alcohol or drugs;9
(viii) The name or names of the physician's trained advanced 10
emergency medical ((service intermediate life support )) technician 11
and paramedic, emergency medical technician, or first responder who 12
provided treatment to the patient; and 13
(ix) The name of the facility to which the patient is being 14
transported for additional treatment. 15
(2) A physician's trained advanced emergency medical ((service 16
intermediate life support )) technician and paramedic, emergency 17
medical technician, first responder, or other individual who 18
discloses information pursuant to this section is immune from civil 19
or criminal liability or professional licensure action for the 20
disclosure, provided that the physician's trained advanced emergency 21
medical ((service intermediate life support )) technician and 22
paramedic, emergency medical technician, first responder, or other 23
individual acted in good faith and without gross negligence or 24
willful or wanton misconduct. 25
(3) The obligation to provide information pursuant to this 26
section is secondary to patient care needs. Information must be 27
provided as soon as reasonably possible taking into consideration a 28
patient's emergency care needs. 29
(4) For purposes of this section, "a physician's trained advanced 30
emergency medical ((service intermediate life support )) technician 31
and paramedic" has the same meaning as in RCW 18.71.200.32
Sec. 2008. RCW 18.330.040 and 2011 c 357 s 5 are each amended to 33
read as follows: 34
(1) Each agency shall keep records of all referrals rendered to 35
or on behalf of clients. These records must contain:36
(a) The name of the vulnerable adult, and the address and phone 37
number of the client or the client's representative, if any;38
p. 29 HB 1281
(b) The kind of supportive housing or care services for which 1
referral was sought; 2
(c) The location of the care services or supportive housing 3
referred to the client and probable duration, if known;4
(d) The monthly or unit cost of the supportive housing or care 5
services, if known; 6
(e) If applicable, the amount of the agency's fee to the client 7
or to the provider; 8
(f) If applicable, the dates and amounts of refund of the 9
agency's fee, if any, and reason for such refund; and10
(g) A copy of the client's disclosure and intake forms described 11
in RCW 18.330.050 and 18.330.060. 12
(2) Each agency shall also keep records of any contract or 13
written agreement entered into with any provider for services 14
rendered to or on behalf of a vulnerable adult, including any 15
referrals to a provider. Any provision in a contract or written 16
agreement not consistent with this chapter is void and unenforceable.17
(3) The agency must maintain the records covered by this chapter 18
for a period of six years. The agency's records identifying a client 19
are considered "health care information" and the provisions of 20
chapter 70.02 RCW apply but only to the extent that such information 21
meets the definition of "health care information" under RCW 22
70.02.010(((7))) (17). The client must have access upon request to 23
the agency's records concerning the client and covered by this 24
chapter. 25
Sec. 2009. RCW 19.116.040 and 1990 c 44 s 5 are each amended to 26
read as follows: 27
(1) It is a violation of this chapter for a vehicle dealer, as 28
defined in RCW 46.70.011(((3))), to engage in the unlawful transfer 29
of an ownership interest in motor vehicles. 30
(2) It is a violation of this chapter for a person to engage in 31
the unlawful subleasing of motor vehicles. 32
Sec. 2010. RCW 19.182.040 and 2011 c 333 s 2 are each amended to 33
read as follows: 34
(1) Except as authorized under subsection (2) of this section, no 35
consumer reporting agency may make a consumer report containing any 36
of the following items of information: 37
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(a) Bankruptcies that, from date of adjudication of the most 1
recent bankruptcy, antedate the report by more than ten years;2
(b) Suits and judgments that, from date of entry, antedate the 3
report by more than seven years or until the governing statute of 4
limitations has expired, whichever is the longer period;5
(c) Paid tax liens that, from date of payment, antedate the 6
report by more than seven years; 7
(d) Accounts placed for collection or charged to profit and loss 8
that antedate the report by more than seven years; 9
(e) Records of arrest, indictment, or conviction of an adult for 10
a crime that, from date of disposition, release, or parole, antedate 11
the report by more than seven years; 12
(f) Juvenile records, as defined in RCW 13.50.010(1)(((c))) (f), 13
when the subject of the records is twenty-one years of age or older 14
at the time of the report; and 15
(g) Any other adverse item of information that antedates the 16
report by more than seven years. 17
(2) Subsection (1)(a) through (e) and (g) of this section is not 18
applicable in the case of a consumer report to be used in connection 19
with: 20
(a) A credit transaction involving, or that may reasonably be 21
expected to involve, a principal amount of fifty thousand dollars or 22
more; 23
(b) The underwriting of life insurance involving, or that may 24
reasonably be expected to involve, a face amount of fifty thousand 25
dollars or more; or 26
(c) The employment of an individual at an annual salary that 27
equals, or that may reasonably be expected to equal, twenty thousand 28
dollars or more. 29
Sec. 2011. RCW 28A.600.385 and 1998 c 63 s 2 are each amended to 30
read as follows: 31
(1) School districts in Washington and community colleges in 32
Oregon and Idaho may enter into cooperative agreements under chapter 33
39.34 RCW for the purpose of allowing eleventh and twelfth grade 34
students who are enrolled in the school districts to earn high school 35
and college credit concurrently. 36
(2) Except as provided in subsection (3) of this section, if a 37
school district exercises the authority granted in subsection (1) of 38
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this section, the provisions of RCW 28A.600.310 through 28A.600.360 1
and 28A.600.380 through 28A.600.400 shall apply to the agreements.2
(3) A school district may enter an agreement in which the 3
community college agrees to accept an amount less than the statewide 4
uniform rate under RCW 28A.600.310(((2))) (9) if the community 5
college does not charge participating students tuition and fees. A 6
school district may not pay a per-credit rate in excess of the 7
statewide uniform rate under RCW 28A.600.310(((2))) (9).8
(4) To the extent feasible, the agreements shall permit 9
participating students to attend the community college without paying 10
any tuition and fees. The agreements shall not permit the community 11
college to charge participating students nonresident tuition and fee 12
rates. 13
(5) The agreements shall ensure that participating students are 14
permitted to enroll only in courses that are transferable to one or 15
more institutions of higher education as defined in RCW 28B.10.016.16
Sec. 2012. RCW 28B.20.810 and 1991 sp.s. c 13 s 78 are each 17
amended to read as follows: 18
The board of regents of the University of Washington is empowered 19
to authorize from time to time the transfer from the state university 20
permanent fund to be held in reserve in the bond retirement fund 21
created by RCW 28B.20.720 any unobligated funds and investments 22
derived from lands set apart for the support of the university by 23
chapter 91, Laws of 1903 and section 9, chapter 122, Laws of 1893, to 24
the extent required to comply with bond covenants regarding principal 25
and interest payments and reserve requirements for bonds payable out 26
of the bond retirement fund up to a total amount of five million 27
dollars, and to transfer any or all of said unobligated funds and 28
investments in excess of five million dollars to the university 29
building account created by RCW 43.79.330(((22))) (9). Any funds 30
transferred to the bond retirement fund pursuant to this section 31
shall be replaced by moneys first available out of the moneys 32
required to be deposited in such fund pursuant to RCW 28B.20.800. The 33
board is further empowered to direct the state finance committee to 34
convert any investments in such permanent fund acquired with funds 35
derived from such lands into cash or obligations of or guaranteed by 36
the United States of America prior to the transfer of such funds and 37
investments to such reserve account or building account.38
p. 32 HB 1281
Sec. 2013. RCW 28B.76.730 and 2023 c 314 s 3 are each amended to 1
read as follows: 2
(1) The legislature recognizes that dual credit programs reduce 3
both the cost and time of attendance to obtain a postsecondary 4
degree. The legislature intends to reduce barriers and increase 5
access to postsecondary educational opportunities for low-income 6
students by removing the financial barriers for dual enrollment 7
programs for students. 8
(2) The office, in consultation with the institutions of higher 9
education and the office of the superintendent of public instruction, 10
shall create the Washington dual enrollment scholarship pilot 11
program. The office shall administer the Washington dual enrollment 12
scholarship pilot program and may adopt rules as necessary.13
(3) Eligible students are those who meet the following 14
requirements: 15
(a) Qualify for the free or reduced-price lunch program;16
(b) Are enrolled in one or more dual credit programs, as defined 17
in RCW 28B.15.821, such as running start; and 18
(c) Have at least a 2.0 grade point average. 19
(4) Subject to availability of amounts appropriated for this 20
specific purpose, beginning with the 2019-20 academic year, the 21
office may award scholarships to eligible students. The scholarship 22
award must be as follows for eligible students enrolled in running 23
start: 24
(a) Mandatory fees, as defined in RCW 28A.600.310(((2))), 25
prorated based on credit load; 26
(b) Course fees or laboratory fees as determined appropriate by 27
college or university policies to pay for specified course related 28
costs; 29
(c) A textbook voucher to be used at the institution of higher 30
education's bookstore where the student is enrolled. For every credit 31
per quarter the student is enrolled, the student shall receive a 32
textbook voucher for ten dollars, up to a maximum of fifteen credits 33
per quarter, or the equivalent, per year; and 34
(d) Apprenticeship materials as determined appropriate by the 35
college or university to pay for specific course-related material 36
costs, which may include occupation-specific tools, work clothes, 37
rain gear, or boots. 38
p. 33 HB 1281
(5) The Washington dual enrollment scholarship pilot program must 1
apply after the fee waivers for low-income students under RCW 2
28A.600.310 are provided for. 3
Sec. 2014. RCW 35.82.080 and 1989 c 363 s 3 are each amended to 4
read as follows: 5
It is hereby declared to be the policy of this state that each 6
housing authority shall manage and operate its housing projects in an 7
efficient manner so as to enable it to fix the rentals for low-income 8
dwelling accommodations at the lowest possible rates consistent with 9
its providing decent, safe and sanitary dwelling accommodations, and 10
that no housing authority shall construct or operate any such project 11
for profit, or as a source of revenue to the city or the county. To 12
this end, an authority shall fix the rentals for rental units for 13
persons of low income in projects owned or leased by the authority at 14
no higher rates than it shall find to be necessary in order to 15
produce revenues which (together with all other available moneys, 16
revenues, income and receipts of the authority from whatever sources 17
derived) will be sufficient (1) to pay, as the same become due, the 18
principal and interest on the bonds or other obligations of the 19
authority issued or incurred to finance the projects; (2) to meet the 20
cost of, and to provide for, maintaining and operating the projects 21
(including the cost of any insurance) and the administrative expenses 22
of the authority; and (3) to create (during not less than the six 23
years immediately succeeding its issuance of any such bonds) a 24
reserve sufficient to meet the largest principal and interest 25
payments which will be due on such bonds in any one year thereafter 26
and to maintain such reserve. Nothing contained in this section shall 27
be construed to limit an authority's power to rent commercial space 28
located in buildings containing housing projects or non low-income 29
units owned, acquired, financed, or constructed under RCW 30
35.82.070(5), (((16))) (19), or (((17))) (20) at profitable rates and 31
to use any profit realized from such rentals in carrying into effect 32
the powers and purposes provided to housing authorities under this 33
chapter. 34
Sec. 2015. RCW 35.82.285 and 1991 c 167 s 3 are each amended to 35
read as follows: 36
Housing authorities created under this chapter may establish and 37
operate group homes or halfway houses to serve juveniles released 38
p. 34 HB 1281
from state juvenile or correctional institutions, or to serve ((the 1
developmentally disabled )) individuals with developmental 2
disabilities as defined in RCW 71A.10.020(((2))). Authorities may 3
contract for the operation of facilities so established, with 4
qualified nonprofit organizations as agent of the authority. 5
Authorities may provide support or supportive services in facilities 6
serving juveniles, ((the developmentally disabled )) individuals with 7
developmental disabilities or other persons under a disability, and 8
the frail elderly, whether or not they are operated by the authority.9
Action under this section shall be taken by the authority only 10
after a public hearing as provided by chapter 42.30 RCW. In 11
exercising this power the authority shall not be empowered to acquire 12
property by eminent domain, and the facilities established shall 13
comply with all zoning, building, fire, and health regulations and 14
procedures applicable in the locality. 15
Sec. 2016. RCW 36.32.440 and 1974 ex.s. c 171 s 3 are each 16
amended to read as follows: 17
The board of county commissioners of the several counties may 18
employ such staff as deemed appropriate to serve the several boards 19
directly in matters including but not limited to purchasing, poverty 20
and relief programs, parks and recreation, emergency services, 21
budgetary preparations set forth in RCW 36.40.010-36.40.050, code 22
enforcement and general administrative coordination. Such authority 23
shall in no way infringe upon or relieve the county auditor of 24
responsibilities contained in RCW 36.22.010(((9))) (6) and 36.22.020.25
Sec. 2017. RCW 38.52.020 and 2015 c 61 s 2 are each amended to 26
read as follows: 27
(1) Because of the existing and increasing possibility of the 28
occurrence of disasters of unprecedented size and destructiveness as 29
defined in RCW 38.52.010(((5))) (13), and in order to insure that 30
preparations of this state will be adequate to deal with such 31
disasters, to insure the administration of state and federal programs 32
providing disaster relief to individuals, and further to insure 33
adequate support for search and rescue operations, and generally to 34
protect the public peace, health, and safety, and to preserve the 35
lives and property of the people of the state, it is hereby found and 36
declared to be necessary: 37
p. 35 HB 1281
(a) To provide for emergency management by the state, and to 1
authorize the creation of local organizations for emergency 2
management in the political subdivisions of the state;3
(b) To confer upon the governor and upon the executive heads of 4
the political subdivisions of the state the emergency powers provided 5
herein; 6
(c) To provide for the rendering of mutual aid among the 7
political subdivisions of the state and with other states and to 8
cooperate with the federal government with respect to the carrying 9
out of emergency management functions; 10
(d) To provide a means of compensating emergency management 11
workers who may suffer any injury, as herein defined, or death; who 12
suffer economic harm including personal property damage or loss; or 13
who incur expenses for transportation, telephone or other methods of 14
communication, and the use of personal supplies as a result of 15
participation in emergency management activities; 16
(e) To provide programs, with intergovernmental cooperation, to 17
educate and train the public to be prepared for emergencies; and18
(f) To provide for the prioritization, development, and exercise 19
of continuity of operations plans by the state. 20
(2) It is further declared to be the purpose of this chapter and 21
the policy of the state that all emergency management functions of 22
this state and its political subdivisions be coordinated to the 23
maximum extent with the comparable functions of the federal 24
government including its various departments and agencies of other 25
states and localities, and of private agencies of every type, to the 26
end that the most effective preparation and use may be made of the 27
nation's manpower, resources, and facilities for dealing with any 28
disaster that may occur. 29
Sec. 2018. RCW 38.52.390 and 1986 c 266 s 42 are each amended to 30
read as follows: 31
The governor, or upon his or her direction, the director, or any 32
political subdivision of the state, is authorized to contract with 33
any person, firm, corporation, or entity to provide construction or 34
work on a cost basis to be used in emergency management functions or 35
activities as defined in RCW 38.52.010(((1))) or as hereafter 36
amended, said functions or activities to expressly include natural 37
disasters, as well as all other emergencies of a type contemplated by 38
RCW 38.52.110, 38.52.180, 38.52.195, 38.52.205, 38.52.207, 38.52.220 39
p. 36 HB 1281
and 38.52.390. All funds received for purposes of RCW 38.52.110, 1
38.52.180, 38.52.195, 38.52.205, 38.52.207, 38.52.220 and 38.52.390, 2
whether appropriated funds, local funds, or from whatever source, may 3
be used to pay for the construction, equipment, or work contracted 4
for under this section. 5
Sec. 2019. RCW 41.32.345 and 1992 c 212 s 18 are each amended to 6
read as follows: 7
(1) Subject to the limitations contained in this section, for the 8
purposes of RCW 41.32.010(((10)(a)(ii))) (14)(a)(iv), earnable 9
compensation means the compensation the member would have received in 10
the same position if employed on a regular full-time basis for the 11
same contract period. 12
(2) In order to ensure that the benefit provided by this section 13
is not used to unfairly inflate a member's retirement allowance, the 14
department shall adopt rules having the force of law to govern the 15
application of this section. 16
(3)(a) In adopting rules which apply to a member employed by a 17
school district, the department may consult the district's salary 18
schedule and related workload provisions, if any, adopted pursuant to 19
RCW 28A.405.200. The rules may require that, in order to be eligible 20
for this benefit, a member's position must either be included on the 21
district's schedule, or the position must have duties, 22
responsibilities, and method of pay which are similar to those found 23
on the district's schedule. 24
(b) In adopting rules which apply to a member employed by a 25
community college district, the department may consult the district's 26
salary schedule and workload provisions contained in an agreement 27
negotiated pursuant to chapter 28B.52 RCW, or similar documents. The 28
rules may require that, in order to be eligible for this benefit, a 29
member's position must either be included on the district's 30
agreement, or the position must have duties, responsibilities, and 31
method of pay which are similar to those found on the district's 32
agreement. The maximum full-time workweek used in calculating the 33
benefit for community college employees paid on an hourly rate shall 34
in no case exceed fifteen credit hours, twenty classroom contact 35
hours, or thirty-five assigned hours. 36
(4) If the legislature amends or revokes the benefit provided by 37
this section, no affected employee who thereafter retires is entitled 38
to receive the benefit as a matter of contractual right.39
p. 37 HB 1281
Sec. 2020. RCW 41.56.465 and 2007 c 278 s 1 are each amended to 1
read as follows: 2
(1) In making its determination, the panel shall be mindful of 3
the legislative purpose enumerated in RCW 41.56.430 and, as 4
additional standards or guidelines to aid it in reaching a decision, 5
the panel shall consider: 6
(a) The constitutional and statutory authority of the employer;7
(b) Stipulations of the parties; 8
(c) The average consumer prices for goods and services, commonly 9
known as the cost of living; 10
(d) Changes in any of the circumstances under (a) through (c) of 11
this subsection during the pendency of the proceedings; and12
(e) Such other factors, not confined to the factors under (a) 13
through (d) of this subsection, that are normally or traditionally 14
taken into consideration in the determination of wages, hours, and 15
conditions of employment. For those employees listed in RCW 16
41.56.030(((7))) (14)(a) who are employed by the governing body of a 17
city or town with a population of less than fifteen thousand, or a 18
county with a population of less than seventy thousand, consideration 19
must also be given to regional differences in the cost of living.20
(2) For employees listed in RCW 41.56.030(((7))) (14) (a) through 21
(d), the panel shall also consider a comparison of the wages, hours, 22
and conditions of employment of personnel involved in the proceedings 23
with the wages, hours, and conditions of employment of like personnel 24
of like employers of similar size on the west coast of the United 25
States. 26
(3) For employees listed in RCW 41.56.030(((7))) (14) (e) through 27
(h), the panel shall also consider a comparison of the wages, hours, 28
and conditions of employment of personnel involved in the proceedings 29
with the wages, hours, and conditions of employment of like personnel 30
of public fire departments of similar size on the west coast of the 31
United States. However, when an adequate number of comparable 32
employers exists within the state of Washington, other west coast 33
employers may not be considered. 34
(4) For employees listed in RCW 41.56.028: 35
(a) The panel shall also consider: 36
(i) A comparison of child care provider subsidy rates and 37
reimbursement programs by public entities, including counties and 38
municipalities, along the west coast of the United States; and39
p. 38 HB 1281
(ii) The financial ability of the state to pay for the 1
compensation and benefit provisions of a collective bargaining 2
agreement; and 3
(b) The panel may consider: 4
(i) The public's interest in reducing turnover and increasing 5
retention of child care providers; 6
(ii) The state's interest in promoting, through education and 7
training, a stable child care workforce to provide quality and 8
reliable child care from all providers throughout the state; and9
(iii) In addition, for employees exempt from licensing under 10
chapter 74.15 RCW, the state's fiscal interest in reducing reliance 11
upon public benefit programs including but not limited to medical 12
coupons, food stamps, subsidized housing, and emergency medical 13
services. 14
(5) For employees listed in RCW 74.39A.270: 15
(a) The panel shall consider: 16
(i) A comparison of wages, hours, and conditions of employment of 17
publicly reimbursed personnel providing similar services to similar 18
clients, including clients who are elderly, frail, or have 19
developmental disabilities, both in the state and across the United 20
States; and 21
(ii) The financial ability of the state to pay for the 22
compensation and fringe benefit provisions of a collective bargaining 23
agreement; and 24
(b) The panel may consider: 25
(i) A comparison of wages, hours, and conditions of employment of 26
publicly employed personnel providing similar services to similar 27
clients, including clients who are elderly, frail, or have 28
developmental disabilities, both in the state and across the United 29
States; 30
(ii) The state's interest in promoting a stable long-term care 31
workforce to provide quality and reliable care to vulnerable elderly 32
and disabled recipients; 33
(iii) The state's interest in ensuring access to affordable, 34
quality health care for all state citizens; and 35
(iv) The state's fiscal interest in reducing reliance upon public 36
benefit programs including but not limited to medical coupons, food 37
stamps, subsidized housing, and emergency medical services.38
(6) Subsections (2) and (3) of this section may not be construed 39
to authorize the panel to require the employer to pay, directly or 40
p. 39 HB 1281
indirectly, the increased employee contributions resulting from 1
chapter 502, Laws of 1993 or chapter 517, Laws of 1993 as required 2
under chapter 41.26 RCW. 3
Sec. 2021. RCW 41.56.492 and 1993 c 473 s 1 are each amended to 4
read as follows: 5
In addition to the classes of employees listed in RCW 6
41.56.030(((7))) (14), the provisions of RCW 41.56.430 through 7
41.56.452, 41.56.470, 41.56.480, and 41.56.490 shall also be 8
applicable to the employees of a public passenger transportation 9
system of a metropolitan municipal corporation, county transportation 10
authority, public transportation benefit area, or city public 11
passenger transportation system, subject to the following:12
(1) Negotiations between the public employer and the bargaining 13
representative may commence at any time agreed to by the parties. If 14
no agreement has been reached ninety days after commencement of 15
negotiations, either party may demand that the issues in disagreement 16
be submitted to a mediator. The services of the mediator shall be 17
provided by the commission without cost to the parties, but nothing 18
in this section or RCW 41.56.440 shall be construed to prohibit the 19
public employer and the bargaining representative from agreeing to 20
substitute at their own expense some other mediator or mediation 21
procedure; and 22
(2) If an agreement has not been reached following a reasonable 23
period of negotiations and mediation, and the mediator finds that the 24
parties remain at impasse, either party may demand that the issues in 25
disagreement be submitted to an arbitration panel for a binding and 26
final determination. In making its determination, the arbitration 27
panel shall be mindful of the legislative purpose enumerated in RCW 28
41.56.430 and as additional standards or guidelines to aid it in 29
reaching a ((decisions [decision] )) decision, shall take into 30
consideration the following factors: 31
(a) The constitutional and statutory authority of the employer;32
(b) Stipulations of the parties; 33
(c) Compensation package comparisons, economic indices, fiscal 34
constraints, and similar factors determined by the arbitration panel 35
to be pertinent to the case; and 36
(d) Such other factors, not confined to the foregoing, which are 37
normally or traditionally taken into consideration in the 38
determination of wages, hours, and conditions of employment.39
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Sec. 2022. RCW 43.20B.670 and 1985 c 245 s 10 are each amended 1
to read as follows: 2
When the department provides grant assistance to persons who 3
possess excess real property under RCW 74.04.005(((10)(f))) (13)(h), 4
the department may file a lien against, or otherwise perfect its 5
interest in such real property as a condition of granting such 6
assistance, and the department shall have the status of a secured 7
creditor. 8
Sec. 2023. RCW 43.21A.662 and 1999 c 251 s 2 are each amended to 9
read as follows: 10
(1) The department shall appoint an advisory committee to oversee 11
the freshwater aquatic weeds management program. 12
(2) The advisory committee shall include representatives from the 13
following groups: 14
(a) Recreational boaters interested in freshwater aquatic weed 15
management; 16
(b) Residents adjacent to lakes, rivers, or streams with public 17
boat launch facilities; 18
(c) Local governments; 19
(d) Scientific specialists; 20
(e) Pesticide registrants, as defined in RCW 15.58.030(((34))); 21
and22
(f) Certified pesticide applicators, as defined in RCW 23
17.21.020(((5))), who specialize in the use of aquatic pesticides ((; 24
and25
(g) If chapter . . ., Laws of 1999 (Senate Bill No. 5315) is 26
enacted by June 30, 1999, the aquatic nuisance species coordinating 27
committee)). 28
(3) The advisory committee shall review and provide 29
recommendations to the department on freshwater aquatic weeds 30
management program activities and budget and establish criteria for 31
grants funded from the freshwater aquatic weeds account.32
Sec. 2024. RCW 43.70.670 and 2011 1st sp.s. c 15 s 72 are each 33
amended to read as follows: 34
(1) "Human immunodeficiency virus insurance program," as used in 35
this section, means a program that provides health insurance coverage 36
for individuals with human immunodeficiency virus, as defined in RCW 37
70.24.017(7), who are not eligible for medical assistance programs 38
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from the health care authority as defined in RCW 74.09.010(((10))) 1
and meet eligibility requirements established by the department of 2
health. 3
(2) The department of health may pay for health insurance 4
coverage on behalf of persons with human immunodeficiency virus, who 5
meet department eligibility requirements, and who are eligible for 6
"continuation coverage" as provided by the federal consolidated 7
omnibus budget reconciliation act of 1985, group health insurance 8
policies, or individual policies. 9
Sec. 2025. RCW 43.216.152 and 2010 c 231 s 2 are each amended to 10
read as follows: 11
The definitions in this section apply throughout this chapter 12
unless the context clearly requires otherwise. 13
(1) "Community-based early learning providers" includes for-14
profit and nonprofit licensed providers of child care and preschool 15
programs. 16
(2) "Program" means the program of early learning established in 17
RCW ((43.215.141)) 43.216.555 for eligible children who are three and 18
four years of age. 19
Sec. 2026. RCW 43.330.430 and 2000 c 120 s 2 are each amended to 20
read as follows: 21
The definitions in this section apply throughout RCW ((43.330.200 22
through 43.330.230)) 43.330.431 through 43.330.436.23
(1) "Developmental disability" has the meaning in RCW 24
71A.10.020(((3))) (6). 25
(2) "Developmental disabilities endowment trust fund" means the 26
fund established in the custody of the state treasurer in RCW 27
((43.330.200)) 43.330.431, comprised of private, public, or private 28
and public sources, to finance services for persons with 29
developmental disabilities. All moneys in the fund, all property and 30
rights purchased from the fund, and all income attributable to the 31
fund, shall be held in trust by the state investment board, as 32
provided in RCW 43.33A.030, for the exclusive benefit of fund 33
beneficiaries. The principal and interest of the endowment fund must 34
be maintained until such time as the governing board policy specifies 35
except for the costs and expenses of the state treasurer and the 36
state investment board otherwise provided for in chapter 120, Laws of 37
2000. 38
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(3) "Governing board" means the developmental disabilities 1
endowment governing board in RCW ((43.330.205)) 43.330.432.2
(4) "Individual trust account" means accounts established within 3
the endowment trust fund for each individual named beneficiary for 4
the benefit of whom contributions have been made to the fund. The 5
money in each of the individual accounts is held in trust as provided 6
for in subsection (2) of this section, and shall not be considered 7
state funds or revenues of the state. The governing board serves as 8
administrator, manager, and recordkeeper for the individual trust 9
accounts for the benefit of the individual beneficiaries. The 10
policies governing the disbursements, and the qualifying services for 11
the trust accounts, shall be established by the governing board. 12
Individual trust accounts are separate accounts within the 13
developmental disabilities endowment trust fund, and are invested for 14
the beneficiaries through the endowment trust fund.15
Sec. 2027. RCW 43.330.435 and 2000 c 120 s 7 are each amended to 16
read as follows: 17
To the extent funds are appropriated for this purpose, the 18
governing board shall contract with an appropriate organization for 19
the development of a proposed operating plan for the developmental 20
disabilities endowment program. The proposed operating plan shall be 21
consistent with the endowment principles specified in RCW 22
((43.330.220)) 43.330.434. The plan shall address at least the 23
following elements: 24
(1) The recommended types of services to be available through the 25
endowment program and their projected average costs per beneficiary;26
(2) An assessment of the number of people likely to apply for 27
participation in the endowment under alternative rates of matching 28
funds, minimum service year requirements, and contribution timing 29
approaches; 30
(3) An actuarial analysis of the number of ((disabled)) 31
beneficiaries with disabilities who are likely to be supported under 32
alternative levels of public contribution to the endowment, and the 33
length of time the beneficiaries are likely to be served, under 34
alternative rates of matching funds, minimum service year 35
requirements, and contribution timing approaches; 36
(4) Recommended eligibility criteria for participation in the 37
endowment program; 38
p. 43 HB 1281
(5) Recommended policies regarding withdrawal of private 1
contributions from the endowment in cases of movement out of state, 2
death of the beneficiary, or other circumstances; 3
(6) Recommended matching rate of public and private contributions 4
and, for each beneficiary, the maximum annual and lifetime amount of 5
private contributions eligible for public matching funds;6
(7) The recommended minimum years of service on behalf of a 7
beneficiary that must be supported by private contributions in order 8
for the contributions to qualify for public matching funds from the 9
endowment; 10
(8) The recommended schedule according to which lump sum or 11
periodic private contributions should be made to the endowment in 12
order to qualify for public matching funds; 13
(9) A recommended program for educating families about the 14
endowment, and about planning for their child's long-term future; and15
(10) Recommended criteria and procedure for selecting an 16
organization or organizations to administer the developmental 17
disabilities endowment program, and projected administrative costs.18
Sec. 2028. RCW 46.18.205 and 2010 c 161 s 616 are each amended 19
to read as follows: 20
(1) A registered owner may apply to the department for special 21
license plates showing the official amateur radio call letters 22
assigned by the federal communications commission. The amateur radio 23
operator must: 24
(a) Provide a copy of the current valid federal communications 25
commission amateur radio license; 26
(b) Pay the amateur radio license plate fee required under RCW 27
46.17.220(((1)(a))) (2), in addition to any other fees and taxes due; 28
and 29
(c) Be recorded as the registered owner of the vehicle on which 30
the amateur radio license plates will be displayed.31
(2) Amateur radio license plates must be issued only for motor 32
vehicles owned by persons who have a valid official radio operator 33
license issued by the federal communications commission.34
(3) The department shall not issue or may refuse to issue amateur 35
radio license plates that display the consecutive letters "WSP."36
(4) A person who has been issued amateur radio operator license 37
plates as provided in this section must: 38
p. 44 HB 1281
(a) Notify the department within thirty days after the federal 1
communications commission license assigned is canceled or expires, 2
and return the amateur radio license plates; and 3
(b) Provide a copy of the renewed federal communications 4
commission license to the department after it is renewed.5
(5) Amateur radio license plates may be transferred from one 6
motor vehicle to another motor vehicle owned by the amateur radio 7
operator upon application to the department, county auditor or other 8
agent, or subagent appointed by the director. 9
(6) Facilities of official amateur radio stations may be utilized 10
to the fullest extent in the work of governmental agencies. The 11
director shall furnish the state military department, the department 12
of commerce, the Washington state patrol, and all county sheriffs a 13
list of the names, addresses, and license plate or official amateur 14
radio call letters of each person possessing the amateur radio 15
license plates. 16
(7) Failure to return the amateur radio license plates as 17
required under subsection (4) of this section is a traffic 18
infraction. 19
Sec. 2029. RCW 46.61.100 and 2018 c 18 s 1 are each amended to 20
read as follows: 21
(1) Upon all roadways of sufficient width a vehicle shall be 22
driven upon the right half of the roadway, except as follows:23
(a) When overtaking and passing another vehicle proceeding in the 24
same direction under the rules governing such movement;25
(b) When an obstruction exists making it necessary to drive to 26
the left of the center of the highway; provided, any person so doing 27
shall yield the right-of-way to all vehicles traveling in the proper 28
direction upon the unobstructed portion of the highway within such 29
distance as to constitute an immediate hazard; 30
(c) Upon a roadway divided into three marked lanes and providing 31
for two-way movement traffic under the rules applicable thereon;32
(d) Upon a street or highway restricted to one-way traffic; or33
(e) Upon a highway having three lanes or less, when approaching 34
the following vehicles in the manner described under RCW 35
46.61.212(((1)(d)(ii))) (2)(b): (i) A stationary authorized emergency 36
vehicle; (ii) a tow truck or other vehicle providing roadside 37
assistance while operating warning lights with three hundred sixty 38
degree visibility; (iii) a police vehicle; or (iv) a stationary or 39
p. 45 HB 1281
slow moving highway construction vehicle, highway maintenance 1
vehicle, solid waste vehicle, or utility service vehicle that meets 2
the lighting requirements identified in RCW 46.61.212(1).3
(2) Upon all roadways having two or more lanes for traffic moving 4
in the same direction, all vehicles shall be driven in the right-hand 5
lane then available for traffic, except (a) when overtaking and 6
passing another vehicle proceeding in the same direction, (b) when 7
traveling at a speed greater than the traffic flow, (c) when moving 8
left to allow traffic to merge, or (d) when preparing for a left turn 9
at an intersection, exit, or into a private road or driveway when 10
such left turn is legally permitted. On any such roadway, a vehicle 11
or combination over ten thousand pounds shall be driven only in the 12
right-hand lane except under the conditions enumerated in (a) through 13
(d) of this subsection. 14
(3) No vehicle towing a trailer or no vehicle or combination over 15
ten thousand pounds may be driven in the left-hand lane of a limited 16
access roadway having three or more lanes for traffic moving in one 17
direction except when preparing for a left turn at an intersection, 18
exit, or into a private road or driveway when a left turn is legally 19
permitted. This subsection does not apply to a vehicle using a high 20
occupancy vehicle lane. A high occupancy vehicle lane is not 21
considered the left-hand lane of a roadway. The department of 22
transportation, in consultation with the Washington state patrol, 23
shall adopt rules specifying (a) those circumstances where it is 24
permissible for other vehicles to use the left lane in case of 25
emergency or to facilitate the orderly flow of traffic, and (b) those 26
segments of limited access roadway to be exempt from this subsection 27
due to the operational characteristics of the roadway.28
(4) It is a traffic infraction to drive continuously in the left 29
lane of a multilane roadway when it impedes the flow of other 30
traffic. 31
(5) Upon any roadway having four or more lanes for moving traffic 32
and providing for two-way movement of traffic, a vehicle shall not be 33
driven to the left of the center line of the roadway except when 34
authorized by official traffic control devices designating certain 35
lanes to the left side of the center of the roadway for use by 36
traffic not otherwise permitted to use such lanes, or except as 37
permitted under subsection (1)(b) of this section. However, this 38
subsection shall not be construed as prohibiting the crossing of the 39
p. 46 HB 1281
center line in making a left turn into or from an alley, private road 1
or driveway. 2
Sec. 2030. RCW 48.20.555 and 2007 c 296 s 3 are each amended to 3
read as follows: 4
Illness-triggered fixed payment insurance, hospital confinement 5
fixed payment insurance, or other fixed payment insurance policies 6
are not considered to provide coverage for hospital or medical 7
expenses under this chapter, if the benefits provided are a fixed 8
dollar amount that is paid regardless of the amount charged. The 9
benefits may not be related to, or be a percentage of, the amount 10
charged by the provider of service and must be offered as an 11
independent and noncoordinated benefit with any other health plan as 12
defined in RCW 48.43.005(((19))) (33). 13
Sec. 2031. RCW 48.21.375 and 2007 c 296 s 5 are each amended to 14
read as follows: 15
Illness-triggered fixed payment insurance, hospital confinement 16
fixed payment insurance, or other fixed payment insurance policies 17
are not considered to provide coverage for hospital or medical 18
expenses or care under this chapter, if the benefits provided are a 19
fixed dollar amount that is paid regardless of the amount charged. 20
The benefits may not be related to, or be a percentage of, the amount 21
charged by the provider of service and must be offered as an 22
independent and noncoordinated benefit with any other health plan as 23
defined in RCW 48.43.005(((19))) (33). 24
Sec. 2032. RCW 51.14.150 and 1997 c 35 s 1 are each amended to 25
read as follows: 26
(1) For the purposes of this section, "hospital" means a hospital 27
as defined in RCW 70.41.020(((2))) or a ((psychiatric)) behavioral 28
health hospital regulated under chapter 71.12 RCW, but does not 29
include beds utilized by a comprehensive cancer center for cancer 30
research. 31
(2)(a) Any two or more employers which are school districts or 32
educational service districts, or (b) any two or more employers which 33
are public hospital districts or hospitals, and are owned or operated 34
by a state agency or municipal corporation of this state, or (c) any 35
two or more employers which are hospitals, no one of which is owned 36
or operated by a state agency or municipal corporation of this state, 37
p. 47 HB 1281
may enter into agreements to form self-insurance groups for the 1
purposes of this chapter. 2
(3) No more than one group may be formed under subsection (2)(b) 3
of this section and no more than one group may be formed under 4
subsection (2)(c) of this section. 5
(4) The self-insurance groups shall be organized and operated 6
under rules promulgated by the director under RCW 51.14.160. Such a 7
self-insurance group shall be deemed an employer for the purposes of 8
this chapter, and may qualify as a self-insurer if it meets all the 9
other requirements of this chapter. 10
Sec. 2033. RCW 59.22.020 and 2012 c 198 s 17 are each amended to 11
read as follows: 12
The following definitions shall apply throughout this chapter 13
unless the context clearly requires otherwise: 14
(1) "Affordable" means that, where feasible, low-income residents 15
should not pay more than thirty percent of their monthly income for 16
housing costs. 17
(2) "Conversion costs" includes the cost of acquiring the mobile 18
home park, the costs of planning and processing the conversion, the 19
costs of any needed repairs or rehabilitation, and any expenditures 20
required by a government agency or lender for the project.21
(3) "Department" means the department of commerce.22
(4) "Housing costs" means the total cost of owning, occupying, 23
and maintaining a mobile home and a lot or space in a mobile home 24
park. 25
(5) "Individual interest in a mobile home park" means any 26
interest which is fee ownership or a lesser interest which entitles 27
the holder to occupy a lot or space in a mobile home park for a 28
period of not less than either fifteen years or the life of the 29
holder. Individual interests in a mobile home park include, but are 30
not limited to, the following: 31
(a) Ownership of a lot or space in a mobile home park or 32
subdivision; 33
(b) A membership or shares in a stock cooperative, or a limited 34
equity housing cooperative; or 35
(c) Membership in a nonprofit mutual benefit corporation which 36
owns, operates, or owns and operates the mobile home park.37
(6) "Landlord" shall have the same meaning as it does in RCW 38
59.20.030. 39
p. 48 HB 1281
(7) "Low-income resident" means an individual or household who 1
resided in the mobile home park prior to application for a loan 2
pursuant to this chapter and with an annual income at or below eighty 3
percent of the median income for the county of standard metropolitan 4
statistical area of residence. Net worth shall be considered in the 5
calculation of income with the exception of the resident's mobile/6
manufactured home which is used as their primary residence.7
(8) "Low-income spaces" means those spaces in a mobile home park 8
operated by a resident organization which are occupied by low-income 9
residents. 10
(9) "Manufactured housing" means residences constructed on one or 11
more chassis for transportation, and which bear an insignia issued by 12
a state or federal regulatory agency indication compliance with all 13
applicable construction standards of the United States department of 14
housing and urban development. 15
(10) "Mobile home" shall have the same meaning as it does in RCW 16
43.22.335. 17
(11) "Mobile home lot" shall have the same meaning as it does in 18
RCW 59.20.030. 19
(12) "Mobile home park" means a mobile home park, as defined in 20
RCW 59.20.030(((10))), or a manufactured home park subdivision as 21
defined by RCW 59.20.030(((12))) created by the conversion to 22
resident ownership of a mobile home park. 23
(13) "Resident organization" means a group of mobile home park 24
residents who have formed a nonprofit corporation, cooperative 25
corporation, or other entity or organization for the purpose of 26
acquiring the mobile home park in which they reside and converting 27
the mobile home park to resident ownership. The membership of a 28
resident organization shall include at least two-thirds of the 29
households residing in the mobile home park at the time of 30
application for assistance from the department. 31
(14) "Resident ownership" means, depending on the context, either 32
the ownership, by a resident organization, as defined in this 33
section, of an interest in a mobile home park which entitles the 34
resident organization to control the operations of the mobile home 35
park for a term of no less than fifteen years, or the ownership of 36
individual interests in a mobile home park, or both.37
(15) "Tenant" means a person who rents a mobile home lot for a 38
term of one month or longer and owns the mobile home on the lot.39
p. 49 HB 1281
Sec. 2034. RCW 64.34.216 and 1992 c 220 s 7 are each amended to 1
read as follows: 2
(1) The declaration for a condominium must contain:3
(a) The name of the condominium, which must include the word 4
"condominium" or be followed by the words "a condominium," and the 5
name of the association; 6
(b) A legal description of the real property included in the 7
condominium; 8
(c) A statement of the number of units which the declarant has 9
created and, if the declarant has reserved the right to create 10
additional units, the number of such additional units;11
(d) The identifying number of each unit created by the 12
declaration and a description of the boundaries of each unit if and 13
to the extent they are different from the boundaries stated in RCW 14
64.34.204(1); 15
(e) With respect to each existing unit: 16
(i) The approximate square footage; 17
(ii) The number of bathrooms, whole or partial;18
(iii) The number of rooms designated primarily as bedrooms;19
(iv) The number of built-in fireplaces; and 20
(v) The level or levels on which each unit is located.21
The data described in (ii), (iii), and (iv) of this subsection 22
(1)(e) may be omitted with respect to units restricted to 23
nonresidential use; 24
(f) The number of parking spaces and whether covered, uncovered, 25
or enclosed; 26
(g) The number of moorage slips, if any; 27
(h) A description of any limited common elements, other than 28
those specified in RCW 64.34.204 (2) and (4), as provided in RCW 29
64.34.232(2)(j); 30
(i) A description of any real property which may be allocated 31
subsequently by the declarant as limited common elements, other than 32
limited common elements specified in RCW 64.34.204 (2) and (4), 33
together with a statement that they may be so allocated;34
(j) A description of any development rights and other special 35
declarant rights under RCW 64.34.020(((29))) (40) reserved by the 36
declarant, together with a description of the real property to which 37
the development rights apply, and a time limit within which each of 38
those rights must be exercised; 39
p. 50 HB 1281
(k) If any development right may be exercised with respect to 1
different parcels of real property at different times, a statement to 2
that effect together with: (i) Either a statement fixing the 3
boundaries of those portions and regulating the order in which those 4
portions may be subjected to the exercise of each development right, 5
or a statement that no assurances are made in those regards; and (ii) 6
a statement as to whether, if any development right is exercised in 7
any portion of the real property subject to that development right, 8
that development right must be exercised in all or in any other 9
portion of the remainder of that real property; 10
(l) Any other conditions or limitations under which the rights 11
described in (j) of this subsection may be exercised or will lapse;12
(m) An allocation to each unit of the allocated interests in the 13
manner described in RCW 64.34.224; 14
(n) Any restrictions in the declaration on use, occupancy, or 15
alienation of the units; 16
(o) A cross-reference by recording number to the survey map and 17
plans for the units created by the declaration; and18
(p) All matters required or permitted by RCW 64.34.220 through 19
64.34.232, 64.34.256, 64.34.260, 64.34.276, and 64.34.308(((4))) (5).20
(2) All amendments to the declaration shall contain a cross-21
reference by recording number to the declaration and to any prior 22
amendments thereto. All amendments to the declaration adding units 23
shall contain a cross-reference by recording number to the survey map 24
and plans relating to the added units and set forth all information 25
required by RCW 64.34.216(1) with respect to the added units.26
(3) The declaration may contain any other matters the declarant 27
deems appropriate. 28
Sec. 2035. RCW 64.34.316 and 1989 c 43 s 3-105 are each amended 29
to read as follows: 30
(1) No special declarant right, as described in RCW 31
64.34.020(((29))) (40), created or reserved under this chapter may be 32
transferred except by an instrument evidencing the transfer executed 33
by the declarant or the declarant's successor and the transferee is 34
recorded in every county in which any portion of the condominium is 35
located. Each unit owner shall receive a copy of the recorded 36
instrument, but the failure to furnish the copy shall not invalidate 37
the transfer. 38
p. 51 HB 1281
(2) Upon transfer of any special declarant right, the liability 1
of a transferor declarant is as follows: 2
(a) A transferor is not relieved of any obligation or liability 3
arising before the transfer and remains liable for warranty 4
obligations imposed upon the transferor by this chapter. Lack of 5
privity does not deprive any unit owner of standing to maintain an 6
action to enforce any obligation of the transferor.7
(b) If a successor to any special declarant right is an affiliate 8
of a declarant as described in RCW 64.34.020(1), the transferor is 9
jointly and severally liable with the successor for any obligations 10
or liabilities of the successor relating to the condominium.11
(c) If a transferor retains any special declarant right, but 12
transfers other special declarant rights to a successor who is not an 13
affiliate of the declarant, the transferor is liable for any 14
obligations or liabilities imposed on a declarant by this chapter or 15
by the declaration relating to the retained special declarant rights 16
arising after the transfer. 17
(d) A transferor has no liability for any act or omission or any 18
breach of a contractual or warranty obligation arising from the 19
exercise of a special declarant right by a successor declarant who is 20
not an affiliate of the transferor. 21
(3) In case of foreclosure of a mortgage, tax sale, judicial 22
sale, or sale under bankruptcy code or receivership proceedings of 23
any unit owned by a declarant or real property in a condominium 24
subject to development rights, a person acquiring title to all the 25
real property being foreclosed or sold succeeds to all special 26
declarant rights related to that real property held by that declarant 27
and to any rights reserved in the declaration pursuant to RCW 28
64.34.256 and held by that declarant to maintain models, sales 29
offices, and signs, unless such person requests that all or any of 30
such rights not be transferred. The instrument conveying title shall 31
describe any special declarant rights not being transferred.32
(4) Upon foreclosure of a mortgage, tax sale, judicial sale, or 33
sale under bankruptcy code or receivership proceedings of all units 34
and other real property in a condominium owned by a declarant:35
(a) The declarant ceases to have any special declarant rights; 36
and 37
(b) The period of declarant control as described in RCW 38
64.34.308(((4))) (5) terminates unless the judgment or instrument 39
p. 52 HB 1281
conveying title provides for transfer of all special declarant rights 1
held by that declarant to a successor declarant. 2
(5) The liabilities and obligations of a person who succeeds to 3
special declarant rights are as follows: 4
(a) A successor to any special declarant right who is an 5
affiliate of a declarant is subject to all obligations and 6
liabilities imposed on the transferor by this chapter or by the 7
declaration; 8
(b) A successor to any special declarant right, other than a 9
successor described in (c) or (d) of this subsection, who is not an 10
affiliate of a declarant is subject to all obligations and 11
liabilities imposed by this chapter or the declaration:12
(i) On a declarant which relate to such successor's exercise or 13
nonexercise of special declarant rights; or 14
(ii) On the declarant's transferor, other than:15
(A) Misrepresentations by any previous declarant;16
(B) Warranty obligations on improvements made by any previous 17
declarant or made before the condominium was created;18
(C) Breach of any fiduciary obligation by any previous declarant 19
or the declarant's appointees to the board of directors; or20
(D) Any liability or obligation imposed on the transferor as a 21
result of the transferor's acts or omissions after the transfer;22
(c) A successor to only a right reserved in the declaration to 23
maintain models, sales offices, and signs as described in RCW 24
64.34.256, if the successor is not an affiliate of a declarant, may 25
not exercise any other special declarant right and is not subject to 26
any liability or obligation as a declarant, except the obligation to 27
provide a public offering statement and any liability arising as a 28
result thereof; 29
(d) A successor to all special declarant rights held by the 30
successor's transferor who is not an affiliate of that declarant and 31
who succeeded to those rights pursuant to a foreclosure, a deed in 32
lieu of foreclosure, or a judgment or instrument conveying title to 33
units under subsection (3) of this section may declare his or her 34
intention in a recorded instrument to hold those rights solely for 35
transfer to another person. Thereafter, until transferring all 36
special declarant rights to any person acquiring title to any unit 37
owned by the successor or until recording an instrument permitting 38
exercise of all those rights, that successor may not exercise any of 39
those rights other than any right held by the successor's transferor 40
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to control the board of directors in accordance with the provisions 1
of RCW 64.34.308(((4))) (5) for the duration of any period of 2
declarant control, and any attempted exercise of those rights is 3
void. So long as a successor declarant may not exercise special 4
declarant rights under this subsection, the successor is not subject 5
to any liability or obligation as a declarant other than liability 6
for the successor's acts and omissions under RCW 64.34.308(((4))) 7
(5); 8
(e) Nothing in this section subjects any successor to a special 9
declarant right to any claims against or other obligations of a 10
transferor declarant, other than claims and obligations arising under 11
this chapter or the declaration. 12
Sec. 2036. RCW 64.34.324 and 2004 c 201 s 3 are each amended to 13
read as follows: 14
(1) Unless provided for in the declaration, the bylaws of the 15
association shall provide for: 16
(a) The number, qualifications, powers and duties, terms of 17
office, and manner of electing and removing the board of directors 18
and officers and filling vacancies; 19
(b) Election by the board of directors of such officers of the 20
association as the bylaws specify; 21
(c) Which, if any, of its powers the board of directors or 22
officers may delegate to other persons or to a managing agent;23
(d) Which of its officers may prepare, execute, certify, and 24
record amendments to the declaration on behalf of the association;25
(e) The method of amending the bylaws; and 26
(f) A statement of the standard of care for officers and members 27
of the board of directors imposed by RCW 64.34.308(1).28
(2) Subject to the provisions of the declaration, the bylaws may 29
provide for any other matters the association deems necessary and 30
appropriate. 31
(3) In determining the qualifications of any officer or director 32
of the association, notwithstanding the provision of RCW 33
64.34.020(((32))) (44) the term "unit owner" in such context shall, 34
unless the declaration or bylaws otherwise provide, be deemed to 35
include any director, officer, partner in, or trustee of any person, 36
who is, either alone or in conjunction with another person or 37
persons, a unit owner. Any officer or director of the association who 38
would not be eligible to serve as such if he or she were not a 39
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director, officer, partner in, or trustee of such a person shall be 1
disqualified from continuing in office if he or she ceases to have 2
any such affiliation with that person, or if that person would have 3
been disqualified from continuing in such office as a natural person.4
Sec. 2037. RCW 64.34.400 and 1992 c 220 s 20 are each amended to 5
read as follows: 6
(1) This article applies to all units subject to this chapter, 7
except as provided in subsection (2) of this section and unless and 8
to the extent otherwise agreed to in writing by the seller and 9
purchasers of those units that are restricted to nonresidential use 10
in the declaration. 11
(2) This article shall not apply in the case of:12
(a) A conveyance by gift, devise, or descent; 13
(b) A conveyance pursuant to court order; 14
(c) A disposition by a government or governmental agency;15
(d) A conveyance by foreclosure; 16
(e) A disposition of all of the units in a condominium in a 17
single transaction; 18
(f) A disposition to other than a purchaser as defined in RCW 19
64.34.020(((26))) (32); or 20
(g) A disposition that may be canceled at any time and for any 21
reason by the purchaser without penalty. 22
Sec. 2038. RCW 69.25.030 and 1975 1st ex.s. c 201 s 4 are each 23
amended to read as follows: 24
The purpose of this chapter is to promote uniformity of state 25
legislation and regulations with the federal egg products inspection 26
act, 21 U.S.C. sec. 1031, et seq., and regulations adopted 27
thereunder. In accord with such declared purpose, any regulations 28
adopted under the federal egg products inspection act relating to 29
eggs and egg products, as defined in RCW 69.25.020 (((11) and (12))) 30
(15) and (18), in effect on July 1, 1975, are hereby deemed to have 31
been adopted under the provisions hereof. Further, to promote such 32
uniformity, any regulations adopted hereafter under the provisions of 33
the federal egg products inspection act relating to eggs and egg 34
products, as defined in RCW 69.25.020 (((11) and (12))) (15) and 35
(18), and published in the federal register, shall be deemed to have 36
been adopted under the provisions of this chapter in accord with 37
chapter 34.05 RCW, as now or hereafter amended. The director may, 38
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however, within thirty days of the publication of the adoption of any 1
such regulation under the federal egg products inspection act, give 2
public notice that a hearing will be held to determine if such 3
regulations shall not be applicable under the provisions of this 4
chapter. Such hearing shall be in accord with the requirements of 5
chapter 34.05 RCW, as now or hereafter amended. 6
The director, in addition to the foregoing, may adopt any rule 7
and regulation necessary to carry out the purpose and provisions of 8
this chapter. 9
Sec. 2039. RCW 70.14.050 and 2003 1st sp.s. c 29 s 9 are each 10
amended to read as follows: 11
(1) Each agency administering a state purchased health care 12
program as defined in RCW 41.05.011(((2))) shall, in cooperation with 13
other agencies, take any necessary actions to control costs without 14
reducing the quality of care when reimbursing for or purchasing 15
drugs. To accomplish this purpose, participating agencies may 16
establish an evidence-based prescription drug program.17
(2) In developing the evidence-based prescription drug program 18
authorized by this section, agencies: 19
(a) Shall prohibit reimbursement for drugs that are determined to 20
be ineffective by the United States food and drug administration;21
(b) Shall adopt rules in order to ensure that less expensive 22
generic drugs will be substituted for brand name drugs in those 23
instances where the quality of care is not diminished;24
(c) Where possible, may authorize reimbursement for drugs only in 25
economical quantities; 26
(d) May limit the prices paid for drugs by such means as 27
negotiated discounts from pharmaceutical manufacturers, central 28
purchasing, volume contracting, or setting maximum prices to be paid;29
(e) Shall consider the approval of drugs with lower abuse 30
potential in substitution for drugs with significant abuse potential;31
(f) May take other necessary measures to control costs of drugs 32
without reducing the quality of care; and 33
(g) Shall adopt rules governing practitioner endorsement and use 34
of any list developed as part of the program authorized by this 35
section. 36
(3) Agencies shall provide for reasonable exceptions, consistent 37
with RCW 69.41.190, to any list developed as part of the program 38
authorized by this section. 39
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(4) Agencies shall establish an independent pharmacy and 1
therapeutics committee to evaluate the effectiveness of prescription 2
drugs in the development of the program authorized by this section.3
Sec. 2040. RCW 70.122.020 and 2012 c 10 s 53 are each amended to 4
read as follows: 5
Unless the context clearly requires otherwise, the definitions 6
contained in this section shall apply throughout this chapter.7
(1) "Adult person" means a person who has attained the age of 8
majority as defined in RCW 26.28.010 and 26.28.015, and who has the 9
capacity to make health care decisions. 10
(2) "Attending physician" means the physician selected by, or 11
assigned to, the patient who has primary responsibility for the 12
treatment and care of the patient. 13
(3) "Directive" means a written document voluntarily executed by 14
the declarer generally consistent with the guidelines of RCW 15
70.122.030. 16
(4) "Health facility" means a hospital as defined in RCW 17
70.41.020(((4))) or a nursing home as defined in RCW 18.51.010, a 18
home health agency or hospice agency as defined in RCW 70.126.010, or 19
an assisted living facility as defined in RCW 18.20.020.20
(5) "Life-sustaining treatment" means any medical or surgical 21
intervention that uses mechanical or other artificial means, 22
including artificially provided nutrition and hydration, to sustain, 23
restore, or replace a vital function, which, when applied to a 24
qualified patient, would serve only to prolong the process of dying. 25
"Life-sustaining treatment" shall not include the administration of 26
medication or the performance of any medical or surgical intervention 27
deemed necessary solely to alleviate pain. 28
(6) "Permanent unconscious condition" means an incurable and 29
irreversible condition in which the patient is medically assessed 30
within reasonable medical judgment as having no reasonable 31
probability of recovery from an irreversible coma or a persistent 32
vegetative state. 33
(7) "Physician" means a person licensed under chapter ((s)) 18.71 34
or 18.57 RCW. 35
(8) "Qualified patient" means an adult person who is a patient 36
diagnosed in writing to have a terminal condition by the patient's 37
attending physician, who has personally examined the patient, or a 38
patient who is diagnosed in writing to be in a permanent unconscious 39
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condition in accordance with accepted medical standards by two 1
physicians, one of whom is the patient's attending physician, and 2
both of whom have personally examined the patient. 3
(9) "Terminal condition" means an incurable and irreversible 4
condition caused by injury, disease, or illness, that, within 5
reasonable medical judgment, will cause death within a reasonable 6
period of time in accordance with accepted medical standards, and 7
where the application of life-sustaining treatment serves only to 8
prolong the process of dying. 9
Sec. 2041. RCW 71.09.098 and 2009 c 409 s 11 are each amended to 10
read as follows: 11
(1) Any service provider submitting reports pursuant to RCW 12
71.09.096(((6))) (8), the supervising community corrections officer, 13
the prosecuting agency, or the secretary's designee may petition the 14
court for an immediate hearing for the purpose of revoking or 15
modifying the terms of the person's conditional release to a less 16
restrictive alternative if the petitioner believes the released 17
person: (a) Violated or is in violation of the terms and conditions 18
of the court's conditional release order; or (b) is in need of 19
additional care, monitoring, supervision, or treatment.20
(2) The community corrections officer or the secretary's designee 21
may restrict the person's movement in the community until the 22
petition is determined by the court. The person may be taken into 23
custody if: 24
(a) The supervising community corrections officer, the 25
secretary's designee, or a law enforcement officer reasonably 26
believes the person has violated or is in violation of the court's 27
conditional release order; or 28
(b) The supervising community corrections officer or the 29
secretary's designee reasonably believes that the person is in need 30
of additional care, monitoring, supervision, or treatment because the 31
person presents a danger to himself or herself or others if his or 32
her conditional release under the conditions imposed by the court's 33
release order continues. 34
(3)(a) Persons taken into custody pursuant to subsection (2) of 35
this section shall: 36
(i) Not be released until such time as a hearing is held to 37
determine whether to revoke or modify the person's conditional 38
release order and the court has issued its decision; and39
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(ii) Be held in the county jail, at a secure community transition 1
facility, or at the total confinement facility, at the discretion of 2
the secretary's designee. 3
(b) The court shall be notified before the close of the next 4
judicial day that the person has been taken into custody and shall 5
promptly schedule a hearing. 6
(4) Before any hearing to revoke or modify the person's 7
conditional release order, both the prosecuting agency and the 8
released person shall have the right to request an immediate mental 9
examination of the released person. If the conditionally released 10
person is indigent, the court shall, upon request, assist him or her 11
in obtaining a qualified expert or professional person to conduct the 12
examination. 13
(5) At any hearing to revoke or modify the conditional release 14
order: 15
(a) The prosecuting agency shall represent the state, including 16
determining whether to proceed with revocation or modification of the 17
conditional release order; 18
(b) Hearsay evidence is admissible if the court finds that it is 19
otherwise reliable; and 20
(c) The state shall bear the burden of proving by a preponderance 21
of the evidence that the person has violated or is in violation of 22
the court's conditional release order or that the person is in need 23
of additional care, monitoring, supervision, or treatment.24
(6)(a) If the court determines that the state has met its burden 25
referenced in subsection (5)(c) of this section, and the issue before 26
the court is revocation of the court's conditional release order, the 27
court shall consider the evidence presented by the parties and the 28
following factors relevant to whether continuing the person's 29
conditional release is in the person's best interests or adequate to 30
protect the community: 31
(i) The nature of the condition that was violated by the person 32
or that the person was in violation of in the context of the person's 33
criminal history and underlying mental conditions;34
(ii) The degree to which the violation was intentional or grossly 35
negligent; 36
(iii) The ability and willingness of the released person to 37
strictly comply with the conditional release order;38
(iv) The degree of progress made by the person in community-based 39
treatment; and 40
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(v) The risk to the public or particular persons if the 1
conditional release continues under the conditional release order 2
that was violated. 3
(b) Any factor alone, or in combination, shall support the 4
court's determination to revoke the conditional release order.5
(7) If the court determines the state has met its burden 6
referenced in subsection (5)(c) of this section, and the issue before 7
the court is modification of the court's conditional release order, 8
the court shall modify the conditional release order by adding 9
conditions if the court determines that the person is in need of 10
additional care, monitoring, supervision, or treatment. The court has 11
authority to modify its conditional release order by substituting a 12
new treatment provider, requiring new housing for the person, or 13
imposing such additional supervision conditions as the court deems 14
appropriate. 15
(8) A person whose conditional release has been revoked shall be 16
remanded to the custody of the secretary for control, care, and 17
treatment in a total confinement facility as designated in RCW 18
71.09.060(1). The person is thereafter eligible for conditional 19
release only in accord with the provisions of RCW 71.09.090 and 20
related statutes. 21
Sec. 2042. RCW 71A.12.210 and 2006 c 303 s 2 are each amended to 22
read as follows: 23
RCW 71A.12.220 through 71A.12.280 apply to a person:24
(1)(a) Who has been charged with or convicted of a crime and 25
meets the following criteria: 26
(i) Has been convicted of one of the following:27
(A) A crime of sexual violence as defined in chapter 9A.44 or 28
71.09 RCW including, but not limited to, rape, rape of a child, and 29
child molestation; 30
(B) Sexual acts directed toward strangers, individuals with whom 31
a relationship has been established or promoted for the primary 32
purpose of victimization, or persons of casual acquaintance with whom 33
no substantial personal relationship exists; or 34
(C) One or more violent offenses, as defined by RCW 9.94A.030; 35
and 36
(ii) Constitutes a current risk to others as determined by a 37
qualified professional. Charges or crimes that resulted in acquittal 38
must be excluded; or 39
p. 60 HB 1281
(b) Who has not been charged with and/or convicted of a crime, 1
but meets the following criteria: 2
(i) Has a history of stalking, violent, sexually violent, 3
predatory, and/or opportunistic behavior which demonstrates a 4
likelihood to commit a violent, sexually violent, and/or predatory 5
act; and 6
(ii) Constitutes a current risk to others as determined by a 7
qualified professional; and 8
(2) Who has been determined to have a developmental disability as 9
defined by RCW 71A.10.020(((3))). 10
Sec. 2043. RCW 71A.12.220 and 2006 c 303 s 3 are each amended to 11
read as follows: 12
The definitions in this section apply throughout this chapter 13
unless the context clearly requires otherwise. 14
(1) "Assessment" means the written opinion of a qualified 15
professional stating, at a minimum: 16
(a) Whether a person meets the criteria established in RCW 17
71A.12.210; 18
(b) What restrictions are necessary. 19
(2) "Certified community protection program intensive supported 20
living services" means access to twenty-four-hour supervision, 21
instruction, and support services as identified in the person's plan 22
of care. 23
(3) "Community protection program" means services specifically 24
designed to support persons who meet the criteria of RCW 71A.12.210.25
(4) "Constitutes a risk to others" means a determination of a 26
person's risk and/or dangerousness based upon a thorough assessment 27
by a qualified professional. 28
(5) "Department" means the department of social and health 29
services. 30
(6) "Developmental disability" means that condition defined in 31
RCW 71A.10.020(((3))). 32
(7) "Disclosure" means providing copies of professional 33
assessments, incident reports, legal documents, and other information 34
pertaining to community protection issues to ensure the provider has 35
all relevant information. Polygraph and plethysmograph reports are 36
excluded from disclosure. 37
(8) "Division" means the division of developmental disabilities.38
p. 61 HB 1281
(9) "Managed successfully" means that a person supported by a 1
community protection program does not engage in the behavior 2
identified in RCW 71A.12.210. 3
(10) "Opportunistic behavior" means an act committed on impulse, 4
which is not premeditated. 5
(11) "Predatory" means acts directed toward strangers, 6
individuals with whom a relationship has been established or promoted 7
for the primary purpose of victimization, or casual acquaintances 8
with whom no substantial personal relationship exists. Predatory 9
behavior may be characterized by planning and/or rehearsing the act, 10
stalking, and/or grooming the victim. 11
(12) "Qualified professional" means a person with at least three 12
years' prior experience working with individuals with developmental 13
disabilities, and: (a) If the person being assessed has demonstrated 14
sexually aggressive or sexually violent behavior, that person must be 15
assessed by a qualified professional who is a certified sex offender 16
treatment provider, or affiliate sex offender treatment provider 17
working under the supervision of a certified sex offender treatment 18
provider; or (b) if the person being assessed has demonstrated 19
violent, dangerous, or aggressive behavior, that person must be 20
assessed by a licensed psychologist or psychiatrist who has received 21
specialized training in the treatment of or has at least three years' 22
prior experience treating violent or aggressive behavior.23
(13) "Treatment team" means the program participant and the group 24
of people responsible for the development, implementation, and 25
monitoring of the person's individualized supports and services. This 26
group may include, but is not limited to, the case resource manager, 27
therapist, residential provider, employment/day program provider, and 28
the person's legal representative and/or family, provided the person 29
consents to the family member's involvement. 30
(14) "Violent offense" means any felony defined as a violent 31
offense in RCW 9.94A.030. 32
(15) "Waiver" means the community-based funding under section 33
1915 of Title XIX of the federal social security act.34
Sec. 2044. RCW 74.04.00511 and 2003 c 19 s 8 are each amended to 35
read as follows: 36
For purposes of RCW 74.04.005 (((10) and (11))) (9) and (13), 37
(("resource" and)) "income" and "resource" do not include educational 38
assistance awarded under the gaining independence for students with 39
p. 62 HB 1281
dependents program as defined in chapter 19, Laws of 2003 for 1
recipients of temporary assistance for needy families.2
Sec. 2045. RCW 74.04.300 and 2003 c 208 s 1 are each amended to 3
read as follows: 4
If a recipient receives public assistance and/or food stamps or 5
food stamp benefits transferred electronically for which the 6
recipient is not eligible, or receives public assistance and/or food 7
stamps or food stamp benefits transferred electronically in an amount 8
greater than that for which the recipient is eligible, the portion of 9
the payment to which the recipient is not entitled shall be a debt 10
due the state recoverable under RCW 43.20B.030 and 43.20B.620 through 11
43.20B.645. It shall be the duty of recipients of cash benefits to 12
notify the department of changes to earned income as defined in RCW 13
74.04.005(((11))). It shall be the duty of recipients of cash 14
benefits to notify the department of changes to liquid resources as 15
defined in RCW 74.04.005(((10))) that would result in ineligibility 16
for cash benefits. It shall be the duty of recipients of food 17
benefits to report changes in income that result in ineligibility for 18
food benefits. All recipients shall report changes required in this 19
section by the tenth of the month following the month in which the 20
change occurs. The department shall make a determination of 21
eligibility within ten days from the date it receives the reported 22
change from the recipient. The department shall adopt rules 23
consistent with federal law and regulations for additional reporting 24
requirements. The department shall advise applicants for assistance 25
that failure to report as required, failure to reveal resources or 26
income, and false statements will result in recovery by the state of 27
any overpayment and may result in criminal prosecution.28
Sec. 2046. RCW 74.04.670 and 2007 c 161 s 1 are each amended to 29
read as follows: 30
(1) For purposes of RCW 74.04.005(((10))) (13)(a), an applicant 31
or recipient is not eligible for long-term care services if the 32
applicant or recipient's equity interest in the home exceeds an 33
amount established by the department in rule, which shall not be less 34
than five hundred thousand dollars. This requirement does not apply 35
if any of the following persons related to the applicant or recipient 36
are legally residing in the home: 37
(a) A spouse; or 38
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(b) A dependent child under age twenty-one; or 1
(c) A dependent child with a disability; or 2
(d) A dependent child who is blind; and 3
(e) The dependent child in (c) and (d) of this subsection meets 4
the federal supplemental security income program criteria for 5
disabled and blind. 6
(2) The dollar amounts specified in this section shall be 7
increased annually, beginning in 2011, from year to year based on the 8
percentage increase in the consumer price index for all urban 9
consumers, all items, United States city average, rounded to the 10
nearest one thousand dollars. 11
(3) This section applies to individuals who are determined 12
eligible for medical assistance with respect to long-term care 13
services based on an application filed on or after May 1, 2006.14
Sec. 2047. RCW 79A.05.065 and 2011 c 171 s 115 are each amended 15
to read as follows: 16
(1)(a) The commission shall grant to any person who meets the 17
eligibility requirements specified in this section a senior citizen's 18
pass which shall: (i) Entitle such a person, and members of his or 19
her camping unit, to a fifty percent reduction in the campsite rental 20
fee prescribed by the commission; and (ii) entitle such a person to 21
free admission to any state park. 22
(b) The commission shall grant a senior citizen's pass to any 23
person who applies for the senior citizen's pass and who meets the 24
following requirements: 25
(i) The person is at least sixty-two years of age;26
(ii) The person is a domiciliary of the state of Washington and 27
meets reasonable residency requirements prescribed by the commission; 28
and 29
(iii) The person and his or her spouse have a combined income 30
that would qualify the person for a property tax exemption pursuant 31
to RCW 84.36.381. The financial eligibility requirements of this 32
subsection (1)(b)(iii) apply regardless of whether the applicant for 33
a senior citizen's pass owns taxable property or has obtained or 34
applied for such property tax exemption. 35
(c) Each senior citizen's pass granted pursuant to this section 36
is valid as long as the senior citizen meets the requirements of 37
(b)(ii) of this subsection. A senior citizen meeting the eligibility 38
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requirements of this section may make a voluntary donation for the 1
upkeep and maintenance of state parks. 2
(d) A holder of a senior citizen's pass shall surrender the pass 3
upon request of a commission employee when the employee has reason to 4
believe the holder fails to meet the criteria in (b) of this 5
subsection. The holder shall have the pass returned upon providing 6
proof to the satisfaction of the director that the holder meets the 7
eligibility criteria for obtaining the senior citizen's pass.8
(2)(a) Any resident of Washington who is disabled as defined by 9
the social security administration and who receives social security 10
benefits for that disability, or any other benefits for that 11
disability from any other governmental or nongovernmental source, or 12
who is entitled to benefits for permanent disability under RCW 13
71A.10.020(((3))) (6) due to unemployability full time at the minimum 14
wage, or who is legally blind or profoundly deaf, or who has been 15
issued a card, decal, or special license plate for a permanent 16
disability under RCW 46.19.010 shall be entitled to receive, 17
regardless of age and upon making application therefor, a disability 18
pass at no cost to the holder. The pass shall: (i) Entitle such a 19
person, and members of his or her camping unit, to a fifty percent 20
reduction in the campsite rental fee prescribed by the commission; 21
and (ii) entitle such a person to free admission to any state park.22
(b) A card, decal, or special license plate issued for a 23
permanent disability under RCW 46.19.010 may serve as a pass for the 24
holder to entitle that person and members of the person's camping 25
unit to a fifty percent reduction in the campsite rental fee 26
prescribed by the commission, and to allow the holder free admission 27
to state parks. 28
(3) Any resident of Washington who is a veteran and has a 29
service-connected disability of at least thirty percent shall be 30
entitled to receive a lifetime veteran's disability pass at no cost 31
to the holder. The pass shall: (a) Entitle such a person, and members 32
of his or her camping unit, to free use of any campsite within any 33
state park; (b) entitle such a person to free admission to any state 34
park; and (c) entitle such a person to an exemption from any 35
reservation fees. 36
(4)(a) Any Washington state resident who provides out-of-home 37
care to a child, as either a licensed foster family home or a person 38
related to the child, is entitled to a foster home pass.39
p. 65 HB 1281
(b) An applicant for a foster home pass must request a pass in 1
the manner required by the commission. Upon receipt of a properly 2
submitted request, the commission shall verify with the department of 3
social and health services that the applicant qualifies under (a) of 4
this subsection. Once issued, a foster home pass is valid for the 5
period, which may not be less than one year, designated by the 6
commission. 7
(c) When accompanied by a child receiving out-of-home care from 8
the pass holder, a foster home pass: (i) Entitles such a person, and 9
members of his or her camping unit, to free use of any campsite 10
within any state park; and (ii) entitles such a person to free 11
admission to any state park. 12
(d) For the purposes of this subsection (4): 13
(i) "Out-of-home care" means placement in a foster family home or 14
with a person related to the child under the authority of chapter 15
13.32A, 13.34, or 74.13 RCW; 16
(ii) "Foster family home" has the same meaning as defined in RCW 17
74.15.020; and 18
(iii) "Person related to the child" means those persons referred 19
to in RCW 74.15.020(2)(a) (i) through (vi). 20
(5) All passes issued pursuant to this section are valid at all 21
parks any time during the year. However, the pass is not valid for 22
admission to concessionaire operated facilities. 23
(6) The commission shall negotiate payment and costs, to allow 24
holders of a foster home pass free access and usage of park 25
campsites, with the following nonoperated, nonstate -owned parks: 26
Central Ferry, Chief Timothy, Crow Butte, and Lyons Ferry. The 27
commission shall seek state general fund reimbursement on a biennial 28
basis. 29
(7) The commission may deny or revoke any Washington state park 30
pass issued under this section for cause, including but not limited 31
to the following: 32
(a) Residency outside the state of Washington;33
(b) Violation of laws or state park rules resulting in eviction 34
from a state park; 35
(c) Intimidating, obstructing, or assaulting a park employee or 36
park volunteer who is engaged in the performance of official duties;37
(d) Fraudulent use of a pass; 38
(e) Providing false information or documentation in the 39
application for a state parks pass; 40
p. 66 HB 1281
(f) Refusing to display or show the pass to park employees when 1
requested; or 2
(g) Failing to provide current eligibility information upon 3
request by the agency or when eligibility ceases or changes.4
(8) This section shall not affect or otherwise impair the power 5
of the commission to continue or discontinue any other programs it 6
has adopted for senior citizens. 7
(9) The commission may engage in a mutually agreed upon 8
reciprocal or discounted program for all or specific pass programs 9
with other outdoor recreation agencies. 10
(10) The commission shall adopt those rules as it finds 11
appropriate for the administration of this section. Among other 12
things, the rules shall prescribe a definition of "camping unit" 13
which will authorize a reasonable number of persons traveling with 14
the person having a pass to stay at the campsite rented by such a 15
person, a minimum Washington residency requirement for applicants for 16
a senior citizen's pass, and an application form to be completed by 17
applicants for a senior citizen's pass. 18
Sec. 2048. RCW 80.70.020 and 2004 c 224 s 2 are each amended to 19
read as follows: 20
(1) The provisions of this chapter apply to: 21
(a) New fossil-fueled thermal electric generation facilities with 22
station-generating capability of three hundred fifty thousand 23
kilowatts or more and fossil-fueled floating thermal electric 24
generation facilities of one hundred thousand kilowatts or more under 25
RCW 80.50.020(14)(((a))) (b), for which an application for site 26
certification is made to the council after July 1, 2004;27
(b) New fossil-fueled thermal electric generation facilities with 28
station-generating capability of more than twenty-five thousand 29
kilowatts, but less than three hundred fifty thousand kilowatts, 30
except for fossil-fueled floating thermal electric generation 31
facilities under the council's jurisdiction, for which an application 32
for an order of approval has been submitted after July 1, 2004;33
(c) Fossil-fueled thermal electric generation facilities with 34
station-generating capability of three hundred fifty thousand 35
kilowatts or more that have an existing site certification agreement 36
and, after July 1, 2004, apply to the council to increase the output 37
of carbon dioxide emissions by fifteen percent or more through 38
p. 67 HB 1281
permanent changes in facility operations or modification or 1
equipment; and 2
(d) Fossil-fueled thermal electric generation facilities with 3
station-generating capability of more than twenty-five thousand 4
kilowatts, but less than three hundred fifty thousand kilowatts, 5
except for fossil-fueled floating thermal electric generation 6
facilities under the council's jurisdiction, that have an existing 7
order of approval and, after July 1, 2004, apply to the department or 8
authority, as appropriate, to permanently modify the facility so as 9
to increase its station-generating capability by at least twenty-five 10
thousand kilowatts or to increase the output of carbon dioxide 11
emissions by fifteen percent or more, whichever measure is greater.12
(2)(a) A proposed site certification agreement submitted to the 13
governor under RCW 80.50.100 and a final site certification agreement 14
issued under RCW 80.50.100 shall include an approved carbon dioxide 15
mitigation plan. 16
(b) For fossil-fueled thermal electric generation facilities not 17
under jurisdiction of the council, the order of approval shall 18
require an approved carbon dioxide mitigation plan.19
(c) Site certification agreement holders or order of approval 20
holders may request, at any time, a change in conditions of an 21
approved carbon dioxide mitigation plan if the council, department, 22
or authority, as appropriate, finds that the change meets all 23
requirements and conditions for approval of such plans.24
(3) An applicant for a fossil-fueled thermal electric generation 25
facility shall include one or a combination of the following carbon 26
dioxide mitigation options as part of its mitigation plan:27
(a) Payment to a third party to provide mitigation;28
(b) Direct purchase of permanent carbon credits; or29
(c) Investment in applicant-controlled carbon dioxide mitigation 30
projects, including combined heat and power (cogeneration).31
(4) Fossil-fueled thermal electric generation facilities that 32
receive site certification approval or an order of approval shall 33
provide mitigation for twenty percent of the total carbon dioxide 34
emissions produced by the facility. 35
(5) If the certificate holder or order of approval holder chooses 36
to pay a third party to provide the mitigation, the mitigation rate 37
shall be one dollar and sixty cents per metric ton of carbon dioxide 38
to be mitigated. For a cogeneration plant, the monetary amount is 39
p. 68 HB 1281
based on the difference between twenty percent of the total carbon 1
dioxide emissions and the cogeneration credit. 2
(a) Through rule making, the council may adjust the rate per ton 3
biennially as long as any increase or decrease does not exceed fifty 4
percent of the current rate. The department or authority shall use 5
the adjusted rate established by the council pursuant to this 6
subsection for fossil-fueled thermal electric generation facilities 7
subject to the provisions of this chapter. 8
(b) In adjusting the mitigation rate the council shall consider, 9
but is not limited to, the current market price of a ton of carbon 10
dioxide. The council's adjusted mitigation rate shall be consistent 11
with RCW 80.50.010(((3))) (4). 12
(6) The applicant may choose to make to the third party a lump 13
sum payment or partial payment over a period of five years.14
(a) Under the lump sum payment option, the payment amount is 15
determined by multiplying the total carbon dioxide emissions by the 16
twenty percent mitigation requirement under subsection (4) of this 17
section and by the per ton mitigation rate established under 18
subsection (5) of this section. 19
(b) No later than one hundred twenty days after the start of 20
commercial operation, the certificate holder or order of approval 21
holder shall make a one-time payment to the independent qualified 22
organization for the amount determined under subsection (5) of this 23
section. 24
(c) As an alternative to a one-time payment, the certificate 25
holder or order of approval holder may make a partial payment of 26
twenty percent of the amount determined under subsection (5) of this 27
section no later than one hundred twenty days after commercial 28
operation and a payment in the same amount or as adjusted according 29
to subsection (5)(a) of this section, on the anniversary date of the 30
initial payment in each of the following four years. With the initial 31
payment, the certificate holder or order of approval holder shall 32
provide a letter of credit or other comparable security acceptable to 33
the council or the department for the remaining eighty percent 34
mitigation payment amount including possible changes to the rate per 35
metric ton from rule making under subsection (5)(a) of this section.36
Sec. 2049. RCW 88.02.610 and 2011 c 171 s 132 are each amended 37
to read as follows: 38
p. 69 HB 1281
(1) A vessel owner shall apply for a vessel visitor permit if the 1
vessel is: 2
(a) Currently registered or numbered under the laws of a country 3
other than the United States or has a valid United States customs 4
service cruising license issued under 19 C.F.R. Sec. 4.94; and5
(b) Being used on Washington state waters for the personal use of 6
the owner for more than sixty days. 7
(2) A vessel visitor permit: 8
(a) May be obtained from the department, county auditor or other 9
agent, or subagent appointed by the director; 10
(b) Must show the date the vessel first came into Washington 11
state; and 12
(c) Is valid as long as the vessel remains currently registered 13
or numbered under the laws of a country other than the United States 14
or the United States customs service cruising license remains valid.15
(3) The department, county auditor or other agent, or subagent 16
appointed by the director shall collect the fee required in RCW 17
88.02.640(1)(((m))) (p) when issuing a vessel visitor permit.18
(4) The department shall adopt rules to implement this section, 19
including rules on issuing and displaying the vessel visitor permit.20
Sec. 2050. RCW 90.58.090 and 2011 c 353 s 14 and 2011 c 277 s 2 21
are each reenacted and amended to read as follows:22
(1) A master program, segment of a master program, or an 23
amendment to a master program shall become effective when approved by 24
the department as provided in subsection (7) of this section. Within 25
the time period provided in RCW 90.58.080, each local government 26
shall have submitted a master program, either totally or by segments, 27
for all shorelines of the state within its jurisdiction to the 28
department for review and approval. 29
The department shall strive to achieve final action on a 30
submitted master program within one hundred eighty days of receipt 31
and shall post an annual assessment related to this performance 32
benchmark on the agency website. 33
(2) Upon receipt of a proposed master program or amendment, the 34
department shall: 35
(a) Provide notice to and opportunity for written comment by all 36
interested parties of record as a part of the local government review 37
process for the proposal and to all persons, groups, and agencies 38
that have requested in writing notice of proposed master programs or 39
p. 70 HB 1281
amendments generally or for a specific area, subject matter, or 1
issue. The comment period shall be at least thirty days, unless the 2
department determines that the level of complexity or controversy 3
involved supports a shorter period; 4
(b) In the department's discretion, conduct a public hearing 5
during the thirty-day comment period in the jurisdiction proposing 6
the master program or amendment; 7
(c) Within fifteen days after the close of public comment, 8
request the local government to review the issues identified by the 9
public, interested parties, groups, and agencies and provide a 10
written response as to how the proposal addresses the identified 11
issues; 12
(d) Within thirty days after receipt of the local government 13
response pursuant to (c) of this subsection, make written findings 14
and conclusions regarding the consistency of the proposal with the 15
policy of RCW 90.58.020 and the applicable guidelines, provide a 16
response to the issues identified in (c) of this subsection, and 17
either approve the proposal as submitted, recommend specific changes 18
necessary to make the proposal approvable, or deny approval of the 19
proposal in those instances where no alteration of the proposal 20
appears likely to be consistent with the policy of RCW 90.58.020 and 21
the applicable guidelines. The written findings and conclusions shall 22
be provided to the local government, and made available to all 23
interested persons, parties, groups, and agencies of record on the 24
proposal; 25
(e) If the department recommends changes to the proposed master 26
program or amendment, within thirty days after the department mails 27
the written findings and conclusions to the local government, the 28
local government may: 29
(i) Agree to the proposed changes by written notice to the 30
department; or 31
(ii) Submit an alternative proposal. If, in the opinion of the 32
department, the alternative is consistent with the purpose and intent 33
of the changes originally submitted by the department and with this 34
chapter it shall approve the changes and provide notice to all 35
recipients of the written findings and conclusions. If the department 36
determines the proposal is not consistent with the purpose and intent 37
of the changes proposed by the department, the department may 38
resubmit the proposal for public and agency review pursuant to this 39
section or reject the proposal. 40
p. 71 HB 1281
(3) The department shall approve the segment of a master program 1
relating to shorelines unless it determines that the submitted 2
segments are not consistent with the policy of RCW 90.58.020 and the 3
applicable guidelines. 4
(4) The department shall approve the segment of a master program 5
relating to critical areas as defined by RCW 36.70A.030(((5))) 6
provided the master program segment is consistent with RCW 90.58.020 7
and applicable shoreline guidelines, and if the segment provides a 8
level of protection of critical areas at least equal to that provided 9
by the local government's critical areas ordinances adopted and 10
thereafter amended pursuant to RCW 36.70A.060(2). 11
(5) The department shall approve those segments of the master 12
program relating to shorelines of statewide significance only after 13
determining the program provides the optimum implementation of the 14
policy of this chapter to satisfy the statewide interest. If the 15
department does not approve a segment of a local government master 16
program relating to a shoreline of statewide significance, the 17
department may develop and by rule adopt an alternative to the local 18
government's proposal. 19
(6) In the event a local government has not complied with the 20
requirements of RCW 90.58.070 it may thereafter upon written notice 21
to the department elect to adopt a master program for the shorelines 22
within its jurisdiction, in which event it shall comply with the 23
provisions established by this chapter for the adoption of a master 24
program for such shorelines. 25
Upon approval of such master program by the department it shall 26
supersede such master program as may have been adopted by the 27
department for such shorelines. 28
(7) A master program or amendment to a master program takes 29
effect when and in such form as approved or adopted by the 30
department. The effective date is fourteen days from the date of the 31
department's written notice of final action to the local government 32
stating the department has approved or rejected the proposal. For 33
master programs adopted by rule, the effective date is governed by 34
RCW 34.05.380. The department's written notice to the local 35
government must conspicuously and plainly state that it is the 36
department's final decision and that there will be no further 37
modifications to the proposal. 38
(a) Shoreline master programs that were adopted by the department 39
prior to July 22, 1995, in accordance with the provisions of this 40
p. 72 HB 1281
section then in effect, shall be deemed approved by the department in 1
accordance with the provisions of this section that became effective 2
on that date. 3
(b) The department shall maintain a record of each master 4
program, the action taken on any proposal for adoption or amendment 5
of the master program, and any appeal of the department's action. The 6
department's approved document of record constitutes the official 7
master program. 8
(8) Promptly after approval or disapproval of a local 9
government's shoreline master program or amendment, the department 10
shall publish a notice consistent with RCW 36.70A.290 that the 11
shoreline master program or amendment has been approved or 12
disapproved. This notice must be filed for all shoreline master 13
programs or amendments. If the notice is for a local government that 14
does not plan under RCW 36.70A.040, the department must, on the day 15
the notice is published, notify the legislative authority of the 16
applicable local government by telephone or electronic means, 17
followed by written communication as necessary, to ensure that the 18
local government has received the full written decision of the 19
approval or disapproval. 20
NEW SECTION. Sec. 2051. Sections 2034 through 2037 of this act 21
expire January 1, 2028.22
PART III23
MULTIPLE AMENDMENT MERGES24
Sec. 3001. RCW 18.130.175 and 2023 c 469 s 19 and 2023 c 425 s 25
25 are each reenacted and amended to read as follows:26
(1) In lieu of disciplinary action under RCW 18.130.160 and if 27
the disciplining authority determines that the unprofessional conduct 28
may be the result of an applicable impairing or potentially impairing 29
health condition, the disciplining authority may refer the license 30
holder to a physician health program or a voluntary substance use 31
disorder monitoring program approved by the disciplining authority.32
The cost of evaluation and treatment shall be the responsibility 33
of the license holder, but the responsibility does not preclude 34
payment by an employer, existing insurance coverage, or other 35
sources. Evaluation and treatment shall be provided by providers 36
approved by the entity or the commission. The disciplining authority 37
p. 73 HB 1281
may also approve the use of out-of-state programs. Referral of the 1
license holder to the physician health program or voluntary substance 2
use disorder monitoring program shall be done only with the consent 3
of the license holder. Referral to the physician health program or 4
voluntary substance use disorder monitoring program may also include 5
probationary conditions for a designated period of time. If the 6
license holder does not consent to be referred to the program or does 7
not successfully complete the program, the disciplining authority may 8
take appropriate action under RCW 18.130.160 which includes 9
suspension of the license unless or until the disciplining authority, 10
in consultation with the director of the applicable program, 11
determines the license holder is able to practice safely. The 12
secretary shall adopt uniform rules for the evaluation by the 13
disciplining authority of return to substance use or program 14
violation on the part of a license holder in the program. The 15
evaluation shall encourage program participation with additional 16
conditions, in lieu of disciplinary action, when the disciplining 17
authority determines that the license holder is able to continue to 18
practice with reasonable skill and safety. 19
(2) In addition to approving the physician health program or the 20
voluntary substance use disorder monitoring program that may receive 21
referrals from the disciplining authority, the disciplining authority 22
may establish by rule requirements for participation of license 23
holders who are not being investigated or monitored by the 24
disciplining authority. License holders voluntarily participating in 25
the approved programs without being referred by the disciplining 26
authority shall not be subject to disciplinary action under RCW 27
18.130.160 for their impairing or potentially impairing health 28
condition, and shall not have their participation made known to the 29
disciplining authority, if they meet the requirements of this section 30
and the program in which they are participating. 31
(3) The license holder shall sign a waiver allowing the program 32
to release information to the disciplining authority if the licensee 33
does not comply with the requirements of this section or is unable to 34
practice with reasonable skill or safety. The physician health 35
program or voluntary substance use disorder program shall report to 36
the disciplining authority any license holder who fails to comply 37
with the requirements of this section or the program or who, in the 38
opinion of the program, is unable to practice with reasonable skill 39
or safety. License holders shall report to the disciplining authority 40
p. 74 HB 1281
if they fail to comply with this section or do not complete the 1
program's requirements. License holders may, upon the agreement of 2
the program and disciplining authority, reenter the program if they 3
have previously failed to comply with this section.4
(4) Program records including, but not limited to, case notes, 5
progress notes, laboratory reports, evaluation and treatment records, 6
electronic and written correspondence within the program, and between 7
the program and the participant or other involved entities including, 8
but not limited to, employers, credentialing bodies, referents, or 9
other collateral sources, relating to license holders referred to or 10
voluntarily participating in approved programs are confidential and 11
exempt from disclosure under chapter 42.56 RCW and shall not be 12
subject to discovery by subpoena or admissible as evidence except:13
(a) To defend any civil action by a license holder regarding the 14
restriction or revocation of that individual's clinical or staff 15
privileges, or termination of a license holder's employment. In such 16
an action, the program will, upon subpoena issued by either party to 17
the action, and upon the requesting party seeking a protective order 18
for the requested disclosure, provide to both parties of the action 19
written disclosure that includes the following information:20
(i) Verification of a health care professional's participation in 21
the physician health program or voluntary substance use disorder 22
monitoring program as it relates to aspects of program involvement at 23
issue in the civil action; 24
(ii) The dates of participation; 25
(iii) Whether or not the program identified an impairing or 26
potentially impairing health condition; 27
(iv) Whether the health care professional was compliant with the 28
requirements of the physician health program or voluntary substance 29
use disorder monitoring program; and 30
(v) Whether the health care professional successfully completed 31
the physician health program or voluntary substance use disorder 32
monitoring program; and 33
(b) Records provided to the disciplining authority for cause as 34
described in subsection (3) of this section. Program records relating 35
to license holders mandated to the program, through order or by 36
stipulation, by the disciplining authority or relating to license 37
holders reported to the disciplining authority by the program for 38
cause, must be released to the disciplining authority at the request 39
of the disciplining authority. Records held by the disciplining 40
p. 75 HB 1281
authority under this section are exempt from chapter 42.56 RCW and 1
are not subject to discovery by subpoena except by the license 2
holder. 3
(5) This section does not affect an employer's right or ability 4
to make employment-related decisions regarding a license holder. This 5
section does not restrict the authority of the disciplining authority 6
to take disciplinary action for any other unprofessional conduct.7
(6) A person who, in good faith, reports information or takes 8
action in connection with this section is immune from civil liability 9
for reporting information or taking the action. 10
(a) The immunity from civil liability provided by this section 11
shall be liberally construed to accomplish the purposes of this 12
section, and applies to both license holders and students and 13
trainees when students and trainees of the applicable professions are 14
served by the program. The persons entitled to immunity shall 15
include: 16
(i) An approved physician health program or voluntary substance 17
use disorder monitoring program; 18
(ii) The professional association affiliated with the program;19
(iii) Members, employees, or agents of the program or 20
associations; 21
(iv) Persons reporting a license holder as being possibly 22
impaired or providing information about the license holder's 23
impairment; and 24
(v) Professionals supervising or monitoring the course of the 25
program participant's treatment or rehabilitation.26
(b) The courts are strongly encouraged to impose sanctions on 27
program participants and their attorneys whose allegations under this 28
subsection are not made in good faith and are without either 29
reasonable objective, substantive grounds, or both.30
(c) The immunity provided in this section is in addition to any 31
other immunity provided by law. 32
(7) In the case of a person who is applying to be a substance use 33
disorder professional or substance use disorder professional trainee 34
certified under chapter 18.205 RCW, an agency affiliated counselor 35
((registered)) credentialed under chapter 18.19 RCW, or a peer 36
specialist or peer specialist trainee certified under chapter 18.420 37
RCW, if the person is: 38
(a) Less than one year in recovery from a substance use disorder, 39
the duration of time that the person may be required to participate 40
p. 76 HB 1281
in an approved substance use disorder monitoring program may not 1
exceed the amount of time necessary for the person to achieve one 2
year in recovery; or 3
(b) At least one year in recovery from a substance use disorder, 4
the person may not be required to participate in the approved 5
substance use disorder monitoring program. 6
(8) The provisions of subsection (7) of this section apply to any 7
person employed as a peer specialist as of July 1, 2025, 8
participating in a program under this section as of July 1, 2025, and 9
applying to become a certified peer specialist under RCW 18.420.050, 10
regardless of when the person's participation in a program began. To 11
this extent, subsection (7) of this section applies retroactively, 12
but in all other respects it applies prospectively.13
Sec. 3002. RCW 19.09.085 and 2011 c 199 s 12 and 2011 c 183 s 1 14
are each reenacted to read as follows: 15
(1) Registration under this chapter is effective for one year or 16
as established by the secretary. 17
(2) Renewals required under RCW 19.09.075 or 19.09.079 must be 18
submitted to the secretary no later than the date established by the 19
secretary by rule. 20
(3) The secretary must notify entities registered under this 21
chapter of the need to renew upon the expiration of their current 22
registration. The notification must be made approximately sixty days 23
prior to the expiration date and must be made through postal or 24
electronic means. Failure to renew shall not be excused by a failure 25
of the secretary to send the notice or by an entity's failure to 26
receive the notice. 27
(4) Entities required to register and renew under this chapter 28
must file a notice of change of information within thirty days of any 29
change in the information contained in RCW 19.09.075 (1)(a) through 30
(k) or 19.09.079 (1) through (7) and (9). 31
(5) Entities are deemed registered under RCW 19.09.075 or 32
19.09.079 no sooner than twenty days after receipt of the 33
registration or renewal form by the secretary and may thereafter 34
solicit contributions from the general public. 35
(6) If the secretary determines that the application for initial 36
registration or renewal is incomplete, the secretary must notify the 37
applicant of the information necessary to complete the application. 38
The secretary may hold the application up to thirty days to allow the 39
p. 77 HB 1281
applicant time to provide additional information. If the applicant 1
fails to provide complete information as requested by the secretary, 2
the applicant must be deemed unregistered and must cease all 3
solicitations as defined by this chapter. 4
(7) If an applicant fails to pay a required fee for any filing, 5
the secretary must notify the applicant of the necessary fee to 6
complete the application. The secretary may hold the application up 7
to thirty days to allow the applicant time to submit the required 8
payment. If the applicant fails to provide the required payment as 9
requested by the secretary, the applicant must be deemed unregistered 10
and must cease all solicitations as defined by this chapter.11
Sec. 3003. RCW 28B.76.526 and 2023 c 475 s 922 and 2023 c 475 s 12
1901 are each reenacted to read as follows: 13
The Washington opportunity pathways account is created in the 14
state treasury. Expenditures from the account may be used only for 15
programs in chapter 28A.710 RCW (charter schools), chapter 28B.12 RCW 16
(state work-study), chapter 28B.50 RCW (opportunity grant), RCW 17
28B.76.660 (Washington scholars award), RCW 28B.76.670 (Washington 18
award for vocational excellence), chapter 28B.92 RCW (Washington 19
college grant program), chapter 28B.105 RCW (GET ready for math and 20
science scholarship), chapter 28B.117 RCW (passport to careers), 21
chapter 28B.118 RCW (college bound scholarship), and chapter 43.216 22
RCW (early childhood education and assistance program). During the 23
2019-2021, 2021-2023, and 2023-2025 fiscal biennia, the account may 24
also be appropriated for public schools funded under chapters 28A.150 25
and 28A.715 RCW. 26
Sec. 3004. RCW 43.03.230 and 2011 c 5 s 903 and 2011 1st sp.s. c 27
21 s 56 are each reenacted to read as follows: 28
(1) Any agricultural commodity board or commission established 29
pursuant to Title 15 or 16 RCW shall be identified as a class two 30
group for purposes of compensation. 31
(2) Except as otherwise provided in this section, each member of 32
a class two group is eligible to receive compensation in an amount 33
not to exceed one hundred dollars for each day during which the 34
member attends an official meeting of the group or performs 35
statutorily prescribed duties approved by the chairperson of the 36
group. A person shall not receive compensation for a day of service 37
under this section if the person (a) occupies a position, normally 38
p. 78 HB 1281
regarded as full-time in nature, in any agency of the federal 1
government, Washington state government, or Washington state local 2
government; and (b) receives any compensation from such government 3
for working that day. 4
(3) Compensation may be paid a member under this section only if 5
it is authorized under the law dealing in particular with the 6
specific group to which the member belongs or dealing in particular 7
with the members of that specific group. 8
(4) No person designated as a member of a class two board, 9
commission, council, committee, or similar group may receive an 10
allowance for subsistence, lodging, or travel expenses if the 11
allowance cost is funded by the state general fund. Exceptions may be 12
granted under RCW 43.03.049. Class two groups, when feasible, shall 13
use an alternative means of conducting a meeting that does not 14
require travel while still maximizing member and public participation 15
and may use a meeting format that requires members to be physically 16
present at one location only when necessary or required by law.17
(5) Class two groups that are funded by sources other than the 18
state general fund are encouraged to reduce travel, lodging, and 19
other costs associated with conducting the business of the group 20
including use of other meeting formats that do not require travel.21
Sec. 3005. RCW 43.03.240 and 2011 c 5 s 904 and 2011 1st sp.s. c 22
21 s 57 are each reenacted to read as follows: 23
(1) Any part-time, statutory board, commission, council, 24
committee, or other similar group which has rule-making authority, 25
performs quasi-judicial functions, has responsibility for the 26
administration or policy direction of a state agency or program, or 27
performs regulatory or licensing functions with respect to a specific 28
profession, occupation, business, or industry shall be identified as 29
a class three group for purposes of compensation. 30
(2) Except as otherwise provided in this section, each member of 31
a class three group is eligible to receive compensation in an amount 32
not to exceed fifty dollars for each day during which the member 33
attends an official meeting of the group or performs statutorily 34
prescribed duties approved by the chairperson of the group. A person 35
shall not receive compensation for a day of service under this 36
section if the person (a) occupies a position, normally regarded as 37
full-time in nature, in any agency of the federal government, 38
Washington state government, or Washington state local government; 39
p. 79 HB 1281
and (b) receives any compensation from such government for working 1
that day. 2
(3) Compensation may be paid a member under this section only if 3
it is authorized under the law dealing in particular with the 4
specific group to which the member belongs or dealing in particular 5
with the members of that specific group. 6
(4) No person designated as a member of a class three board, 7
commission, council, committee, or similar group may receive an 8
allowance for subsistence, lodging, or travel expenses if the 9
allowance cost is funded by the state general fund. Exceptions may be 10
granted under RCW 43.03.049. Class three groups, when feasible, shall 11
use an alternative means of conducting a meeting that does not 12
require travel while still maximizing member and public participation 13
and may use a meeting format that requires members to be physically 14
present at one location only when necessary or required by law.15
(5) Class three groups that are funded by sources other than the 16
state general fund are encouraged to reduce travel, lodging, and 17
other costs associated with conducting the business of the group 18
including use of other meeting formats that do not require travel.19
Sec. 3006. RCW 43.03.250 and 2011 c 5 s 905 and 2011 1st sp.s. c 20
21 s 58 are each reenacted to read as follows: 21
(1) A part-time, statutory board, commission, council, committee, 22
or other similar group shall be identified as a class four group for 23
purposes of compensation if the group: 24
(a) Has rule-making authority, performs quasi-judicial functions, 25
or has responsibility for the administration or policy direction of a 26
state agency or program; 27
(b) Has duties that are deemed by the legislature to be of 28
overriding sensitivity and importance to the public welfare and the 29
operation of state government; and 30
(c) Requires service from its members representing a significant 31
demand on their time that is normally in excess of one hundred hours 32
of meeting time per year. 33
(2) Each member of a class four group is eligible to receive 34
compensation in an amount not to exceed one hundred dollars for each 35
day during which the member attends an official meeting of the group 36
or performs statutorily prescribed duties approved by the chairperson 37
of the group. A person shall not receive compensation for a day of 38
service under this section if the person (a) occupies a position, 39
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normally regarded as full-time in nature, in any agency of the 1
federal government, Washington state government, or Washington state 2
local government; and (b) receives any compensation from such 3
government for working that day. 4
(3) Compensation may be paid a member under this section only if 5
it is authorized under the law dealing in particular with the 6
specific group to which the member belongs or dealing in particular 7
with the members of that specific group. 8
(4) Class four groups, when feasible, shall use an alternative 9
means of conducting a meeting that does not require travel while 10
still maximizing member and public participation and may use a 11
meeting format that requires members to be physically present at one 12
location only when necessary or required by law. 13
Sec. 3007. RCW 43.03.265 and 2011 c 5 s 906 and 2011 1st sp.s. c 14
21 s 59 are each reenacted to read as follows: 15
(1) Any part-time commission that has rule-making authority, 16
performs quasi-judicial functions, has responsibility for the policy 17
direction of a health profession credentialing program, and performs 18
regulatory and licensing functions with respect to a health care 19
profession licensed under Title 18 RCW shall be identified as a class 20
five group for purposes of compensation. 21
(2) Except as otherwise provided in this section, each member of 22
a class five group is eligible to receive compensation in an amount 23
not to exceed two hundred fifty dollars for each day during which the 24
member attends an official meeting of the group or performs 25
statutorily prescribed duties approved by the chairperson of the 26
group. A person shall not receive compensation for a day of service 27
under this section if the person (a) occupies a position, normally 28
regarded as full-time in nature, in any agency of the federal 29
government, Washington state government, or Washington state local 30
government; and (b) receives any compensation from such government 31
for working that day. 32
(3) Compensation may be paid a member under this section only if 33
it is necessarily incurred in the course of authorized business 34
consistent with the responsibilities of the commission established by 35
law. 36
(4) No person designated as a member of a class five board, 37
commission, council, committee, or similar group may receive an 38
allowance for subsistence, lodging, or travel expenses if the 39
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allowance cost is funded by the state general fund. Exceptions may be 1
granted under RCW 43.03.049. Class five groups, when feasible, shall 2
use an alternative means of conducting a meeting that does not 3
require travel while still maximizing member and public participation 4
and may use a meeting format that requires members to be physically 5
present at one location only when necessary or required by law.6
(5) Class five groups that are funded by sources other than the 7
state general fund are encouraged to reduce travel, lodging, and 8
other costs associated with conducting the business of the group 9
including use of other meeting formats that do not require travel.10
Sec. 3008. RCW 43.21B.300 and 2024 c 347 s 6 and 2024 c 340 s 5 11
are each reenacted and amended to read as follows:12
(1) Any civil penalty provided in RCW 18.104.155, 70A.15.3160, 13
70A.205.280, 70A.230.080, 70A.300.090, 70A.20.050, 70A.245.040, 14
70A.245.050, 70A.245.070, 70A.245.080, 70A.245.130, 70A.245.140, 15
70A.65.200, 70A.430.070, 70A.455.090, 70A.500.260, 70A.505.110, 16
70A.555.110, 70A.560.020, 70A.565.030, 86.16.081, 88.46.090, 17
90.03.600, 90.46.270, 90.48.144, 90.56.310, 90.56.330, and 90.64.102 18
and chapter 70A.355 RCW shall be imposed by a notice in writing, 19
either by certified mail with return receipt requested or by personal 20
service, to the person incurring the penalty from the department or 21
the local air authority, describing the violation with reasonable 22
particularity. For penalties issued by local air authorities, within 23
30 days after the notice is received, the person incurring the 24
penalty may apply in writing to the authority for the remission or 25
mitigation of the penalty. Upon receipt of the application, the 26
authority may remit or mitigate the penalty upon whatever terms the 27
authority in its discretion deems proper. The authority may ascertain 28
the facts regarding all such applications in such reasonable manner 29
and under such rules as it may deem proper and shall remit or 30
mitigate the penalty only upon a demonstration of extraordinary 31
circumstances such as the presence of information or factors not 32
considered in setting the original penalty. 33
(2) Any penalty imposed under this section may be appealed to the 34
pollution control hearings board in accordance with this chapter if 35
the appeal is filed with the hearings board and served on the 36
department or authority 30 days after the date of receipt by the 37
person penalized of the notice imposing the penalty or 30 days after 38
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the date of receipt of the notice of disposition by a local air 1
authority of the application for relief from penalty.2
(3) A penalty shall become due and payable on the later of:3
(a) 30 days after receipt of the notice imposing the penalty;4
(b) 30 days after receipt of the notice of disposition by a local 5
air authority on application for relief from penalty, if such an 6
application is made; or 7
(c) 30 days after receipt of the notice of decision of the 8
hearings board if the penalty is appealed. 9
(4) If the amount of any penalty is not paid to the department 10
within 30 days after it becomes due and payable, the attorney 11
general, upon request of the department, shall bring an action in the 12
name of the state of Washington in the superior court of Thurston 13
county, or of any county in which the violator does business, to 14
recover the penalty. If the amount of the penalty is not paid to the 15
authority within 30 days after it becomes due and payable, the 16
authority may bring an action to recover the penalty in the superior 17
court of the county of the authority's main office or of any county 18
in which the violator does business. In these actions, the procedures 19
and rules of evidence shall be the same as in an ordinary civil 20
action. 21
(5) All penalties recovered shall be paid into the state treasury 22
and credited to the general fund except the following:23
(a) Penalties imposed pursuant to RCW 18.104.155 must be credited 24
to the reclamation account as provided in RCW 18.104.155(7);25
(b) Penalties imposed pursuant to RCW 70A.15.3160 must be 26
disposed of pursuant to RCW 70A.15.3160; 27
(c) Penalties imposed pursuant to RCW 70A.230.080, 70A.300.090, 28
70A.430.070, 70A.555.110, ((and)) 70A.560.020, and 70A.565.030 must 29
be credited to the model toxics control operating account created in 30
RCW 70A.305.180; 31
(d) Penalties imposed pursuant to RCW 70A.245.040 and 70A.245.050 32
must be credited to the recycling enhancement account created in RCW 33
70A.245.100; 34
(e) Penalties imposed pursuant to RCW 70A.500.260 must be 35
deposited into the electronic products recycling account created in 36
RCW 70A.500.130; 37
(f) Penalties imposed pursuant to RCW 70A.65.200 must be credited 38
to the climate investment account created in RCW 70A.65.250;39
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(g) Penalties imposed pursuant to RCW 90.56.330 must be credited 1
to the coastal protection fund established in RCW 90.48.390; and2
(h) Penalties imposed pursuant to RCW 70A.355.070 must be 3
credited to the underground storage tank account created in RCW 4
70A.355.090. 5
Sec. 3009. RCW 43.43.842 and 2023 c 469 s 20 and 2023 c 425 s 23 6
are each reenacted and amended to read as follows: 7
(1)(a) The secretary of social and health services and the 8
secretary of health shall adopt additional requirements for the 9
licensure or relicensure of agencies, facilities, and licensed 10
individuals who provide care and treatment to vulnerable adults, 11
including nursing pools registered under chapter 18.52C RCW. These 12
additional requirements shall ensure that any person associated with 13
a licensed agency or facility having unsupervised access with a 14
vulnerable adult shall not be the respondent in an active vulnerable 15
adult protection order under chapter 7.105 RCW, nor have been: (i) 16
Convicted of a crime against children or other persons as defined in 17
RCW 43.43.830, except as provided in this section; (ii) convicted of 18
crimes relating to financial exploitation as defined in RCW 19
43.43.830, except as provided in this section; or (iii) found in any 20
disciplinary board final decision to have abused a vulnerable adult 21
as defined in RCW 43.43.830. 22
(b) A person associated with a licensed agency or facility who 23
has unsupervised access with a vulnerable adult shall make the 24
disclosures specified in RCW 43.43.834(2). The person shall make the 25
disclosures in writing, sign, and swear to the contents under penalty 26
of perjury. The person shall, in the disclosures, specify all crimes 27
against children or other persons, all crimes relating to financial 28
exploitation, and all crimes relating to drugs as defined in RCW 29
43.43.830, committed by the person. 30
(2) The rules adopted under this section shall permit the 31
licensee to consider the criminal history of an applicant for 32
employment in a licensed facility when the applicant has one or more 33
convictions for a past offense and: 34
(a) The offense was simple assault, assault in the fourth degree, 35
or the same offense as it may be renamed, and three or more years 36
have passed between the most recent conviction and the date of 37
application for employment; 38
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(b) The offense was prostitution, or the same offense as it may 1
be renamed, and three or more years have passed between the most 2
recent conviction and the date of application for employment;3
(c) The offense was theft in the third degree, or the same 4
offense as it may be renamed, and three or more years have passed 5
between the most recent conviction and the date of application for 6
employment; 7
(d) The offense was theft in the second degree, or the same 8
offense as it may be renamed, and five or more years have passed 9
between the most recent conviction and the date of application for 10
employment; 11
(e) The offense was forgery, or the same offense as it may be 12
renamed, and five or more years have passed between the most recent 13
conviction and the date of application for employment;14
(f) The department of social and health services reviewed the 15
employee's otherwise disqualifying criminal history through the 16
department of social and health services' background assessment 17
review team process conducted in 2002, and determined that such 18
employee could remain in a position covered by this section; or19
(g) The otherwise disqualifying conviction or disposition has 20
been the subject of a pardon, annulment, or other equivalent 21
procedure. 22
The offenses set forth in (a) through (g) of this subsection do 23
not automatically disqualify an applicant from employment by a 24
licensee. Nothing in this section may be construed to require the 25
employment of any person against a licensee's judgment.26
(3) The rules adopted pursuant to subsection (2) of this section 27
may not allow a licensee to automatically deny an applicant with a 28
conviction for an offense set forth in subsection (2) of this section 29
for a position as a substance use disorder professional or substance 30
use disorder professional trainee certified under chapter 18.205 RCW, 31
as an agency affiliated counselor ((registered)) credentialed under 32
chapter 18.19 RCW practicing as a peer counselor in an agency or 33
facility, or as a peer specialist or peer specialist trainee 34
certified under chapter 18.420 RCW, if: 35
(a) At least one year has passed between the applicant's most 36
recent conviction for an offense set forth in subsection (2) of this 37
section and the date of application for employment;38
(b) The offense was committed as a result of the applicant's 39
substance use or untreated mental health symptoms; and40
p. 85 HB 1281
(c) The applicant is at least one year in recovery from a 1
substance use disorder, whether through abstinence or stability on 2
medication-assisted therapy, or in recovery from a mental health 3
disorder. 4
(4) In consultation with law enforcement personnel, the secretary 5
of social and health services and the secretary of health shall 6
investigate, or cause to be investigated, the conviction record and 7
the protection proceeding record information under this chapter of 8
the staff of each agency or facility under their respective 9
jurisdictions seeking licensure or relicensure. An individual 10
responding to a criminal background inquiry request from his or her 11
employer or potential employer shall disclose the information about 12
his or her criminal history under penalty of perjury. The secretaries 13
shall use the information solely for the purpose of determining 14
eligibility for licensure or relicensure. Criminal justice agencies 15
shall provide the secretaries such information as they may have and 16
that the secretaries may require for such purpose.17
Sec. 3010. RCW 43.79.195 and 2021 c 334 s 971 and 2021 c 170 s 6 18
are each reenacted to read as follows: 19
(1) The workforce education investment account is created in the 20
state treasury. All revenues from the workforce investment surcharge 21
created in RCW 82.04.299 and those revenues as specified under RCW 22
82.04.290(2)(c) must be deposited directly into the account. Moneys 23
in the account may be spent only after appropriation. Expenditures 24
from the account may be used only for higher education programs, 25
higher education operations, higher education compensation, state-26
funded student aid programs, and workforce development including 27
career connected learning as defined by RCW 28C.30.020.28
(2) Expenditures from the workforce education investment account 29
must be used to supplement, not supplant, other federal, state, and 30
local funding for higher education. 31
Sec. 3011. RCW 70A.65.030 and 2023 c 475 s 936 and 2023 c 475 s 32
1902 are each reenacted to read as follows: 33
(1) Except as provided in subsection (4) of this section, each 34
year or biennium, as appropriate, when allocating funds from the 35
carbon emissions reduction account created in RCW 70A.65.240, the 36
climate commitment account created in RCW 70A.65.260, the natural 37
climate solutions account created in RCW 70A.65.270, the climate 38
p. 86 HB 1281
investment account created in RCW 70A.65.250, the air quality and 1
health disparities improvement account created in RCW 70A.65.280, the 2
climate transit programs account created in RCW 46.68.500, or the 3
climate active transportation account created in RCW 46.68.490, or 4
administering grants or programs funded by the accounts, agencies 5
shall conduct an environmental justice assessment consistent with the 6
requirements of RCW 70A.02.060 and establish a minimum of not less 7
than 35 percent and a goal of 40 percent of total investments that 8
provide direct and meaningful benefits to vulnerable populations 9
within the boundaries of overburdened communities through: (a) The 10
direct reduction of environmental burdens in overburdened 11
communities; (b) the reduction of disproportionate, cumulative risk 12
from environmental burdens, including those associated with climate 13
change; (c) the support of community led project development, 14
planning, and participation costs; or (d) meeting a community need 15
identified by the community that is consistent with the intent of 16
this chapter or RCW 70A.02.010. 17
(2) The allocation of funding under subsection (1) of this 18
section must adhere to the following principles, additional to the 19
requirements of RCW 70A.02.080: (a) Benefits and programs should be 20
directed to areas and targeted to vulnerable populations and 21
overburdened communities to reduce statewide disparities; (b) 22
investments and benefits should be made roughly proportional to the 23
health disparities that a specific community experiences, with a goal 24
of eliminating the disparities; (c) investments and programs should 25
focus on creating environmental benefits, including eliminating 26
health burdens, creating community and population resilience, and 27
raising the quality of life of those in the community; and (d) 28
efforts should be made to balance investments and benefits across the 29
state and within counties, local jurisdictions, and unincorporated 30
areas as appropriate to reduce disparities by location and to ensure 31
efforts contribute to a reduction in disparities that exist based on 32
race or ethnicity, socioeconomic status, or other factors.33
(3) Except as provided in subsection (4) of this section, state 34
agencies allocating funds or administering grants or programs from 35
the carbon emissions reduction account created in RCW 70A.65.240, the 36
climate commitment account created in RCW 70A.65.260, the natural 37
climate solutions account created in RCW 70A.65.270, the climate 38
investment account created in RCW 70A.65.250, the air quality and 39
health disparities improvement account created in RCW 70A.65.280, the 40
p. 87 HB 1281
climate transit programs account created in RCW 46.68.500, or the 1
climate active transportation account created in RCW 46.68.490, must:2
(a) Report annually to the environmental justice council created 3
in RCW 70A.02.110 regarding progress toward meeting environmental 4
justice and environmental health goals; 5
(b) Consider recommendations by the environmental justice 6
council; and 7
(c)(i) If the agency is not a covered agency subject to the 8
requirements of chapter 70A.02 RCW, create and adopt a community 9
engagement plan to describe how it will engage with overburdened 10
communities and vulnerable populations in allocating funds or 11
administering grants or programs from the climate investment account.12
(ii) The plan must include methods for outreach and communication 13
with those who face barriers, language or otherwise, to 14
participation. 15
(4) During the 2023-2025 fiscal biennium: 16
(a) The requirement of subsection (1) of this section to conduct 17
an environmental justice assessment applies only to covered agencies 18
as defined in RCW 70A.02.010 and to significant agency actions as 19
defined in RCW 70A.02.010. 20
(b) Agencies shall coordinate with the department and the office 21
of financial management to achieve total statewide spending from the 22
accounts listed in subsection (1) of this section of not less than 35 23
percent and a goal of 40 percent of total investments that provide 24
direct and meaningful benefits to vulnerable populations within the 25
boundaries of overburdened communities as otherwise described in 26
subsection (1)(a) through (d) of this section and in accordance with 27
RCW 70A.65.230. 28
(c) The requirements of subsection (3)(c) of this section for 29
agencies other than covered agencies to create and adopt community 30
engagement plans apply only to executive branch agencies and 31
institutions of higher education, as defined in RCW 28B.10.016, 32
receiving total appropriations of more than $2,000,000 for the 33
2023-2025 fiscal biennium from the accounts listed in subsection (1) 34
of this section. 35
PART IV36
CANNABIS TERMINOLOGY CONFORMING AMENDMENTS37
p. 88 HB 1281
Sec. 4001. 2021 c 167 s 1 (uncodified) is amended to read as 1
follows: 2
(1) The legislature finds that student behavioral health issues 3
have become a crisis in Washington state, necessitating the 4
deployment of behavioral health resources in schools throughout the 5
state. The legislature's concerns are based on the following facts:6
(a) According to the healthy youth survey conducted by the office 7
of the superintendent of public instruction in 2018, one in five 8
students in eighth, 10th, and 12th grades considered attempting 9
suicide in the past year while just half of those surveyed had an 10
adult to turn to when feeling sad or hopeless; 11
(b) According to the national institute for mental health, more 12
than one in 25 adolescents between 13 and 18 years of age are 13
experiencing an eating disorder; 14
(c) According to the national institute of drug abuse, nearly 15
half of 12th grade students have used illicit drugs, six in 10 have 16
drank alcohol, and four in 10 have used ((marijuana [cannabis] )) 17
cannabis; 18
(d) The COVID-19 pandemic has increased the prevalence of and 19
exacerbated existing behavioral health disorders for minors across 20
the state; and 21
(e) A major barrier to behavioral health support for minors is 22
lack of awareness and access to information about existing services.23
(2) The legislature intends to require that contact information 24
for a suicide prevention organization, depression or anxiety support 25
organization, eating disorder support organization, substance abuse 26
support organization, and a mental health referral service for 27
children and teens be listed on the home page of each public school 28
website for the following reasons: 29
(a) Immediate access to behavioral health services often prevents 30
suicide, attempted suicide, and other self-harm; and31
(b) Students in public schools often have access to and spend 32
time on the website for their school. 33
Sec. 4002. 2015 c 207 s 1 (uncodified) is amended to read as 34
follows: 35
The legislature intends to further the government-to-government 36
relationship between the state of Washington and federally recognized 37
Indian tribes in the state of Washington by authorizing the governor 38
to enter into agreements concerning the regulation of ((marijuana 39
p. 89 HB 1281
[cannabis])) cannabis. Such agreements may include provisions 1
pertaining to: The lawful commercial production, processing, sale, 2
and possession of ((marijuana [cannabis] )) cannabis for both 3
recreational and medical purposes; ((marijuana [cannabis])) cannabis-4
related research activities; law enforcement, both criminal and 5
civil; and taxation. The legislature finds that these agreements will 6
facilitate and promote a cooperative and mutually beneficial 7
relationship between the state and the tribes regarding matters 8
relating to the legalization of ((marijuana [cannabis] )) cannabis, 9
particularly in light of the fact that federal Indian law precludes 10
the state from enforcing its civil regulatory laws in Indian country. 11
Such cooperative agreements will enhance public health and safety, 12
ensure a lawful and well-regulated ((marijuana [cannabis] )) cannabis 13
market, encourage economic development, and provide fiscal benefits 14
to both the tribes and the state. 15
Sec. 4003. 2015 c 70 s 2 (uncodified) is amended to read as 16
follows: 17
The legislature finds that since voters approved Initiative 18
Measure No. 692 in 1998, it has been the public policy of the state 19
to permit the medical use of ((marijuana [cannabis] )) cannabis. 20
Between 1998 and the present day, there have been multiple 21
legislative attempts to clarify what is meant by the medical use of 22
((marijuana [cannabis] )) cannabis and to ensure qualifying patients 23
have a safe, consistent, and adequate source of ((marijuana 24
[cannabis])) cannabis for their medical needs. 25
The legislature further finds that qualifying patients are people 26
with serious medical conditions and have been responsible for finding 27
their own source of ((marijuana [cannabis] )) cannabis for their own 28
personal medical use. Either by growing it themselves, designating 29
someone to grow for them, or participating in collective gardens, 30
patients have developed methods of access in spite of continued 31
federal opposition to the medical use of ((marijuana [cannabis] )) 32
cannabis. In a time when access itself was an issue and no safe, 33
consistent source of ((marijuana [cannabis])) cannabis was available, 34
this unregulated system was permitted by the state to ensure some, 35
albeit limited, access to ((marijuana [cannabis] )) cannabis for 36
medical use. Also permitted were personal possession limits of 37
fifteen plants and twenty-four ounces of useable ((marijuana 38
[cannabis])) cannabis, which was deemed to be the amount of 39
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((marijuana [cannabis])) cannabis needed for a sixty-day supply. In a 1
time when supply was not consistent, this amount of ((marijuana 2
[cannabis])) cannabis was necessary to ensure patients would be able 3
to address their immediate medical needs. 4
The legislature further finds that while possession amounts are 5
provided in statute, these do not amount to protection from arrest 6
and prosecution for patients. In fact, patients in compliance with 7
state law are not provided arrest protection. They may be arrested 8
and their only remedy is to assert an affirmative defense at trial 9
that they are in compliance with the law and have a medical need. Too 10
many patients using ((marijuana [cannabis] )) cannabis for medical 11
purposes today do not know this; many falsely believe they cannot be 12
arrested so long as their health care provider has authorized them 13
for the medical use of ((marijuana [cannabis])) cannabis.14
The legislature further finds that in 2012 voters passed 15
Initiative Measure No. 502 which permitted the recreational use of 16
((marijuana [cannabis])) cannabis. For the first time in our nation's 17
history, ((marijuana [cannabis])) cannabis would be regulated, taxed, 18
and sold for recreational consumption. Initiative Measure No. 502 19
provides for strict regulation on the production, processing, and 20
distribution of ((marijuana [cannabis] )) cannabis. Under Initiative 21
Measure No. 502, ((marijuana [cannabis])) cannabis is trackable from 22
seed to sale and may only be sold or grown under license. ((Marijuana 23
[Cannabis])) Cannabis must be tested for impurities and purchasers of 24
((marijuana [cannabis] )) cannabis must be informed of the THC level 25
in the ((marijuana [cannabis] )) cannabis. Since its passage, two 26
hundred fifty producer/processor licenses and sixty-three retail 27
licenses have been issued, covering the majority of the state. With 28
the current product canopy exceeding 2.9 million square feet, and 29
retailers in place, the state now has a system of safe, consistent, 30
and adequate access to ((marijuana [cannabis] )) cannabis; the 31
marketplace is not the same marketplace envisioned by the voters in 32
1998. While medical needs remain, the state is in the untenable 33
position of having a recreational product that is tested and subject 34
to production standards that ensure safe access for recreational 35
users. No such standards exist for medical users and, consequently, 36
the very people originally meant to be helped through the medical use 37
of ((marijuana [cannabis])) cannabis do not know if their product has 38
been tested for molds, do not know where their ((marijuana 39
[cannabis])) cannabis has been grown, have no certainty in the level 40
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of THC or CBD in their products, and have no assurances that their 1
products have been handled through quality assurance measures. It is 2
not the public policy of the state to allow qualifying patients to 3
only have access to products that may be endangering their health.4
The legislature, therefore, intends to adopt a comprehensive act 5
that uses the regulations in place for the recreational market to 6
provide regulation for the medical use of ((marijuana [cannabis] )) 7
cannabis. It intends to ensure that patients retain their ability to 8
grow their own ((marijuana [cannabis] )) cannabis for their own 9
medical use and it intends to ensure that patients have the ability 10
to possess more ((marijuana [cannabis] )) cannabis-infused products, 11
useable ((marijuana [cannabis] )) cannabis, and ((marijuana 12
[cannabis])) cannabis concentrates than what is available to a 13
nonmedical user. It further intends that medical specific regulations 14
be adopted as needed and under consultation of the departments of 15
health and agriculture so that safe handling practices will be 16
adopted and so that testing standards for medical products meet or 17
exceed those standards in use in the recreational market.18
The legislature further intends that the costs associated with 19
implementing and administering the medical ((marijuana [cannabis] )) 20
cannabis authorization database shall be financed from the health 21
professions account and that these funds shall be restored to the 22
health professions account through future appropriations using funds 23
derived from the dedicated ((marijuana [cannabis])) cannabis account.24
Sec. 4004. 2013 c 3 s 1 (uncodified) is amended to read as 25
follows: 26
The people intend to stop treating adult ((marijuana [cannabis])) 27
cannabis use as a crime and try a new approach that:28
(1) Allows law enforcement resources to be focused on violent and 29
property crimes; 30
(2) Generates new state and local tax revenue for education, 31
health care, research, and substance abuse prevention; and32
(3) Takes ((marijuana [cannabis] )) cannabis out of the hands of 33
illegal drug organizations and brings it under a tightly regulated, 34
state-licensed system similar to that for controlling hard alcohol.35
This measure authorizes the state liquor control board to 36
regulate and tax ((marijuana [cannabis] )) cannabis for persons 37
twenty-one years of age and older, and add a new threshold for 38
driving under the influence of ((marijuana [cannabis])) cannabis.39
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Sec. 4005. 2017 c 317 s 12 (uncodified) is amended to read as 1
follows: 2
The legislature finds that protecting the state's children, 3
youth, and young adults under the legal age to purchase and consume 4
((marijuana [cannabis] )) cannabis, by establishing limited 5
restrictions on the advertising of ((marijuana [cannabis] )) cannabis 6
and ((marijuana [cannabis] )) cannabis products, is necessary to 7
assist the state's efforts to discourage and prevent underage 8
consumption and the potential risks associated with underage 9
consumption. The legislature finds that these restrictions assist the 10
state in maintaining a strong and effective regulatory and 11
enforcement system as specified by the federal government. The 12
legislature finds this act leaves ample opportunities for licensed 13
((marijuana [cannabis])) cannabis businesses to market their products 14
to those who are of legal age to purchase them, without infringing on 15
the free speech rights of business owners. Finally, the legislature 16
finds that the state has a substantial and compelling interest in 17
enacting this act aimed at protecting Washington's children, youth, 18
and young adults. 19
Sec. 4006. 2015 2nd sp.s. c 4 s 101 (uncodified) is amended to 20
read as follows: 21
(1)(a) The legislature finds the implementation of Initiative 22
Measure No. 502 has established a clearly disadvantaged regulated 23
legal market with respect to prices and the ability to compete with 24
the unregulated medical dispensary market and the illicit market. The 25
legislature further finds that it is crucial that the state continues 26
to ensure a safe, highly regulated system in Washington that protects 27
valuable state revenues while continuing efforts towards disbanding 28
the unregulated ((marijuana [cannabis] )) cannabis markets. The 29
legislature further finds that ongoing evaluation on the impact of 30
meaningful ((marijuana [cannabis] )) cannabis tax reform for the 31
purpose of stabilizing revenues is crucial to the overall effort of 32
protecting the citizens and resources of this state. The legislature 33
further finds that a partnership with local jurisdictions in this 34
effort is imperative to the success of the legislature's policy 35
objective. The legislature further finds that sharing revenues to 36
promote a successful partnership in achieving the legislature's 37
intent should be transparent and hold local jurisdictions accountable 38
for their use of state shared revenues. Therefore, the legislature 39
p. 93 HB 1281
intends to reform the current tax structure for the regulated legal 1
((marijuana [cannabis])) cannabis system to create price parity with 2
the large medical and illicit markets with the specific objective of 3
increasing the market share of the legal and highly regulated 4
((marijuana [cannabis] )) cannabis market. The legislature further 5
intends to share ((marijuana [cannabis])) cannabis tax revenues with 6
local jurisdictions for public safety purposes and to facilitate the 7
ongoing process of ensuring a safe regulated ((marijuana [cannabis])) 8
cannabis market in all communities across the state.9
(b) The legislature further finds ((marijuana [cannabis] )) 10
cannabis use for qualifying patients is a valid and necessary option 11
health care professionals may recommend for their patients. The 12
legislature further finds that while recognizing the difference 13
between recreational and medical use of ((marijuana [cannabis] )) 14
cannabis, it is also imperative to distinguish that the authorization 15
for medical use of ((marijuana [cannabis] )) cannabis is different 16
from a valid prescription provided by a doctor to a patient. The 17
legislature further finds the authorization for medical use of 18
((marijuana [cannabis] )) cannabis is unlike over-the-counter 19
medications that require no oversight by a health care professional. 20
The legislature further finds that due to the unique characterization 21
of authorizations for the medical use of ((marijuana [cannabis] )) 22
cannabis, the policy of providing a tax preference benefit for 23
patients using an authorization should in no way be construed as 24
precedent for changes in the treatment of prescription medications or 25
over-the-counter medications. Therefore, the legislature intends to 26
provide qualifying patients and their designated providers a retail 27
sales and use tax exemption on ((marijuana [cannabis] )) cannabis 28
purchased or obtained for medical use when authorized by a health 29
care professional. 30
(2)(a) This subsection is the tax preference performance 31
statement for the retail sales and use tax exemption for ((marijuana 32
[cannabis])) cannabis purchased or obtained by qualifying patients or 33
their designated providers provided in RCW 82.08.9998(1) and 34
82.12.9998(1). The performance statement is only intended to be used 35
for subsequent evaluation of the tax preference. It is not intended 36
to create a private right of action by any party or be used to 37
determine eligibility for preferential tax treatment.38
p. 94 HB 1281
(b) The legislature categorizes the tax preference as one 1
intended to accomplish the general purposes indicated in RCW 2
82.32.808(2)(e). 3
(c) It is the legislature's specific public policy objective to 4
provide qualifying patients and their designated providers a retail 5
sales and use tax exemption on ((marijuana [cannabis] )) cannabis 6
purchased or obtained for medical use when authorized by a health 7
care professional. 8
(d) To measure the effectiveness of the exemption provided in 9
chapter 4, Laws of 2015 2nd sp. sess. in achieving the specific 10
public policy objective described in (c) of this subsection, the 11
department of revenue must provide the necessary data and assistance 12
to the state liquor and cannabis board for the report required in RCW 13
69.50.535. 14
Sec. 4007. 2020 c 236 s 1 (uncodified) is amended to read as 15
follows: 16
(1) The legislature finds that additional efforts are necessary 17
to reduce barriers to entry to the cannabis industry for individuals 18
and communities most adversely impacted by the enforcement of 19
cannabis-related laws. In the interest of establishing a cannabis 20
industry that is equitable and accessible to those most adversely 21
impacted by the enforcement of drug-related laws, including cannabis-22
related laws, the legislature finds a social equity program should be 23
created. 24
(2) The legislature finds that individuals who have been arrested 25
or incarcerated due to drug laws, and those who have resided in areas 26
of high poverty, suffer long-lasting adverse consequences, including 27
impacts to employment, business ownership, housing, health, and long-28
term financial well-being. The legislature also finds that family 29
members, especially children, and communities of those who have been 30
arrested or incarcerated due to drug laws, suffer from emotional, 31
psychological, and financial harms as a result of such arrests and 32
incarceration. The legislature further finds that individuals in 33
disproportionately impacted areas suffered the harms of enforcement 34
of cannabis-related laws. Those communities face greater difficulties 35
accessing traditional banking systems and capital for establishing 36
businesses. 37
(3) The legislature therefore finds that in the interest of 38
remedying harms resulting from the enforcement of cannabis-related 39
p. 95 HB 1281
laws in disproportionately impacted areas, creating a social equity 1
program will further an equitable cannabis industry by promoting 2
business ownership among individuals who have resided in areas of 3
high poverty and high enforcement of cannabis-related laws. The 4
social equity program should offer, among other things, financial and 5
technical assistance and license application benefits to individuals 6
most directly and adversely impacted by the enforcement of cannabis-7
related laws who are interested in starting cannabis business 8
enterprises. It is the intent of the legislature that implementation 9
of the social equity program authorized by this act not result in an 10
increase in the number of ((marijuana [cannabis])) cannabis retailer 11
licenses above the limit on the number of ((marijuana [cannabis] )) 12
cannabis retailer licenses in the state established by the 13
(([Washington state liquor and cannabis] )) Washington state liquor 14
and cannabis board before January 1, 2020. 15
Sec. 4008. 2020 c 133 s 1 (uncodified) is amended to read as 16
follows: 17
The legislature finds that recent reports of lung illnesses 18
associated with vapor products demand serious attention by the state 19
in the interest of protecting public health and preventing youth 20
access. While state law grants the liquor and cannabis board broad 21
authority to regulate vapor products containing ((marijuana 22
[cannabis])) cannabis, the legislature finds that risks to public 23
health and youth access can be mitigated by clarifying that the board 24
is granted specific authority to prohibit the use of any additive, 25
solvent, ingredient, or compound in ((marijuana [cannabis])) cannabis 26
vapor product production and processing and to prohibit any device 27
used in conjunction with a ((marijuana [cannabis] )) cannabis vapor 28
product. 29
Sec. 4009. 2019 c 393 s 1 (uncodified) is amended to read as 30
follows: 31
The legislature intends to allow additional information on the 32
labels and labeling of ((marijuana [cannabis])) cannabis products to 33
assist consumers in making purchases of these products.34
The legislature declares that labels and labeling should not make 35
any disease claim indicating the product is intended for use in the 36
diagnosis, treatment, cure, or prevention of any disease.37
p. 96 HB 1281
The legislature recognizes that it may be useful for a label or 1
labeling to describe the intended role of a ((marijuana [cannabis])) 2
cannabis product that contains nutrients or other dietary 3
ingredients, including herbs and other botanicals, to maintain a 4
structure or function of the body, or characterize the documented 5
mechanism by which the product acts to maintain such structure or 6
function, provided that the claim is truthful and not misleading.7
Sec. 4010. 2007 c 371 s 1 (uncodified) is amended to read as 8
follows: 9
The legislature intends to clarify the law on medical ((marijuana 10
[cannabis])) cannabis so that the lawful use of this substance is not 11
impaired and medical practitioners are able to exercise their best 12
professional judgment in the delivery of medical treatment, 13
qualifying patients may fully participate in the medical use of 14
((marijuana [cannabis] )) cannabis, and designated providers may 15
assist patients in the manner provided by this act without fear of 16
state criminal prosecution. This act is also intended to provide 17
clarification to law enforcement and to all participants in the 18
judicial system. 19
PART V20
NURSING TERMINOLOGY CONFORMING AMENDMENTS21
Sec. 5001. RCW 18.20.230 and 2012 c 10 s 15 are each amended to 22
read as follows: 23
(1) The department of social and health services shall review, in 24
coordination with the department of health, the ((nursing care 25
quality assurance commission )) state board of nursing , adult family 26
home providers, assisted living facility providers, in-home personal 27
care providers, and long-term care consumers and advocates, training 28
standards for administrators and resident caregiving staff. Any 29
proposed enhancements shall be consistent with this section, shall 30
take into account and not duplicate other training requirements 31
applicable to assisted living facilities and staff, and shall be 32
developed with the input of assisted living facility and resident 33
representatives, health care professionals, and other vested interest 34
groups. Training standards and the delivery system shall be relevant 35
to the needs of residents served by the assisted living facility and 36
recipients of long-term in-home personal care services and shall be 37
p. 97 HB 1281
sufficient to ensure that administrators and caregiving staff have 1
the skills and knowledge necessary to provide high quality, 2
appropriate care. 3
(2) The recommendations on training standards and the delivery 4
system developed under subsection (1) of this section shall be based 5
on a review and consideration of the following: Quality of care; 6
availability of training; affordability, including the training costs 7
incurred by the department of social and health services and private 8
providers; portability of existing training requirements; competency 9
testing; practical and clinical coursework; methods of delivery of 10
training; standards for management and caregiving staff training; and 11
necessary enhancements for special needs populations and resident 12
rights training. Residents with special needs include, but are not 13
limited to, residents with a diagnosis of mental illness, dementia, 14
or developmental disability. 15
Sec. 5002. RCW 18.50.032 and 1994 sp.s. c 9 s 704 are each 16
amended to read as follows: 17
Registered nurses and nurse midwives certified by the ((nursing 18
care quality assurance commission )) state board of nursing under 19
chapter 18.79 RCW shall be exempt from the requirements and 20
provisions of this chapter. 21
Sec. 5003. RCW 18.79.010 and 1994 sp.s. c 9 s 401 are each 22
amended to read as follows: 23
It is the purpose of the ((nursing care quality assurance 24
commission)) state board of nursing to regulate the competency and 25
quality of professional health care providers under its jurisdiction 26
by establishing, monitoring, and enforcing qualifications for 27
licensing, consistent standards of practice, continuing competency 28
mechanisms, and discipline. Rules, policies, and procedures developed 29
by the ((commission)) board must promote the delivery of quality 30
health care to the residents of the state of Washington.31
Sec. 5004. RCW 18.79.040 and 2020 c 80 s 15 are each amended to 32
read as follows: 33
(1) "Registered nursing practice" means the performance of acts 34
requiring substantial specialized knowledge, judgment, and skill 35
based on the principles of the biological, physiological, behavioral, 36
and sociological sciences in either: 37
p. 98 HB 1281
(a) The observation, assessment, diagnosis, care or counsel, and 1
health teaching of individuals with illnesses, injuries, or 2
disabilities, or in the maintenance of health or prevention of 3
illness of others; 4
(b) The performance of such additional acts requiring education 5
and training and that are recognized by the medical and nursing 6
professions as proper and recognized by the ((commission)) board to 7
be performed by registered nurses licensed under this chapter and 8
that are authorized by the ((commission)) board through its rules;9
(c) The administration, supervision, delegation, and evaluation 10
of nursing practice. However, nothing in this subsection affects the 11
authority of a hospital, hospital district, in-home service agency, 12
community-based care setting, medical clinic, or office, concerning 13
its administration and supervision; 14
(d) The teaching of nursing; 15
(e) The executing of medical regimen as prescribed by a licensed 16
physician and surgeon, dentist, osteopathic physician and surgeon, 17
podiatric physician and surgeon, physician assistant, or advanced 18
registered nurse practitioner, or as directed by a licensed midwife 19
within his or her scope of practice. 20
(2) Nothing in this section prohibits a person from practicing a 21
profession for which a license has been issued under the laws of this 22
state or specifically authorized by any other law of the state of 23
Washington. 24
(3) This section does not prohibit (a) the nursing care of the 25
sick, without compensation, by an unlicensed person who does not hold 26
himself or herself out to be a registered nurse, (b) the practice of 27
licensed practical nursing by a licensed practical nurse, or (c) the 28
practice of a nursing assistant, providing delegated nursing tasks 29
under chapter 18.88A RCW. 30
Sec. 5005. RCW 18.79.050 and 2000 c 64 s 2 are each amended to 31
read as follows: 32
"Advanced registered nursing practice" means the performance of 33
the acts of a registered nurse and the performance of an expanded 34
role in providing health care services as recognized by the medical 35
and nursing professions, the scope of which is defined by rule by the 36
((commission)) board. Upon approval by the ((commission)) board, an 37
advanced registered nurse practitioner may prescribe legend drugs and 38
controlled substances contained in Schedule V of the Uniform 39
p. 99 HB 1281
Controlled Substances Act, chapter 69.50 RCW, and Schedules II 1
through IV subject to RCW 18.79.240(1) (r) or (s). 2
Nothing in this section prohibits a person from practicing a 3
profession for which a license has been issued under the laws of this 4
state or specifically authorized by any other law of the state of 5
Washington. 6
This section does not prohibit (1) the nursing care of the sick, 7
without compensation, by an unlicensed person who does not hold 8
himself or herself out to be an advanced registered nurse 9
practitioner, or (2) the practice of registered nursing by a licensed 10
registered nurse or the practice of licensed practical nursing by a 11
licensed practical nurse. 12
Sec. 5006. RCW 18.79.070 and 2022 c 240 s 32 are each amended to 13
read as follows: 14
(1) The state ((nursing care quality assurance commission )) board 15
of nursing is established, consisting of fifteen members to be 16
appointed by the governor to four-year terms. The governor shall 17
consider nursing members who are recommended for appointment by the 18
appropriate professional associations in the state. No person may 19
serve as a member of the ((commission)) board for more than two 20
consecutive full terms. 21
(2) There must be seven registered nurse members, two advanced 22
registered nurse practitioner members, three licensed practical nurse 23
members, and three public members on the ((commission)) board. Each 24
member of the ((commission)) board must be a resident of this state.25
(3)(a) Registered nurse members of the ((commission)) board must:26
(i) Be licensed as registered nurses under this chapter; and27
(ii) Have had at least three years' experience in the active 28
practice of nursing and have been engaged in that practice within two 29
years of appointment. 30
(b) In addition: 31
(i) At least one member must be on the faculty at a four-year 32
university nursing program; 33
(ii) At least one member must be on the faculty at a two-year 34
community college nursing program; 35
(iii) At least two members must be staff nurses providing direct 36
patient care; and 37
(iv) At least one member must be a nurse manager or a nurse 38
executive. 39
p. 100 HB 1281
(4) Advanced registered nurse practitioner members of the 1
((commission)) board must: 2
(a) Be licensed as advanced registered nurse practitioners under 3
this chapter; and 4
(b) Have had at least three years' experience in the active 5
practice of advanced registered nursing and have been engaged in that 6
practice within two years of appointment. 7
(5) Licensed practical nurse members of the ((commission)) board 8
must: 9
(a) Be licensed as licensed practical nurses under this chapter; 10
and 11
(b) Have had at least three years' actual experience as a 12
licensed practical nurse and have been engaged in practice as a 13
practical nurse within two years of appointment. 14
(6) Public members of the ((commission)) board may not be a 15
member of any other health care licensing board or commission, or 16
have a fiduciary obligation to a facility rendering health services 17
regulated by the ((commission)) board, or have a material or 18
financial interest in the rendering of health services regulated by 19
the ((commission)) board. 20
In appointing the initial members of the ((commission)) board, it 21
is the intent of the legislature that, to the extent possible, the 22
governor appoint the existing members of the board of nursing and the 23
board of practical nursing repealed under chapter 9, Laws of 1994 sp. 24
sess. The governor may appoint initial members of the ((commission)) 25
board to staggered terms of from one to four years. Thereafter, all 26
members shall be appointed to full four-year terms. Members of the 27
((commission)) board hold office until their successors are 28
appointed. 29
When the secretary appoints pro tem members, reasonable efforts 30
shall be made to ensure that at least one pro tem member is a 31
registered nurse who is currently practicing and, in addition to 32
meeting other minimum qualifications, has graduated from an associate 33
or baccalaureate nursing program within three years of appointment.34
Sec. 5007. RCW 18.79.080 and 1994 sp.s. c 9 s 408 are each 35
amended to read as follows: 36
The governor may remove a member of the ((commission)) board for 37
neglect of duty, misconduct, malfeasance or misfeasance in office, or 38
for incompetency or unprofessional conduct as defined in chapter 39
p. 101 HB 1281
18.130 RCW. Whenever the governor is satisfied that a member of the 1
((commission)) board has been guilty of neglect of duty, misconduct, 2
malfeasance or misfeasance in office, or of incompetency or 3
unprofessional conduct, the governor shall file with the secretary of 4
state a statement of the causes for and the order of removal from 5
office, and the secretary shall forthwith send a certified copy of 6
the statement of causes and order of removal to the last known post 7
office address of the member. If a vacancy occurs on the 8
((commission)) board, the governor shall appoint a replacement member 9
to fill the remainder of the unexpired term. 10
Sec. 5008. RCW 18.79.090 and 1999 c 366 s 5 are each amended to 11
read as follows: 12
Each ((commission)) board member shall be compensated in 13
accordance with RCW 43.03.265 and shall be paid travel expenses when 14
away from home in accordance with RCW 43.03.050 and 43.03.060.15
Sec. 5009. RCW 18.79.100 and 1994 sp.s. c 9 s 410 are each 16
amended to read as follows: 17
The ((commission)) board shall annually elect officers from among 18
its members. The ((commission)) board shall meet at least quarterly 19
at times and places it designates. It shall hold such other meetings 20
during the year as may be deemed necessary to transact its business. 21
A majority of the ((commission)) board members appointed and serving 22
constitutes a quorum at a meeting. All meetings of the ((commission)) 23
board must be open and public, except that the ((commission)) board 24
may hold executive sessions to the extent permitted by chapter 42.30 25
RCW. 26
Carrying a motion or resolution, adopting a rule, or passing a 27
measure requires the affirmative vote of a majority of a quorum of 28
the ((commission)) board. The ((commission)) board may appoint panels 29
consisting of at least three members. A quorum for transaction of any 30
business by a panel is a minimum of three members. A majority vote of 31
a quorum of the panel is required to transact business delegated to 32
it by the ((commission)) board. 33
Sec. 5010. RCW 18.79.110 and 2023 c 126 s 8 are each amended to 34
read as follows: 35
(1) The ((commission)) board shall keep a record of all of its 36
proceedings and make such reports to the governor as may be required. 37
p. 102 HB 1281
The ((commission)) board shall define by rules what constitutes 1
specialized and advanced levels of nursing practice as recognized by 2
the medical and nursing profession. The ((commission)) board may 3
adopt rules or issue advisory opinions in response to questions put 4
to it by professional health associations, nursing practitioners, and 5
consumers in this state concerning the authority of various 6
categories of nursing practitioners to perform particular acts.7
(2) The ((commission)) board shall approve curricula and shall 8
establish criteria for minimum standards for schools preparing 9
persons for licensing as registered nurses, advanced registered nurse 10
practitioners, and licensed practical nurses under this chapter. The 11
((commission)) board shall approve such schools of nursing as meet 12
the requirements of this chapter and the ((commission)) board, and 13
the ((commission)) board shall approve establishment of basic nursing 14
education programs and shall establish criteria as to the need for 15
and the size of a program and the type of program and the 16
geographical location. The ((commission)) board shall establish 17
criteria for proof of reasonable currency of knowledge and skill as a 18
basis for safe practice after three years' inactive or lapsed status. 19
The ((commission)) board shall establish criteria for licensing by 20
endorsement. The ((commission)) board shall determine examination 21
requirements for applicants for licensing as registered nurses, 22
advanced registered nurse practitioners, and licensed practical 23
nurses under this chapter, and shall certify to the secretary for 24
licensing duly qualified applicants. The ((commission)) board shall 25
adopt rules which allow for one hour of simulated learning to be 26
counted as equivalent to two hours of clinical placement learning, 27
with simulated learning accounting for up to a maximum of 50 percent 28
of the required clinical hours. 29
(3) The ((commission)) board shall adopt rules on continuing 30
competency. The rules must include exemptions from the continuing 31
competency requirements for registered nurses seeking advanced 32
nursing degrees. Nothing in this subsection prohibits the 33
((commission)) board from providing additional exemptions for any 34
person credentialed under this chapter who is enrolled in an advanced 35
education program. 36
(4) The ((commission)) board shall adopt such rules under chapter 37
34.05 RCW as are necessary to fulfill the purposes of this chapter.38
(5) The ((commission)) board is the successor in interest of the 39
board of nursing and the board of practical nursing. All contracts, 40
p. 103 HB 1281
undertakings, agreements, rules, regulations, decisions, orders, and 1
policies of the former board of nursing or the board of practical 2
nursing continue in full force and effect under the ((commission)) 3
board until the ((commission)) board amends or rescinds those rules, 4
regulations, decisions, orders, or policies. 5
(6) The members of the ((commission)) board are immune from suit 6
in an action, civil or criminal, based on its disciplinary 7
proceedings or other official acts performed in good faith as members 8
of the ((commission)) board. 9
(7) Whenever the workload of the ((commission)) board requires, 10
the ((commission)) board may request that the secretary appoint pro 11
tempore members of the ((commission)) board. When serving, pro 12
tempore members of the ((commission)) board have all of the powers, 13
duties, and immunities, and are entitled to all of the emoluments, 14
including travel expenses, of regularly appointed members of the 15
((commission)) board. 16
Sec. 5011. RCW 18.79.150 and 2023 c 126 s 7 are each amended to 17
read as follows: 18
An institution desiring to conduct a school of registered nursing 19
or a school or program of practical nursing, or both, shall apply to 20
the ((commission)) board and submit evidence satisfactory to the 21
((commission)) board that: 22
(1) It is prepared to carry out the curriculum approved by the 23
((commission)) board for basic registered nursing or practical 24
nursing, or both; and 25
(2) It is prepared to meet other standards established by law and 26
by the ((commission)) board. 27
The ((commission)) board shall make, or cause to be made, such 28
surveys of the schools and programs, and of institutions and agencies 29
to be used by the schools and programs, as it determines are 30
necessary. If in the opinion of the ((commission)) board, the 31
requirements for an approved school of registered nursing or a school 32
or program of practical nursing, or both, are met, the ((commission)) 33
board shall approve the school or program. The ((nursing commission)) 34
board may grant approval to baccalaureate nursing education programs 35
where the nurse administrator holds a graduate degree with a major in 36
nursing and has sufficient experience as a registered nurse but does 37
not hold a doctoral degree. 38
p. 104 HB 1281
Sec. 5012. RCW 18.79.160 and 2004 c 262 s 6 are each amended to 1
read as follows: 2
(1) An applicant for a license to practice as a registered nurse 3
shall submit to the ((commission)) board: 4
(a) An attested written application on a department form;5
(b) An official transcript demonstrating graduation and 6
successful completion of an approved program of nursing; and7
(c) Any other official records specified by the ((commission)) 8
board. 9
(2) An applicant for a license to practice as an advanced 10
registered nurse practitioner shall submit to the ((commission)) 11
board: 12
(a) An attested written application on a department form;13
(b) An official transcript demonstrating graduation and 14
successful completion of an advanced registered nurse practitioner 15
program meeting criteria established by the ((commission)) board; and16
(c) Any other official records specified by the ((commission)) 17
board. 18
(3) An applicant for a license to practice as a licensed 19
practical nurse shall submit to the ((commission)) board:20
(a) An attested written application on a department form;21
(b) Written official evidence that the applicant is over the age 22
of eighteen; 23
(c) An official transcript demonstrating graduation and 24
successful completion of an approved practical nursing program, or 25
its equivalent; and 26
(d) Any other official records specified by the ((commission)) 27
board. 28
(4) At the time of submission of the application, the applicant 29
for a license to practice as a registered nurse, advanced registered 30
nurse practitioner, or licensed practical nurse must not be in 31
violation of chapter 18.130 RCW or this chapter. 32
(5) The ((commission)) board shall establish by rule the criteria 33
for evaluating the education of all applicants. 34
Sec. 5013. RCW 18.79.170 and 1994 sp.s. c 9 s 417 are each 35
amended to read as follows: 36
An applicant for a license to practice as a registered nurse, 37
advanced registered nurse practitioner, or licensed practical nurse 38
must pass an examination in subjects determined by the ((commission)) 39
p. 105 HB 1281
board. The examination may be supplemented by an oral or practical 1
examination. The ((commission)) board shall establish by rule the 2
requirements for applicants who have failed the examination to 3
qualify for reexamination. 4
Sec. 5014. RCW 18.79.180 and 1994 sp.s. c 9 s 418 are each 5
amended to read as follows: 6
When authorized by the ((commission)) board, the department shall 7
issue an interim permit authorizing the applicant to practice 8
registered nursing, advanced registered nursing, or licensed 9
practical nursing, as appropriate, from the time of verification of 10
the completion of the school or training program until notification 11
of the results of the examination. Upon the applicant passing the 12
examination, and if all other requirements established by the 13
((commission)) board for licensing are met, the department shall 14
issue the applicant a license to practice registered nursing, 15
advanced registered nursing, or licensed practical nursing, as 16
appropriate. If the applicant fails the examination, the interim 17
permit expires upon notification to the applicant, and is not 18
renewable. The holder of an interim permit is subject to chapter 19
18.130 RCW. 20
Sec. 5015. RCW 18.79.190 and 1994 sp.s. c 9 s 419 are each 21
amended to read as follows: 22
Upon approval of the application by the ((commission)) board, the 23
department shall issue a license by endorsement without examination 24
to practice as a registered nurse or as a licensed practical nurse to 25
a person who is licensed as a registered nurse or licensed practical 26
nurse under the laws of another state, territory, or possession of 27
the United States, and who meets all other qualifications for 28
licensing. 29
An applicant who has graduated from a school or program of 30
nursing outside the United States and is licensed as a registered 31
nurse or licensed practical nurse, or their equivalents, outside the 32
United States must meet all qualifications required by this chapter 33
and pass examinations as determined by the ((commission)) board.34
Sec. 5016. RCW 18.79.230 and 1994 sp.s. c 9 s 423 are each 35
amended to read as follows: 36
p. 106 HB 1281
A person licensed under this chapter who desires to retire 1
temporarily from registered nursing practice, advanced registered 2
nursing practice, or licensed practical nursing practice in this 3
state shall send a written notice to the secretary.4
Upon receipt of the notice the department shall place the name of 5
the person on inactive status. While remaining on this status the 6
person shall not practice in this state any form of nursing provided 7
for in this chapter. When the person desires to resume practice, the 8
person shall apply to the ((commission)) board for renewal of the 9
license and pay a renewal fee to the state treasurer. Persons on 10
inactive status for three years or more must provide evidence of 11
knowledge and skill of current practice as required by the 12
((commission)) board or as provided in this chapter.13
Sec. 5017. RCW 18.79.240 and 2020 c 80 s 17 are each amended to 14
read as follows: 15
(1) In the context of the definition of registered nursing 16
practice and advanced registered nursing practice, this chapter shall 17
not be construed as: 18
(a) Prohibiting the incidental care of the sick by domestic 19
servants or persons primarily employed as housekeepers, so long as 20
they do not practice registered nursing within the meaning of this 21
chapter; 22
(b) Preventing a person from the domestic administration of 23
family remedies or the furnishing of nursing assistance in case of 24
emergency; 25
(c) Prohibiting the practice of nursing by students enrolled in 26
approved schools as may be incidental to their course of study or 27
prohibiting the students from working as nursing technicians;28
(d) Prohibiting auxiliary services provided by persons carrying 29
out duties necessary for the support of nursing services, including 30
those duties that involve minor nursing services for persons 31
performed in hospitals, nursing homes, or elsewhere under the 32
direction of licensed physicians or the supervision of licensed 33
registered nurses; 34
(e) Prohibiting the practice of nursing in this state by a 35
legally qualified nurse of another state or territory whose 36
engagement requires him or her to accompany and care for a patient 37
temporarily residing in this state during the period of one such 38
engagement, not to exceed six months in length, if the person does 39
p. 107 HB 1281
not represent or hold himself or herself out as a registered nurse 1
licensed to practice in this state; 2
(f) Prohibiting nursing or care of the sick, with or without 3
compensation, when done in connection with the practice of the 4
religious tenets of a church by adherents of the church so long as 5
they do not engage in the practice of nursing as defined in this 6
chapter; 7
(g) Prohibiting the practice of a legally qualified nurse of 8
another state who is employed by the United States government or a 9
bureau, division, or agency thereof, while in the discharge of his or 10
her official duties; 11
(h) Permitting the measurement of the powers or range of human 12
vision, or the determination of the accommodation and refractive 13
state of the human eye or the scope of its functions in general, or 14
the fitting or adaptation of lenses for the aid thereof;15
(i) Permitting the prescribing or directing the use of, or using, 16
an optical device in connection with ocular exercises, visual 17
training, vision training, or orthoptics; 18
(j) Permitting the prescribing of contact lenses for, or the 19
fitting and adaptation of contact lenses to, the human eye;20
(k) Prohibiting the performance of routine visual screening;21
(l) Permitting the practice of dentistry or dental hygiene as 22
defined in chapters 18.32 and 18.29 RCW, respectively;23
(m) Permitting the practice of chiropractic as defined in chapter 24
18.25 RCW including the adjustment or manipulation of the 25
articulation of the spine; 26
(n) Permitting the practice of podiatric medicine and surgery as 27
defined in chapter 18.22 RCW; 28
(o) Permitting the performance of major surgery, except such 29
minor surgery as the ((commission)) board may have specifically 30
authorized by rule adopted in accordance with chapter 34.05 RCW;31
(p) Permitting the prescribing of controlled substances as 32
defined in Schedule I of the Uniform Controlled Substances Act, 33
chapter 69.50 RCW; 34
(q) Prohibiting the determination and pronouncement of death;35
(r) Prohibiting advanced registered nurse practitioners, approved 36
by the ((commission)) board as certified registered nurse 37
anesthetists from selecting, ordering, or administering controlled 38
substances as defined in Schedules II through IV of the Uniform 39
Controlled Substances Act, chapter 69.50 RCW, consistent with their 40
p. 108 HB 1281
((commission)) board-recognized scope of practice; subject to 1
facility-specific protocols, and subject to a request for certified 2
registered nurse anesthetist anesthesia services issued by a 3
physician licensed under chapter 18.71 RCW, an osteopathic physician 4
and surgeon licensed under chapter 18.57 RCW, a dentist licensed 5
under chapter 18.32 RCW, or a podiatric physician and surgeon 6
licensed under chapter 18.22 RCW; the authority to select, order, or 7
administer Schedule II through IV controlled substances being limited 8
to those drugs that are to be directly administered to patients who 9
require anesthesia for diagnostic, operative, obstetrical, or 10
therapeutic procedures in a hospital, clinic, ambulatory surgical 11
facility, or the office of a practitioner licensed under chapter 12
18.71, 18.22, 18.36, 18.36A, 18.57, or 18.32 RCW; "select" meaning 13
the decision-making process of choosing a drug, dosage, route, and 14
time of administration; and "order" meaning the process of directing 15
licensed individuals pursuant to their statutory authority to 16
directly administer a drug or to dispense, deliver, or distribute a 17
drug for the purpose of direct administration to a patient, under 18
instructions of the certified registered nurse anesthetist. 19
"Protocol" means a statement regarding practice and documentation 20
concerning such items as categories of patients, categories of 21
medications, or categories of procedures rather than detailed case-22
specific formulas for the practice of nurse anesthesia;23
(s) Prohibiting advanced registered nurse practitioners from 24
ordering or prescribing controlled substances as defined in Schedules 25
II through IV of the Uniform Controlled Substances Act, chapter 69.50 26
RCW, if and to the extent that doing so is permitted by their scope 27
of practice; 28
(t) Prohibiting the practice of registered nursing or advanced 29
registered nursing by a student enrolled in an approved school if:30
(i) The student performs services without compensation or 31
expectation of compensation as part of a volunteer activity;32
(ii) The student is under the direct supervision of a registered 33
nurse or advanced registered nurse practitioner licensed under this 34
chapter, a pharmacist licensed under chapter 18.64 RCW, an 35
osteopathic physician and surgeon licensed under chapter 18.57 RCW, 36
or a physician licensed under chapter 18.71 RCW; 37
(iii) The services the student performs are within the scope of 38
practice of: (A) The nursing profession for which the student is 39
receiving training; and (B) the person supervising the student;40
p. 109 HB 1281
(iv) The school in which the student is enrolled verifies the 1
student has demonstrated competency through his or her education and 2
training to perform the services; and 3
(v) The student provides proof of current malpractice insurance 4
to the volunteer activity organizer prior to performing any services.5
(2) In the context of the definition of licensed practical 6
nursing practice, this chapter shall not be construed as:7
(a) Prohibiting the incidental care of the sick by domestic 8
servants or persons primarily employed as housekeepers, so long as 9
they do not practice practical nursing within the meaning of this 10
chapter; 11
(b) Preventing a person from the domestic administration of 12
family remedies or the furnishing of nursing assistance in case of 13
emergency; 14
(c) Prohibiting the practice of practical nursing by students 15
enrolled in approved schools as may be incidental to their course of 16
study or prohibiting the students from working as nursing assistants;17
(d) Prohibiting auxiliary services provided by persons carrying 18
out duties necessary for the support of nursing services, including 19
those duties that involve minor nursing services for persons 20
performed in hospitals, nursing homes, or elsewhere under the 21
direction of licensed physicians or the supervision of licensed 22
registered nurses; 23
(e) Prohibiting or preventing the practice of nursing in this 24
state by a legally qualified nurse of another state or territory 25
whose engagement requires him or her to accompany and care for a 26
patient temporarily residing in this state during the period of one 27
such engagement, not to exceed six months in length, if the person 28
does not represent or hold himself or herself out as a licensed 29
practical nurse licensed to practice in this state;30
(f) Prohibiting nursing or care of the sick, with or without 31
compensation, when done in connection with the practice of the 32
religious tenets of a church by adherents of the church so long as 33
they do not engage in licensed practical nurse practice as defined in 34
this chapter; 35
(g) Prohibiting the practice of a legally qualified nurse of 36
another state who is employed by the United States government or any 37
bureau, division, or agency thereof, while in the discharge of his or 38
her official duties. 39
p. 110 HB 1281
Sec. 5018. RCW 18.79.250 and 2000 c 64 s 4 are each amended to 1
read as follows: 2
An advanced registered nurse practitioner under his or her 3
license may perform for compensation nursing care, as that term is 4
usually understood, of the ill, injured, or infirm, and in the course 5
thereof, she or he may do the following things that shall not be done 6
by a person not so licensed, except as provided in RCW 18.79.260 and 7
18.79.270: 8
(1) Perform specialized and advanced levels of nursing as 9
recognized jointly by the medical and nursing professions, as defined 10
by the ((commission)) board; 11
(2) Prescribe legend drugs and Schedule V controlled substances, 12
as defined in the Uniform Controlled Substances Act, chapter 69.50 13
RCW, and Schedules II through IV subject to RCW 18.79.240(1) (r) or 14
(s) within the scope of practice defined by the ((commission)) board;15
(3) Perform all acts provided in RCW 18.79.260;16
(4) Hold herself or himself out to the public or designate 17
herself or himself as an advanced registered nurse practitioner or as 18
a nurse practitioner. 19
Sec. 5019. RCW 18.79.260 and 2022 c 14 s 2 are each amended to 20
read as follows: 21
(1) A registered nurse under his or her license may perform for 22
compensation nursing care, as that term is usually understood, to 23
individuals with illnesses, injuries, or disabilities.24
(2) A registered nurse may, at or under the general direction of 25
a licensed physician and surgeon, dentist, osteopathic physician and 26
surgeon, naturopathic physician, optometrist, podiatric physician and 27
surgeon, physician assistant, advanced registered nurse practitioner, 28
or midwife acting within the scope of his or her license, administer 29
medications, treatments, tests, and inoculations, whether or not the 30
severing or penetrating of tissues is involved and whether or not a 31
degree of independent judgment and skill is required. Such direction 32
must be for acts which are within the scope of registered nursing 33
practice. 34
(3) A registered nurse may delegate tasks of nursing care to 35
other individuals where the registered nurse determines that it is in 36
the best interest of the patient. 37
(a) The delegating nurse shall: 38
p. 111 HB 1281
(i) Determine the competency of the individual to perform the 1
tasks; 2
(ii) Evaluate the appropriateness of the delegation;3
(iii) Supervise the actions of the person performing the 4
delegated task; and 5
(iv) Delegate only those tasks that are within the registered 6
nurse's scope of practice. 7
(b) A registered nurse, working for a home health or hospice 8
agency regulated under chapter 70.127 RCW, may delegate the 9
application, instillation, or insertion of medications to a 10
registered or certified nursing assistant under a plan of care.11
(c) Except as authorized in (b) or (e) of this subsection, a 12
registered nurse may not delegate the administration of medications. 13
Except as authorized in (e) or (f) of this subsection, a registered 14
nurse may not delegate acts requiring substantial skill, and may not 15
delegate piercing or severing of tissues. Acts that require nursing 16
judgment shall not be delegated. 17
(d) No person may coerce a nurse into compromising patient safety 18
by requiring the nurse to delegate if the nurse determines that it is 19
inappropriate to do so. Nurses shall not be subject to any employer 20
reprisal or disciplinary action by the ((nursing care quality 21
assurance commission )) board for refusing to delegate tasks or 22
refusing to provide the required training for delegation if the nurse 23
determines delegation may compromise patient safety.24
(e) For delegation in community-based care settings or in-home 25
care settings, a registered nurse may delegate nursing care tasks 26
only to registered or certified nursing assistants under chapter 27
18.88A RCW or home care aides certified under chapter 18.88B RCW. 28
Simple care tasks such as blood pressure monitoring, personal care 29
service, diabetic insulin device set up, verbal verification of 30
insulin dosage for sight-impaired individuals, or other tasks as 31
defined by the ((nursing care quality assurance commission )) board 32
are exempted from this requirement. 33
(i) "Community-based care settings" includes: Community 34
residential programs for people with developmental disabilities, 35
certified by the department of social and health services under 36
chapter 71A.12 RCW; adult family homes licensed under chapter 70.128 37
RCW; and assisted living facilities licensed under chapter 18.20 RCW. 38
Community-based care settings do not include acute care or skilled 39
nursing facilities. 40
p. 112 HB 1281
(ii) "In-home care settings" include an individual's place of 1
temporary or permanent residence, but does not include acute care or 2
skilled nursing facilities, and does not include community-based care 3
settings as defined in (e)(i) of this subsection. 4
(iii) Delegation of nursing care tasks in community-based care 5
settings and in-home care settings is only allowed for individuals 6
who have a stable and predictable condition. "Stable and predictable 7
condition" means a situation in which the individual's clinical and 8
behavioral status is known and does not require the frequent presence 9
and evaluation of a registered nurse. 10
(iv) The determination of the appropriateness of delegation of a 11
nursing task is at the discretion of the registered nurse. Other than 12
delegation of the administration of insulin by injection for the 13
purpose of caring for individuals with diabetes, the administration 14
of medications by injection, sterile procedures, and central line 15
maintenance may never be delegated. 16
(v) When delegating insulin injections under this section, the 17
registered nurse delegator must instruct the individual regarding 18
proper injection procedures and the use of insulin, demonstrate 19
proper injection procedures, and must supervise and evaluate the 20
individual performing the delegated task as required by the 21
((commission)) board by rule. If the registered nurse delegator 22
determines that the individual is competent to perform the injection 23
properly and safely, supervision and evaluation shall occur at an 24
interval determined by the ((commission)) board by rule.25
(vi)(A) The registered nurse shall verify that the nursing 26
assistant or home care aide, as the case may be, has completed the 27
required core nurse delegation training required in chapter 18.88A or 28
18.88B RCW prior to authorizing delegation. 29
(B) Before commencing any specific nursing tasks authorized to be 30
delegated in this section, a home care aide must be certified 31
pursuant to chapter 18.88B RCW and must comply with RCW 18.88B.070.32
(vii) The nurse is accountable for his or her own individual 33
actions in the delegation process. Nurses acting within the protocols 34
of their delegation authority are immune from liability for any 35
action performed in the course of their delegation duties.36
(viii) Nursing task delegation protocols are not intended to 37
regulate the settings in which delegation may occur, but are intended 38
to ensure that nursing care services have a consistent standard of 39
practice upon which the public and the profession may rely, and to 40
p. 113 HB 1281
safeguard the authority of the nurse to make independent professional 1
decisions regarding the delegation of a task. 2
(f) The delegation of nursing care tasks only to registered or 3
certified nursing assistants under chapter 18.88A RCW or to home care 4
aides certified under chapter 18.88B RCW may include glucose 5
monitoring and testing. 6
(g) The ((nursing care quality assurance commission )) board may 7
adopt rules to implement this section. 8
(4) Only a person licensed as a registered nurse may instruct 9
nurses in technical subjects pertaining to nursing.10
(5) Only a person licensed as a registered nurse may hold herself 11
or himself out to the public or designate herself or himself as a 12
registered nurse. 13
Sec. 5020. RCW 18.79.290 and 1994 sp.s. c 9 s 429 are each 14
amended to read as follows: 15
(1) In accordance with rules adopted by the ((commission)) board, 16
public school districts and private schools that offer classes for 17
any of grades kindergarten through twelve may provide for clean, 18
intermittent bladder catheterization of students or assisted self-19
catheterization of students who are in the custody of the school 20
district or private school at the time. After consultation with staff 21
of the superintendent of public instruction, the ((commission)) board 22
shall adopt rules in accordance with chapter 34.05 RCW, that provide 23
for the following and such other matters as the ((commission)) board 24
deems necessary to the proper implementation of this section:25
(a) A requirement for a written, current, and unexpired request 26
from a parent, legal guardian, or other person having legal control 27
over the student that the school district or private school provide 28
for the catheterization of the student; 29
(b) A requirement for a written, current, and unexpired request 30
from a physician licensed under chapter 18.71 or 18.57 RCW, that 31
catheterization of the student be provided for during the hours when 32
school is in session or the hours when the student is under the 33
supervision of school officials; 34
(c) A requirement for written, current, and unexpired 35
instructions from an advanced registered nurse practitioner or a 36
registered nurse licensed under this chapter regarding 37
catheterization that include (i) a designation of the school district 38
or private school employee or employees who may provide for the 39
p. 114 HB 1281
catheterization, and (ii) a description of the nature and extent of 1
any required supervision; and 2
(d) The nature and extent of acceptable training that shall (i) 3
be provided by a physician, advanced registered nurse practitioner, 4
or registered nurse licensed under chapter 18.71 or 18.57 RCW, or 5
this chapter, and (ii) be required of school district or private 6
school employees who provide for the catheterization of a student 7
under this section, except that a licensed practical nurse licensed 8
under this chapter is exempt from training. 9
(2) This section does not require school districts to provide 10
intermittent bladder catheterization of students. 11
Sec. 5021. RCW 18.79.310 and 1994 sp.s. c 9 s 431 are each 12
amended to read as follows: 13
As of July 1, 1994, all rules, regulations, decisions, and orders 14
of the board of nursing under chapter 18.88 RCW or the board of 15
practical nursing under chapter 18.78 RCW continue to be in effect 16
under the ((commission)) board, until the ((commission)) board acts 17
to modify the rules, regulations, decisions, or orders.18
Sec. 5022. RCW 18.79.340 and 2012 c 153 s 13 are each amended to 19
read as follows: 20
(1) "Nursing technician" means a nursing student employed in a 21
hospital licensed under chapter 70.41 RCW, a clinic, or a nursing 22
home licensed under chapter 18.51 RCW, who: 23
(a) Is currently enrolled in good standing in a nursing program 24
approved by the ((commission)) board and has not graduated; or25
(b) Is a graduate of a nursing program approved by the 26
((commission)) board who graduated: 27
(i) Within the past thirty days; or 28
(ii) Within the past sixty days and has received a determination 29
from the secretary that there is good cause to continue the 30
registration period, as defined by the secretary in rule.31
(2) No person may practice or represent oneself as a nursing 32
technician by use of any title or description of services without 33
being registered under this chapter, unless otherwise exempted by 34
this chapter. 35
(3) The ((commission)) board may adopt rules to implement chapter 36
258, Laws of 2003. 37
p. 115 HB 1281
Sec. 5023. RCW 18.79.390 and 2013 c 81 s 5 are each amended to 1
read as follows: 2
(1) The secretary shall employ an executive director that is:3
(a) Hired by and serves at the pleasure of the ((commission)) 4
board; 5
(b) Exempt from the provisions of the civil service law, chapter 6
41.06 RCW and whose salary is established by the ((commission)) board 7
in accordance with RCW 43.03.028; and 8
(c) Responsible for performing all administrative duties of the 9
((commission)) board, including preparing an annual budget, and any 10
other duties as delegated to the executive director by the 11
((commission)) board. 12
(2) Consistent with the budgeting and accounting act, the 13
((commission)) board is responsible for proposing its own biennial 14
budget which the secretary must submit to the office of financial 15
management. 16
(3) Prior to adopting credentialing fees under RCW 43.70.250, the 17
secretary shall collaborate with the ((commission)) board to 18
determine the appropriate fees necessary to support the activities of 19
the ((commission)) board. 20
(4) Prior to the secretary exercising the secretary's authority 21
to adopt uniform rules and guidelines, or any other actions that 22
might impact the licensing or disciplinary authority of the 23
((commission)) board, the secretary shall first meet with the 24
((commission)) board to determine how those rules or guidelines, or 25
changes to rules or guidelines, might impact the ((commission's)) 26
board's ability to effectively carry out its statutory duties. If the 27
((commission)) board, in consultation with the secretary, determines 28
that the proposed rules or guidelines, or changes to existing rules 29
or guidelines, will negatively impact the ((commission's)) board's 30
ability to effectively carry out its statutory duties, then the 31
individual ((commission)) board shall collaborate with the secretary 32
to develop alternative solutions to mitigate the impacts. If an 33
alternative solution cannot be reached, the parties may resolve the 34
dispute through a mediator as set forth in subsection (6) of this 35
section. 36
(5) The ((commission)) board shall negotiate with the secretary 37
to develop performance-based expectations, including identification 38
of key performance measures. The performance expectations should 39
focus on consistent, timely regulation of health care professionals.40
p. 116 HB 1281
(6) In the event there is a disagreement between the 1
((commission)) board and the secretary, that is unable to be resolved 2
through negotiation, a representative of both parties shall agree on 3
the designation of a third party to mediate the dispute.4
(7) The secretary shall employ staff that are hired and managed 5
by the executive director provided that nothing contained in this 6
section may be construed to alter any existing collective bargaining 7
unit or the provisions of any existing collective bargaining 8
agreement. 9
(8) By December 31, 2013, the ((commission)) board must present a 10
report with recommendations to the governor and the legislature 11
regarding: 12
(a) Evidence-based practices and research-based practices used by 13
boards of nursing when conducting licensing, educational, 14
disciplinary, and financial activities and the use of such practices 15
by the ((commission)) board; and 16
(b) A comparison of the ((commission's)) board's licensing, 17
education, disciplinary, and financial outcomes with those of other 18
boards of nursing using a national database. 19
Sec. 5024. RCW 18.79.400 and 2010 c 209 s 7 are each amended to 20
read as follows: 21
(1) By June 30, 2011, the ((commission)) board shall adopt new 22
rules on chronic, noncancer pain management that contain the 23
following elements: 24
(a)(i) Dosing criteria, including: 25
(A) A dosage amount that must not be exceeded unless an advanced 26
registered nurse practitioner or certified registered nurse 27
anesthetist first consults with a practitioner specializing in pain 28
management; and 29
(B) Exigent or special circumstances under which the dosage 30
amount may be exceeded without consultation with a practitioner 31
specializing in pain management. 32
(ii) The rules regarding consultation with a practitioner 33
specializing in pain management must, to the extent practicable, take 34
into account: 35
(A) Circumstances under which repeated consultations would not be 36
necessary or appropriate for a patient undergoing a stable, ongoing 37
course of treatment for pain management; 38
p. 117 HB 1281
(B) Minimum training and experience that is sufficient to exempt 1
an advanced registered nurse practitioner or certified registered 2
nurse anesthetist from the specialty consultation requirement;3
(C) Methods for enhancing the availability of consultations;4
(D) Allowing the efficient use of resources; and5
(E) Minimizing the burden on practitioners and patients;6
(b) Guidance on when to seek specialty consultation and ways in 7
which electronic specialty consultations may be sought;8
(c) Guidance on tracking clinical progress by using assessment 9
tools focusing on pain interference, physical function, and overall 10
risk for poor outcome; and 11
(d) Guidance on tracking the use of opioids, particularly in the 12
emergency department. 13
(2) The ((commission)) board shall consult with the agency 14
medical directors' group, the department of health, the University of 15
Washington, and the largest professional associations for advanced 16
registered nurse practitioners and certified registered nurse 17
anesthetists in the state. 18
(3) The rules adopted under this section do not apply:19
(a) To the provision of palliative, hospice, or other end -of-life 20
care; or 21
(b) To the management of acute pain caused by an injury or a 22
surgical procedure. 23
Sec. 5025. RCW 18.79.410 and 2013 c 81 s 6 are each amended to 24
read as follows: 25
In addition to the authority provided in RCW 42.52.804, the 26
((commission)) board, its members, or staff as directed by the 27
((commission)) board, may communicate, present information requested, 28
volunteer information, testify before legislative committees, and 29
educate the legislature, as the ((commission)) board may from time to 30
time see fit. 31
Sec. 5026. RCW 18.79.430 and 2023 c 126 s 9 are each amended to 32
read as follows: 33
(1) Subject to the availability of amounts appropriated for this 34
specific purpose, the legislature intends to expand the student nurse 35
preceptor grant program to help reduce the shortage of health care 36
training settings for students and increase the numbers of nurses in 37
the workforce. 38
p. 118 HB 1281
(2)(a) The grant program shall provide incentive pay for 1
individuals serving as clinical supervisors to nursing candidates 2
with a focus on acute shortage areas including those in rural and 3
underserved communities and long-term care facilities. The desired 4
outcomes of the grant program include increased clinical 5
opportunities for nursing students. In part, increased clinical 6
opportunities shall be achieved through reducing the required number 7
of qualifying hours of precepting clinical instruction per student 8
from 100 to 80. The ((commission)) board shall consult with 9
collective bargaining representatives of nurses who serve as clinical 10
supervisors in the development of the grant program.11
(b) The ((commission)) board shall submit a report, in accordance 12
with RCW 43.01.036, to the office of financial management and the 13
appropriate committees of the legislature by September 30, 2025, on 14
the outcomes of the grant program. The report must include:15
(i) A description of the mechanism for incentivizing supervisor 16
pay and other strategies; 17
(ii) The number of supervisors that received bonus pay and the 18
number of sites used; 19
(iii) The number of students that received supervision at each 20
site; 21
(iv) The number of supervision hours provided at each site;22
(v) Initial reporting on the number of students who received 23
supervision through the programs that moved into a permanent position 24
with the program at the end of their supervision; and25
(vi) Recommendations to scale up the program or otherwise recruit 26
nurse preceptors in shortage areas. 27
Sec. 5027. RCW 18.79.435 and 2023 c 126 s 11 are each amended to 28
read as follows: 29
(1) Subject to the availability of amounts appropriated for this 30
specific purpose, the ((commission)) board, in collaboration with 31
rural hospitals, relevant employer and exclusive bargaining unit 32
partnerships, nursing assistant-certified training programs, the 33
department of health, and the department of labor and industries, 34
shall establish at least two pilot projects for rural hospitals to 35
utilize high school students who are training to become nursing 36
assistant-certified or high school students who are nursing 37
assistant-certified to help address the workforce shortages and 38
promote nursing careers in rural hospitals. As part of the program, 39
p. 119 HB 1281
students must receive information about related careers and 1
educational and training opportunities including certified medical 2
assistants, licensed practical nurses, and registered nurses.3
(2) At least one of the rural hospitals participating in the 4
pilot projects must be east of the crest of the Cascade mountains and 5
at least one of the rural hospitals participating in the pilot 6
projects must be west of the crest of the Cascade mountains.7
(3) The pilot projects shall prioritize using the nursing 8
assistant-certified high school students to their full scope of 9
practice and identify any barriers to doing this. 10
(4) The ((commission)) board may contract with an employer and 11
exclusive bargaining unit partnership, nursing consultant, and health 12
services consultant to assist with establishing and supporting the 13
pilot project, including identifying participants, coordinating with 14
the groups and agencies as referenced in subsection (1) of this 15
section and other stakeholders, and preparing reports to the 16
legislature. 17
(5) The ((commission)) board shall submit a report, in accordance 18
with RCW 43.01.036, to the health care committees of the legislature 19
by December 1, 2024, and December 1, 2025, with the status of the 20
pilot projects and any findings and recommendations.21
(6) This section expires July 1, 2026. 22
Sec. 5028. RCW 18.79.440 and 2023 c 141 s 1 are each amended to 23
read as follows: 24
(1) The department or ((commission)) board may not post 25
information regarding an enforcement action taken by the 26
((commission)) board against a person licensed under this chapter, 27
including any supporting documents or indication that the enforcement 28
action was taken, on any public website when the following conditions 29
are met: 30
(a) In connection with the enforcement action, the person has 31
been required by an order or agreement with the ((commission)) board 32
to contact a ((commission)) board-approved substance use disorder 33
monitoring program authorized by RCW 18.130.175, and if recommended 34
by the program, to contract with and participate in the program;35
(b) The ((commission)) board has found that the person has 36
substantially complied with the terms of the order or agreement; and37
p. 120 HB 1281
(c) If the website is a third-party website, the department or 1
((commission)) board has the ability to prevent information regarding 2
the enforcement action from being posted on the public website.3
(2) Subject to the availability of amounts appropriated for this 4
specific purpose, the ((commission)) board shall establish a stipend 5
program to defray the out-of-pocket expenses incurred in connection 6
with participation in the ((commission's)) board's approved substance 7
use disorder monitoring program authorized by RCW 18.130.175.8
(3) To be eligible for the stipend program, a person must:9
(a) Hold an active, inactive, or suspended license issued 10
pursuant to this chapter; 11
(b) Submit an application on forms provided by the ((commission)) 12
board; 13
(c) Be actively participating in the ((commission's)) board's 14
approved substance use disorder monitoring program or have completed 15
the ((commission's)) board's approved substance use disorder 16
monitoring program within six months of submission of an application 17
for the stipend program; and 18
(d) Have a demonstrated need for financial assistance with the 19
expenses incurred in connection with participation in the 20
((commission's)) board's approved substance use disorder monitoring 21
program. 22
(4) A person is not eligible for the stipend program if they have 23
previously applied for and participated in the stipend program.24
(5) The ((commission)) board may defray up to 80 percent of each 25
out-of-pocket expense deemed eligible for defrayment under this 26
section. 27
(6) Out-of-pocket expenses eligible for defrayment under this 28
section include the costs of substance use evaluation, treatment, and 29
other ancillary services, including drug testing, participation in 30
professional peer support groups, and any other expenses deemed 31
appropriate by the ((commission)) board. 32
(7) A person participating in the stipend program established in 33
this section shall document their out-of-pocket expenses in a manner 34
specified by the ((commission)) board. 35
(8) The ((commission)) board must provide updated information on 36
its website regarding the total number of individuals that have 37
participated in the stipend program, the average total amount of 38
eligible expenses defrayed for each participant, the aggregated total 39
amount of expenses that have been defrayed for all individuals that 40
p. 121 HB 1281
have participated in the stipend program, and the amount of funds 1
available for the stipend program. 2
(9) The ((commission)) board shall establish the stipend program 3
no later than July 1, 2024. 4
(10) The ((commission)) board may adopt rules necessary to 5
implement this section. 6
Sec. 5029. RCW 18.79.800 and 2017 c 297 s 8 are each amended to 7
read as follows: 8
(1) By January 1, 2019, the ((commission)) board must adopt rules 9
establishing requirements for prescribing opioid drugs. The rules may 10
contain exemptions based on education, training, amount of opioids 11
prescribed, patient panel, and practice environment.12
(2) In developing the rules, the ((commission)) board must 13
consider the agency medical directors' group and centers for disease 14
control guidelines, and may consult with the department of health, 15
the University of Washington, and the largest professional 16
associations for advanced registered nurse practitioners and 17
certified registered nurse anesthetists in the state.18
Sec. 5030. RCW 18.79.810 and 2019 c 314 s 10 are each amended to 19
read as follows: 20
By January 1, 2020, the ((commission)) board must adopt or amend 21
its rules to require advanced registered nurse practitioners who 22
prescribe opioids to inform patients of their right to refuse an 23
opioid prescription or order for any reason. If a patient indicates a 24
desire to not receive an opioid, the advanced registered nurse 25
practitioner must document the patient's request and avoid 26
prescribing or ordering opioids, unless the request is revoked by the 27
patient. 28
Sec. 5031. RCW 18.88A.020 and 2018 c 201 s 9008 are each amended 29
to read as follows: 30
Unless the context clearly requires otherwise, the definitions in 31
this section apply throughout this chapter. 32
(1) "Alternative training" means a nursing assistant-certified 33
program meeting criteria adopted by the ((commission)) board under 34
RCW 18.88A.087 to meet the requirements of a state-approved nurse 35
aide competency evaluation program consistent with 42 U.S.C. Sec. 36
1395i-3(e) and (f) of the federal social security act.37
p. 122 HB 1281
(2) "Approved training program" means a nursing assistant-1
certified training program approved by the ((commission)) board to 2
meet the requirements of a state-approved nurse aide training and 3
competency evaluation program consistent with 42 U.S.C. Sec. 4
1395i-3(e) and (f) of the federal social security act. For community 5
college, vocational-technical institutes, skill centers, and 6
secondary school as defined in chapter 28B.50 RCW, nursing assistant-7
certified training programs shall be approved by the ((commission)) 8
board in cooperation with the board for community and technical 9
colleges or the superintendent of public instruction.10
(3) (("Commission" means the Washington nursing care quality 11
assurance commission.)) "Board" means the state board of nursing.12
(4) "Competency evaluation" means the measurement of an 13
individual's knowledge and skills as related to safe, competent 14
performance as a nursing assistant. 15
(5) "Department" means the department of health.16
(6) "Health care facility" means a nursing home, hospital 17
licensed under chapter 70.41 or 71.12 RCW, hospice care facility, 18
home health care agency, hospice agency, licensed or certified 19
service provider under chapter 71.24 RCW other than an individual 20
health care provider, or other entity for delivery of health care 21
services as defined by the ((commission)) board. 22
(7) "Medication assistant" means a nursing assistant-certified 23
with a medication assistant endorsement issued under RCW 18.88A.082 24
who is authorized, in addition to his or her duties as a nursing 25
assistant-certified, to administer certain medications and perform 26
certain treatments in a nursing home under the supervision of a 27
registered nurse under RCW 18.88A.082. 28
(8) "Nursing assistant" means an individual, regardless of title, 29
who, under the direction and supervision of a registered nurse or 30
licensed practical nurse, assists in the delivery of nursing and 31
nursing-related activities to patients in a health care facility. The 32
two levels of nursing assistants are: 33
(a) "Nursing assistant-certified," an individual certified under 34
this chapter; and 35
(b) "Nursing assistant-registered," an individual registered 36
under this chapter. 37
(9) "Nursing home" means a nursing home licensed under chapter 38
18.51 RCW. 39
(10) "Secretary" means the secretary of health.40
p. 123 HB 1281
Sec. 5032. RCW 18.88A.030 and 2021 c 203 s 16 are each amended 1
to read as follows: 2
(1)(a) A nursing assistant may assist in the care of individuals 3
as delegated by and under the direction and supervision of a licensed 4
(registered) nurse or licensed practical nurse. 5
(b) A health care facility shall not assign a nursing assistant-6
registered to provide care until the nursing assistant-registered has 7
demonstrated skills necessary to perform competently all assigned 8
duties and responsibilities. 9
(c) Nothing in this chapter shall be construed to confer on a 10
nursing assistant the authority to administer medication unless 11
delegated as a specific nursing task pursuant to this chapter or to 12
practice as a licensed (registered) nurse or licensed practical nurse 13
as defined in chapter 18.79 RCW. 14
(2)(a) A nursing assistant employed in a nursing home must have 15
successfully obtained certification through: (i) An approved training 16
program and the competency evaluation within a period of time 17
determined in rule by the ((commission)) board; or (ii) alternative 18
training and the competency evaluation prior to employment.19
(b) Certification is voluntary for nursing assistants working in 20
health care facilities other than nursing homes unless otherwise 21
required by state or federal law or regulation. 22
(3) The ((commission)) board may adopt rules to implement the 23
provisions of this chapter. 24
Sec. 5033. RCW 18.88A.060 and 2012 c 208 s 6 are each amended to 25
read as follows: 26
In addition to any other authority provided by law, the 27
((commission)) board may: 28
(1) Determine minimum nursing assistant education requirements 29
and approve training programs; 30
(2) Approve education and training programs and examinations for 31
medication assistants as provided in RCW 18.88A.082;32
(3) Define the prescriber-ordered treatments a medication 33
assistant is authorized to perform under RCW 18.88A.082;34
(4) Prepare, grade, and administer, or determine the nature of, 35
and supervise the grading and administration of, the competency 36
evaluation for applicants for nursing assistant certification, using 37
the same competency evaluation for all applicants, whether qualifying 38
p. 124 HB 1281
to take the competency evaluation under an approved training program 1
or alternative training; 2
(5) Establish forms and procedures for evaluation of an 3
applicant's alternative training under criteria adopted pursuant to 4
RCW 18.88A.087; 5
(6) Define and approve any experience requirement for nursing 6
assistant certification; 7
(7) Adopt rules implementing a continuing competency evaluation 8
program for nursing assistants; and 9
(8) Adopt rules to enable it to carry into effect the provisions 10
of this chapter. 11
Sec. 5034. RCW 18.88A.080 and 1994 sp.s. c 9 s 711 are each 12
amended to read as follows: 13
(1) The secretary shall issue a registration to any applicant who 14
pays any applicable fees and submits, on forms provided by the 15
secretary, the applicant's name, address, and other information as 16
determined by the secretary, provided there are no grounds for denial 17
of registration or issuance of a conditional registration under this 18
chapter or chapter 18.130 RCW. 19
(2) Applicants must file an application with the ((commission)) 20
board for registration within three days of employment.21
Sec. 5035. RCW 18.88A.082 and 2012 c 208 s 3 are each amended to 22
read as follows: 23
(1) Beginning July 1, 2013, the secretary shall issue a 24
medication assistant endorsement to any nursing assistant-certified 25
who meets the following requirements: 26
(a) Ongoing certification as a nursing assistant-certified in 27
good standing under this chapter; 28
(b) Completion of a minimum number of hours of documented work 29
experience as a nursing assistant-certified in a long-term care 30
setting as defined in rule by the ((commission)) board;31
(c) Successful completion of an education and training program 32
approved by the ((commission)) board by rule, such as the model 33
medication assistant-certified curriculum adopted by the national 34
council of state boards of nursing. The education and training 35
program must include training on the specific tasks listed in 36
subsection (2) of this section as well as training on identifying 37
p. 125 HB 1281
tasks that a medication assistant may not perform under subsection 1
(4) of this section; 2
(d) Passage of an examination approved by the ((commission)) 3
board by rule, such as the medication aide competency examination 4
available through the national council of state boards of nursing; 5
and 6
(e) Continuing competency requirements as defined in rule by the 7
((commission)) board. 8
(2) Subject to subsection (3) of this section, a medication 9
assistant may perform the following additional tasks:10
(a) The administration of medications orally, topically, and 11
through inhalation; 12
(b) The performance of simple prescriber-ordered treatments, 13
including blood glucose monitoring, noncomplex clean dressing 14
changes, pulse oximetry reading, and oxygen administration, to be 15
defined by the ((commission)) board by rule; and 16
(c) The documentation of the tasks in this subsection (2) on 17
applicable medication or treatment forms. 18
(3) A medication assistant may only perform the additional tasks 19
in subsection (2) of this section: 20
(a) In a nursing home; 21
(b) Under the direct supervision of a designated registered nurse 22
who is on-site and immediately accessible during the medication 23
assistant's shift. The registered nurse shall assess the resident 24
prior to the medication assistant administering medications or 25
treatments and determine whether it is safe to administer the 26
medications or treatments. The judgment and decision to administer 27
medications or treatments is retained by the registered nurse; and28
(c) If, while functioning as a medication assistant, the primary 29
responsibility of the medication assistant is performing the 30
additional tasks. The ((commission)) board may adopt rules regarding 31
the medication assistant's primary responsibilities and limiting the 32
duties, within the scope of practice of a nursing assistant-33
certified, that a nursing assistant-certified may perform while 34
functioning as a medication assistant. 35
(4) A medication assistant may not: 36
(a) Accept telephone or verbal orders from a prescriber;37
(b) Calculate medication dosages; 38
(c) Inject any medications; 39
(d) Perform any sterile task; 40
p. 126 HB 1281
(e) Administer medications through a tube; 1
(f) Administer any Schedule I, II, or III controlled substance; 2
or 3
(g) Perform any task that requires nursing judgment.4
(5) Nothing in this section requires a nursing home to employ a 5
nursing assistant-certified with a medication assistant endorsement.6
(6) A medication assistant is responsible and accountable for his 7
or her specific functions. 8
(7) A medication assistant's employer may limit or restrict the 9
range of functions permitted under this section, but may not expand 10
those functions. 11
Sec. 5036. RCW 18.88A.085 and 2010 c 169 s 7 are each amended to 12
read as follows: 13
(1) After January 1, 1990, the secretary shall issue a nursing 14
assistant certificate to any applicant who demonstrates to the 15
secretary's satisfaction that the following requirements have been 16
met: 17
(a) Successful completion of an approved training program or 18
successful completion of alternative training meeting established 19
criteria adopted by the ((commission)) board under RCW 18.88A.087; 20
and 21
(b) Successful completion of the competency evaluation.22
(2) In addition, applicants shall be subject to the grounds for 23
denial of certification under chapter 18.130 RCW. 24
Sec. 5037. RCW 18.88A.087 and 2021 c 203 s 17 are each amended 25
to read as follows: 26
(1) The ((commission)) board shall adopt criteria for evaluating 27
an applicant's alternative training to determine the applicant's 28
eligibility to take the competency evaluation for nursing assistant 29
certification. At least one option adopted by the ((commission)) 30
board must allow an applicant to take the competency evaluation if he 31
or she: 32
(a)(i) Is a certified home care aide pursuant to chapter 18.88B 33
RCW; or 34
(ii) Is a certified medical assistant pursuant to a certification 35
program accredited by a national medical assistant accreditation 36
organization and approved by the ((commission)) board; and37
p. 127 HB 1281
(b) Has successfully completed at least twenty-four hours of 1
training that the ((commission)) board determines is necessary to 2
provide training equivalent to approved training on topics not 3
addressed in the training specified for certification as a home care 4
aide or medical assistant, as applicable. In the ((commission's)) 5
board's discretion, a portion of these hours may include clinical 6
training. 7
(2)(a) The ((commission)) board, in consultation with the 8
secretary, the department of social and health services, and 9
consumer, employer, and worker representatives, shall adopt rules to 10
implement this section and to provide for a program of credentialing 11
reciprocity to the extent required by this section between home care 12
aide and medical assistant certification and nursing assistant 13
certification. The secretary shall also adopt such rules as may be 14
necessary to implement this section and the credentialing reciprocity 15
program. 16
(b) Rules adopted under this section must be consistent with 17
requirements under 42 U.S.C. Sec. 1395i-3 (e) and (f) of the federal 18
social security act relating to state-approved competency evaluation 19
programs for certified nurse aides. 20
(3) The secretary, in consultation with the ((commission)) board, 21
shall report annually by December 1st to the governor and the 22
appropriate committees of the legislature on the progress made in 23
achieving career advancement for certified home care aides and 24
medical assistants into nursing practice. 25
Sec. 5038. RCW 18.88A.088 and 2011 c 32 s 10 are each amended to 26
read as follows: 27
An applicant with military training or experience satisfies the 28
training or experience requirements of this chapter unless the 29
((commission)) board determines that the military training or 30
experience is not substantially equivalent to the standards of this 31
state. 32
Sec. 5039. RCW 18.88A.090 and 2010 c 169 s 8 are each amended to 33
read as follows: 34
(1) The ((commission)) board shall examine each applicant, by a 35
written or oral and a manual component of competency evaluation. The 36
competency evaluation shall be limited to the purpose of determining 37
p. 128 HB 1281
whether the applicant possesses the minimum skill and knowledge 1
necessary to practice competently. 2
(2) Any applicant failing to make the required grade in the first 3
competency evaluation may take up to three subsequent competency 4
evaluations as the applicant desires upon prepaying a fee determined 5
by the secretary under RCW 43.70.250 for each subsequent competency 6
evaluation. Upon failing four competency evaluations, the secretary 7
may invalidate the original application and require such remedial 8
education before the person may take future competency evaluations.9
The ((commission)) board may approve a competency evaluation 10
prepared or administered by a private testing agency or association 11
of licensing agencies for use by an applicant in meeting the 12
credentialing requirements. 13
Sec. 5040. RCW 18.88A.100 and 1994 sp.s. c 9 s 714 are each 14
amended to read as follows: 15
The secretary shall waive the competency evaluation and certify a 16
person to practice within the state of Washington if the 17
((commission)) board determines that the person meets commonly 18
accepted standards of education and experience for the nursing 19
assistants. This section applies only to those individuals who file 20
an application for waiver by December 31, 1991. 21
Sec. 5041. RCW 18.88A.210 and 2008 c 146 s 12 are each amended 22
to read as follows: 23
(1) A nursing assistant meeting the requirements of this section 24
who provides care to individuals in community-based care settings or 25
in-home care settings, as defined in RCW 18.79.260(3), may accept 26
delegation of nursing care tasks by a registered nurse as provided in 27
RCW 18.79.260(3). 28
(2) For the purposes of this section, "nursing assistant" means a 29
nursing assistant-registered or a nursing assistant-certified. 30
Nothing in this section may be construed to affect the authority of 31
nurses to delegate nursing tasks to other persons, including licensed 32
practical nurses, as authorized by law. 33
(3)(a) Before commencing any specific nursing care tasks 34
authorized under this chapter, the nursing assistant must (i) provide 35
to the delegating nurse a certificate of completion issued by the 36
department of social and health services indicating the completion of 37
basic core nurse delegation training, (ii) be regulated by the 38
p. 129 HB 1281
department of health pursuant to this chapter, subject to the uniform 1
disciplinary act under chapter 18.130 RCW, and (iii) meet any 2
additional training requirements identified by the ((nursing care 3
quality assurance commission )) board. Exceptions to these training 4
requirements must adhere to RCW 18.79.260(3)(e) (vi).5
(b) In addition to meeting the requirements of (a) of this 6
subsection, before commencing the care of individuals with diabetes 7
that involves administration of insulin by injection, the nursing 8
assistant must provide to the delegating nurse a certificate of 9
completion issued by the department of social and health services 10
indicating completion of specialized diabetes nurse delegation 11
training. The training must include, but is not limited to, 12
instruction regarding diabetes, insulin, sliding scale insulin 13
orders, and proper injection procedures. 14
Sec. 5042. RCW 18.88B.070 and 2012 c 164 s 406 are each amended 15
to read as follows: 16
(1) The legislature recognizes that nurses have been successfully 17
delegating nursing care tasks to family members and others for many 18
years. The opportunity for a nurse to delegate nursing care tasks to 19
home care aides certified under this chapter may enhance the 20
viability and quality of health care services in community-based care 21
settings and in-home care settings to allow individuals to live as 22
independently as possible with maximum safeguards.23
(2)(a) A certified home care aide who wishes to perform a nurse 24
delegated task pursuant to RCW 18.79.260 must complete nurse 25
delegation core training under chapter 18.88A RCW before the home 26
care aide may be delegated a nursing care task by a registered nurse 27
delegator. Before administering insulin, a home care aide must also 28
complete the specialized diabetes nurse delegation training under 29
chapter 18.88A RCW. Before commencing any specific nursing care tasks 30
authorized under RCW 18.79.260, the home care aide must:31
(i) Provide to the delegating nurse a transcript or certificate 32
of successful completion of training issued by an approved instructor 33
or approved training entity indicating the completion of basic core 34
nurse delegation training; and 35
(ii) Meet any additional training requirements mandated by the 36
((nursing care quality assurance commission )) state board of nursing . 37
Any exception to these training requirements is subject to RCW 38
18.79.260(3)(e)(vi). 39
p. 130 HB 1281
(b) In addition to meeting the requirements of (a) of this 1
subsection, before providing delegated nursing care tasks that 2
involve administration of insulin by injection to individuals with 3
diabetes, the home care aide must provide to the delegating nurse a 4
transcript or certificate of successful completion of training issued 5
by an approved instructor or approved training entity indicating 6
completion of specialized diabetes nurse delegation training. The 7
training must include, but is not limited to, instruction regarding 8
diabetes, insulin, sliding scale insulin orders, and proper injection 9
procedures. 10
(3) The home care aide is accountable for his or her own 11
individual actions in the delegation process. Home care aides 12
accurately following written delegation instructions from a 13
registered nurse are immune from liability regarding the performance 14
of the delegated duties. 15
(4) Home care aides are not subject to any employer reprisal or 16
disciplinary action by the secretary for refusing to accept 17
delegation of a nursing care task based on his or her concerns about 18
patient safety issues. No provider of a community-based care setting 19
as defined in RCW 18.79.260, or in-home services agency as defined in 20
RCW 70.127.010, may discriminate or retaliate in any manner against a 21
person because the person made a complaint about the nurse delegation 22
process or cooperated in the investigation of the complaint.23
Sec. 5043. RCW 28A.210.275 and 2014 c 204 s 2 are each amended 24
to read as follows: 25
(1) Beginning July 1, 2014, a school district employee not 26
licensed under chapter 18.79 RCW who is asked to administer 27
medications or perform nursing services not previously recognized in 28
law shall at the time he or she is asked to administer the medication 29
or perform the nursing service file, without coercion by the 30
employer, a voluntary written, current, and unexpired letter of 31
intent stating the employee's willingness to administer the new 32
medication or nursing service. It is understood that the letter of 33
intent will expire if the conditions of acceptance are substantially 34
changed. If a school employee who is not licensed under chapter 18.79 35
RCW chooses not to file a letter under this section, the employee is 36
not subject to any employer reprisal or disciplinary action for 37
refusing to file a letter. 38
p. 131 HB 1281
(2) In the event a school employee provides the medication or 1
service to a student in substantial compliance with (a) rules adopted 2
by the state ((nursing care quality assurance commission )) board of 3
nursing and the instructions of a registered nurse or advanced 4
registered nurse practitioner issued under such rules, and (b) 5
written policies of the school district, then the employee, the 6
employee's school district or school of employment, and the members 7
of the governing board and chief administrator thereof are not liable 8
in any criminal action or for civil damages in his or her individual, 9
marital, governmental, corporate, or other capacity as a result of 10
providing the medication or service. 11
(3) The board of directors shall designate a professional person 12
licensed under chapter 18.71, 18.57, or 18.79 RCW as it applies to 13
registered nurses and advanced registered nurse practitioners to 14
consult and coordinate with the student's parents and health care 15
provider, and train and supervise the appropriate school district 16
personnel in proper procedures to ensure a safe, therapeutic learning 17
environment. School employees must receive the training provided 18
under this subsection before they are authorized to deliver the 19
service or medication. Such training must be provided, where 20
necessary, on an ongoing basis to ensure that the proper procedures 21
are not forgotten because the services or medication are delivered 22
infrequently. 23
Sec. 5044. RCW 28A.210.280 and 2003 c 172 s 1 are each amended 24
to read as follows: 25
(1) Public school districts and private schools that offer 26
classes for any of grades kindergarten through twelve must provide 27
for clean, intermittent bladder catheterization of students, or 28
assisted self-catheterization of students pursuant to RCW 18.79.290. 29
The catheterization must be provided in substantial compliance with:30
(a) Rules adopted by the state ((nursing care quality assurance 31
commission)) board of nursing and the instructions of a registered 32
nurse or advanced registered nurse practitioner issued under such 33
rules; and 34
(b) Written policies of the school district or private school 35
which shall be adopted in order to implement this section and shall 36
be developed in accordance with such requirements of chapters 41.56 37
and 41.59 RCW as may be applicable. 38
p. 132 HB 1281
(2) School district employees, except those licensed under 1
chapter 18.79 RCW, who have not agreed in writing to perform clean, 2
intermittent bladder catheterization as a specific part of their job 3
description, may file a written letter of refusal to perform clean, 4
intermittent bladder catheterization of students. This written letter 5
of refusal may not serve as grounds for discharge, nonrenewal, or 6
other action adversely affecting the employee's contract status.7
(3) Any public school district or private school that provides 8
clean, intermittent bladder catheterization shall document the 9
provision of training given to employees who perform these services. 10
These records shall be made available for review at any audit.11
Sec. 5045. RCW 28A.210.290 and 1994 sp.s. c 9 s 722 are each 12
amended to read as follows: 13
(1) In the event a school employee provides for the 14
catheterization of a student pursuant to RCW 18.79.290 and 15
28A.210.280 in substantial compliance with (a) rules adopted by the 16
state ((nursing care quality assurance commission )) board of nursing 17
and the instructions of a registered nurse or advanced registered 18
nurse practitioner issued under such rules, and (b) written policies 19
of the school district or private school, then the employee, the 20
employee's school district or school of employment, and the members 21
of the governing board and chief administrator thereof shall not be 22
liable in any criminal action or for civil damages in their 23
individual, marital, governmental, corporate, or other capacity as a 24
result of providing for the catheterization. 25
(2) Providing for the catheterization of any student pursuant to 26
RCW 18.79.290 and 28A.210.280 may be discontinued by a public school 27
district or private school and the school district or school, its 28
employees, its chief administrator, and members of its governing 29
board shall not be liable in any criminal action or for civil damages 30
in their individual, marital, governmental, corporate, or other 31
capacity as a result of the discontinuance: PROVIDED, That the chief 32
administrator of the public school district or private school, or his 33
or her designee, has first provided actual notice orally or in 34
writing in advance of the date of discontinuance to a parent or legal 35
guardian of the student or other person having legal control over the 36
student: PROVIDED FURTHER, That the public school district otherwise 37
provides for the catheterization of the student to the extent 38
required by federal or state law. 39
p. 133 HB 1281
Sec. 5046. RCW 28B.115.020 and 2023 c 442 s 2 are each amended 1
to read as follows: 2
Unless the context clearly requires otherwise, the definitions in 3
this section apply throughout this chapter. 4
(1) "Approved nursing program" means a nursing educational 5
program that leads to a degree or licensure in nursing that is 6
approved by the ((nursing care quality assurance commission )) state 7
board of nursing under RCW 18.79.070 and is located at an institution 8
of higher education that is authorized to participate in state 9
financial aid programs under chapter 28B.92 RCW. 10
(2) "Council" means the Washington state forensic investigations 11
council created in chapter 43.103 RCW. 12
(3) "Credentialed health care profession" means a health care 13
profession regulated by a disciplining authority in the state of 14
Washington under RCW 18.130.040 or by the pharmacy quality assurance 15
commission under chapter 18.64 RCW and designated by the department 16
in RCW 28B.115.070 as a profession having shortages of credentialed 17
health care professionals in the state. 18
(4) "Credentialed health care professional" means a person 19
regulated by a disciplining authority in the state of Washington to 20
practice a health care profession under RCW 18.130.040 or by the 21
pharmacy quality assurance commission under chapter 18.64 RCW.22
(5) "Department" means the state department of health.23
(6) "Eligible education and training programs" means education 24
and training programs approved by the department that lead to 25
eligibility for a credential as a credentialed health care 26
professional. 27
(7) "Eligible expenses" means reasonable expenses associated with 28
the costs of acquiring an education such as tuition, books, 29
equipment, fees, room and board, and other expenses determined by the 30
office. 31
(8) "Eligible student" means a student who has been accepted into 32
an eligible education or training program and has a declared 33
intention to serve in a health professional shortage area upon 34
completion of the education or training program. 35
(9) "Forgiven" or "to forgive" or "forgiveness" means to render 36
health care services in a health professional shortage area, an 37
underserved behavioral health area, or as a nurse educator in the 38
state of Washington in lieu of monetary repayment.39
p. 134 HB 1281
(10) "Health professional shortage areas" means those areas where 1
credentialed health care professionals are in short supply as a 2
result of geographic maldistribution or as the result of a short 3
supply of credentialed health care professionals in specialty health 4
care areas and where vacancies exist in serious numbers that 5
jeopardize patient care and pose a threat to the public health and 6
safety. The department shall determine health professional shortage 7
areas as provided for in RCW 28B.115.070. In making health 8
professional shortage area designations in the state the department 9
may be guided by applicable federal standards for "health manpower 10
shortage areas," and "medically underserved areas," and "medically 11
underserved populations." 12
(11) "Identified shortage areas" means those areas where 13
qualified forensic pathologists are in short supply because of 14
geographic maldistribution or where vacancies exist that may 15
compromise death investigations. The council, with assistance from 16
the department, shall determine shortage areas. 17
(12) "Loan repayment" means a loan that is paid in full or in 18
part if the participant: 19
(a) Renders health care services in a health professional 20
shortage area or an underserved behavioral health area as defined by 21
the department; 22
(b) Teaches as a nurse educator for an approved nursing program; 23
or 24
(c) Renders services as a qualified board-certified forensic 25
pathologist as determined by the department. 26
(13) "Nonshortage rural area" means a nonurban area of the state 27
of Washington that has not been designated as a rural physician 28
shortage area. The department shall identify the nonshortage rural 29
areas of the state. 30
(14) "Nurse educator" means an individual with an advanced 31
nursing degree beyond a bachelor's degree that teaches nursing 32
curriculum and is a faculty member for an approved nursing program.33
(15) "Office" means the office of student financial assistance.34
(16) "Participant" means: 35
(a) A credentialed health care professional who has received a 36
loan repayment award and has commenced practice as a credentialed 37
health care provider in a designated health professional shortage 38
area or an underserved behavioral health area; 39
(b) A nurse educator teaching in an approved nursing program;40
p. 135 HB 1281
(c) An eligible student who has received a scholarship under this 1
program; or 2
(d) A board-certified forensic pathologist who has commenced 3
working in or is committed to working in identified shortage areas in 4
the state of Washington for the pathologist's required service 5
obligation. 6
(17) "Required service obligation" means an obligation by the 7
participant to: 8
(a) Provide health care services in a health professional 9
shortage area or an underserved behavioral health area for a period 10
to be established as provided for in this chapter;11
(b) Teach as a nurse educator for a period to be established as 12
provided for in this chapter; or 13
(c) Provide services as a board-certified forensic pathologist in 14
identified shortage areas as determined by the council.15
(18) "Rural physician shortage area" means rural geographic areas 16
where primary care physicians are in short supply as a result of 17
geographic maldistributions and where their limited numbers 18
jeopardize patient care and pose a threat to public health and 19
safety. The department shall designate rural physician shortage 20
areas. 21
(19) "Satisfied" means paid-in-full. 22
(20) "Scholarship" means a loan that is forgiven in whole or in 23
part if the recipient renders health care services in a health 24
professional shortage area or an underserved behavioral health area.25
(21) "Sponsoring community" means a rural hospital or hospitals 26
as authorized in chapter 70.41 RCW, a rural health care facility or 27
facilities as authorized in chapter 70.175 RCW, or a city or county 28
government or governments. 29
(22) "Underserved behavioral health area" means a geographic 30
area, population, or facility that has a shortage of health care 31
professionals providing behavioral health services, as determined by 32
the department. 33
Sec. 5047. RCW 41.05.180 and 1994 sp.s. c 9 s 725 are each 34
amended to read as follows: 35
Each health plan offered to public employees and their covered 36
dependents under this chapter that is not subject to the provisions 37
of Title 48 RCW and is established or renewed after January 1, 1990, 38
and that provides benefits for hospital or medical care shall provide 39
p. 136 HB 1281
benefits for screening or diagnostic mammography services, provided 1
that such services are delivered upon the recommendation of the 2
patient's physician or advanced registered nurse practitioner as 3
authorized by the ((nursing care quality assurance commission )) state 4
board of nursing pursuant to chapter 18.79 RCW or physician assistant 5
pursuant to chapter 18.71A RCW. 6
This section shall not be construed to prevent the application of 7
standard health plan provisions applicable to other benefits such as 8
deductible or copayment provisions. This section does not limit the 9
authority of the state health care authority to negotiate rates and 10
contract with specific providers for the delivery of mammography 11
services. This section shall not apply to medicare supplement 12
policies or supplemental contracts covering a specified disease or 13
other limited benefits. 14
Sec. 5048. RCW 48.20.393 and 2023 c 366 s 3 are each amended to 15
read as follows: 16
Each disability insurance policy issued or renewed after January 17
1, 1990, that provides coverage for hospital or medical expenses 18
shall provide coverage for screening or diagnostic mammography 19
services, provided that such services are delivered upon the 20
recommendation of the patient's physician or advanced registered 21
nurse practitioner as authorized by the ((nursing care quality 22
assurance commission )) state board of nursing pursuant to chapter 23
18.79 RCW or physician assistant pursuant to chapter 18.71A RCW.24
This section shall not be construed to prevent the application of 25
standard policy provisions, other than the cost-sharing prohibition 26
provided in RCW 48.43.076, that are applicable to other benefits. 27
This section does not limit the authority of an insurer to negotiate 28
rates and contract with specific providers for the delivery of 29
mammography services. This section shall not apply to medicare 30
supplement policies or supplemental contracts covering a specified 31
disease or other limited benefits. 32
Sec. 5049. RCW 48.21.225 and 2023 c 366 s 4 are each amended to 33
read as follows: 34
Each group disability insurance policy issued or renewed after 35
January 1, 1990, that provides coverage for hospital or medical 36
expenses shall provide coverage for screening or diagnostic 37
mammography services, provided that such services are delivered upon 38
p. 137 HB 1281
the recommendation of the patient's physician or advanced registered 1
nurse practitioner as authorized by the ((nursing care quality 2
assurance commission )) state board of nursing pursuant to chapter 3
18.79 RCW or physician assistant pursuant to chapter 18.71A RCW.4
This section shall not be construed to prevent the application of 5
standard policy provisions, other than the cost-sharing prohibition 6
provided in RCW 48.43.076, that are applicable to other benefits. 7
This section does not limit the authority of an insurer to negotiate 8
rates and contract with specific providers for the delivery of 9
mammography services. This section shall not apply to medicare 10
supplement policies or supplemental contracts covering a specified 11
disease or other limited benefits. 12
Sec. 5050. RCW 48.43.087 and 2001 c 251 s 33 are each amended to 13
read as follows: 14
(1) For purposes of this section: 15
(a) "Health carrier" includes disability insurers regulated under 16
chapter 48.20 or 48.21 RCW, health care services contractors 17
regulated under chapter 48.44 RCW, plans operating under the health 18
care authority under chapter 41.05 RCW, the basic health plan 19
operating under chapter 70.47 RCW, the state health insurance pool 20
operating under chapter 48.41 RCW, insuring entities regulated under 21
this chapter, and health maintenance organizations regulated under 22
chapter 48.46 RCW. 23
(b) "Intermediary" means a person duly authorized to negotiate 24
and execute provider contracts with health carriers on behalf of 25
mental health care practitioners. 26
(c) Consistent with their lawful scopes of practice, "mental 27
health care practitioners" includes only the following: Any generally 28
recognized medical specialty of practitioners licensed under chapter 29
18.57 or 18.71 RCW who provide mental health services, advanced 30
practice psychiatric nurses as authorized by the ((nursing care 31
quality assurance commission )) state board of nursing under chapter 32
18.79 RCW, psychologists licensed under chapter 18.83 RCW, and mental 33
health counselors, marriage and family therapists, and social workers 34
licensed under chapter 18.225 RCW. 35
(d) "Mental health services" means outpatient services.36
(2) Consistent with federal and state law and rule, no contract 37
between a mental health care practitioner and an intermediary or 38
between a mental health care practitioner and a health carrier that 39
p. 138 HB 1281
is written, amended, or renewed after June 6, 1996, may contain a 1
provision prohibiting a practitioner and an enrollee from agreeing to 2
contract for services solely at the expense of the enrollee as 3
follows: 4
(a) On the exhaustion of the enrollee's mental health care 5
coverage; 6
(b) During an appeal or an adverse certification process;7
(c) When an enrollee's condition is excluded from coverage; or8
(d) For any other clinically appropriate reason at any time.9
(3) If a mental health care practitioner provides services to an 10
enrollee during an appeal or adverse certification process, the 11
practitioner must provide to the enrollee written notification that 12
the enrollee is responsible for payment of these services, unless the 13
health carrier elects to pay for services provided.14
(4) This section does not apply to a mental health care 15
practitioner who is employed full time on the staff of a health 16
carrier. 17
Sec. 5051. RCW 48.44.325 and 2023 c 366 s 5 are each amended to 18
read as follows: 19
Each health care service contract issued or renewed after January 20
1, 1990, that provides benefits for hospital or medical care shall 21
provide benefits for screening or diagnostic mammography services, 22
provided that such services are delivered upon the recommendation of 23
the patient's physician or advanced registered nurse practitioner as 24
authorized by the ((nursing care quality assurance commission )) state 25
board of nursing pursuant to chapter 18.79 RCW or physician assistant 26
pursuant to chapter 18.71A RCW. 27
This section shall not be construed to prevent the application of 28
standard contract provisions, other than the cost-sharing prohibition 29
provided in RCW 48.43.076, that are applicable to other benefits. 30
This section does not limit the authority of a contractor to 31
negotiate rates and contract with specific providers for the delivery 32
of mammography services. This section shall not apply to medicare 33
supplement policies or supplemental contracts covering a specified 34
disease or other limited benefits. 35
Sec. 5052. RCW 48.46.275 and 2023 c 366 s 6 are each amended to 36
read as follows: 37
p. 139 HB 1281
Each health maintenance agreement issued or renewed after January 1
1, 1990, that provides benefits for hospital or medical care shall 2
provide benefits for screening or diagnostic mammography services, 3
provided that such services are delivered upon the recommendation of 4
the patient's physician or advanced registered nurse practitioner as 5
authorized by the ((nursing care quality assurance commission )) state 6
board of nursing pursuant to chapter 18.79 RCW or physician assistant 7
pursuant to chapter 18.71A RCW. 8
All services must be provided by the health maintenance 9
organization or rendered upon referral by the health maintenance 10
organization. This section shall not be construed to prevent the 11
application of standard agreement provisions, other than the cost-12
sharing prohibition provided in RCW 48.43.076, that are applicable to 13
other benefits. This section does not limit the authority of a health 14
maintenance organization to negotiate rates and contract with 15
specific providers for the delivery of mammography services. This 16
section shall not apply to medicare supplement policies or 17
supplemental contracts covering a specified disease or other limited 18
benefits. 19
Sec. 5053. RCW 69.45.010 and 2020 c 80 s 42 are each amended to 20
read as follows: 21
The definitions in this section apply throughout this chapter.22
(1) "Commission" means the pharmacy quality assurance commission.23
(2) "Controlled substance" means a drug, substance, or immediate 24
precursor of such drug or substance, so designated under or pursuant 25
to chapter 69.50 RCW, the uniform controlled substances act.26
(3) "Deliver" or "delivery" means the actual, constructive, or 27
attempted transfer from one person to another of a drug or device, 28
whether or not there is an agency relationship. 29
(4) "Department" means the department of health.30
(5) "Dispense" means the interpretation of a prescription or 31
order for a drug, biological, or device and, pursuant to that 32
prescription or order, the proper selection, measuring, compounding, 33
labeling, or packaging necessary to prepare that prescription or 34
order for delivery. 35
(6) "Distribute" means to deliver, other than by administering or 36
dispensing, a legend drug. 37
(7) "Drug samples" means any federal food and drug administration 38
approved controlled substance, legend drug, or products requiring 39
p. 140 HB 1281
prescriptions in this state, which is distributed at no charge to a 1
practitioner by a manufacturer or a manufacturer's representative, 2
exclusive of drugs under clinical investigations approved by the 3
federal food and drug administration. 4
(8) "Legend drug" means any drug that is required by state law or 5
by regulations of the commission to be dispensed on prescription only 6
or is restricted to use by practitioners only. 7
(9) "Manufacturer" means a person or other entity engaged in the 8
manufacture or distribution of drugs or devices, but does not include 9
a manufacturer's representative. 10
(10) "Manufacturer's representative" means an agent or employee 11
of a drug manufacturer who is authorized by the drug manufacturer to 12
possess drug samples for the purpose of distribution in this state to 13
appropriately authorized health care practitioners.14
(11) "Person" means any individual, corporation, government or 15
governmental subdivision or agency, business trust, estate, trust, 16
partnership, association, or any other legal entity.17
(12) "Practitioner" means a physician under chapter 18.71 RCW, an 18
osteopathic physician or an osteopathic physician and surgeon under 19
chapter 18.57 RCW, a dentist under chapter 18.32 RCW, a podiatric 20
physician and surgeon under chapter 18.22 RCW, a veterinarian under 21
chapter 18.92 RCW, a pharmacist under chapter 18.64 RCW, a 22
commissioned medical or dental officer in the United States armed 23
forces or the public health service in the discharge of his or her 24
official duties, a duly licensed physician or dentist employed by the 25
veterans administration in the discharge of his or her official 26
duties, a registered nurse or advanced registered nurse practitioner 27
under chapter 18.79 RCW when authorized to prescribe by the ((nursing 28
care quality assurance commission )) state board of nursing , or a 29
physician assistant under chapter 18.71A RCW when authorized by the 30
Washington medical commission. 31
(13) "Reasonable cause" means a state of facts found to exist 32
that would warrant a reasonably intelligent and prudent person to 33
believe that a person has violated state or federal drug laws or 34
regulations. 35
(14) "Secretary" means the secretary of health or the secretary's 36
designee. 37
Sec. 5054. RCW 69.51A.300 and 2022 c 16 s 133 are each amended 38
to read as follows: 39
p. 141 HB 1281
The board of naturopathy, the board of osteopathic medicine and 1
surgery, the Washington medical commission, and the ((nursing care 2
quality assurance commission )) state board of nursing shall develop 3
and approve continuing education programs related to the use of 4
cannabis for medical purposes for the health care providers that they 5
each regulate that are based upon practice guidelines that have been 6
adopted by each entity. 7
Sec. 5055. RCW 70.41.230 and 2019 c 104 s 1, 2019 c 55 s 15, and 8
2019 c 49 s 1 are each reenacted and amended to read as follows:9
(1) Except as provided in subsection (3) of this section, prior 10
to granting or renewing clinical privileges or association of any 11
physician, physician assistant, or advanced registered nurse 12
practitioner or hiring a physician, physician assistant, or advanced 13
registered nurse practitioner who will provide clinical care under 14
his or her license, a hospital or facility approved pursuant to this 15
chapter shall request from the physician, physician assistant, or 16
advanced registered nurse practitioner and the physician, physician 17
assistant, or advanced registered nurse practitioner shall provide 18
the following information: 19
(a) The name of any hospital or facility with or at which the 20
physician, physician assistant, or advanced registered nurse 21
practitioner had or has any association, employment, privileges, or 22
practice during the prior five years: PROVIDED, That the hospital may 23
request additional information going back further than five years, 24
and the physician, physician assistant, or advanced registered nurse 25
practitioner shall use his or her best efforts to comply with such a 26
request for additional information; 27
(b) Whether the physician, physician assistant, or advanced 28
registered nurse practitioner has ever been or is in the process of 29
being denied, revoked, terminated, suspended, restricted, reduced, 30
limited, sanctioned, placed on probation, monitored, or not renewed 31
for any professional activity listed in (b)(i) through (x) of this 32
subsection, or has ever voluntarily or involuntarily relinquished, 33
withdrawn, or failed to proceed with an application for any 34
professional activity listed in (b)(i) through (x) of this subsection 35
in order to avoid an adverse action or to preclude an investigation 36
or while under investigation relating to professional competence or 37
conduct: 38
(i) License to practice any profession in any jurisdiction;39
p. 142 HB 1281
(ii) Other professional registration or certification in any 1
jurisdiction; 2
(iii) Specialty or subspecialty board certification;3
(iv) Membership on any hospital medical staff; 4
(v) Clinical privileges at any facility, including hospitals, 5
ambulatory surgical centers, or skilled nursing facilities;6
(vi) Medicare, medicaid, the food and drug administration, the 7
national institute (([s]))s of health (office of human research 8
protection), governmental, national, or international regulatory 9
agency, or any public program; 10
(vii) Professional society membership or fellowship;11
(viii) Participation or membership in a health maintenance 12
organization, preferred provider organization, independent practice 13
association, physician-hospital organization, or other entity;14
(ix) Academic appointment; 15
(x) Authority to prescribe controlled substances (drug 16
enforcement agency or other authority); 17
(c) Any pending professional medical misconduct proceedings or 18
any pending medical malpractice actions in this state or another 19
state, the substance of the allegations in the proceedings or 20
actions, and any additional information concerning the proceedings or 21
actions as the physician, physician assistant, or advanced registered 22
nurse practitioner deems appropriate; 23
(d) The substance of the findings in the actions or proceedings 24
and any additional information concerning the actions or proceedings 25
as the physician, physician assistant, or advanced registered nurse 26
practitioner deems appropriate; 27
(e) A waiver by the physician, physician assistant, or advanced 28
registered nurse practitioner of any confidentiality provisions 29
concerning the information required to be provided to hospitals 30
pursuant to this subsection; and 31
(f) A verification by the physician, physician assistant, or 32
advanced registered nurse practitioner that the information provided 33
by the physician, physician assistant, or advanced registered nurse 34
practitioner is accurate and complete. 35
(2) Except as provided in subsection (3) of this section, prior 36
to granting privileges or association to any physician, physician 37
assistant, or advanced registered nurse practitioner or hiring a 38
physician, physician assistant, or advanced registered nurse 39
practitioner who will provide clinical care under his or her license, 40
p. 143 HB 1281
a hospital or facility approved pursuant to this chapter shall 1
request from any hospital with or at which the physician, physician 2
assistant, or advanced registered nurse practitioner had or has 3
privileges, was associated, or was employed, during the preceding 4
five years, the following information concerning the physician, 5
physician assistant, or advanced registered nurse practitioner:6
(a) Any pending professional medical misconduct proceedings or 7
any pending medical malpractice actions, in this state or another 8
state; 9
(b) Any judgment or settlement of a medical malpractice action 10
and any finding of professional misconduct in this state or another 11
state by a licensing or disciplinary board; and 12
(c) Any information required to be reported by hospitals pursuant 13
to RCW 18.71.0195. 14
(3) In lieu of the requirements of subsections (1) and (2) of 15
this section, when granting or renewing credentials and privileges or 16
association of any physician, physician assistant, or advanced 17
registered nurse practitioner providing telemedicine or store and 18
forward services, an originating site hospital may rely on a distant 19
site hospital's decision to grant or renew credentials and clinical 20
privileges or association of the physician, physician assistant, or 21
advanced registered nurse practitioner if the originating site 22
hospital obtains reasonable assurances, through a written agreement 23
with the distant site hospital, that all of the following provisions 24
are met: 25
(a) The distant site hospital providing the telemedicine or store 26
and forward services is a medicare participating hospital;27
(b) Any physician, physician assistant, or advanced registered 28
nurse practitioner providing telemedicine or store and forward 29
services at the distant site hospital will be fully credentialed and 30
privileged to provide such services by the distant site hospital;31
(c) Any physician, physician assistant, or advanced registered 32
nurse practitioner providing telemedicine or store and forward 33
services will hold and maintain a valid license to perform such 34
services issued or recognized by the state of Washington; and35
(d) With respect to any distant site physician, physician 36
assistant, or advanced registered nurse practitioner who holds 37
current credentials and privileges at the originating site hospital 38
whose patients are receiving the telemedicine or store and forward 39
services, the originating site hospital has evidence of an internal 40
p. 144 HB 1281
review of the distant site physician's, physician assistant's, or 1
advanced registered nurse practitioner's performance of these 2
credentials and privileges and sends the distant site hospital such 3
performance information for use in the periodic appraisal of the 4
distant site physician, physician assistant, or advanced registered 5
nurse practitioner. At a minimum, this information must include all 6
adverse events, as defined in RCW 70.56.010, that result from the 7
telemedicine or store and forward services provided by the distant 8
site physician, physician assistant, or advanced registered nurse 9
practitioner to the originating site hospital's patients and all 10
complaints the originating site hospital has received about the 11
distant site physician, physician assistant, or advanced registered 12
nurse practitioner. 13
(4)(a) The Washington medical commission or the board of 14
osteopathic medicine and surgery shall be advised within thirty days 15
of the name of any physician or physician assistant denied staff 16
privileges, association, or employment on the basis of adverse 17
findings under subsection (1) of this section. 18
(b) The ((nursing care quality assurance commission )) state board 19
of nursing shall be advised within thirty days of the name of any 20
advanced registered nurse practitioner denied staff privileges, 21
association, or employment on the basis of adverse findings under 22
subsection (1) of this section. 23
(5) A hospital or facility that receives a request for 24
information from another hospital or facility pursuant to subsections 25
(1) through (3) of this section shall provide such information 26
concerning the physician, physician assistant, or advanced registered 27
nurse practitioner in question to the extent such information is 28
known to the hospital or facility receiving such a request, including 29
the reasons for suspension, termination, or curtailment of employment 30
or privileges at the hospital or facility. A hospital, facility, or 31
other person providing such information in good faith is not liable 32
in any civil action for the release of such information.33
(6) Information and documents, including complaints and incident 34
reports, created specifically for, and collected, and maintained by a 35
quality improvement committee are not subject to discovery or 36
introduction into evidence in any civil action, and no person who was 37
in attendance at a meeting of such committee or who participated in 38
the creation, collection, or maintenance of information or documents 39
specifically for the committee shall be permitted or required to 40
p. 145 HB 1281
testify in any civil action as to the content of such proceedings or 1
the documents and information prepared specifically for the 2
committee. This subsection does not preclude: (a) In any civil 3
action, the discovery of the identity of persons involved in the 4
medical care that is the basis of the civil action whose involvement 5
was independent of any quality improvement activity; (b) in any civil 6
action, the testimony of any person concerning the facts which form 7
the basis for the institution of such proceedings of which the person 8
had personal knowledge acquired independently of such proceedings; 9
(c) in any civil action by a health care provider regarding the 10
restriction or revocation of that individual's clinical or staff 11
privileges, introduction into evidence information collected and 12
maintained by quality improvement committees regarding such health 13
care provider; (d) in any civil action, disclosure of the fact that 14
staff privileges were terminated or restricted, including the 15
specific restrictions imposed, if any and the reasons for the 16
restrictions; or (e) in any civil action, discovery and introduction 17
into evidence of the patient's medical records required by regulation 18
of the department of health to be made regarding the care and 19
treatment received. 20
(7) Hospitals shall be granted access to information held by the 21
Washington medical commission, the board of osteopathic medicine and 22
surgery, and the ((nursing care quality assurance commission )) state 23
board of nursing pertinent to decisions of the hospital regarding 24
credentialing and recredentialing of practitioners.25
(8) Violation of this section shall not be considered negligence 26
per se. 27
Sec. 5056. RCW 70.128.210 and 2012 c 10 s 56 are each amended to 28
read as follows: 29
(1) The department of social and health services shall review, in 30
coordination with the department of health, the ((nursing care 31
quality assurance commission )) state board of nursing , adult family 32
home providers, assisted living facility providers, in-home personal 33
care providers, and long-term care consumers and advocates, training 34
standards for providers, resident managers, and resident caregiving 35
staff. The departments and the ((commission)) board shall submit to 36
the appropriate committees of the house of representatives and the 37
senate by December 1, 1998, specific recommendations on training 38
standards and the delivery system, including necessary statutory 39
p. 146 HB 1281
changes and funding requirements. Any proposed enhancements shall be 1
consistent with this section, shall take into account and not 2
duplicate other training requirements applicable to adult family 3
homes and staff, and shall be developed with the input of adult 4
family home and resident representatives, health care professionals, 5
and other vested interest groups. Training standards and the delivery 6
system shall be relevant to the needs of residents served by the 7
adult family home and recipients of long-term in-home personal care 8
services and shall be sufficient to ensure that providers, resident 9
managers, and caregiving staff have the skills and knowledge 10
necessary to provide high quality, appropriate care.11
(2) The recommendations on training standards and the delivery 12
system developed under subsection (1) of this section shall be based 13
on a review and consideration of the following: Quality of care; 14
availability of training; affordability, including the training costs 15
incurred by the department of social and health services and private 16
providers; portability of existing training requirements; competency 17
testing; practical and clinical coursework; methods of delivery of 18
training; standards for management; uniform caregiving staff 19
training; necessary enhancements for special needs populations; and 20
resident rights training. Residents with special needs include, but 21
are not limited to, residents with a diagnosis of mental illness, 22
dementia, or developmental disability. Development of training 23
recommendations for developmental disabilities services shall be 24
coordinated with the study requirements in section 6, chapter 272, 25
Laws of 1998. 26
(3) The department of social and health services shall report to 27
the appropriate committees of the house of representatives and the 28
senate by December 1, 1998, on the cost of implementing the proposed 29
training standards for state-funded residents, and on the extent to 30
which that cost is covered by existing state payment rates.31
Sec. 5057. RCW 74.42.230 and 2020 c 80 s 57 are each amended to 32
read as follows: 33
(1) The resident's attending or staff physician or authorized 34
practitioner approved by the attending physician shall order all 35
medications for the resident. The order may be oral or written and 36
shall continue in effect until discontinued by a physician or other 37
authorized prescriber, unless the order is specifically limited by 38
time. An "authorized practitioner," as used in this section, is a 39
p. 147 HB 1281
registered nurse under chapter 18.79 RCW when authorized by the 1
((nursing care quality assurance commission )) state board of nursing , 2
a physician assistant under chapter 18.71A RCW when authorized by the 3
Washington medical commission, or a pharmacist under chapter 18.64 4
RCW when authorized by the pharmacy quality assurance commission.5
(2) An oral order shall be given only to a licensed nurse, 6
pharmacist, or another physician. The oral order shall be recorded 7
and physically or electronically signed immediately by the person 8
receiving the order. The attending physician shall sign the record of 9
the oral order in a manner consistent with good medical practice.10
(3) A licensed nurse, pharmacist, or another physician receiving 11
and recording an oral order may, if so authorized by the physician or 12
authorized practitioner, communicate that order to a pharmacy on 13
behalf of the physician or authorized practitioner. The order may be 14
communicated verbally by telephone, by facsimile manually signed by 15
the person receiving the order pursuant to subsection (2) of this 16
section, or by electronic transmission pursuant to RCW 69.41.055. The 17
communication of a resident's order to a pharmacy by a licensed 18
nurse, pharmacist, or another physician acting at the prescriber's 19
direction has the same force and effect as if communicated directly 20
by the delegating physician or authorized practitioner. Nothing in 21
this provision limits the authority of a licensed nurse, pharmacist, 22
or physician to delegate to an authorized agent, including but not 23
limited to delegation of operation of a facsimile machine by 24
credentialed facility staff, to the extent consistent with his or her 25
professional license. 26
Sec. 5058. RCW 7.68.030 and 2024 c 62 s 15 are each amended to 27
read as follows: 28
(1) It shall be the duty of the director to establish and 29
administer a program of benefits to innocent victims of criminal acts 30
within the terms and limitations of this chapter. The director may 31
apply for and, subject to appropriation, expend federal funds under 32
Public Law 98-473 and any other federal program providing financial 33
assistance to state crime victim compensation programs. The federal 34
funds shall be deposited in the state general fund and may be 35
expended only for purposes authorized by applicable federal law.36
(2) The director shall: 37
(a) Establish and adopt rules governing the administration of 38
this chapter in accordance with chapter 34.05 RCW;39
p. 148 HB 1281
(b) Regulate the proof of accident and extent thereof, the proof 1
of death, and the proof of relationship and the extent of dependency;2
(c) Supervise the medical, surgical, and hospital treatment to 3
the intent that it may be in all cases efficient and up to the 4
recognized standard of modern surgery; 5
(d) Issue proper receipts for moneys received and certificates 6
for benefits accrued or accruing; 7
(e) Designate a medical director who is licensed under chapter 8
18.57 or 18.71 RCW; 9
(f) Supervise the providing of prompt and efficient care and 10
treatment, including care provided by physician assistants governed 11
by the provisions of chapter 18.71A RCW, including chiropractic care, 12
and including care provided by licensed advanced ((registered nurse 13
practitioners)) practice registered nurses , to victims at the least 14
cost consistent with promptness and efficiency, without 15
discrimination or favoritism, and with as great uniformity as the 16
various and diverse surrounding circumstances and locations of 17
industries will permit and to that end shall, from time to time, 18
establish and adopt and supervise the administration of printed 19
forms, electronic communications, rules, regulations, and practices 20
for the furnishing of such care and treatment. The medical coverage 21
decisions of the department do not constitute a "rule" as used in RCW 22
34.05.010(16), nor are such decisions subject to the rule -making 23
provisions of chapter 34.05 RCW except that criteria for establishing 24
medical coverage decisions shall be adopted by rule. The department 25
may recommend to a victim particular health care services and 26
providers where specialized treatment is indicated or where cost-27
effective payment levels or rates are obtained by the department, and 28
the department may enter into contracts for goods and services 29
including, but not limited to, durable medical equipment so long as 30
statewide access to quality service is maintained for injured 31
victims; 32
(g) In consultation with interested persons, establish and, in 33
his or her discretion, periodically change as may be necessary, and 34
make available a fee schedule of the maximum charges to be made by 35
any physician, surgeon, chiropractor, hospital, druggist, licensed 36
advanced ((registered nurse practitioner )) practice registered nurse , 37
physician assistants as defined in chapter 18.71A RCW, acting under 38
the supervision of or in coordination with a participating physician, 39
as defined in RCW 18.71A.010, or other agency or person rendering 40
p. 149 HB 1281
services to victims. The department shall coordinate with other state 1
purchasers of health care services to establish as much consistency 2
and uniformity in billing and coding practices as possible, taking 3
into account the unique requirements and differences between 4
programs. No service covered under this title, including services 5
provided to victims, whether aliens or other victims, who are not 6
residing in the United States at the time of receiving the services, 7
shall be charged or paid at a rate or rates exceeding those specified 8
in such fee schedule, and no contract providing for greater fees 9
shall be valid as to the excess. The establishment of such a 10
schedule, exclusive of conversion factors, does not constitute 11
"agency action" as used in RCW 34.05.010(3), nor does such a fee 12
schedule constitute a "rule" as used in RCW 34.05.010(16). Payments 13
for providers' services under the fee schedule established pursuant 14
to this subsection (2) may not be less than payments provided for 15
comparable services under the workers' compensation program under 16
Title 51 RCW, provided: 17
(i) If the department, using caseload estimates, projects a 18
deficit in funding for the program by July 15th for the following 19
fiscal year, the director shall notify the governor and the 20
appropriate committees of the legislature and request funding 21
sufficient to continue payments to not less than payments provided 22
for comparable services under the workers' compensation program. If 23
sufficient funding is not provided to continue payments to not less 24
than payments provided for comparable services under the workers' 25
compensation program, the director shall reduce the payments under 26
the fee schedule for the following fiscal year based on caseload 27
estimates and available funding, except payments may not be reduced 28
to less than seventy percent of payments for comparable services 29
under the workers' compensation program; 30
(ii) If an unforeseeable catastrophic event results in 31
insufficient funding to continue payments to not less than payments 32
provided for comparable services under the workers' compensation 33
program, the director shall reduce the payments under the fee 34
schedule to not less than seventy percent of payments provided for 35
comparable services under the workers' compensation program, provided 36
that the reduction may not be more than necessary to fund benefits 37
under the program; and 38
(iii) Once sufficient funding is provided or otherwise available, 39
the director shall increase the payments under the fee schedule to 40
p. 150 HB 1281
not less than payments provided for comparable services under the 1
workers' compensation program; 2
(h) Make a record of the commencement of every disability and the 3
termination thereof and, when bills are rendered for the care and 4
treatment of injured victims, shall approve and pay those which 5
conform to the adopted rules, regulations, established fee schedules, 6
and practices of the director and may reject any bill or item thereof 7
incurred in violation of the principles laid down in this section or 8
the rules, regulations, or the established fee schedules and rules 9
and regulations adopted under it. 10
(3) The director and his or her authorized assistants:11
(a) Have power to issue subpoenas to enforce the attendance and 12
testimony of witnesses and the production and examination of books, 13
papers, photographs, tapes, and records before the department in 14
connection with any claim made to the department or any billing 15
submitted to the department. The superior court has the power to 16
enforce any such subpoena by proper proceedings; 17
(b)(i) May apply for and obtain a superior court order approving 18
and authorizing a subpoena in advance of its issuance. The 19
application may be made in the county where the subpoenaed person 20
resides or is found, or the county where the subpoenaed records or 21
documents are located, or in Thurston county. The application must 22
(A) state that an order is sought pursuant to this subsection; (B) 23
adequately specify the records, documents, or testimony; and (C) 24
declare under oath that an investigation is being conducted for a 25
lawfully authorized purpose related to an investigation within the 26
department's authority and that the subpoenaed documents or testimony 27
are reasonably related to an investigation within the department's 28
authority. 29
(ii) Where the application under this subsection (3)(b) is made 30
to the satisfaction of the court, the court must issue an order 31
approving the subpoena. An order under this subsection constitutes 32
authority of law for the agency to subpoena the records or testimony.33
(iii) The director and his or her authorized assistants may seek 34
approval and a court may issue an order under this subsection without 35
prior notice to any person, including the person to whom the subpoena 36
is directed and the person who is the subject of an investigation.37
(4) In all hearings, actions, or proceedings before the 38
department, any physician or licensed advanced ((registered nurse 39
practitioner)) practice registered nurse having theretofore examined 40
p. 151 HB 1281
or treated the claimant may be required to testify fully regarding 1
such examination or treatment, and shall not be exempt from so 2
testifying by reason of the relation of the physician or licensed 3
advanced ((registered nurse practitioner )) practice registered nurse 4
to the patient. 5
Sec. 5059. RCW 7.68.063 and 2011 c 346 s 303 are each amended to 6
read as follows: 7
Where death results from injury the parties eligible for 8
compensation under this chapter, or someone in their behalf, shall 9
make application for the same to the department, which application 10
must be accompanied with proof of death and proof of relationship 11
showing the parties to be eligible for compensation under this 12
chapter, certificates of attending physician or licensed advanced 13
((registered nurse practitioner )) practice registered nurse , if any, 14
and such proof as required by the rules of the department.15
Sec. 5060. RCW 7.68.080 and 2024 c 297 s 4 are each amended to 16
read as follows: 17
(1) When the injury to any victim is so serious as to require the 18
victim being taken from the place of injury to a place of treatment, 19
reasonable transportation costs to and from the nearest place of 20
proper treatment to a reasonable location of the victim's choice 21
shall be reimbursed by the department as part of the victim's total 22
claim under RCW 7.68.070(1). 23
(2) In the case of alleged rape or molestation of a child, the 24
reasonable costs of a colposcopy examination shall be reimbursed by 25
the department. Costs for a colposcopy examination given under this 26
subsection shall not be included as part of the victim's total claim 27
under RCW 7.68.070(1). 28
(3) The director shall adopt rules for fees and charges for 29
hospital, clinic, medical, and other health care services, including 30
fees and costs for durable medical equipment, eyeglasses, hearing 31
aids, and other medically necessary devices for crime victims under 32
this chapter. The director shall set these service levels and fees at 33
a level no lower than those established for comparable services under 34
the workers' compensation program under Title 51 RCW, except the 35
director shall comply with the requirements of RCW 7.68.030(2)(g) (i) 36
through (iii) when setting service levels and fees, including 37
reducing levels and fees when required. In establishing fees for 38
p. 152 HB 1281
medical and other health care services, the director shall consider 1
the director's duty to purchase health care in a prudent, cost-2
effective manner. The director shall establish rules adopted in 3
accordance with chapter 34.05 RCW. Nothing in this chapter may be 4
construed to require the payment of interest on any billing, fee, or 5
charge. 6
(4) Whenever the director deems it necessary in order to resolve 7
any medical issue, a victim shall submit to examination by a 8
physician or physicians selected by the director, with the rendition 9
of a report to the person ordering the examination. The department 10
shall provide the physician performing an examination with all 11
relevant medical records from the victim's claim file. The director, 12
in his or her discretion, may charge the cost of such examination or 13
examinations to the crime victims' compensation fund. If the 14
examination is paid for by the victim, then the cost of said 15
examination shall be reimbursed to the victim for reasonable costs 16
connected with the examination as part of the victim's total claim 17
under RCW 7.68.070(1). 18
(5) Victims of sexual assault are eligible to receive appropriate 19
counseling. Fees for such counseling shall be determined by the 20
department. Counseling services may include, if determined 21
appropriate by the department, counseling of members of the victim's 22
immediate family, other than the perpetrator of the assault.23
(6)(a) Immediate family members of a homicide victim may receive 24
appropriate counseling to assist in dealing with the immediate, 25
near-term consequences of the related effects of the homicide. Except 26
as provided in (b) of this subsection, up to 12 counseling sessions 27
may be received after the crime victim's claim has been allowed. Fees 28
for counseling shall be determined by the department in accordance 29
with and subject to this section. Payment of counseling benefits 30
under this section may not be provided to the perpetrator of the 31
homicide. The benefits under this subsection may be provided only 32
with respect to homicides committed on or after July 1, 1992.33
(b) The immediate family members of a homicide victim may receive 34
more than 12 counseling sessions under this subsection (6) if a 35
licensed mental health provider determines that: 36
(i) Additional sessions are needed as a direct result of the 37
near-term consequences of the related effects of the homicide; and38
(ii) The recipient of the counseling would benefit from 39
additional sessions. 40
p. 153 HB 1281
(7) Pursuant to RCW 7.68.070(13), a victim of a sex offense that 1
occurred outside of Washington may be eligible to receive mental 2
health counseling related to participation in proceedings to civilly 3
commit a perpetrator. 4
(8) The crime victims' compensation program shall consider 5
payment of benefits solely for the effects of the criminal act.6
(9) The legislature finds and declares it to be in the public 7
interest of the state of Washington that a proper regulatory and 8
inspection program be instituted in connection with the provision of 9
any services provided to crime victims pursuant to this chapter. In 10
order to effectively accomplish such purpose and to assure that the 11
victim receives such services as are paid for by the state of 12
Washington, the acceptance by the victim of such services, and the 13
request by a provider of services for reimbursement for providing 14
such services, shall authorize the director of the department or the 15
director's authorized representative to inspect and audit all records 16
in connection with the provision of such services. In the conduct of 17
such audits or investigations, the director or the director's 18
authorized representatives may: 19
(a) Examine all records, or portions thereof, including patient 20
records, for which services were rendered by a health care provider 21
and reimbursed by the department, notwithstanding the provisions of 22
any other statute which may make or purport to make such records 23
privileged or confidential, except that no original patient records 24
shall be removed from the premises of the health care provider, and 25
that the disclosure of any records or information obtained under 26
authority of this section by the department is prohibited and 27
constitutes a violation of RCW 42.52.050, unless such disclosure is 28
directly connected to the official duties of the department. The 29
disclosure of patient information as required under this section 30
shall not subject any physician, licensed advanced ((registered nurse 31
practitioner)) practice registered nurse , or other health care 32
provider to any liability for breach of any confidential 33
relationships between the provider and the patient. The director or 34
the director's authorized representative shall destroy all copies of 35
patient medical records in their possession upon completion of the 36
audit, investigation, or proceedings; 37
(b) Approve or deny applications to participate as a provider of 38
services furnished to crime victims pursuant to this title;39
p. 154 HB 1281
(c) Terminate or suspend eligibility to participate as a provider 1
of services furnished to victims pursuant to this title; and2
(d) Pursue collection of unpaid overpayments and/or penalties 3
plus interest accrued from health care providers pursuant to RCW 4
51.32.240(6). 5
(10) When contracting for health care services and equipment, the 6
department, upon request of a contractor, shall keep confidential 7
financial and valuable trade information, which shall be exempt from 8
public inspection and copying under chapter 42.56 RCW.9
Sec. 5061. RCW 9.02.110 and 2022 c 65 s 3 are each amended to 10
read as follows: 11
The state may not deny or interfere with a pregnant individual's 12
right to choose to have an abortion prior to viability of the fetus, 13
or to protect the pregnant individual's life or health.14
A physician, physician assistant, advanced ((registered nurse 15
practitioner)) practice registered nurse , or other health care 16
provider acting within the provider's scope of practice may terminate 17
and a health care provider may assist a physician, physician 18
assistant, advanced ((registered nurse practitioner )) practice 19
registered nurse , or other health care provider acting within the 20
provider's scope of practice in terminating a pregnancy as permitted 21
by this section. 22
Sec. 5062. RCW 9.02.130 and 2022 c 65 s 4 are each amended to 23
read as follows: 24
The good faith judgment of a physician, physician assistant, 25
advanced ((registered nurse practitioner )) practice registered nurse , 26
or other health care provider acting within the provider's scope of 27
practice as to viability of the fetus or as to the risk to life or 28
health of a pregnant individual and the good faith judgment of a 29
health care provider as to the duration of pregnancy shall be a 30
defense in any proceeding in which a violation of this chapter is an 31
issue. 32
Sec. 5063. RCW 9.02.170 and 2022 c 65 s 7 are each reenacted and 33
amended to read as follows: 34
For purposes of this chapter: 35
p. 155 HB 1281
(1) "Abortion" means any medical treatment intended to induce the 1
termination of a pregnancy except for the purpose of producing a live 2
birth. 3
(2) "Advanced ((registered nurse practitioner" means an advanced 4
registered nurse practitioner )) practice registered nurse" means an 5
advanced practice registered nurse licensed under chapter 18.79 RCW.6
(3) "Health care provider" means a person regulated under Title 7
18 RCW to practice health or health-related services or otherwise 8
practicing health care services in this state consistent with state 9
law. 10
(4) "Physician" means a physician licensed to practice under 11
chapter 18.57 or 18.71 RCW in the state of Washington.12
(5) "Physician assistant" means a physician assistant licensed to 13
practice under chapter 18.71A RCW in the state of Washington.14
(6) "Pregnancy" means the reproductive process beginning with the 15
implantation of an embryo. 16
(7) "Private medical facility" means any medical facility that is 17
not owned or operated by the state. 18
(8) "State" means the state of Washington and counties, cities, 19
towns, municipal corporations, and quasi-municipal corporations in 20
the state of Washington. 21
(9) "Viability" means the point in the pregnancy when, in the 22
judgment of the physician, physician assistant, advanced ((registered 23
nurse practitioner)) practice registered nurse , or other health care 24
provider acting within the provider's scope of practice on the 25
particular facts of the case before such physician, physician 26
assistant, advanced ((registered nurse practitioner )) practice 27
registered nurse , or other health care provider acting within the 28
provider's scope of practice, there is a reasonable likelihood of the 29
fetus's sustained survival outside the uterus without the application 30
of extraordinary medical measures. 31
Sec. 5064. RCW 9.41.010 and 2024 c 289 s 1 and 2024 c 62 s 32 32
are each reenacted and amended to read as follows:33
Unless the context clearly requires otherwise, the definitions in 34
this section apply throughout this chapter. 35
(1) "Antique firearm" means a firearm or replica of a firearm not 36
designed or redesigned for using rim fire or conventional center fire 37
ignition with fixed ammunition and manufactured in or before 1898, 38
including any matchlock, flintlock, percussion cap, or similar type 39
p. 156 HB 1281
of ignition system and also any firearm using fixed ammunition 1
manufactured in or before 1898, for which ammunition is no longer 2
manufactured in the United States and is not readily available in the 3
ordinary channels of commercial trade. 4
(2)(a) "Assault weapon" means: 5
(i) Any of the following specific firearms regardless of which 6
company produced and manufactured the firearm: 7
8 AK-47 in all forms
9 AK-74 in all forms
10 Algimec AGM-1 type semiautomatic
11 American Arms Spectre da semiautomatic carbine
12 AR15, M16, or M4 in all forms
13 AR 180 type semiautomatic
14 Argentine L.S.R. semiautomatic
15 Australian Automatic
16 Auto-Ordnance Thompson M1 and 1927 semiautomatics
17 Barrett .50 cal light semiautomatic
18 Barrett .50 cal M87
19 Barrett .50 cal M107A1
20 Barrett REC7
21 Beretta AR70/S70 type semiautomatic
22 Bushmaster Carbon 15
23 Bushmaster ACR
24 Bushmaster XM-15
25 Bushmaster MOE
26 Calico models M100 and M900
27 CETME Sporter
28 CIS SR 88 type semiautomatic
29 Colt CAR 15
30 Daewoo K-1
31 Daewoo K-2
32 Dragunov semiautomatic
33 Fabrique Nationale FAL in all forms
p. 157 HB 1281
1 Fabrique Nationale F2000
2 Fabrique Nationale L1A1 Sporter
3 Fabrique Nationale M249S
4 Fabrique Nationale PS90
5 Fabrique Nationale SCAR
6 FAMAS .223 semiautomatic
7 Galil
8 Heckler & Koch G3 in all forms
9 Heckler & Koch HK-41/91
10 Heckler & Koch HK-43/93
11 Heckler & Koch HK94A2/3
12 Heckler & Koch MP-5 in all forms
13 Heckler & Koch PSG-1
14 Heckler & Koch SL8
15 Heckler & Koch UMP
16 Manchester Arms Commando MK-45
17 Manchester Arms MK-9
18 SAR-4800
19 SIG AMT SG510 in all forms
20 SIG SG550 in all forms
21 SKS
22 Spectre M4
23 Springfield Armory BM-59
24 Springfield Armory G3
25 Springfield Armory SAR-8
26 Springfield Armory SAR-48
27 Springfield Armory SAR-3
28 Springfield Armory M-21 sniper
29 Springfield Armory M1A
30 Smith & Wesson M&P 15
31 Sterling Mk 1
32 Sterling Mk 6/7
p. 158 HB 1281
1 Steyr AUG
2 TNW M230
3 FAMAS F11
4 Uzi 9mm carbine/rifle
(ii) A semiautomatic rifle that has an overall length of less 5
than 30 inches; 6
(iii) A conversion kit, part, or combination of parts, from which 7
an assault weapon can be assembled or from which a firearm can be 8
converted into an assault weapon if those parts are in the possession 9
or under the control of the same person; or 10
(iv) A semiautomatic, center fire rifle that has the capacity to 11
accept a detachable magazine and has one or more of the following:12
(A) A grip that is independent or detached from the stock that 13
protrudes conspicuously beneath the action of the weapon. The 14
addition of a fin attaching the grip to the stock does not exempt the 15
grip if it otherwise resembles the grip found on a pistol;16
(B) Thumbhole stock; 17
(C) Folding or telescoping stock; 18
(D) Forward pistol, vertical, angled, or other grip designed for 19
use by the nonfiring hand to improve control; 20
(E) Flash suppressor, flash guard, flash eliminator, flash hider, 21
sound suppressor, silencer, or any item designed to reduce the visual 22
or audio signature of the firearm; 23
(F) Muzzle brake, recoil compensator, or any item designed to be 24
affixed to the barrel to reduce recoil or muzzle rise;25
(G) Threaded barrel designed to attach a flash suppressor, sound 26
suppressor, muzzle break, or similar item; 27
(H) Grenade launcher or flare launcher; or 28
(I) A shroud that encircles either all or part of the barrel 29
designed to shield the bearer's hand from heat, except a solid 30
forearm of a stock that covers only the bottom of the barrel;31
(v) A semiautomatic, center fire rifle that has a fixed magazine 32
with the capacity to accept more than 10 rounds; 33
(vi) A semiautomatic pistol that has the capacity to accept a 34
detachable magazine and has one or more of the following:35
(A) A threaded barrel, capable of accepting a flash suppressor, 36
forward handgrip, or silencer; 37
(B) A second hand grip; 38
p. 159 HB 1281
(C) A shroud that encircles either all or part of the barrel 1
designed to shield the bearer's hand from heat, except a solid 2
forearm of a stock that covers only the bottom of the barrel; or3
(D) The capacity to accept a detachable magazine at some location 4
outside of the pistol grip; 5
(vii) A semiautomatic shotgun that has any of the following:6
(A) A folding or telescoping stock; 7
(B) A grip that is independent or detached from the stock that 8
protrudes conspicuously beneath the action of the weapon. The 9
addition of a fin attaching the grip to the stock does not exempt the 10
grip if it otherwise resembles the grip found on a pistol;11
(C) A thumbhole stock; 12
(D) A forward pistol, vertical, angled, or other grip designed 13
for use by the nonfiring hand to improve control; 14
(E) A fixed magazine in excess of seven rounds; or15
(F) A revolving cylinder shotgun. 16
(b) For the purposes of this subsection, "fixed magazine" means 17
an ammunition feeding device contained in, or permanently attached 18
to, a firearm in such a manner that the device cannot be removed 19
without disassembly of the firearm action. 20
(c) "Assault weapon" does not include antique firearms, any 21
firearm that has been made permanently inoperable, or any firearm 22
that is manually operated by bolt, pump, lever, or slide action.23
(3) "Assemble" means to fit together component parts.24
(4) "Barrel length" means the distance from the bolt face of a 25
closed action down the length of the axis of the bore to the crown of 26
the muzzle, or in the case of a barrel with attachments to the end of 27
any legal device permanently attached to the end of the muzzle.28
(5) "Bump-fire stock" means a butt stock designed to be attached 29
to a semiautomatic firearm with the effect of increasing the rate of 30
fire achievable with the semiautomatic firearm to that of a fully 31
automatic firearm by using the energy from the recoil of the firearm 32
to generate reciprocating action that facilitates repeated activation 33
of the trigger. 34
(6) "Conviction" or "convicted" means, whether in an adult court 35
or adjudicated in a juvenile court, that a plea of guilty has been 36
accepted or a verdict of guilty has been filed, or a finding of guilt 37
has been entered, notwithstanding the pendency of any future 38
proceedings including, but not limited to, sentencing or disposition, 39
posttrial or post-fact-finding motions, and appeals. "Conviction" 40
p. 160 HB 1281
includes a dismissal entered after a period of probation, suspension, 1
or deferral of sentence, and also includes equivalent dispositions by 2
courts in jurisdictions other than Washington state.3
(7) "Crime of violence" means: 4
(a) Any of the following felonies, as now existing or hereafter 5
amended: Any felony defined under any law as a class A felony or an 6
attempt to commit a class A felony, criminal solicitation of or 7
criminal conspiracy to commit a class A felony, manslaughter in the 8
first degree, manslaughter in the second degree, indecent liberties 9
if committed by forcible compulsion, kidnapping in the second degree, 10
arson in the second degree, assault in the second degree, assault of 11
a child in the second degree, extortion in the first degree, burglary 12
in the second degree, residential burglary, and robbery in the second 13
degree; 14
(b) Any conviction for a felony offense in effect at any time 15
prior to June 6, 1996, which is comparable to a felony classified as 16
a crime of violence in (a) of this subsection; and17
(c) Any federal or out-of-state conviction for an offense 18
comparable to a felony classified as a crime of violence under (a) or 19
(b) of this subsection. 20
(8) "Curio or relic" has the same meaning as provided in 27 21
C.F.R. Sec. 478.11. 22
(9) "Dealer" means a person engaged in the business of selling 23
firearms at wholesale or retail who has, or is required to have, a 24
federal firearms license under 18 U.S.C. Sec. 923 (a). A person who 25
does not have, and is not required to have, a federal firearms 26
license under 18 U.S.C. Sec. 923 (a), is not a dealer if that person 27
makes only occasional sales, exchanges, or purchases of firearms for 28
the enhancement of a personal collection or for a hobby, or sells all 29
or part of his or her personal collection of firearms.30
(10) "Detachable magazine" means an ammunition feeding device 31
that can be loaded or unloaded while detached from a firearm and 32
readily inserted into a firearm. 33
(11) "Distribute" means to give out, provide, make available, or 34
deliver a firearm or large capacity magazine to any person in this 35
state, with or without consideration, whether the distributor is in-36
state or out-of-state. "Distribute" includes, but is not limited to, 37
filling orders placed in this state, online or otherwise. 38
"Distribute" also includes causing a firearm or large capacity 39
magazine to be delivered in this state. 40
p. 161 HB 1281
(12) "Domestic violence" has the same meaning as provided in RCW 1
10.99.020. 2
(13) "Family or household member" has the same meaning as in RCW 3
7.105.010. 4
(14) "Federal firearms dealer" means a licensed dealer as defined 5
in 18 U.S.C. Sec. 921(a)(11). 6
(15) "Federal firearms importer" means a licensed importer as 7
defined in 18 U.S.C. Sec. 921(a)(9). 8
(16) "Federal firearms manufacturer" means a licensed 9
manufacturer as defined in 18 U.S.C. Sec. 921(a)(10).10
(17) "Felony" means any felony offense under the laws of this 11
state or any federal or out-of-state offense comparable to a felony 12
offense under the laws of this state. 13
(18) "Felony firearm offender" means a person who has previously 14
been convicted or found not guilty by reason of insanity in this 15
state of any felony firearm offense. A person is not a felony firearm 16
offender under this chapter if any and all qualifying offenses have 17
been the subject of an expungement, pardon, annulment, certificate, 18
or rehabilitation, or other equivalent procedure based on a finding 19
of the rehabilitation of the person convicted or a pardon, annulment, 20
or other equivalent procedure based on a finding of innocence.21
(19) "Felony firearm offense" means: 22
(a) Any felony offense that is a violation of this chapter;23
(b) A violation of RCW 9A.36.045; 24
(c) A violation of RCW 9A.56.300; 25
(d) A violation of RCW 9A.56.310; 26
(e) Any felony offense if the offender was armed with a firearm 27
in the commission of the offense. 28
(20) "Firearm" means a weapon or device from which a projectile 29
or projectiles may be fired by an explosive such as gunpowder. For 30
the purposes of RCW 9.41.040, "firearm" also includes frames and 31
receivers. "Firearm" does not include a flare gun or other 32
pyrotechnic visual distress signaling device, or a powder-actuated 33
tool or other device designed solely to be used for construction 34
purposes. 35
(21)(a) "Frame or receiver" means a part of a firearm that, when 36
the complete firearm is assembled, is visible from the exterior and 37
provides housing or a structure designed to hold or integrate one or 38
more fire control components, even if pins or other attachments are 39
required to connect the fire control components. Any such part 40
p. 162 HB 1281
identified with a serial number shall be presumed, absent an official 1
determination by the bureau of alcohol, tobacco, firearms, and 2
explosives or other reliable evidence to the contrary, to be a frame 3
or receiver. 4
(b) For purposes of this subsection, "fire control component" 5
means a component necessary for the firearm to initiate, complete, or 6
continue the firing sequence, including any of the following: Hammer, 7
bolt, bolt carrier, breechblock, cylinder, trigger mechanism, firing 8
pin, striker, or slide rails. 9
(22) "Gun" has the same meaning as firearm. 10
(23) "Import" means to move, transport, or receive an item from a 11
place outside the territorial limits of the state of Washington to a 12
place inside the territorial limits of the state of Washington. 13
"Import" does not mean situations where an individual possesses a 14
large capacity magazine or assault weapon when departing from, and 15
returning to, Washington state, so long as the individual is 16
returning to Washington in possession of the same large capacity 17
magazine or assault weapon the individual transported out of state.18
(24) "Intimate partner" has the same meaning as provided in RCW 19
7.105.010. 20
(25) "Large capacity magazine" means an ammunition feeding device 21
with the capacity to accept more than 10 rounds of ammunition, or any 22
conversion kit, part, or combination of parts, from which such a 23
device can be assembled if those parts are in possession of or under 24
the control of the same person, but shall not be construed to include 25
any of the following: 26
(a) An ammunition feeding device that has been permanently 27
altered so that it cannot accommodate more than 10 rounds of 28
ammunition; 29
(b) A 22 caliber tube ammunition feeding device; or30
(c) A tubular magazine that is contained in a lever-action 31
firearm. 32
(26) "Law enforcement officer" includes a general authority 33
Washington peace officer as defined in RCW 10.93.020, or a specially 34
commissioned Washington peace officer as defined in RCW 10.93.020. 35
"Law enforcement officer" also includes a limited authority 36
Washington peace officer as defined in RCW 10.93.020 if such officer 37
is duly authorized by his or her employer to carry a concealed 38
pistol. 39
p. 163 HB 1281
(27) "Lawful permanent resident" has the same meaning afforded a 1
person "lawfully admitted for permanent residence" in 8 U.S.C. Sec. 2
1101(a)(20). 3
(28) "Licensed collector" means a person who is federally 4
licensed under 18 U.S.C. Sec. 923(b). 5
(29) "Licensed dealer" means a person who is federally licensed 6
under 18 U.S.C. Sec. 923(a). 7
(30) "Loaded" means: 8
(a) There is a cartridge in the chamber of the firearm;9
(b) Cartridges are in a clip that is locked in place in the 10
firearm; 11
(c) There is a cartridge in the cylinder of the firearm, if the 12
firearm is a revolver; 13
(d) There is a cartridge in the tube or magazine that is inserted 14
in the action; or 15
(e) There is a ball in the barrel and the firearm is capped or 16
primed if the firearm is a muzzle loader. 17
(31) "Machine gun" means any firearm known as a machine gun, 18
mechanical rifle, submachine gun, or any other mechanism or 19
instrument not requiring that the trigger be pressed for each shot 20
and having a reservoir clip, disc, drum, belt, or other separable 21
mechanical device for storing, carrying, or supplying ammunition 22
which can be loaded into the firearm, mechanism, or instrument, and 23
fired therefrom at the rate of five or more shots per second.24
(32) "Manufacture" means, with respect to a firearm or large 25
capacity magazine, the fabrication, making, formation, production, or 26
construction of a firearm or large capacity magazine, by manual labor 27
or by machinery. 28
(33) "Mental health professional" means a psychiatrist, 29
psychologist, or physician assistant working with a psychiatrist who 30
is acting as a participating physician as defined in RCW 18.71A.010, 31
psychiatric advanced ((registered nurse practitioner )) practice 32
registered nurse , psychiatric nurse, social worker, mental health 33
counselor, marriage and family therapist, or such other mental health 34
professionals as may be defined in statute or by rules adopted by the 35
department of health pursuant to the provisions of chapter 71.05 RCW.36
(34) "Nonimmigrant alien" means a person defined as such in 8 37
U.S.C. Sec. 1101(a)(15). 38
p. 164 HB 1281
(35) "Person" means any individual, corporation, company, 1
association, firm, partnership, club, organization, society, joint 2
stock company, or other legal entity. 3
(36) "Pistol" means any firearm with a barrel less than 16 inches 4
in length, or is designed to be held and fired by the use of a single 5
hand. 6
(37) "Rifle" means a weapon designed or redesigned, made or 7
remade, and intended to be fired from the shoulder and designed or 8
redesigned, made or remade, and intended to use the energy of the 9
explosive in a fixed metallic cartridge to fire only a single 10
projectile through a rifled bore for each single pull of the trigger.11
(38) "Sale" and "sell" mean the actual approval of the delivery 12
of a firearm in consideration of payment or promise of payment.13
(39) "Secure gun storage" means: 14
(a) A locked box, gun safe, or other secure locked storage space 15
that is designed to prevent unauthorized use or discharge of a 16
firearm; and 17
(b) The act of keeping an unloaded firearm stored by such means.18
(40) "Semiautomatic" means any firearm which utilizes a portion 19
of the energy of a firing cartridge to extract the fired cartridge 20
case and chamber the next round, and which requires a separate pull 21
of the trigger to fire each cartridge. 22
(41)(a) "Semiautomatic assault rifle" means any rifle which 23
utilizes a portion of the energy of a firing cartridge to extract the 24
fired cartridge case and chamber the next round, and which requires a 25
separate pull of the trigger to fire each cartridge.26
(b) "Semiautomatic assault rifle" does not include antique 27
firearms, any firearm that has been made permanently inoperable, or 28
any firearm that is manually operated by bolt, pump, lever, or slide 29
action. 30
(42) "Serious offense" means any of the following felonies or a 31
felony attempt to commit any of the following felonies, as now 32
existing or hereafter amended: 33
(a) Any crime of violence; 34
(b) Any felony violation of the uniform controlled substances 35
act, chapter 69.50 RCW, that is classified as a class B felony or 36
that has a maximum term of imprisonment of at least 10 years;37
(c) Child molestation in the second degree; 38
(d) Incest when committed against a child under age 14;39
(e) Indecent liberties; 40
p. 165 HB 1281
(f) Leading organized crime; 1
(g) Promoting prostitution in the first degree;2
(h) Rape in the third degree; 3
(i) Drive-by shooting; 4
(j) Sexual exploitation; 5
(k) Vehicular assault, when caused by the operation or driving of 6
a vehicle by a person while under the influence of intoxicating 7
liquor or any drug or by the operation or driving of a vehicle in a 8
reckless manner; 9
(l) Vehicular homicide, when proximately caused by the driving of 10
any vehicle by any person while under the influence of intoxicating 11
liquor or any drug as defined by RCW 46.61.502, or by the operation 12
of any vehicle in a reckless manner; 13
(m) Any other class B felony offense with a finding of sexual 14
motivation, as "sexual motivation" is defined under RCW 9.94A.030;15
(n) Any other felony with a deadly weapon verdict under RCW 16
9.94A.825; 17
(o) Any felony offense in effect at any time prior to June 6, 18
1996, that is comparable to a serious offense, or any federal or out-19
of-state conviction for an offense that under the laws of this state 20
would be a felony classified as a serious offense;21
(p) Any felony conviction under RCW 9.41.115; or22
(q) Any felony charged under RCW 46.61.502(6) or 46.61.504(6).23
(43) "Sex offense" has the same meaning as provided in RCW 24
9.94A.030. 25
(44) "Short-barreled rifle" means a rifle having one or more 26
barrels less than 16 inches in length and any weapon made from a 27
rifle by any means of modification if such modified weapon has an 28
overall length of less than 26 inches. 29
(45) "Short-barreled shotgun" means a shotgun having one or more 30
barrels less than 18 inches in length and any weapon made from a 31
shotgun by any means of modification if such modified weapon has an 32
overall length of less than 26 inches. 33
(46) "Shotgun" means a weapon with one or more barrels, designed 34
or redesigned, made or remade, and intended to be fired from the 35
shoulder and designed or redesigned, made or remade, and intended to 36
use the energy of the explosive in a fixed shotgun shell to fire 37
through a smooth bore either a number of ball shot or a single 38
projectile for each single pull of the trigger. 39
p. 166 HB 1281
(47) "Substance use disorder professional" means a person 1
certified under chapter 18.205 RCW. 2
(48) "Transfer" means the intended delivery of a firearm to 3
another person without consideration of payment or promise of payment 4
including, but not limited to, gifts and loans. "Transfer" does not 5
include the delivery of a firearm owned or leased by an entity 6
licensed or qualified to do business in the state of Washington to, 7
or return of such a firearm by, any of that entity's employees or 8
agents, defined to include volunteers participating in an honor 9
guard, for lawful purposes in the ordinary course of business.10
(49) "Undetectable firearm" means any firearm that is not as 11
detectable as 3.7 ounces of 17-4 PH stainless steel by walk-through 12
metal detectors or magnetometers commonly used at airports or any 13
firearm where the barrel, the slide or cylinder, or the frame or 14
receiver of the firearm would not generate an image that accurately 15
depicts the shape of the part when examined by the types of X-ray 16
machines commonly used at airports. 17
(50)(a) "Unfinished frame or receiver" means a frame or receiver 18
that is partially complete, disassembled, or inoperable, that: (i) 19
Has reached a stage in manufacture where it may readily be completed, 20
assembled, converted, or restored to a functional state; or (ii) is 21
marketed or sold to the public to become or be used as the frame or 22
receiver of a functional firearm once finished or completed, 23
including without limitation products marketed or sold to the public 24
as an 80 percent frame or receiver or unfinished frame or receiver.25
(b) For purposes of this subsection: 26
(i) "Readily" means a process that is fairly or reasonably 27
efficient, quick, and easy, but not necessarily the most efficient, 28
speedy, or easy process. Factors relevant in making this 29
determination, with no single one controlling, include the following: 30
(A) Time, i.e., how long it takes to finish the process; (B) ease, 31
i.e., how difficult it is to do so; (C) expertise, i.e., what 32
knowledge and skills are required; (D) equipment, i.e., what tools 33
are required; (E) availability, i.e., whether additional parts are 34
required, and how easily they can be obtained; (F) expense, i.e., how 35
much it costs; (G) scope, i.e., the extent to which the subject of 36
the process must be changed to finish it; and (H) feasibility, i.e., 37
whether the process would damage or destroy the subject of the 38
process, or cause it to malfunction. 39
p. 167 HB 1281
(ii) "Partially complete," as it modifies frame or receiver, 1
means a forging, casting, printing, extrusion, machined body, or 2
similar article that has reached a stage in manufacture where it is 3
clearly identifiable as an unfinished component part of a firearm.4
(51) "Unlicensed person" means any person who is not a licensed 5
dealer under this chapter. 6
(52) "Untraceable firearm" means any firearm manufactured after 7
July 1, 2019, that is not an antique firearm and that cannot be 8
traced by law enforcement by means of a serial number affixed to the 9
firearm by a federal firearms manufacturer, federal firearms 10
importer, or federal firearms dealer in compliance with all federal 11
laws and regulations. 12
(53) "Washington state patrol firearms background check program" 13
means the division within the state patrol that conducts background 14
checks for all firearm transfers and the disposition of firearms.15
Sec. 5065. RCW 10.77.010 and 2023 c 453 s 2 and 2023 c 120 s 5 16
are each reenacted and amended to read as follows:17
As used in this chapter: 18
(1) "Admission" means acceptance based on medical necessity, of a 19
person as a patient. 20
(2) "Authority" means the Washington state health care authority.21
(3) "Clinical intervention specialist" means a licensed 22
professional with prescribing authority who is employed by or 23
contracted with the department to provide direct services, enhanced 24
oversight and monitoring of the behavioral health status of in-25
custody defendants who have been referred for evaluation or 26
restoration services related to competency to stand trial and who 27
coordinate treatment options with forensic navigators, the 28
department, and jail health services. 29
(4) "Commitment" means the determination by a court that a person 30
should be detained for a period of either evaluation or treatment, or 31
both, in an inpatient or a less-restrictive setting.32
(5) "Community behavioral health agency" has the same meaning as 33
"licensed or certified behavioral health agency" defined in RCW 34
71.24.025. 35
(6) "Conditional release" means modification of a court-ordered 36
commitment, which may be revoked upon violation of any of its terms.37
(7) A "criminally insane" person means any person who has been 38
acquitted of a crime charged by reason of insanity, and thereupon 39
p. 168 HB 1281
found to be a substantial danger to other persons or to present a 1
substantial likelihood of committing criminal acts jeopardizing 2
public safety or security unless kept under further control by the 3
court or other persons or institutions. 4
(8) "Department" means the state department of social and health 5
services. 6
(9) "Designated crisis responder" has the same meaning as 7
provided in RCW 71.05.020. 8
(10) "Detention" or "detain" means the lawful confinement of a 9
person, under the provisions of this chapter, pending evaluation.10
(11) "Developmental disabilities professional" means a person who 11
has specialized training and experience in directly treating or 12
working with persons with developmental disabilities and is a 13
psychiatrist or psychologist, or a social worker, and such other 14
developmental disabilities professionals as may be defined by rules 15
adopted by the secretary. 16
(12) "Developmental disability" means the condition as defined in 17
RCW 71A.10.020. 18
(13) "Discharge" means the termination of hospital medical 19
authority. The commitment may remain in place, be terminated, or be 20
amended by court order. 21
(14) "Furlough" means an authorized leave of absence for a 22
resident of a state institution operated by the department designated 23
for the custody, care, and treatment of the criminally insane, 24
consistent with an order of conditional release from the court under 25
this chapter, without any requirement that the resident be 26
accompanied by, or be in the custody of, any law enforcement or 27
institutional staff, while on such unescorted leave.28
(15) "Genuine doubt as to competency" means that there is 29
reasonable cause to believe, based upon actual interactions with or 30
observations of the defendant or information provided by counsel, 31
that a defendant is incompetent to stand trial. 32
(16) "Habilitative services" means those services provided by 33
program personnel to assist persons in acquiring and maintaining life 34
skills and in raising their levels of physical, mental, social, and 35
vocational functioning. Habilitative services include education, 36
training for employment, and therapy. The habilitative process shall 37
be undertaken with recognition of the risk to the public safety 38
presented by the person being assisted as manifested by prior charged 39
criminal conduct. 40
p. 169 HB 1281
(17) "History of one or more violent acts" means violent acts 1
committed during: (a) The 10-year period of time prior to the filing 2
of criminal charges; plus (b) the amount of time equal to time spent 3
during the 10-year period in a mental health facility or in 4
confinement as a result of a criminal conviction. 5
(18) "Immediate family member" means a spouse, child, stepchild, 6
parent, stepparent, grandparent, sibling, or domestic partner.7
(19) "Incompetency" means a person lacks the capacity to 8
understand the nature of the proceedings against him or her or to 9
assist in his or her own defense as a result of mental disease or 10
defect. 11
(20) "Indigent" means any person who is indigent as defined in 12
RCW 10.101.010, or financially unable to obtain counsel or other 13
necessary expert or professional services without causing substantial 14
hardship to the person or his or her family. 15
(21) "Individualized service plan" means a plan prepared by a 16
developmental disabilities professional with other professionals as a 17
team, for an individual with developmental disabilities, which shall 18
state: 19
(a) The nature of the person's specific problems, prior charged 20
criminal behavior, and habilitation needs; 21
(b) The conditions and strategies necessary to achieve the 22
purposes of habilitation; 23
(c) The intermediate and long-range goals of the habilitation 24
program, with a projected timetable for the attainment;25
(d) The rationale for using this plan of habilitation to achieve 26
those intermediate and long-range goals; 27
(e) The staff responsible for carrying out the plan;28
(f) Where relevant in light of past criminal behavior and due 29
consideration for public safety, the criteria for proposed movement 30
to less-restrictive settings, criteria for proposed eventual release, 31
and a projected possible date for release; and 32
(g) The type of residence immediately anticipated for the person 33
and possible future types of residences. 34
(22) "Professional person" means: 35
(a) A psychiatrist licensed as a physician and surgeon in this 36
state who has, in addition, completed three years of graduate 37
training in psychiatry in a program approved by the American medical 38
association or the American osteopathic association and is certified 39
or eligible to be certified by the American board of psychiatry and 40
p. 170 HB 1281
neurology or the American osteopathic board of neurology and 1
psychiatry; 2
(b) A psychologist licensed as a psychologist pursuant to chapter 3
18.83 RCW; 4
(c) A psychiatric advanced ((registered nurse practitioner )) 5
practice registered nurse, as defined in RCW 71.05.020; or6
(d) A social worker with a master's or further advanced degree 7
from a social work educational program accredited and approved as 8
provided in RCW 18.320.010. 9
(23) "Release" means legal termination of the court-ordered 10
commitment under the provisions of this chapter. 11
(24) "Secretary" means the secretary of the department of social 12
and health services or his or her designee. 13
(25) "Treatment" means any currently standardized medical or 14
mental health procedure including medication. 15
(26) "Treatment records" include registration and all other 16
records concerning persons who are receiving or who at any time have 17
received services for mental illness, which are maintained by the 18
department, by behavioral health administrative services 19
organizations and their staffs, by managed care organizations and 20
their staffs, and by treatment facilities. Treatment records do not 21
include notes or records maintained for personal use by a person 22
providing treatment services for the department, behavioral health 23
administrative services organizations, managed care organizations, or 24
a treatment facility if the notes or records are not available to 25
others. 26
(27) "Violent act" means behavior that: (a)(i) Resulted in; (ii) 27
if completed as intended would have resulted in; or (iii) was 28
threatened to be carried out by a person who had the intent and 29
opportunity to carry out the threat and would have resulted in, 30
homicide, nonfatal injuries, or substantial damage to property; or 31
(b) recklessly creates an immediate risk of serious physical injury 32
to another person. As used in this subsection, "nonfatal injuries" 33
means physical pain or injury, illness, or an impairment of physical 34
condition. "Nonfatal injuries" shall be construed to be consistent 35
with the definition of "bodily injury," as defined in RCW 9A.04.110.36
Sec. 5066. RCW 10.77.175 and 2024 c 62 s 13 are each amended to 37
read as follows: 38
p. 171 HB 1281
(1) Conditional release planning should start at admission and 1
proceed in coordination between the department and the person's 2
managed care organization, or behavioral health administrative 3
services organization if the person is not eligible for medical 4
assistance under chapter 74.09 RCW. If needed, the department shall 5
assist the person to enroll in medical assistance in suspense status 6
under RCW 74.09.670. The state hospital liaison for the managed care 7
organization or behavioral health administrative services 8
organization shall facilitate conditional release planning in 9
collaboration with the department. 10
(2) Less restrictive alternative treatment pursuant to a 11
conditional release order, at a minimum, includes the following 12
services: 13
(a) Assignment of a care coordinator; 14
(b) An intake evaluation with the provider of the conditional 15
treatment; 16
(c) A psychiatric evaluation or a substance use disorder 17
evaluation, or both; 18
(d) A schedule of regular contacts with the provider of the less 19
restrictive alternative treatment services for the duration of the 20
order; 21
(e) A transition plan addressing access to continued services at 22
the expiration of the order; 23
(f) An individual crisis plan; 24
(g) Consultation about the formation of a mental health advance 25
directive under chapter 71.32 RCW; 26
(h) Appointment of a transition team under RCW 10.77.150; and27
(i) Notification to the care coordinator assigned in (a) of this 28
subsection and to the transition team as provided in RCW 10.77.150 if 29
reasonable efforts to engage the client fail to produce substantial 30
compliance with court-ordered treatment conditions.31
(3) Less restrictive alternative treatment pursuant to a 32
conditional release order may additionally include requirements to 33
participate in the following services: 34
(a) Medication management; 35
(b) Psychotherapy; 36
(c) Nursing; 37
(d) Substance use disorder counseling; 38
(e) Residential treatment; 39
(f) Partial hospitalization; 40
p. 172 HB 1281
(g) Intensive outpatient treatment; 1
(h) Support for housing, benefits, education, and employment; and2
(i) Periodic court review. 3
(4) Nothing in this section prohibits items in subsection (2) of 4
this section from beginning before the conditional release of the 5
individual. 6
(5) If the person was provided with involuntary medication under 7
RCW 10.77.094 or pursuant to a judicial order during the involuntary 8
commitment period, the less restrictive alternative treatment 9
pursuant to the conditional release order may authorize the less 10
restrictive alternative treatment provider or its designee to 11
administer involuntary antipsychotic medication to the person if the 12
provider has attempted and failed to obtain the informed consent of 13
the person and there is a concurring medical opinion approving the 14
medication by a psychiatrist, physician assistant working with a 15
psychiatrist who is acting as a participating physician as defined in 16
RCW 18.71A.010, psychiatric advanced ((registered nurse 17
practitioner)) practice registered nurse , or physician or physician 18
assistant in consultation with an independent mental health 19
professional with prescribing authority. 20
(6) Less restrictive alternative treatment pursuant to a 21
conditional release order must be administered by a provider that is 22
certified or licensed to provide or coordinate the full scope of 23
services required under the less restrictive alternative order and 24
that has agreed to assume this responsibility. 25
(7) The care coordinator assigned to a person ordered to less 26
restrictive alternative treatment pursuant to a conditional release 27
order must submit an individualized plan for the person's treatment 28
services to the court that entered the order. An initial plan must be 29
submitted as soon as possible following the intake evaluation and a 30
revised plan must be submitted upon any subsequent modification in 31
which a type of service is removed from or added to the treatment 32
plan. 33
(8) A care coordinator may disclose information and records 34
related to mental health treatment under RCW 70.02.230(2)(k) for 35
purposes of implementing less restrictive alternative treatment 36
pursuant to a conditional release order. 37
(9) For the purpose of this section, "care coordinator" means a 38
representative from the department of social and health services who 39
coordinates the activities of less restrictive alternative treatment 40
p. 173 HB 1281
pursuant to a conditional release order. The care coordinator 1
coordinates activities with the person's transition team that are 2
necessary for enforcement and continuation of the conditional release 3
order and is responsible for coordinating service activities with 4
other agencies and establishing and maintaining a therapeutic 5
relationship with the individual on a continuing basis.6
Sec. 5067. RCW 11.130.290 and 2020 c 312 s 203 are each amended 7
to read as follows: 8
(1) On receipt of a petition under RCW 11.130.270 and at the time 9
the court appoints a court visitor under RCW 11.130.280, the court 10
shall order a professional evaluation of the respondent.11
(2) The respondent must be examined by a physician licensed to 12
practice under chapter 18.71 or 18.57 RCW, psychologist licensed 13
under chapter 18.83 RCW, advanced ((registered nurse practitioner )) 14
practice registered nurse licensed under chapter 18.79 RCW, or 15
physician assistant licensed under chapter 18.71A RCW selected by the 16
court visitor who is qualified to evaluate the respondent's alleged 17
cognitive and functional abilities and limitations and will not be 18
advantaged or disadvantaged by a decision to grant the petition or 19
otherwise have a conflict of interest. If the respondent opposes the 20
professional selected by the court visitor, the court visitor shall 21
obtain a professional evaluation from the professional selected by 22
the respondent. The court visitor, after receiving a professional 23
evaluation from the individual selected by the respondent, may obtain 24
a supplemental evaluation from a different professional.25
(3) The individual conducting the evaluation shall provide the 26
completed evaluation report to the court visitor within thirty days 27
of the examination of the respondent. The court visitor shall file 28
the report in a sealed record with the court. Unless otherwise 29
directed by the court, the report must contain: 30
(a) The professional's name, address, education, and experience;31
(b) A description of the nature, type, and extent of the 32
respondent's cognitive and functional abilities and limitations;33
(c) An evaluation of the respondent's mental and physical 34
condition and, if appropriate, educational potential, adaptive 35
behavior, and social skills; 36
(d) A prognosis for improvement and recommendation for the 37
appropriate treatment, support, or habilitation plan;38
p. 174 HB 1281
(e) A description of the respondent's current medications, and 1
the effect of the medications on the respondent's cognitive and 2
functional abilities; 3
(f) Identification or persons with whom the professional has met 4
or spoken with regarding the respondent; and 5
(g) The date of the examination on which the report is based.6
(4) If the respondent declines to participate in an evaluation 7
ordered under subsection (1) of this section, the court may proceed 8
with the hearing under RCW 11.130.275 if the court finds that it has 9
sufficient information to determine the respondent's needs and 10
abilities without the professional evaluation. 11
Sec. 5068. RCW 11.130.390 and 2020 c 312 s 212 are each amended 12
to read as follows: 13
(1) On receipt of a petition under RCW 11.130.360 and at the time 14
the court appoints a court visitor under RCW 11.130.380, the court 15
shall order a professional evaluation of the respondent.16
(2) The respondent must be examined by a physician licensed to 17
practice under chapter 18.71 or 18.57 RCW, psychologist licensed 18
under chapter 18.83 RCW, advanced ((registered nurse practitioner )) 19
practice registered nurse licensed under chapter 18.79 RCW, or 20
physician assistant licensed under chapter 18.71A RCW, selected by 21
the court visitor who is qualified to evaluate the respondent's 22
alleged cognitive and functional abilities and limitations and will 23
not be advantaged or disadvantaged by a decision to grant the 24
petition or otherwise have a conflict of interest. If the respondent 25
opposes the professional selected by the court visitor, the court 26
visitor shall obtain a professional evaluation from the professional 27
selected by the respondent. The court visitor, after receiving a 28
professional evaluation from the individual selected by the 29
respondent, may obtain a supplemental evaluation from a different 30
professional. 31
(3) The individual conducting the evaluation shall promptly 32
provide the completed evaluation report to the court visitor who 33
shall file the report in a sealed record with the court. Unless 34
otherwise directed by the court, the report must contain:35
(a) The professional's name, address, education, and experience;36
(b) A description of the nature, type, and extent of the 37
respondent's cognitive and functional abilities and limitations with 38
p. 175 HB 1281
regard to the management of the respondent's property and financial 1
affairs; 2
(c) An evaluation of the respondent's mental and physical 3
condition and, if appropriate, educational potential, adaptive 4
behavior, and social skills; 5
(d) A prognosis for improvement with regard to the ability to 6
manage the respondent's property and financial affairs;7
(e) A description of the respondent's current medications, and 8
the effect of the medications on the respondent's cognitive and 9
functional abilities; 10
(f) Identification or persons with whom the professional has met 11
or spoken with regarding the respondent; and 12
(g) The date of the examination on which the report is based.13
(4) If the respondent declines to participate in an evaluation 14
ordered under subsection (1) of this section, the court may proceed 15
with the hearing under RCW 11.130.370 if the court finds that it has 16
sufficient information to determine the respondent's needs and 17
abilities without the professional evaluation. 18
(5) A professional evaluation is not required if a petition for 19
appointment of a conservator under RCW 11.130.360 is for a 20
conservator for the property or financial affairs of a minor or for 21
an adult missing, detained, or unable to return to the United States.22
Sec. 5069. RCW 11.130.615 and 2020 c 312 s 319 are each amended 23
to read as follows: 24
(1) On receipt of a petition under RCW 11.130.595 and at the time 25
the court appoints a court visitor under RCW 11.130.605, the court 26
shall order a professional evaluation of the respondent.27
(2) The respondent must be examined by a physician licensed to 28
practice under chapter 18.71 or 18.57 RCW, psychologist licensed 29
under chapter 18.83 RCW, advanced ((registered nurse practitioner )) 30
practice registered nurse licensed under chapter 18.79 RCW, or 31
physician assistant licensed under chapter 18.71A RCW selected by the 32
court visitor who is qualified to evaluate the respondent's alleged 33
cognitive and functional abilities and limitations and will not be 34
advantaged or disadvantaged by a decision to grant the petition or 35
otherwise have a conflict of interest. If the respondent opposes the 36
professional selected by the court visitor, the court visitor shall 37
obtain a professional evaluation from the professional selected by 38
the respondent. The court visitor, after receiving a professional 39
p. 176 HB 1281
evaluation from the individual selected by the respondent, may obtain 1
a supplemental evaluation from a different professional.2
(3) The individual conducting the evaluation shall provide the 3
completed evaluation report to the court visitor within thirty days 4
of the examination of the respondent. The court visitor shall file 5
the report in a sealed record with the court. Unless otherwise 6
directed by the court, the report must contain: 7
(a) The professional's name, address, education, and experience;8
(b) A description of the nature, type, and extent of the 9
respondent's cognitive and functional abilities and limitations;10
(c) An evaluation of the respondent's mental and physical 11
condition and, if appropriate, education potential, adaptive 12
behavior, and social skills; 13
(d) A prognosis for improvement and recommendation for the 14
appropriate treatment, support, or habilitation plan;15
(e) A description of the respondent's current medications, and 16
the effect of the medications on the respondent's cognitive and 17
functional abilities; 18
(f) Identification or persons with whom the professional has met 19
or spoken with regarding the respondent; and 20
(g) The date of the examination on which the report is based.21
(4) If the respondent declines to participate in an evaluation 22
ordered under subsection (1) of this section, the court may proceed 23
with the hearing under RCW 11.130.600 if the court finds that it has 24
sufficient information to determine the respondent's needs and 25
abilities without the professional evaluation. 26
Sec. 5070. RCW 18.16.260 and 2013 c 187 s 11 are each amended to 27
read as follows: 28
(1)(a) Prior to July 1, 2005, (i) a cosmetology licensee who held 29
a license in good standing between June 30, 1999, and June 30, 2003, 30
may request a renewal of the license or an additional license in 31
barbering, manicuring, and/or esthetics; and (ii) a licensee who held 32
a barber, manicurist, or esthetics license between June 30, 1999, and 33
June 30, 2003, may request a renewal of such licenses held during 34
that period. 35
(b) A license renewal fee, including, if applicable, a renewal 36
fee, at the current rate, for each year the licensee did not hold a 37
license in good standing between July 1, 2001, and the date of the 38
renewal request, must be paid prior to issuance of each type of 39
p. 177 HB 1281
license requested. After June 30, 2005, any cosmetology licensee 1
wishing to renew an expired license or obtain additional licenses 2
must meet the applicable renewal, training, and examination 3
requirements of this chapter. 4
(2)(a) Any person holding an active license in good standing as 5
an esthetician prior to January 1, 2015, may be licensed as an 6
esthetician licensee after paying the appropriate license fee.7
(b) Prior to January 1, 2015, an applicant for a master 8
esthetician license must have an active license in good standing as 9
an esthetician, pay the appropriate license fee, and provide the 10
department with proof of having satisfied one or more of the 11
following requirements: 12
(i)(A)(I) A minimum of thirty-five hours employment as a provider 13
of medium depth peels under the delegation or supervision of a 14
licensed physician, advanced ((registered nurse practitioner )) 15
practice registered nurse , or physician assistant, or other licensed 16
professional whose licensure permits such delegation or supervision; 17
or 18
(II) Seven hours of training in theory and application of medium 19
depth peels; and 20
(B)(I) A minimum of one hundred fifty hours employment as a laser 21
operator under the delegation or supervision of a licensed physician, 22
advanced ((registered nurse practitioner )) practice registered nurse , 23
or physician assistant, or other licensed professional whose 24
licensure permits such delegation or supervision; or25
(II) Seventy-five hours of laser training; 26
(ii) A national or international diploma or certification in 27
esthetics that is recognized by the department by rule;28
(iii) An instructor in esthetics who has been licensed as an 29
instructor in esthetics by the department for a minimum of three 30
years; or 31
(iv) Completion of one thousand two hundred hours of an esthetic 32
curriculum approved by the department. 33
(3) The director may, as provided in RCW 43.24.140, modify the 34
duration of any additional license granted under this section to make 35
all licenses issued to a person expire on the same date.36
Sec. 5071. RCW 18.50.005 and 2022 c 289 s 1 are each amended to 37
read as follows: 38
p. 178 HB 1281
Unless the context clearly requires otherwise, the definitions in 1
this section apply throughout this chapter: 2
(1) "Advanced ((registered nurse practitioner" means an advanced 3
registered nurse practitioner )) practice registered nurse" means an 4
advanced practice registered nurse licensed under chapter 18.79 RCW.5
(2) "Department" means the department of health.6
(3) "Secretary" means the secretary of health. 7
(4) "Midwife" means a midwife licensed under this chapter.8
(5) "Naturopath" means a naturopath licensed under chapter 18.36A 9
RCW. 10
(6) "Physician" means a physician licensed under chapter 18.57 or 11
18.71 RCW. 12
(7) "Physician assistant" means a physician assistant licensed 13
under chapter 18.71A RCW. 14
Sec. 5072. RCW 18.50.115 and 2022 c 289 s 6 are each amended to 15
read as follows: 16
(1) A midwife licensed under this chapter may obtain and 17
administer prophylactic ophthalmic medication, postpartum oxytocic, 18
vitamin K, Rho immune globulin (human), and local anesthetic and may 19
administer such other drugs or medications as prescribed by a 20
physician, an advanced ((registered nurse practitioner )) practice 21
registered nurse , a naturopath, or a physician assistant acting 22
within the practitioner's scope of practice. A pharmacist who 23
dispenses such drugs to a licensed midwife shall not be liable for 24
any adverse reactions caused by any method of use by the midwife.25
(2) A midwife licensed under this chapter who has been granted a 26
limited prescriptive license extension by the secretary may 27
prescribe, obtain, and administer: 28
(a) Antibiotic, antiemetic, antiviral, antifungal, low-potency 29
topical steroid, and antipruritic medications and therapies, and 30
other medications and therapies as defined in the midwifery legend 31
drugs and devices rule for the prevention and treatment of conditions 32
that do not constitute a significant deviation from normal in 33
pregnancy or postpartum; and 34
(b) Hormonal and nonhormonal family planning methods.35
(3) A midwife licensed under this chapter who has been granted an 36
additional license extension to include medical devices and implants 37
by the secretary may prescribe, obtain, and administer hormonal and 38
nonhormonal family planning medical devices, as prescribed in rule.39
p. 179 HB 1281
(4) The secretary, after collaboration with representatives of 1
the midwifery advisory committee, the pharmacy quality assurance 2
commission, and the Washington medical commission, may adopt rules 3
that authorize licensed midwives to prescribe, obtain, and administer 4
legend drugs and devices in addition to the drugs authorized in this 5
chapter. 6
Sec. 5073. RCW 18.57.040 and 2021 c 247 s 2 are each amended to 7
read as follows: 8
Nothing in this chapter shall be construed to prohibit:9
(1) Service in the case of emergency; 10
(2) The domestic administration of family remedies;11
(3) The practice of midwifery as permitted under chapter 18.50 12
RCW; 13
(4) The practice of osteopathic medicine and surgery by any 14
commissioned medical officer in the United States government or 15
military service or by any osteopathic physician and surgeon employed 16
by a federal agency, in the discharge of his or her official duties;17
(5) Practice by a dentist licensed under chapter 18.32 RCW when 18
engaged exclusively in the practice of dentistry; 19
(6) The consultation through telemedicine or other means by a 20
practitioner, licensed by another state or territory in which he or 21
she resides, with a practitioner licensed in this state who has 22
responsibility for the diagnosis and treatment of the patient within 23
this state; 24
(7) In-person practice by any osteopathic physician and surgeon 25
from any other state or territory in which he or she resides: 26
PROVIDED, That such practitioner shall not open an office or appoint 27
a place of meeting patients or receive calls within the limits of 28
this state; 29
(8) Practice by a person who is a student enrolled in an 30
accredited school of osteopathic medicine and surgery approved by the 31
board if: 32
(a) The performance of such services is only pursuant to a course 33
of instruction or assignments from his or her instructor or school, 34
and such services are performed only under the supervision of a 35
person licensed pursuant to this chapter or chapter 18.71 RCW; or36
(b)(i) Such services are performed without compensation or 37
expectation of compensation as part of a volunteer activity;38
p. 180 HB 1281
(ii) The student is under the direct supervision and control of a 1
pharmacist licensed under chapter 18.64 RCW, a physician licensed 2
under chapter 18.71 RCW, an osteopathic physician and surgeon 3
licensed under this chapter, or a registered nurse or advanced 4
((registered nurse practitioner )) practice registered nurse licensed 5
under chapter 18.79 RCW; 6
(iii) The services the student performs are within the scope of 7
practice of: (A) An osteopathic physician and surgeon licensed under 8
this chapter; and (B) the person supervising the student;9
(iv) The school in which the student is enrolled verifies the 10
student has demonstrated competency through his or her education and 11
training to perform the services; and 12
(v) The student provides proof of current malpractice insurance 13
to the volunteer activity organizer prior to performing any services;14
(9) Practice by an osteopathic physician and surgeon serving a 15
period of clinical postgraduate medical training in a postgraduate 16
program approved by the board: PROVIDED, That the performance of such 17
services be only pursuant to a course of instruction in said program, 18
and said services are performed only under the supervision and 19
control of a person licensed pursuant to this chapter or chapter 20
18.71 RCW; or 21
(10) Practice by a person who is enrolled in a physician 22
assistant program approved by the board who is performing such 23
services only pursuant to a course of instruction in said program: 24
PROVIDED, That such services are performed only under the supervision 25
and control of a person licensed pursuant to this chapter or chapter 26
18.71 RCW. 27
This chapter shall not be construed to apply in any manner to any 28
other system or method of treating the sick or afflicted or to apply 29
to or interfere in any way with the practice of religion or any kind 30
of treatment by prayer. 31
Sec. 5074. RCW 18.59.100 and 2015 c 10 s 1 are each amended to 32
read as follows: 33
An occupational therapist shall, after evaluating a patient and 34
if the case is a medical one, refer the case to a physician for 35
appropriate medical direction if such direction is lacking. Treatment 36
by an occupational therapist of such a medical case may take place 37
only upon the referral of a physician, osteopathic physician, 38
podiatric physician and surgeon, naturopath, chiropractor, physician 39
p. 181 HB 1281
assistant, psychologist, optometrist, or advanced ((registered nurse 1
practitioner)) practice registered nurse licensed to practice in this 2
state. 3
Sec. 5075. RCW 18.64.253 and 2019 c 270 s 1 are each amended to 4
read as follows: 5
(1) This chapter does not prohibit a student from practicing 6
pharmacy if: 7
(a) The student is enrolled in a college or school of pharmacy 8
accredited by the commission and is registered as a pharmacy intern 9
under RCW 18.64.080; 10
(b) The student performs services without compensation or the 11
expectation of compensation as part of a volunteer activity;12
(c) The student is under the direct supervision of a pharmacist 13
licensed under this chapter, a physician licensed under chapter 18.71 14
RCW, an osteopathic physician and surgeon licensed under chapter 15
18.57 RCW, or a registered nurse or advanced ((registered nurse 16
practitioner)) practice registered nurse licensed under chapter 18.79 17
RCW; 18
(d) The services the student performs are within the scope of 19
practice of: (i) A pharmacist licensed under this chapter; and (ii) 20
the person supervising the student; 21
(e) The college or school in which the student is enrolled 22
verifies that the student has demonstrated competency through his or 23
her education and training to perform the services; and24
(f) The student provides proof of current malpractice insurance 25
to the volunteer activity organizer prior to performing any services.26
(2) The commission may adopt rules to implement the requirements 27
of this section. 28
Sec. 5076. RCW 18.64.560 and 2016 c 148 s 3 are each amended to 29
read as follows: 30
(1) A pharmacy or pharmacist may provide a limited quantity of 31
drugs to a nursing home or hospice program without a prescription for 32
emergency administration by authorized personnel of the facility or 33
program pursuant to a valid prescription. The drugs so provided must 34
be limited to those required to meet the immediate therapeutic needs 35
of residents or patients and may not be available from another 36
authorized source in sufficient time to prevent risk of harm by delay 37
resulting from obtaining drugs from another source. Emergency kits 38
p. 182 HB 1281
must be secured in a locked room, container, or device to prevent 1
unauthorized access and to ensure the proper environment for 2
preservation of the drugs. 3
(2) In addition to or in connection with the emergency kit 4
authorized under subsection (1) of this section, a nursing home that 5
employs a unit dose drug distribution system may maintain a 6
supplemental dose kit for supplemental nonemergency drug therapy. 7
Supplemental dose kits must be secured in a locked room, container, 8
or device to prevent unauthorized access, and to ensure the proper 9
environment for preservation of the drugs. Administration of drugs 10
from a supplemental dose kit must be under a valid prescription or 11
chart order. 12
(3) The types and quantity of drugs appropriate to serve the 13
resident or patient population of a nursing home or hospice program 14
using an emergency kit or supplemental dose kit and procedures for 15
the proper storage and security of drugs must be determined by a 16
pharmaceutical services committee that includes a pharmacist licensed 17
under this chapter, a physician licensed under chapter 18.71 RCW, an 18
osteopathic physician licensed under chapter 18.57 RCW, or an 19
advanced ((registered nurse practitioner )) practice registered nurse 20
licensed under chapter 18.79 RCW, and appropriate clinical or 21
administrative personnel of the nursing home or hospice program as 22
set forth in rules adopted by the pharmacy quality assurance 23
commission. 24
(4) A registered nurse or licensed practical nurse operating 25
under appropriate direction and supervision by a pharmacist may 26
restock an emergency kit or supplemental dose kit to provide for safe 27
and timely patient access. 28
Sec. 5077. RCW 18.71.030 and 2024 c 62 s 14 are each amended to 29
read as follows: 30
Nothing in this chapter shall be construed to apply to or 31
interfere in any way with the practice of religion or any kind of 32
treatment by prayer; nor shall anything in this chapter be construed 33
to prohibit: 34
(1) The furnishing of medical assistance in cases of emergency 35
requiring immediate attention; 36
(2) The domestic administration of family remedies;37
p. 183 HB 1281
(3) The administration of oral medication of any nature to 1
students by public school district employees or private elementary or 2
secondary school employees as provided for in chapter 28A.210 RCW;3
(4) The practice of dentistry, osteopathic medicine and surgery, 4
nursing, chiropractic, podiatric medicine and surgery, optometry, 5
naturopathy, or any other healing art licensed under the methods or 6
means permitted by such license; 7
(5) The practice of medicine in this state by any commissioned 8
medical officer serving in the armed forces of the United States or 9
public health service or any medical officer on duty with the United 10
States veterans administration while such medical officer is engaged 11
in the performance of the duties prescribed for him or her by the 12
laws and regulations of the United States; 13
(6) The consultation through telemedicine or other means by a 14
practitioner, licensed by another state or territory in which he or 15
she resides, with a practitioner licensed in this state who has 16
responsibility for the diagnosis and treatment of the patient within 17
this state; 18
(7) The in-person practice of medicine by any practitioner 19
licensed by another state or territory in which he or she resides, 20
provided that such practitioner shall not open an office or appoint a 21
place of meeting patients or receiving calls within this state;22
(8) The practice of medicine by a person who is a regular student 23
in a school of medicine approved and accredited by the commission if:24
(a) The performance of such services is only pursuant to a 25
regular course of instruction or assignments from his or her 26
instructor; or 27
(b) Such services are performed only under the supervision and 28
control of a person licensed pursuant to this chapter; or29
(c)(i) Such services are performed without compensation or 30
expectation of compensation as part of a volunteer activity;31
(ii) The student is under the direct supervision and control of a 32
pharmacist licensed under chapter 18.64 RCW, an osteopathic physician 33
and surgeon licensed under chapter 18.57 RCW, or a registered nurse 34
or advanced ((registered nurse practitioner )) practice registered 35
nurse licensed under chapter 18.79 RCW; 36
(iii) The services the student performs are within the scope of 37
practice of: (A) A physician licensed under this chapter; and (B) the 38
person supervising the student; 39
p. 184 HB 1281
(iv) The school in which the student is enrolled verifies the 1
student has demonstrated competency through his or her education and 2
training to perform the services; and 3
(v) The student provides proof of current malpractice insurance 4
to the volunteer activity organizer prior to performing any services;5
(9) The practice of medicine by a person serving a period of 6
postgraduate medical training in a program of clinical medical 7
training sponsored by a college or university in this state or by a 8
hospital accredited in this state, however, the performance of such 9
services shall be only pursuant to his or her duties as a trainee;10
(10) The practice of medicine by a person who is regularly 11
enrolled in a physician assistant program approved by the commission, 12
however, the performance of such services shall be only pursuant to a 13
regular course of instruction in said program and such services are 14
performed only under the supervision and control of a person licensed 15
pursuant to this chapter; 16
(11) The practice of medicine by a licensed physician assistant 17
which practice is performed under the supervision of or in 18
collaboration with a physician licensed pursuant to this chapter;19
(12) The practice of medicine, in any part of this state which 20
shares a common border with Canada and which is surrounded on three 21
sides by water, by a physician licensed to practice medicine and 22
surgery in Canada or any province or territory thereof;23
(13) The administration of nondental anesthesia by a dentist who 24
has completed a residency in anesthesiology at a school of medicine 25
approved by the commission, however, a dentist allowed to administer 26
nondental anesthesia shall do so only under authorization of the 27
patient's attending surgeon, obstetrician, or psychiatrist, and the 28
commission has jurisdiction to discipline a dentist practicing under 29
this exemption and enjoin or suspend such dentist from the practice 30
of nondental anesthesia according to this chapter and chapter 18.130 31
RCW; 32
(14) Emergency lifesaving service rendered by a physician's 33
trained advanced emergency medical technician and paramedic, as 34
defined in RCW 18.71.200, if the emergency lifesaving service is 35
rendered under the responsible supervision and control of a licensed 36
physician; 37
(15) The provision of clean, intermittent bladder catheterization 38
for students by public school district employees or private school 39
employees as provided for in RCW 18.79.290 and 28A.210.280.40
p. 185 HB 1281
Sec. 5078. RCW 18.74.200 and 2023 c 198 s 2 are each amended to 1
read as follows: 2
(1) Subject to the limitations of this section, a physical 3
therapist may perform intramuscular needling only after being issued 4
an intramuscular needling endorsement by the secretary. The 5
secretary, upon approval by the board, shall issue an endorsement to 6
a physical therapist who has at least one year of postgraduate 7
practice experience that averages at least 36 hours a week and 8
consists of direct patient care and who provides evidence in a manner 9
acceptable to the board of a total of 325 hours of instruction and 10
clinical experience that meet or exceed the following criteria:11
(a) A total of 100 hours of didactic instruction in the following 12
areas: 13
(i) Anatomy and physiology of the musculoskeletal and 14
neuromuscular systems; 15
(ii) Anatomical basis of pain mechanisms, chronic pain, and 16
referred pain; 17
(iii) Trigger point evaluation and management;18
(iv) Universal precautions in avoiding contact with a patient's 19
bodily fluids; and 20
(v) Preparedness and response to unexpected events including but 21
not limited to injury to blood vessels, nerves, and organs, and 22
psychological effects or complications. 23
(b) A total of 75 hours of in-person intramuscular needling 24
instruction in the following areas: 25
(i) Intramuscular needling technique; 26
(ii) Intramuscular needling indications and contraindications;27
(iii) Documentation and informed consent for intramuscular 28
needling; 29
(iv) Management of adverse effects; 30
(v) Practical psychomotor competency; and 31
(vi) Occupational safety and health administration's bloodborne 32
pathogens protocol. 33
(c) A successful clinical review of a minimum of 150 hours of at 34
least 150 individual intramuscular needling treatment sessions by a 35
qualified provider. A physical therapist seeking endorsement must 36
submit an affidavit to the department demonstrating successful 37
completion of this clinical review. 38
(2) A qualified provider must be one of the following:39
p. 186 HB 1281
(a) A physician licensed under chapter 18.71 RCW; an osteopathic 1
physician licensed under chapter 18.57 RCW; a licensed naturopath 2
under chapter 18.36A RCW; a licensed acupuncture and Eastern medicine 3
practitioner under chapter 18.06 RCW; or a licensed advanced 4
((registered nurse practitioner )) practice registered nurse under 5
chapter 18.79 RCW; 6
(b) A physical therapist credentialed to perform intramuscular 7
needling in any branch of the United States armed forces;8
(c) A licensed physical therapist who currently holds an 9
intramuscular needling endorsement; or 10
(d) A licensed physical therapist who meets the requirements of 11
the intramuscular needling endorsement. 12
(3) After receiving 100 hours of didactic instruction and 75 13
hours of in-person intramuscular needling instruction, a physical 14
therapist seeking endorsement has up to 18 months to complete a 15
minimum of 150 treatment sessions for review. 16
(4) A physical therapist may not delegate intramuscular needling 17
and must remain in constant attendance of the patient for the 18
entirety of the procedure. 19
(5) A physical therapist can apply for endorsement before they 20
have one year of clinical practice experience if they can meet the 21
requirement of 100 hours of didactic instruction and 75 hours of in-22
person intramuscular needling instruction in subsection (1)(a)(i) and 23
(ii) of this section through their prelicensure coursework and has 24
completed all other requirements set forth in this chapter.25
(6) If a physical therapist is intending to perform intramuscular 26
needling on a patient who the physical therapist knows is being 27
treated by an acupuncturist or acupuncture and Eastern medicine 28
practitioner for the same diagnosis, the physical therapist shall 29
make reasonable efforts to coordinate patient care with the 30
acupuncturist or acupuncture and Eastern medicine practitioner to 31
prevent conflict or duplication of services. 32
(7) All patients receiving intramuscular needling from a physical 33
therapist must sign an informed consent form that includes:34
(a) The definition of intramuscular needling; 35
(b) A description of the risks of intramuscular needling;36
(c) A description of the benefits of intramuscular needling;37
(d) A description of the potential side effects of intramuscular 38
needling; and 39
p. 187 HB 1281
(e) A statement clearly differentiating the procedure from the 1
practice of acupuncture. 2
(8) Intramuscular needling may not be administered as a stand-3
alone treatment within a physical therapy care plan.4
Sec. 5079. RCW 18.89.020 and 2021 c 114 s 2 are each amended to 5
read as follows: 6
Unless the context clearly requires otherwise, the definitions in 7
this section apply throughout this chapter. 8
(1) "Department" means the department of health.9
(2) "Direct supervision" means a health care practitioner is 10
continuously on-site and physically present in the treatment 11
operatory while the procedures are performed by the respiratory care 12
practitioner. 13
(3) "Health care practitioner" means: 14
(a) A physician licensed under chapter 18.71 RCW;15
(b) An osteopathic physician or surgeon licensed under chapter 16
18.57 RCW; or 17
(c) Acting within the scope of their respective licensure, a 18
podiatric physician and surgeon licensed under chapter 18.22 RCW, an 19
advanced ((registered nurse practitioner )) practice registered nurse 20
licensed under chapter 18.79 RCW, a naturopath licensed under chapter 21
18.36A RCW, or a physician assistant licensed under chapter 18.71A 22
RCW. 23
(4) "Respiratory care practitioner" means an individual licensed 24
under this chapter. 25
(5) "Secretary" means the secretary of health or the secretary's 26
designee. 27
Sec. 5080. RCW 18.130.410 and 2020 c 80 s 24 are each amended to 28
read as follows: 29
It is not professional misconduct for a physician licensed under 30
chapter 18.71 RCW; osteopathic physician licensed under chapter 18.57 31
RCW; registered nurse, licensed practical nurse, or advanced 32
((registered nurse practitioner )) practice registered nurse licensed 33
under chapter 18.79 RCW; physician assistant licensed under chapter 34
18.71A RCW; advanced emergency medical technician or paramedic 35
certified under chapter 18.71 RCW; or medical assistant-certified, 36
medical assistant-phlebotomist, or forensic phlebotomist certified 37
under chapter 18.360 RCW, or person holding another credential under 38
p. 188 HB 1281
Title 18 RCW whose scope of practice includes performing venous blood 1
draws, or hospital, or duly licensed clinical laboratory employing or 2
utilizing services of such licensed or certified health care 3
provider, to collect a blood sample without a person's consent when 4
the physician licensed under chapter 18.71 RCW; osteopathic physician 5
licensed under chapter 18.57 RCW; registered nurse, licensed 6
practical nurse, or advanced ((registered nurse practitioner )) 7
practice registered nurse licensed under chapter 18.79 RCW; physician 8
assistant licensed under chapter 18.71A RCW; advanced emergency 9
medical technician or paramedic certified under chapter 18.71 RCW; or 10
medical assistant-certified, medical assistant-phlebotomist, or 11
forensic phlebotomist certified under chapter 18.360 RCW, or person 12
holding another credential under Title 18 RCW whose scope of practice 13
includes performing venous blood draws, or hospital, or duly licensed 14
clinical laboratory employing or utilizing services of such licensed 15
or certified health care provider withdrawing blood was directed by a 16
law enforcement officer to do so for the purpose of a blood test 17
under the provisions of a search warrant or exigent circumstances: 18
PROVIDED, That nothing in this section shall relieve a physician 19
licensed under chapter 18.71 RCW; osteopathic physician licensed 20
under chapter 18.57 RCW; registered nurse, licensed practical nurse, 21
or advanced ((registered nurse practitioner )) practice registered 22
nurse licensed under chapter 18.79 RCW; physician assistant licensed 23
under chapter 18.71A RCW; advanced emergency medical technician or 24
paramedic certified under chapter 18.71 RCW; or medical assistant-25
certified, medical assistant-phlebotomist, or forensic phlebotomist 26
certified under chapter 18.360 RCW, or person holding another 27
credential under Title 18 RCW whose scope of practice includes 28
performing venous blood draws, or hospital, or duly licensed clinical 29
laboratory employing or utilizing services of such licensed or 30
certified health care provider withdrawing blood from professional 31
discipline arising from the use of improper procedures or from 32
failing to exercise the required standard of care.33
Sec. 5081. RCW 18.134.010 and 2024 c 212 s 2 are each amended to 34
read as follows: 35
The definitions in this section apply throughout this chapter 36
unless the context clearly requires otherwise. 37
p. 189 HB 1281
(1) "Disciplining authority" means an entity to which a state has 1
granted the authority to license, certify, or discipline individuals 2
who provide health care. 3
(2) "Electronic" means relating to technology having electrical, 4
digital, magnetic, wireless, optical, electromagnetic, or similar 5
capabilities. 6
(3) "Health care" means care, treatment, or a service or 7
procedure, to maintain, monitor, diagnose, or otherwise affect an 8
individual's physical or behavioral health, injury, or condition.9
(4)(a) "Health care practitioner" means: 10
(i) A physician licensed under chapter 18.71 RCW;11
(ii) An osteopathic physician or surgeon licensed under chapter 12
18.57 RCW; 13
(iii) A podiatric physician and surgeon licensed under chapter 14
18.22 RCW; 15
(iv) An advanced ((registered nurse practitioner )) practice 16
registered nurse licensed under chapter 18.79 RCW;17
(v) A naturopath licensed under chapter 18.36A RCW;18
(vi) A physician assistant licensed under chapter 18.71A RCW; or19
(vii) A person who is otherwise authorized to practice a 20
profession regulated under the authority of RCW 18.130.040 to provide 21
health care in this state, to the extent the profession's scope of 22
practice includes health care that can be provided through 23
telehealth. 24
(b) "Health care practitioner" does not include a veterinarian 25
licensed under chapter 18.92 RCW. 26
(5) "Professional practice standard" includes:27
(a) A standard of care; 28
(b) A standard of professional ethics; and 29
(c) A practice requirement imposed by a disciplining authority.30
(6) "Scope of practice" means the extent of a health care 31
practitioner's authority to provide health care. 32
(7) "State" means a state of the United States, the District of 33
Columbia, Puerto Rico, the United States Virgin Islands, or any other 34
territory or possession subject to the jurisdiction of the United 35
States. The term includes a federally recognized Indian tribe.36
(8) "Telecommunication technology" means technology that supports 37
communication through electronic means. The term is not limited to 38
regulated technology or technology associated with a regulated 39
industry. 40
p. 190 HB 1281
(9) "Telehealth" includes telemedicine and means the use of 1
synchronous or asynchronous telecommunication technology by a 2
practitioner to provide health care to a patient at a different 3
physical location than the practitioner. "Telehealth" does not 4
include the use, in isolation, of email, instant messaging, text 5
messaging, or fax. 6
(10) "Telehealth services" means health care provided through 7
telehealth. 8
Sec. 5082. RCW 18.225.010 and 2013 c 73 s 2 are each amended to 9
read as follows: 10
The definitions in this section apply throughout this chapter 11
unless the context clearly requires otherwise. 12
(1) "Advanced social work" means the application of social work 13
theory and methods, including: 14
(a) Emotional and biopsychosocial assessment; 15
(b) Psychotherapy under the supervision of a licensed independent 16
clinical social worker, psychiatrist, psychologist, psychiatric 17
advanced ((registered nurse practitioner )) practice registered nurse , 18
psychiatric nurse, or other mental health professionals as may be 19
defined by rules adopted by the secretary; 20
(c) Case management; 21
(d) Consultation; 22
(e) Advocacy; 23
(f) Counseling; or 24
(g) Community organization. 25
(2) "Applicant" means a person who completes the required 26
application, pays the required fee, is at least eighteen years of 27
age, and meets any background check requirements and uniform 28
disciplinary act requirements. 29
(3) "Associate" means a prelicensure candidate who has a graduate 30
degree in a mental health field under RCW 18.225.090 and is gaining 31
the supervision and supervised experience necessary to become a 32
licensed independent clinical social worker, a licensed advanced 33
social worker, a licensed mental health counselor, or a licensed 34
marriage and family therapist. 35
(4) "Committee" means the Washington state mental health 36
counselors, marriage and family therapists, and social workers 37
advisory committee. 38
(5) "Department" means the department of health.39
p. 191 HB 1281
(6) "Disciplining authority" means the department.1
(7) "Independent clinical social work" means the diagnosis and 2
treatment of emotional and mental disorders based on knowledge of 3
human development, the causation and treatment of psychopathology, 4
psychotherapeutic treatment practices, and social work practice as 5
defined in advanced social work. Treatment modalities include but are 6
not limited to diagnosis and treatment of individuals, couples, 7
families, groups, or organizations. 8
(8) "Marriage and family therapy" means the diagnosis and 9
treatment of mental and emotional disorders, whether cognitive, 10
affective, or behavioral, within the context of relationships, 11
including marriage and family systems. Marriage and family therapy 12
involves the professional application of psychotherapeutic and family 13
systems theories and techniques in the delivery of services to 14
individuals, couples, and families for the purpose of treating such 15
diagnosed nervous and mental disorders. The practice of marriage and 16
family therapy means the rendering of professional marriage and 17
family therapy services to individuals, couples, and families, singly 18
or in groups, whether such services are offered directly to the 19
general public or through organizations, either public or private, 20
for a fee, monetary or otherwise. 21
(9) "Mental health counseling" means the application of 22
principles of human development, learning theory, psychotherapy, 23
group dynamics, and etiology of mental illness and dysfunctional 24
behavior to individuals, couples, families, groups, and 25
organizations, for the purpose of treatment of mental disorders and 26
promoting optimal mental health and functionality. Mental health 27
counseling also includes, but is not limited to, the assessment, 28
diagnosis, and treatment of mental and emotional disorders, as well 29
as the application of a wellness model of mental health.30
(10) "Secretary" means the secretary of health or the secretary's 31
designee. 32
Sec. 5083. RCW 18.250.010 and 2023 c 143 s 1 are each amended to 33
read as follows: 34
The definitions in this section apply throughout this chapter 35
unless the context clearly requires otherwise. 36
(1) "Athlete" means a person who participates in exercise, 37
recreation, activities, sport, or games requiring physical strength, 38
range-of-motion, flexibility, body awareness and control, speed, 39
p. 192 HB 1281
stamina, or agility, and the exercise, recreation, activities, 1
sports, or games are of a type conducted for the benefits of health 2
and wellness in association with an educational institution or 3
professional, amateur, recreational sports club or organization, 4
hospital, or industrial-based organization. 5
(2) "Athletic injury" means an injury or condition sustained by 6
an athlete that affects the person's participation or performance in 7
exercise, recreation, activities, sport, or games and the injury or 8
condition is within the professional preparation and education of an 9
athletic trainer. 10
(3) "Athletic trainer" means a health care provider who is 11
licensed under this chapter. An athletic trainer can practice 12
athletic training through the consultation, referral, or guidelines 13
of a licensed health care provider as defined in subsection (7) of 14
this section working within their scope of practice.15
(4)(a) "Athletic training" means the application of the following 16
principles and methods as provided by a licensed athletic trainer:17
(i) Risk management and prevention of athletic injuries through 18
preactivity screening and evaluation, educational programs, physical 19
conditioning and reconditioning programs, application of commercial 20
products, use of protective equipment, promotion of healthy 21
behaviors, and reduction of environmental risks; 22
(ii) Recognition, evaluation, and assessment of athletic injuries 23
by obtaining a history of the athletic injury, inspection and 24
palpation of the injured part and associated structures, and 25
performance of specific testing techniques related to stability and 26
function to determine the extent of an injury; 27
(iii) Immediate care of athletic injuries, including emergency 28
medical situations through the application of first -aid and emergency 29
procedures and techniques for nonlife-threatening or life -threatening 30
athletic injuries; 31
(iv) Treatment, rehabilitation, and reconditioning of athletic 32
injuries through the application of physical agents and modalities, 33
therapeutic activities and exercise, standard reassessment techniques 34
and procedures, commercial products, and educational programs, in 35
accordance with guidelines established with a licensed health care 36
provider as provided in RCW 18.250.070; 37
(v) Treatment, rehabilitation, and reconditioning of work-related 38
injuries through the application of physical agents and modalities, 39
therapeutic activities and exercise, standard reassessment techniques 40
p. 193 HB 1281
and procedures, commercial products, and educational programs, under 1
the direct supervision of and in accordance with a plan of care for 2
an individual worker established by a provider authorized to provide 3
physical medicine and rehabilitation services for injured workers; 4
and 5
(vi) Referral of an athlete to an appropriately licensed health 6
care provider if the athletic injury requires further definitive care 7
or the injury or condition is outside an athletic trainer's scope of 8
practice, in accordance with RCW 18.250.070. 9
(b) "Athletic training" does not include: 10
(i) The use of spinal adjustment or manipulative mobilization of 11
the spine and its immediate articulations; 12
(ii) Orthotic or prosthetic services with the exception of 13
evaluation, measurement, fitting, and adjustment of temporary, 14
prefabricated or direct -formed orthosis as defined in chapter 18.200 15
RCW; 16
(iii) The practice of occupational therapy as defined in chapter 17
18.59 RCW; 18
(iv) The practice of acupuncture and Eastern medicine as defined 19
in chapter 18.06 RCW; 20
(v) Any medical diagnosis; and 21
(vi) Prescribing legend drugs or controlled substances, or 22
surgery. 23
(5) "Committee" means the athletic training advisory committee.24
(6) "Department" means the department of health.25
(7) "Licensed health care provider" means a physician, physician 26
assistant, osteopathic physician, advanced ((registered nurse 27
practitioner)) practice registered nurse , naturopath, physical 28
therapist, chiropractor, dentist, massage therapist, acupuncturist, 29
occupational therapist, or podiatric physician and surgeon.30
(8) "Secretary" means the secretary of health or the secretary's 31
designee. 32
Sec. 5084. RCW 18.360.010 and 2024 c 248 s 2 and 2024 c 217 s 1 33
are each reenacted and amended to read as follows:34
The definitions in this section apply throughout this chapter 35
unless the context clearly requires otherwise. 36
(1) "Administer" means the retrieval of medication, and its 37
application to a patient, as authorized in RCW 18.360.050.38
p. 194 HB 1281
(2) "Delegation" means direct authorization granted by a licensed 1
health care practitioner to a medical assistant to perform the 2
functions authorized in this chapter which fall within the scope of 3
practice of the health care provider and the training and experience 4
of the medical assistant. 5
(3) "Department" means the department of health.6
(4) "Forensic phlebotomist" means a police officer, law 7
enforcement officer, or employee of a correctional facility or 8
detention facility, who is certified under this chapter and meets any 9
additional training and proficiency standards of his or her employer 10
to collect a venous blood sample for forensic testing pursuant to a 11
search warrant, a waiver of the warrant requirement, or exigent 12
circumstances. 13
(5) "Health care practitioner" means: 14
(a) A physician licensed under chapter 18.71 RCW;15
(b) An osteopathic physician and surgeon licensed under chapter 16
18.57 RCW; or 17
(c) Acting within the scope of their respective licensure, a 18
podiatric physician and surgeon licensed under chapter 18.22 RCW, a 19
registered nurse or advanced ((registered nurse practitioner )) 20
practice registered nurse licensed under chapter 18.79 RCW, a 21
naturopath licensed under chapter 18.36A RCW, a physician assistant 22
licensed under chapter 18.71A RCW, or an optometrist licensed under 23
chapter 18.53 RCW. 24
(6) "Medical assistant-certified" means a person certified under 25
RCW 18.360.040 who assists a health care practitioner with patient 26
care, executes administrative and clinical procedures, and performs 27
functions as provided in RCW 18.360.050 under the supervision of the 28
health care practitioner. 29
(7) "Medical assistant-EMT" means a person certified under RCW 30
18.360.040 who performs functions as provided in RCW 18.360.050 under 31
the supervision of a health care practitioner and holds: An emergency 32
medical technician certification under RCW 18.73.081; an advanced 33
emergency medical technician certification under RCW 18.71.205; or a 34
paramedic certification under RCW 18.71.205. 35
(8) "Medical assistant-hemodialysis technician" means a person 36
certified under RCW 18.360.040 who performs hemodialysis and other 37
functions pursuant to RCW 18.360.050 under the supervision of a 38
health care practitioner. 39
p. 195 HB 1281
(9) "Medical assistant-phlebotomist" means a person certified 1
under RCW 18.360.040 who performs capillary, venous, and arterial 2
invasive procedures for blood withdrawal and other functions pursuant 3
to RCW 18.360.050 under the supervision of a health care 4
practitioner. 5
(10) "Medical assistant-registered" means a person registered 6
under RCW 18.360.040 who, pursuant to an endorsement by a health care 7
practitioner, clinic, or group practice, assists a health care 8
practitioner with patient care, executes administrative and clinical 9
procedures, and performs functions as provided in RCW 18.360.050 10
under the supervision of the health care practitioner.11
(11) "Secretary" means the secretary of the department of health.12
(12)(a) "Supervision" means supervision of procedures permitted 13
pursuant to this chapter by a health care practitioner who is 14
physically present and is immediately available in the facility, 15
except as provided in (b) and (c) of this subsection.16
(b) The health care practitioner does not need to be present 17
during procedures to withdraw blood, administer vaccines, or obtain 18
specimens for or perform diagnostic testing, but must be immediately 19
available. 20
(c)(i) During a telemedicine visit, supervision over a medical 21
assistant assisting a health care practitioner with the telemedicine 22
visit may be provided through interactive audio and video 23
telemedicine technology. 24
(ii) When administering intramuscular injections for the purposes 25
of treating a known or suspected syphilis infection in accordance 26
with RCW 18.360.050, a medical assistant-certified or medical 27
assistant-registered may be supervised through interactive audio or 28
video telemedicine technology. 29
Sec. 5085. RCW 19.410.010 and 2023 c 364 s 8 are each amended to 30
read as follows: 31
(1) Subject to amounts appropriated for this purpose, the 32
psilocybin therapy services pilot program is established within, and 33
administered by, the University of Washington department of 34
psychiatry and behavioral sciences. No later than January 1, 2025, 35
the University of Washington department of psychiatry and behavioral 36
sciences must implement this section. 37
(2) The pilot program must: 38
p. 196 HB 1281
(a) Offer psilocybin therapy services through pathways approved 1
by the federal food and drug administration, to populations including 2
first responders and veterans who are: 3
(i) 21 years of age or older; and 4
(ii) Experiencing posttraumatic stress disorder, mood disorders, 5
or substance use disorders; 6
(b) Offer psilocybin therapy services facilitated by:7
(i) An advanced social worker, independent clinical social 8
worker, or mental health counselor licensed under chapter 18.225 RCW;9
(ii) A physician licensed under chapter 18.71 RCW; or10
(iii) A psychiatric advanced ((registered nurse practitioner )) 11
practice registered nurse licensed under chapter 18.79 RCW as defined 12
in RCW 71.05.020; 13
(c) Ensure psilocybin therapy services are safe, accessible, and 14
affordable; 15
(d) Require an initial assessment to understand participant goals 16
and expectations, and assess the participant's history for any 17
concerns that require further intervention or information before 18
receiving psilocybin therapy services, and an integration session 19
after receiving psilocybin therapy services; and 20
(e) Use outreach and engagement strategies to include 21
participants from communities or demographic groups that are more 22
likely to be historically marginalized and less likely to be included 23
in research and clinical trials represented by race, sex, sexual 24
orientation, socioeconomic status, age, or geographic location.25
Sec. 5086. RCW 28A.210.090 and 2020 c 80 s 27 are each amended 26
to read as follows: 27
(1) Any child shall be exempt in whole or in part from the 28
immunization measures required by RCW 28A.210.060 through 28A.210.170 29
upon the presentation of any one or more of the certifications 30
required by this section, on a form prescribed by the department of 31
health: 32
(a) A written certification signed by a health care practitioner 33
that a particular vaccine required by rule of the state board of 34
health is, in his or her judgment, not advisable for the child: 35
PROVIDED, That when it is determined that this particular vaccine is 36
no longer contraindicated, the child will be required to have the 37
vaccine; 38
p. 197 HB 1281
(b) A written certification signed by any parent or legal 1
guardian of the child or any adult in loco parentis to the child that 2
the religious beliefs of the signator are contrary to the required 3
immunization measures; or 4
(c) A written certification signed by any parent or legal 5
guardian of the child or any adult in loco parentis to the child that 6
the signator has either a philosophical or personal objection to the 7
immunization of the child. A philosophical or personal objection may 8
not be used to exempt a child from the measles, mumps, and rubella 9
vaccine. 10
(2)(a) The form presented on or after July 22, 2011, must include 11
a statement to be signed by a health care practitioner stating that 12
he or she provided the signator with information about the benefits 13
and risks of immunization to the child. The form may be signed by a 14
health care practitioner at any time prior to the enrollment of the 15
child in a school or licensed day care. Photocopies of the signed 16
form or a letter from the health care practitioner referencing the 17
child's name shall be accepted in lieu of the original form.18
(b) A health care practitioner who, in good faith, signs the 19
statement provided for in (a) of this subsection is immune from civil 20
liability for providing the signature. 21
(c) Any parent or legal guardian of the child or any adult in 22
loco parentis to the child who exempts the child due to religious 23
beliefs pursuant to subsection (1)(b) of this section is not required 24
to have the form provided for in (a) of this subsection signed by a 25
health care practitioner if the parent or legal guardian demonstrates 26
membership in a religious body or a church in which the religious 27
beliefs or teachings of the church preclude a health care 28
practitioner from providing medical treatment to the child.29
(3) For purposes of this section, "health care practitioner" 30
means a physician licensed under chapter 18.71 or 18.57 RCW, a 31
naturopath licensed under chapter 18.36A RCW, a physician assistant 32
licensed under chapter 18.71A RCW, or an advanced ((registered nurse 33
practitioner)) practice registered nurse licensed under chapter 18.79 34
RCW. 35
Sec. 5087. RCW 28A.210.275 and 2014 c 204 s 2 are each amended 36
to read as follows: 37
(1) Beginning July 1, 2014, a school district employee not 38
licensed under chapter 18.79 RCW who is asked to administer 39
p. 198 HB 1281
medications or perform nursing services not previously recognized in 1
law shall at the time he or she is asked to administer the medication 2
or perform the nursing service file, without coercion by the 3
employer, a voluntary written, current, and unexpired letter of 4
intent stating the employee's willingness to administer the new 5
medication or nursing service. It is understood that the letter of 6
intent will expire if the conditions of acceptance are substantially 7
changed. If a school employee who is not licensed under chapter 18.79 8
RCW chooses not to file a letter under this section, the employee is 9
not subject to any employer reprisal or disciplinary action for 10
refusing to file a letter. 11
(2) In the event a school employee provides the medication or 12
service to a student in substantial compliance with (a) rules adopted 13
by the state ((nursing care quality assurance commission )) board of 14
nursing and the instructions of a registered nurse or advanced 15
((registered nurse practitioner )) practice registered nurse issued 16
under such rules, and (b) written policies of the school district, 17
then the employee, the employee's school district or school of 18
employment, and the members of the governing board and chief 19
administrator thereof are not liable in any criminal action or for 20
civil damages in his or her individual, marital, governmental, 21
corporate, or other capacity as a result of providing the medication 22
or service. 23
(3) The board of directors shall designate a professional person 24
licensed under chapter 18.71, 18.57, or 18.79 RCW as it applies to 25
registered nurses and advanced ((registered nurse practitioners )) 26
practice registered nurses to consult and coordinate with the 27
student's parents and health care provider, and train and supervise 28
the appropriate school district personnel in proper procedures to 29
ensure a safe, therapeutic learning environment. School employees 30
must receive the training provided under this subsection before they 31
are authorized to deliver the service or medication. Such training 32
must be provided, where necessary, on an ongoing basis to ensure that 33
the proper procedures are not forgotten because the services or 34
medication are delivered infrequently. 35
Sec. 5088. RCW 28A.210.280 and 2003 c 172 s 1 are each amended 36
to read as follows: 37
(1) Public school districts and private schools that offer 38
classes for any of grades kindergarten through twelve must provide 39
p. 199 HB 1281
for clean, intermittent bladder catheterization of students, or 1
assisted self-catheterization of students pursuant to RCW 18.79.290. 2
The catheterization must be provided in substantial compliance with:3
(a) Rules adopted by the state ((nursing care quality assurance 4
commission)) board of nursing and the instructions of a registered 5
nurse or advanced ((registered nurse practitioner )) practice 6
registered nurse issued under such rules; and 7
(b) Written policies of the school district or private school 8
which shall be adopted in order to implement this section and shall 9
be developed in accordance with such requirements of chapters 41.56 10
and 41.59 RCW as may be applicable. 11
(2) School district employees, except those licensed under 12
chapter 18.79 RCW, who have not agreed in writing to perform clean, 13
intermittent bladder catheterization as a specific part of their job 14
description, may file a written letter of refusal to perform clean, 15
intermittent bladder catheterization of students. This written letter 16
of refusal may not serve as grounds for discharge, nonrenewal, or 17
other action adversely affecting the employee's contract status.18
(3) Any public school district or private school that provides 19
clean, intermittent bladder catheterization shall document the 20
provision of training given to employees who perform these services. 21
These records shall be made available for review at any audit.22
Sec. 5089. RCW 28A.210.290 and 1994 sp.s. c 9 s 722 are each 23
amended to read as follows: 24
(1) In the event a school employee provides for the 25
catheterization of a student pursuant to RCW 18.79.290 and 26
28A.210.280 in substantial compliance with (a) rules adopted by the 27
state ((nursing care quality assurance commission )) board of nursing 28
and the instructions of a registered nurse or advanced ((registered 29
nurse practitioner )) practice registered nurse issued under such 30
rules, and (b) written policies of the school district or private 31
school, then the employee, the employee's school district or school 32
of employment, and the members of the governing board and chief 33
administrator thereof shall not be liable in any criminal action or 34
for civil damages in their individual, marital, governmental, 35
corporate, or other capacity as a result of providing for the 36
catheterization. 37
(2) Providing for the catheterization of any student pursuant to 38
RCW 18.79.290 and 28A.210.280 may be discontinued by a public school 39
p. 200 HB 1281
district or private school and the school district or school, its 1
employees, its chief administrator, and members of its governing 2
board shall not be liable in any criminal action or for civil damages 3
in their individual, marital, governmental, corporate, or other 4
capacity as a result of the discontinuance: PROVIDED, That the chief 5
administrator of the public school district or private school, or his 6
or her designee, has first provided actual notice orally or in 7
writing in advance of the date of discontinuance to a parent or legal 8
guardian of the student or other person having legal control over the 9
student: PROVIDED FURTHER, That the public school district otherwise 10
provides for the catheterization of the student to the extent 11
required by federal or state law. 12
Sec. 5090. RCW 28A.210.305 and 2017 c 84 s 2 are each amended to 13
read as follows: 14
(1)(a) A registered nurse or an advanced ((registered nurse 15
practitioner)) practice registered nurse licensed under chapter 18.79 16
RCW working in a school setting is authorized and responsible for the 17
nursing care of students to the extent that the care is within the 18
practice of nursing as defined in this section. 19
(b) A school administrator may supervise a registered nurse or an 20
advanced ((registered nurse practitioner )) practice registered nurse 21
licensed under chapter 18.79 RCW in aspects of employment other than 22
the practice of nursing as defined in this section.23
(c) Only a registered nurse or an advanced ((registered nurse 24
practitioner)) practice registered nurse licensed under chapter 18.79 25
RCW may supervise, direct, or evaluate a licensed nurse working in a 26
school setting with respect to the practice of nursing as defined in 27
this section. 28
(2) Nothing in this section: 29
(a) Prohibits a nonnurse supervisor from supervising, directing, 30
or evaluating a licensed nurse working in a school setting with 31
respect to matters other than the practice of nursing;32
(b) Requires a registered nurse or an advanced ((registered nurse 33
practitioner)) practice registered nurse to be clinically supervised 34
in a school setting; or 35
(c) Prohibits a nonnurse supervisor from conferring with a 36
licensed nurse working in a school setting with respect to the 37
practice of nursing. 38
p. 201 HB 1281
(3) Within existing funds, the superintendent of public 1
instruction shall notify each school district in this state of the 2
requirements of this section. 3
(4) For purposes of this section, "practice of nursing" means:4
(a) Registered nursing practice as defined in RCW 18.79.040, 5
advanced practice registered nursing ((practice)) as defined in RCW 6
18.79.050, and licensed practical nursing practice as defined in RCW 7
18.79.060, including, but not limited to: 8
(i) The administration of medication pursuant to a medication or 9
treatment order; and 10
(ii) The decision to summon emergency medical assistance; and11
(b) Compliance with any state or federal statute or 12
administrative rule specifically regulating licensed nurses, 13
including any statute or rule defining or establishing standards of 14
patient care or professional conduct or practice. 15
Sec. 5091. RCW 41.05.177 and 2006 c 367 s 1 are each amended to 16
read as follows: 17
(1) Each plan offered to public employees and their covered 18
dependents under this chapter that is not subject to the provisions 19
of Title 48 RCW and is issued or renewed after December 31, 2006, 20
shall provide coverage for prostate cancer screening, provided that 21
the screening is delivered upon the recommendation of the patient's 22
physician, advanced ((registered nurse practitioner )) practice 23
registered nurse, or physician assistant. 24
(2) This section shall not be construed to prevent the 25
application of standard policy provisions applicable to other 26
benefits, such as deductible or copayment provisions. This section 27
does not limit the authority of the health care authority to 28
negotiate rates and contract with specific providers for the delivery 29
of prostate cancer screening services. This section shall not apply 30
to medicare supplemental policies or supplemental contracts covering 31
a specified disease or other limited benefits. 32
Sec. 5092. RCW 41.05.180 and 1994 sp.s. c 9 s 725 are each 33
amended to read as follows: 34
Each health plan offered to public employees and their covered 35
dependents under this chapter that is not subject to the provisions 36
of Title 48 RCW and is established or renewed after January 1, 1990, 37
and that provides benefits for hospital or medical care shall provide 38
p. 202 HB 1281
benefits for screening or diagnostic mammography services, provided 1
that such services are delivered upon the recommendation of the 2
patient's physician or advanced ((registered nurse practitioner )) 3
practice registered nurse as authorized by the ((nursing care quality 4
assurance commission )) state board of nursing pursuant to chapter 5
18.79 RCW or physician assistant pursuant to chapter 18.71A RCW.6
This section shall not be construed to prevent the application of 7
standard health plan provisions applicable to other benefits such as 8
deductible or copayment provisions. This section does not limit the 9
authority of the state health care authority to negotiate rates and 10
contract with specific providers for the delivery of mammography 11
services. This section shall not apply to medicare supplement 12
policies or supplemental contracts covering a specified disease or 13
other limited benefits. 14
Sec. 5093. RCW 41.24.155 and 2007 c 57 s 1 are each amended to 15
read as follows: 16
(1) One of the primary purposes of this section is to enable 17
injured participants to return to their regular occupation, business, 18
or profession, or to engage in any occupation or perform any work for 19
compensation or profit. To this end, the state board shall utilize 20
the services of individuals and organizations, public or private, 21
whose experience, training, and interests in vocational 22
rehabilitation and retraining qualify them to lend expert assistance 23
to the state board in such programs of vocational rehabilitation as 24
may be reasonable to make the participant return to his or her 25
regular occupation, business, or profession, or to engage in any 26
occupation or perform any work for compensation or profit consistent 27
with his or her physical and mental status. After evaluation and 28
recommendation by such individuals or organizations and prior to 29
final evaluation of the participant's permanent disability, if in the 30
sole opinion of the state board, whether or not medical treatment has 31
been concluded, vocational rehabilitation is both necessary and 32
likely to enable the injured participant to return to his or her 33
regular occupation, business, or profession, or to engage in any 34
occupation or perform any work for compensation or profit, the state 35
board may, in its sole discretion, pay the cost as provided in 36
subsection (3) or (4) of this section. 37
(2) When, in the sole discretion of the state board, vocational 38
rehabilitation is both necessary and likely to make the participant 39
p. 203 HB 1281
return to his or her regular occupation, business, or profession, or 1
to engage in any occupation or perform any work for compensation or 2
profit, then the following order of priorities shall be used:3
(a) Return to the previous job with the same employer;4
(b) Modification of the previous job with the same employer 5
including transitional return to work; 6
(c) A new job with the same employer in keeping with any 7
limitations or restrictions; 8
(d) Modification of a new job with the same employer including 9
transitional return to work; 10
(e) Modification of the previous job with a new employer;11
(f) A new job with a new employer or self -employment based upon 12
transferable skills; 13
(g) Modification of a new job with a new employer;14
(h) A new job with a new employer or self -employment involving 15
on-the-job training; 16
(i) Short-term retraining and job placement. 17
(3)(a) Except as provided in (b) of this subsection, costs for 18
vocational rehabilitation benefits allowed by the state board under 19
subsection (1) of this section may include the cost of books, 20
tuition, fees, supplies, equipment, transportation, child or 21
dependent care, and other necessary expenses in an amount not to 22
exceed four thousand dollars. This amount must be used within fifty-23
two weeks of the determination that vocational rehabilitation is 24
permitted under this section. 25
(b) The expenses allowed under (a) of this subsection may include 26
training fees for on -the-job training and the cost of furnishing 27
tools and other equipment necessary for self -employment or 28
reemployment. However, compensation or payment of retraining with job 29
placement expenses under (a) of this subsection may not be authorized 30
for a period of more than fifty -two weeks, except that such period 31
may, in the sole discretion of the state board, after its review, be 32
extended for an additional fifty -two weeks or portion thereof by 33
written order of the state board. However, under no circumstances 34
shall the total amount of benefit paid under this section exceed four 35
thousand dollars. 36
(4) In addition to the vocational rehabilitation expenditures 37
provided for under subsection (3) of this section, an additional five 38
thousand dollars may, upon authorization of the state board, be 39
expended for: (a) Accommodations for an injured participant that are 40
p. 204 HB 1281
medically necessary for participation in an approved retraining plan; 1
and (b) accommodations necessary to perform the essential functions 2
of an occupation in which an injured participant is seeking 3
employment, consistent with the retraining plan or the 4
recommendations of a vocational evaluation. The injured participant's 5
attending physician or licensed advanced ((registered nurse 6
practitioner)) practice registered nurse must verify the necessity of 7
the modifications or accommodations. The total expenditures 8
authorized in this subsection shall not exceed five thousand dollars.9
(5) The state board shall follow the established criteria set 10
forth by the department of labor and industries to monitor the 11
quality and effectiveness of rehabilitation services provided by the 12
individuals and organizations used under subsection (1) of this 13
section. The state board shall make referrals for vocational 14
rehabilitation services based on these performance criteria.15
(6) The state board may engage, where feasible and 16
cost-effective, in a cooperative program with the state employment 17
security department to provide job placement services under this 18
section. 19
(7) Except as otherwise provided in this section, the vocational 20
benefits provided for in this section are available to participants 21
who have claims currently pending as of April 17, 2007, or whose 22
injury occurred on or after January 1, 2006. 23
Sec. 5094. RCW 43.70.442 and 2023 c 460 s 22 and 2023 c 454 s 4 24
are each reenacted and amended to read as follows:25
(1)(a) Each of the following professionals certified or licensed 26
under Title 18 RCW shall, at least once every six years, complete 27
training in suicide assessment, treatment, and management that is 28
approved, in rule, by the relevant disciplining authority:29
(i) An adviser or counselor certified under chapter 18.19 RCW;30
(ii) A substance use disorder professional licensed under chapter 31
18.205 RCW; 32
(iii) A marriage and family therapist licensed under chapter 33
18.225 RCW; 34
(iv) A mental health counselor licensed under chapter 18.225 RCW;35
(v) An occupational therapy practitioner licensed under chapter 36
18.59 RCW; 37
(vi) A psychologist licensed under chapter 18.83 RCW;38
p. 205 HB 1281
(vii) An advanced social worker or independent clinical social 1
worker licensed under chapter 18.225 RCW; and 2
(viii) A social worker associate —advanced or social worker 3
associate—independent clinical licensed under chapter 18.225 RCW.4
(b) The requirements in (a) of this subsection apply to a person 5
holding a retired active license for one of the professions in (a) of 6
this subsection. 7
(c) The training required by this subsection must be at least six 8
hours in length, unless a disciplining authority has determined, 9
under subsection (10)(b) of this section, that training that includes 10
only screening and referral elements is appropriate for the 11
profession in question, in which case the training must be at least 12
three hours in length. 13
(d) Beginning July 1, 2017, the training required by this 14
subsection must be on the model list developed under subsection (6) 15
of this section. Nothing in this subsection (1)(d) affects the 16
validity of training completed prior to July 1, 2017.17
(2)(a) Except as provided in (b) of this subsection:18
(i) A professional listed in subsection (1)(a) of this section 19
must complete the first training required by this section by the end 20
of the first full continuing education reporting period after January 21
1, 2014, or during the first full continuing education reporting 22
period after initial licensure or certification, whichever occurs 23
later. 24
(ii) Beginning July 1, 2021, the second training for a 25
psychologist, a marriage and family therapist, a mental health 26
counselor, an advanced social worker, an independent clinical social 27
worker, a social worker associate-advanced, or a social worker 28
associate-independent clinical must be either: (A) An advanced 29
training focused on suicide management, suicide care protocols, or 30
effective treatments; or (B) a training in a treatment modality shown 31
to be effective in working with people who are suicidal, including 32
dialectical behavior therapy, collaborative assessment and management 33
of suicide risk, or cognitive behavior therapy-suicide prevention. If 34
a professional subject to the requirements of this subsection has 35
already completed the professional's second training prior to July 1, 36
2021, the professional's next training must comply with this 37
subsection. This subsection (2)(a)(ii) does not apply if the licensee 38
demonstrates that the training required by this subsection (2)(a)(ii) 39
is not reasonably available. 40
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(b)(i) A professional listed in subsection (1)(a) of this section 1
applying for initial licensure may delay completion of the first 2
training required by this section for six years after initial 3
licensure if he or she can demonstrate successful completion of the 4
training required in subsection (1) of this section no more than six 5
years prior to the application for initial licensure.6
(ii) Beginning July 1, 2021, a psychologist, a marriage and 7
family therapist, a mental health counselor, an advanced social 8
worker, an independent clinical social worker, a social worker 9
associate-advanced, or a social worker associate-independent clinical 10
exempt from his or her first training under (b)(i) of this subsection 11
must comply with the requirements of (a)(ii) of this subsection for 12
his or her first training after initial licensure. If a professional 13
subject to the requirements of this subsection has already completed 14
the professional's first training after initial licensure, the 15
professional's next training must comply with this subsection 16
(2)(b)(ii). This subsection (2)(b)(ii) does not apply if the licensee 17
demonstrates that the training required by this subsection (2)(b)(ii) 18
is not reasonably available. 19
(3) The hours spent completing training in suicide assessment, 20
treatment, and management under this section count toward meeting any 21
applicable continuing education or continuing competency requirements 22
for each profession. 23
(4)(a) A disciplining authority may, by rule, specify minimum 24
training and experience that is sufficient to exempt an individual 25
professional from the training requirements in subsections (1) and 26
(5) of this section. Nothing in this subsection (4)(a) allows a 27
disciplining authority to provide blanket exemptions to broad 28
categories or specialties within a profession. 29
(b) A disciplining authority may exempt a professional from the 30
training requirements of subsections (1) and (5) of this section if 31
the professional has only brief or limited patient contact.32
(5)(a) Each of the following professionals credentialed under 33
Title 18 RCW shall complete a one-time training in suicide 34
assessment, treatment, and management that is approved by the 35
relevant disciplining authority: 36
(i) A chiropractor licensed under chapter 18.25 RCW;37
(ii) A naturopath licensed under chapter 18.36A RCW;38
(iii) A licensed practical nurse, registered nurse, or advanced 39
((registered nurse practitioner )) practice registered nurse , other 40
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than a certified registered nurse anesthetist, licensed under chapter 1
18.79 RCW; 2
(iv) An osteopathic physician and surgeon licensed under chapter 3
18.57 RCW, other than a holder of a postgraduate osteopathic medicine 4
and surgery license issued under RCW 18.57.035; 5
(v) A physical therapist or physical therapist assistant licensed 6
under chapter 18.74 RCW; 7
(vi) A physician licensed under chapter 18.71 RCW, other than a 8
resident holding a limited license issued under RCW 18.71.095(3);9
(vii) A physician assistant licensed under chapter 18.71A RCW;10
(viii) A pharmacist licensed under chapter 18.64 RCW;11
(ix) A dentist licensed under chapter 18.32 RCW;12
(x) A dental hygienist licensed under chapter 18.29 RCW;13
(xi) An athletic trainer licensed under chapter 18.250 RCW;14
(xii) An optometrist licensed under chapter 18.53 RCW;15
(xiii) An acupuncture and Eastern medicine practitioner licensed 16
under chapter 18.06 RCW; 17
(xiv) A dental therapist licensed under chapter 18.265 RCW; and18
(xv) A person holding a retired active license for one of the 19
professions listed in (a)(i) through (xiv) of this subsection.20
(b)(i) A professional listed in (a)(i) through (vii) of this 21
subsection or a person holding a retired active license for one of 22
the professions listed in (a)(i) through (vii) of this subsection 23
must complete the one-time training by the end of the first full 24
continuing education reporting period after January 1, 2016, or 25
during the first full continuing education reporting period after 26
initial licensure, whichever is later. Training completed between 27
June 12, 2014, and January 1, 2016, that meets the requirements of 28
this section, other than the timing requirements of this subsection 29
(5)(b), must be accepted by the disciplining authority as meeting the 30
one-time training requirement of this subsection (5).31
(ii) A licensed pharmacist or a person holding a retired active 32
pharmacist license must complete the one-time training by the end of 33
the first full continuing education reporting period after January 1, 34
2017, or during the first full continuing education reporting period 35
after initial licensure, whichever is later. 36
(iii) A licensed dentist, a licensed dental hygienist, or a 37
person holding a retired active license as a dentist shall complete 38
the one-time training by the end of the full continuing education 39
reporting period after August 1, 2020, or during the first full 40
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continuing education reporting period after initial licensure, 1
whichever is later. Training completed between July 23, 2017, and 2
August 1, 2020, that meets the requirements of this section, other 3
than the timing requirements of this subsection (5)(b)(iii), must be 4
accepted by the disciplining authority as meeting the one-time 5
training requirement of this subsection (5). 6
(iv) A licensed optometrist or a licensed acupuncture and Eastern 7
medicine practitioner, or a person holding a retired active license 8
as an optometrist or an acupuncture and Eastern medicine 9
practitioner, shall complete the one-time training by the end of the 10
full continuing education reporting period after August 1, 2021, or 11
during the first full continuing education reporting period after 12
initial licensure, whichever is later. Training completed between 13
August 1, 2020, and August 1, 2021, that meets the requirements of 14
this section, other than the timing requirements of this subsection 15
(5)(b)(iv), must be accepted by the disciplining authority as meeting 16
the one-time training requirement of this subsection (5).17
(c) The training required by this subsection must be at least six 18
hours in length, unless a disciplining authority has determined, 19
under subsection (10)(b) of this section, that training that includes 20
only screening and referral elements is appropriate for the 21
profession in question, in which case the training must be at least 22
three hours in length. 23
(d) Beginning July 1, 2017, the training required by this 24
subsection must be on the model list developed under subsection (6) 25
of this section. Nothing in this subsection (5)(d) affects the 26
validity of training completed prior to July 1, 2017.27
(6)(a) The secretary and the disciplining authorities shall work 28
collaboratively to develop a model list of training programs in 29
suicide assessment, treatment, and management. Beginning July 1, 30
2021, for purposes of subsection (2)(a)(ii) of this section, the 31
model list must include advanced training and training in treatment 32
modalities shown to be effective in working with people who are 33
suicidal. 34
(b) The secretary and the disciplining authorities shall update 35
the list at least once every two years. 36
(c) By June 30, 2016, the department shall adopt rules 37
establishing minimum standards for the training programs included on 38
the model list. The minimum standards must require that six-hour 39
trainings include content specific to veterans and the assessment of 40
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issues related to imminent harm via lethal means or self-injurious 1
behaviors and that three-hour trainings for pharmacists or dentists 2
include content related to the assessment of issues related to 3
imminent harm via lethal means. By July 1, 2024, the minimum 4
standards must be updated to require that both the six-hour and 5
three-hour trainings include content specific to the availability of 6
and the services offered by the 988 crisis hotline and the behavioral 7
health crisis response and suicide prevention system and best 8
practices for assisting persons with accessing the 988 crisis hotline 9
and the system. Beginning September 1, 2024, trainings submitted to 10
the department for review and approval must include the updated 11
information in the minimum standards for the model list as well as 12
all subsequent submissions. When adopting the rules required under 13
this subsection (6)(c), the department shall: 14
(i) Consult with the affected disciplining authorities, public 15
and private institutions of higher education, educators, experts in 16
suicide assessment, treatment, and management, the Washington 17
department of veterans affairs, and affected professional 18
associations; and 19
(ii) Consider standards related to the best practices registry of 20
the American foundation for suicide prevention and the suicide 21
prevention resource center. 22
(d) Beginning January 1, 2017: 23
(i) The model list must include only trainings that meet the 24
minimum standards established in the rules adopted under (c) of this 25
subsection and any three-hour trainings that met the requirements of 26
this section on or before July 24, 2015; 27
(ii) The model list must include six-hour trainings in suicide 28
assessment, treatment, and management, and three-hour trainings that 29
include only screening and referral elements; and 30
(iii) A person or entity providing the training required in this 31
section may petition the department for inclusion on the model list. 32
The department shall add the training to the list only if the 33
department determines that the training meets the minimum standards 34
established in the rules adopted under (c) of this subsection.35
(e) By January 1, 2021, the department shall adopt minimum 36
standards for advanced training and training in treatment modalities 37
shown to be effective in working with people who are suicidal. 38
Beginning July 1, 2021, all such training on the model list must meet 39
the minimum standards. When adopting the minimum standards, the 40
p. 210 HB 1281
department must consult with the affected disciplining authorities, 1
public and private institutions of higher education, educators, 2
experts in suicide assessment, treatment, and management, the 3
Washington department of veterans affairs, and affected professional 4
associations. 5
(7) The department shall provide the health profession training 6
standards created in this section to the professional educator 7
standards board as a model in meeting the requirements of RCW 8
28A.410.226 and provide technical assistance, as requested, in the 9
review and evaluation of educator training programs. The educator 10
training programs approved by the professional educator standards 11
board may be included in the department's model list.12
(8) Nothing in this section may be interpreted to expand or limit 13
the scope of practice of any profession regulated under chapter 14
18.130 RCW. 15
(9) The secretary and the disciplining authorities affected by 16
this section shall adopt any rules necessary to implement this 17
section. 18
(10) For purposes of this section: 19
(a) "Disciplining authority" has the same meaning as in RCW 20
18.130.020. 21
(b) "Training in suicide assessment, treatment, and management" 22
means empirically supported training approved by the appropriate 23
disciplining authority that contains the following elements: Suicide 24
assessment, including screening and referral, suicide treatment, and 25
suicide management. However, the disciplining authority may approve 26
training that includes only screening and referral elements if 27
appropriate for the profession in question based on the profession's 28
scope of practice. The board of occupational therapy may also approve 29
training that includes only screening and referral elements if 30
appropriate for occupational therapy practitioners based on practice 31
setting. 32
(11) A state or local government employee is exempt from the 33
requirements of this section if he or she receives a total of at 34
least six hours of training in suicide assessment, treatment, and 35
management from his or her employer every six years. For purposes of 36
this subsection, the training may be provided in one six -hour block 37
or may be spread among shorter training sessions at the employer's 38
discretion. 39
p. 211 HB 1281
(12) An employee of a community mental health agency licensed 1
under chapter 71.24 RCW or a chemical dependency program certified 2
under chapter 71.24 RCW is exempt from the requirements of this 3
section if he or she receives a total of at least six hours of 4
training in suicide assessment, treatment, and management from his or 5
her employer every six years. For purposes of this subsection, the 6
training may be provided in one six-hour block or may be spread among 7
shorter training sessions at the employer's discretion.8
Sec. 5095. RCW 43.70.470 and 2020 c 80 s 31 are each amended to 9
read as follows: 10
The department may establish by rule the conditions of 11
participation in the liability insurance program by retired health 12
care providers at clinics utilizing retired health care providers for 13
the purposes of this section and RCW 43.70.460. These conditions 14
shall include, but not be limited to, the following:15
(1) The participating health care provider associated with the 16
clinic shall hold a valid license to practice as a physician under 17
chapter 18.71 or 18.57 RCW, a naturopath under chapter 18.36A RCW, a 18
physician assistant under chapter 18.71A RCW, an advanced 19
((registered nurse practitioner )) practice registered nurse under 20
chapter 18.79 RCW, a dentist under chapter 18.32 RCW, or other health 21
professionals as may be deemed in short supply by the department. All 22
health care providers must be in conformity with current requirements 23
for licensure, including continuing education requirements;24
(2) Health care shall be limited to noninvasive procedures and 25
shall not include obstetrical care. Noninvasive procedures include 26
injections, suturing of minor lacerations, and incisions of boils or 27
superficial abscesses. Primary dental care shall be limited to 28
diagnosis, oral hygiene, restoration, and extractions and shall not 29
include orthodontia, or other specialized care and treatment;30
(3) The provision of liability insurance coverage shall not 31
extend to acts outside the scope of rendering health care services 32
pursuant to this section and RCW 43.70.460; 33
(4) The participating health care provider shall limit the 34
provision of health care services to primarily low-income persons 35
provided that clinics may, but are not required to, provide means 36
tests for eligibility as a condition for obtaining health care 37
services; 38
p. 212 HB 1281
(5) The participating health care provider shall not accept 1
compensation for providing health care services from patients served 2
pursuant to this section and RCW 43.70.460, nor from clinics serving 3
these patients. "Compensation" shall mean any remuneration of value 4
to the participating health care provider for services provided by 5
the health care provider, but shall not be construed to include any 6
nominal copayments charged by the clinic, nor reimbursement of 7
related expenses of a participating health care provider authorized 8
by the clinic in advance of being incurred; and 9
(6) The use of mediation or arbitration for resolving questions 10
of potential liability may be used, however any mediation or 11
arbitration agreement format shall be expressed in terms clear enough 12
for a person with a sixth grade level of education to understand, and 13
on a form no longer than one page in length. 14
Sec. 5096. RCW 46.19.010 and 2020 c 80 s 32 are each amended to 15
read as follows: 16
(1) A natural person who has a disability that meets one of the 17
following criteria may apply for special parking privileges:18
(a) Cannot walk two hundred feet without stopping to rest;19
(b) Is severely limited in ability to walk due to arthritic, 20
neurological, or orthopedic condition; 21
(c) Has such a severe disability that the person cannot walk 22
without the use of or assistance from a brace, cane, another person, 23
prosthetic device, wheelchair, or other assistive device;24
(d) Uses portable oxygen; 25
(e) Is restricted by lung disease to an extent that forced 26
expiratory respiratory volume, when measured by spirometry, is less 27
than one liter per second or the arterial oxygen tension is less than 28
sixty mm/hg on room air at rest; 29
(f) Impairment by cardiovascular disease or cardiac condition to 30
the extent that the person's functional limitations are classified as 31
class III or IV under standards accepted by the American heart 32
association; 33
(g) Has a disability resulting from an acute sensitivity to 34
automobile emissions that limits or impairs the ability to walk. The 35
personal physician, advanced ((registered nurse practitioner )) 36
practice registered nurse , or physician assistant of the applicant 37
shall document that the disability is comparable in severity to the 38
others listed in this subsection; 39
p. 213 HB 1281
(h) Has limited mobility and has no vision or whose vision with 1
corrective lenses is so limited that the person requires alternative 2
methods or skills to do efficiently those things that are ordinarily 3
done with sight by persons with normal vision; 4
(i) Has an eye condition of a progressive nature that may lead to 5
blindness; or 6
(j) Is restricted by a form of porphyria to the extent that the 7
applicant would significantly benefit from a decrease in exposure to 8
light. 9
(2) The disability must be determined by either:10
(a) A licensed physician; 11
(b) An advanced ((registered nurse practitioner )) practice 12
registered nurse licensed under chapter 18.79 RCW; or13
(c) A physician assistant licensed under chapter 18.71A RCW.14
(3) A health care practitioner listed under subsection (2) of 15
this section who is authorizing a parking permit for purposes of this 16
chapter must provide a signed written authorization: On a 17
prescription pad or paper, as defined in RCW 18.64.500; on office 18
letterhead; or by electronic means, as described by the director in 19
rule. 20
(4) The application for special parking privileges for persons 21
with disabilities must contain: 22
(a) The following statement immediately below the physician's, 23
advanced ((registered nurse practitioner's )) practice registered 24
nurse's, or physician assistant's signature: "A parking permit for a 25
person with disabilities may be issued only for a medical necessity 26
that severely affects mobility or involves acute sensitivity to light 27
(RCW 46.19.010). An applicant or health care practitioner who 28
knowingly provides false information on this application is guilty of 29
a gross misdemeanor. The penalty is up to three hundred sixty-four 30
days in jail and a fine of up to $5,000 or both. In addition, the 31
health care practitioner may be subject to sanctions under chapter 32
18.130 RCW, the Uniform Disciplinary Act"; and 33
(b) Other information as required by the department.34
(5) A natural person who has a disability described in subsection 35
(1) of this section and is expected to improve within twelve months 36
may be issued a temporary placard for a period not to exceed twelve 37
months. If the disability exists after twelve months, a new temporary 38
placard must be issued upon receipt of a new application with 39
certification from the person's physician as prescribed in 40
p. 214 HB 1281
subsections (3) and (4) of this section. Special license plates for 1
persons with disabilities may not be issued to a person with a 2
temporary disability. 3
(6) A natural person who qualifies for special parking privileges 4
under this section must receive an identification card showing the 5
name and date of birth of the person to whom the parking privilege 6
has been issued and the serial number of the placard.7
(7) A natural person who qualifies for permanent special parking 8
privileges under this section may receive one of the following:9
(a) Up to two parking placards; 10
(b) One set of special license plates for persons with 11
disabilities if the person with the disability is the registered 12
owner of the vehicle on which the license plates will be displayed;13
(c) One parking placard and one set of special license plates for 14
persons with disabilities if the person with the disability is the 15
registered owner of the vehicle on which the license plates will be 16
displayed; or 17
(d) One special parking year tab for persons with disabilities 18
and one parking placard. 19
(8) Parking placards and identification cards described in this 20
section must be issued free of charge. 21
(9) The parking placard and identification card must be 22
immediately returned to the department upon the placard holder's 23
death. 24
Sec. 5097. RCW 46.61.506 and 2020 c 80 s 33 are each amended to 25
read as follows: 26
(1) Upon the trial of any civil or criminal action or proceeding 27
arising out of acts alleged to have been committed by any person 28
while driving or in actual physical control of a vehicle while under 29
the influence of intoxicating liquor or any drug, if the person's 30
alcohol concentration is less than 0.08 or the person's THC 31
concentration is less than 5.00, it is evidence that may be 32
considered with other competent evidence in determining whether the 33
person was under the influence of intoxicating liquor or any drug.34
(2)(a) The breath analysis of the person's alcohol concentration 35
shall be based upon grams of alcohol per two hundred ten liters of 36
breath. 37
(b) The blood analysis of the person's THC concentration shall be 38
based upon nanograms per milliliter of whole blood.39
p. 215 HB 1281
(c) The foregoing provisions of this section shall not be 1
construed as limiting the introduction of any other competent 2
evidence bearing upon the question whether the person was under the 3
influence of intoxicating liquor or any drug. 4
(3) Analysis of the person's blood or breath to be considered 5
valid under the provisions of this section or RCW 46.61.502 or 6
46.61.504 shall have been performed according to methods approved by 7
the state toxicologist and by an individual possessing a valid permit 8
issued by the state toxicologist for this purpose. The state 9
toxicologist is directed to approve satisfactory techniques or 10
methods, to supervise the examination of individuals to ascertain 11
their qualifications and competence to conduct such analyses, and to 12
issue permits which shall be subject to termination or revocation at 13
the discretion of the state toxicologist. 14
(4)(a) A breath test performed by any instrument approved by the 15
state toxicologist shall be admissible at trial or in an 16
administrative proceeding if the prosecution or department produces 17
prima facie evidence of the following: 18
(i) The person who performed the test was authorized to perform 19
such test by the state toxicologist; 20
(ii) The person being tested did not vomit or have anything to 21
eat, drink, or smoke for at least fifteen minutes prior to 22
administration of the test; 23
(iii) The person being tested did not have any foreign 24
substances, not to include dental work or piercings, fixed or 25
removable, in his or her mouth at the beginning of the fifteen-minute 26
observation period; 27
(iv) Prior to the start of the test, the temperature of any 28
liquid simulator solution utilized as an external standard, as 29
measured by a thermometer approved of by the state toxicologist was 30
thirty-four degrees centigrade plus or minus 0.3 degrees centigrade;31
(v) The internal standard test resulted in the message 32
"verified"; 33
(vi) The two breath samples agree to within plus or minus ten 34
percent of their mean to be determined by the method approved by the 35
state toxicologist; 36
(vii) The result of the test of the liquid simulator solution 37
external standard or dry gas external standard result did lie 38
between .072 to .088 inclusive; and 39
(viii) All blank tests gave results of .000. 40
p. 216 HB 1281
(b) For purposes of this section, "prima facie evidence" is 1
evidence of sufficient circumstances that would support a logical and 2
reasonable inference of the facts sought to be proved. In assessing 3
whether there is sufficient evidence of the foundational facts, the 4
court or administrative tribunal is to assume the truth of the 5
prosecution's or department's evidence and all reasonable inferences 6
from it in a light most favorable to the prosecution or department.7
(c) Nothing in this section shall be deemed to prevent the 8
subject of the test from challenging the reliability or accuracy of 9
the test, the reliability or functioning of the instrument, or any 10
maintenance procedures. Such challenges, however, shall not preclude 11
the admissibility of the test once the prosecution or department has 12
made a prima facie showing of the requirements contained in (a) of 13
this subsection. Instead, such challenges may be considered by the 14
trier of fact in determining what weight to give to the test result.15
(5) When a blood test is administered under the provisions of RCW 16
46.20.308, the withdrawal of blood for the purpose of determining its 17
alcohol or drug content may be performed only by a physician licensed 18
under chapter 18.71 RCW; an osteopathic physician licensed under 19
chapter 18.57 RCW; a registered nurse, licensed practical nurse, or 20
advanced ((registered nurse practitioner )) practice registered nurse 21
licensed under chapter 18.79 RCW; a physician assistant licensed 22
under chapter 18.71A RCW; an advanced emergency medical technician or 23
paramedic certified under chapter 18.71 RCW; or a medical assistant-24
certified or medical assistant-phlebotomist certified under chapter 25
18.360 RCW, a person holding another credential under Title 18 RCW 26
whose scope of practice includes performing venous blood draws, or a 27
forensic phlebotomist certified under chapter 18.360 RCW. When the 28
blood test is performed outside the state of Washington, the 29
withdrawal of blood for the purpose of determining its alcohol or 30
drug content may be performed by any person who is authorized by the 31
out-of-state jurisdiction to perform venous blood draws. Proof of 32
qualification to draw blood may be established through the department 33
of health's provider credential search. This limitation shall not 34
apply to the taking of breath specimens. 35
(6) When a venous blood sample is performed by a forensic 36
phlebotomist certified under chapter 18.360 RCW, it must be done 37
under the following conditions: 38
p. 217 HB 1281
(a) If taken at the scene, it must be performed in an ambulance 1
or aid service vehicle licensed by the department of health under 2
chapter 18.73 RCW. 3
(b) The collection of blood samples must not interfere with the 4
provision of essential medical care. 5
(c) The blood sample must be collected using sterile equipment 6
and the skin area of puncture must be thoroughly cleansed and 7
disinfected. 8
(d) The person whose blood is collected must be seated, reclined, 9
or lying down when the blood is collected. 10
(7) The person tested may have a licensed or certified health 11
care provider listed in subsection (5) of this section, or a 12
qualified technician, chemist, or other qualified person of his or 13
her own choosing administer one or more tests in addition to any 14
administered at the direction of a law enforcement officer. The test 15
will be admissible if the person establishes the general 16
acceptability of the testing technique or method. The failure or 17
inability to obtain an additional test by a person shall not preclude 18
the admission of evidence relating to the test or tests taken at the 19
direction of a law enforcement officer. 20
(8) Upon the request of the person who shall submit to a test or 21
tests at the request of a law enforcement officer, full information 22
concerning the test or tests shall be made available to him or her or 23
his or her attorney. 24
Sec. 5098. RCW 46.61.508 and 2020 c 80 s 34 are each amended to 25
read as follows: 26
No physician licensed under chapter 18.71 RCW; osteopathic 27
physician licensed under chapter 18.57 RCW; registered nurse, 28
licensed practical nurse, or advanced ((registered nurse 29
practitioner)) practice registered nurse licensed under chapter 18.79 30
RCW; physician assistant licensed under chapter 18.71A RCW; advanced 31
emergency medical technician or paramedic certified under chapter 32
18.71 RCW; or medical assistant-certified or medical assistant-33
phlebotomist certified under chapter 18.360 RCW, person holding 34
another credential under Title 18 RCW whose scope of practice 35
includes performing venous blood draws, or forensic phlebotomist 36
certified under chapter 18.360 RCW, or hospital, or duly licensed 37
clinical laboratory employing or utilizing services of such licensed 38
or certified health care provider, shall incur any civil or criminal 39
p. 218 HB 1281
liability as a result of the act of withdrawing blood from any person 1
when directed by a law enforcement officer to do so for the purpose 2
of a blood test under the provisions of a search warrant, a waiver of 3
the search warrant requirement, exigent circumstances, or any other 4
authority of law: PROVIDED, That nothing in this section shall 5
relieve such licensed or certified health care provider, hospital or 6
duly licensed clinical laboratory, or forensic phlebotomist from 7
civil liability arising from the use of improper procedures or 8
failing to exercise the required standard of care. 9
Sec. 5099. RCW 48.20.392 and 2006 c 367 s 2 are each amended to 10
read as follows: 11
(1) Each disability insurance policy issued or renewed after 12
December 31, 2006, that provides coverage for hospital or medical 13
expenses shall provide coverage for prostate cancer screening, 14
provided that the screening is delivered upon the recommendation of 15
the patient's physician, advanced ((registered nurse practitioner )) 16
practice registered nurse, or physician assistant.17
(2) This section shall not be construed to prevent the 18
application of standard policy provisions applicable to other 19
benefits, such as deductible or copayment provisions. This section 20
does not limit the authority of an insurer to negotiate rates and 21
contract with specific providers for the delivery of prostate cancer 22
screening services. This section shall not apply to medicare 23
supplemental policies or supplemental contracts covering a specified 24
disease or other limited benefits. 25
Sec. 5100. RCW 48.20.393 and 2023 c 366 s 3 are each amended to 26
read as follows: 27
Each disability insurance policy issued or renewed after January 28
1, 1990, that provides coverage for hospital or medical expenses 29
shall provide coverage for screening or diagnostic mammography 30
services, provided that such services are delivered upon the 31
recommendation of the patient's physician or advanced ((registered 32
nurse practitioner )) practice registered nurse as authorized by the 33
((nursing care quality assurance commission )) state board of nursing 34
pursuant to chapter 18.79 RCW or physician assistant pursuant to 35
chapter 18.71A RCW. 36
This section shall not be construed to prevent the application of 37
standard policy provisions, other than the cost-sharing prohibition 38
p. 219 HB 1281
provided in RCW 48.43.076, that are applicable to other benefits. 1
This section does not limit the authority of an insurer to negotiate 2
rates and contract with specific providers for the delivery of 3
mammography services. This section shall not apply to medicare 4
supplement policies or supplemental contracts covering a specified 5
disease or other limited benefits. 6
Sec. 5101. RCW 48.21.225 and 2023 c 366 s 4 are each amended to 7
read as follows: 8
Each group disability insurance policy issued or renewed after 9
January 1, 1990, that provides coverage for hospital or medical 10
expenses shall provide coverage for screening or diagnostic 11
mammography services, provided that such services are delivered upon 12
the recommendation of the patient's physician or advanced 13
((registered nurse practitioner )) practice registered nurse as 14
authorized by the ((nursing care quality assurance commission )) state 15
board of nursing pursuant to chapter 18.79 RCW or physician assistant 16
pursuant to chapter 18.71A RCW. 17
This section shall not be construed to prevent the application of 18
standard policy provisions, other than the cost-sharing prohibition 19
provided in RCW 48.43.076, that are applicable to other benefits. 20
This section does not limit the authority of an insurer to negotiate 21
rates and contract with specific providers for the delivery of 22
mammography services. This section shall not apply to medicare 23
supplement policies or supplemental contracts covering a specified 24
disease or other limited benefits. 25
Sec. 5102. RCW 48.21.227 and 2006 c 367 s 3 are each amended to 26
read as follows: 27
(1) Each group disability insurance policy issued or renewed 28
after December 31, 2006, that provides coverage for hospital or 29
medical expenses shall provide coverage for prostate cancer 30
screening, provided that the screening is delivered upon the 31
recommendation of the patient's physician, advanced ((registered 32
nurse practitioner )) practice registered nurse , or physician 33
assistant. 34
(2) This section shall not be construed to prevent the 35
application of standard policy provisions applicable to other 36
benefits, such as deductible or copayment provisions. This section 37
does not limit the authority of an insurer to negotiate rates and 38
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contract with specific providers for the delivery of prostate cancer 1
screening services. This section shall not apply to medicare 2
supplemental policies or supplemental contracts covering a specified 3
disease or other limited benefits. 4
Sec. 5103. RCW 48.42.100 and 2020 c 80 s 35 are each amended to 5
read as follows: 6
(1) For purposes of this section, health care carriers includes 7
disability insurers regulated under chapter 48.20 or 48.21 RCW, 8
health care services contractors regulated under chapter 48.44 RCW, 9
health maintenance organizations regulated under chapter 48.46 RCW, 10
plans operating under the health care authority under chapter 41.05 11
RCW, the state health insurance pool operating under chapter 48.41 12
RCW, and insuring entities regulated under chapter 48.43 RCW.13
(2) For purposes of this section and consistent with their lawful 14
scopes of practice, types of health care practitioners that provide 15
women's health care services shall include, but need not be limited 16
by a health care carrier to, the following: Any generally recognized 17
medical specialty of practitioners licensed under chapter 18.57 or 18
18.71 RCW who provides women's health care services; practitioners 19
licensed under chapter 18.71A RCW when providing women's health care 20
services; midwives licensed under chapter 18.50 RCW; and advanced 21
((registered nurse practitioner )) practice registered nurse 22
specialists in women's health and midwifery under chapter 18.79 RCW.23
(3) For purposes of this section, women's health care services 24
shall include, but need not be limited by a health care carrier to, 25
the following: Maternity care; reproductive health services; 26
gynecological care; general examination; and preventive care as 27
medically appropriate and medically appropriate follow-up visits for 28
the services listed in this subsection. 29
(4) Health care carriers shall ensure that enrolled female 30
patients have direct access to timely and appropriate covered women's 31
health care services from the type of health care practitioner of 32
their choice in accordance with subsection (5) of this section.33
(5)(a) Health care carrier policies, plans, and programs written, 34
amended, or renewed after July 23, 1995, shall provide women patients 35
with direct access to the type of health care practitioner of their 36
choice for appropriate covered women's health care services without 37
the necessity of prior referral from another type of health care 38
practitioner. 39
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(b) Health care carriers may comply with this section by 1
including all the types of health care practitioners listed in this 2
section for women's health care services for women patients.3
(c) Nothing in this section shall prevent health care carriers 4
from restricting women patients to seeing only health care 5
practitioners who have signed participating provider agreements with 6
the health care carrier. 7
Sec. 5104. RCW 48.43.094 and 2020 c 80 s 36 are each amended to 8
read as follows: 9
(1) For health plans issued or renewed on or after January 1, 10
2017: 11
(a) Benefits shall not be denied for any health care service 12
performed by a pharmacist licensed under chapter 18.64 RCW if:13
(i) The service performed was within the lawful scope of such 14
person's license; 15
(ii) The plan would have provided benefits if the service had 16
been performed by a physician licensed under chapter 18.71 or 18.57 17
RCW, an advanced ((registered nurse practitioner )) practice 18
registered nurse licensed under chapter 18.79 RCW, or a physician's 19
assistant licensed under chapter 18.71A RCW; and 20
(iii) The pharmacist is included in the plan's network of 21
participating providers; and 22
(b) The health plan must include an adequate number of 23
pharmacists in its network of participating medical providers.24
(2) The participation of pharmacies in the plan network's drug 25
benefit does not satisfy the requirement that plans include 26
pharmacists in their networks of participating medical providers.27
(3) For health benefit plans issued or renewed on or after 28
January 1, 2016, but before January 1, 2017, health plans that 29
delegate credentialing agreements to contracted health care 30
facilities must accept credentialing for pharmacists employed or 31
contracted by those facilities. Health plans must reimburse 32
facilities for covered services provided by network pharmacists 33
within the pharmacists' scope of practice per negotiations with the 34
facility. 35
(4) This section does not supersede the requirements of RCW 36
48.43.045. 37
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Sec. 5105. RCW 48.43.115 and 2020 c 80 s 37 are each amended to 1
read as follows: 2
(1) The legislature recognizes the role of health care providers 3
as the appropriate authority to determine and establish the delivery 4
of quality health care services to maternity patients and their newly 5
born children. It is the intent of the legislature to recognize 6
patient preference and the clinical sovereignty of providers as they 7
make determinations regarding services provided and the length of 8
time individual patients may need to remain in a health care facility 9
after giving birth. It is not the intent of the legislature to 10
diminish a carrier's ability to utilize managed care strategies but 11
to ensure the clinical judgment of the provider is not undermined by 12
restrictive carrier contracts or utilization review criteria that 13
fail to recognize individual postpartum needs. 14
(2) Unless otherwise specifically provided, the following 15
definitions apply throughout this section: 16
(a) "Attending provider" means a provider who: Has clinical 17
hospital privileges consistent with RCW 70.43.020; is included in a 18
provider network of the carrier that is providing coverage; and is a 19
physician licensed under chapter 18.57 or 18.71 RCW, a certified 20
nurse midwife licensed under chapter 18.79 RCW, a midwife licensed 21
under chapter 18.50 RCW, a physician's assistant licensed under 22
chapter 18.71A RCW, or an advanced ((registered nurse practitioner )) 23
practice registered nurse licensed under chapter 18.79 RCW.24
(b) "Health carrier" or "carrier" means disability insurers 25
regulated under chapter 48.20 or 48.21 RCW, health care services 26
contractors regulated under chapter 48.44 RCW, health maintenance 27
organizations regulated under chapter 48.46 RCW, plans operating 28
under the health care authority under chapter 41.05 RCW, the state 29
health insurance pool operating under chapter 48.41 RCW, and insuring 30
entities regulated under this chapter. 31
(3)(a) Every health carrier that provides coverage for maternity 32
services must permit the attending provider, in consultation with the 33
mother, to make decisions on the length of inpatient stay, rather 34
than making such decisions through contracts or agreements between 35
providers, hospitals, and insurers. These decisions must be based on 36
accepted medical practice. 37
(b) Covered eligible services may not be denied for inpatient, 38
postdelivery care to a mother and her newly born child after a 39
p. 223 HB 1281
vaginal delivery or a cesarean section delivery for such care as 1
ordered by the attending provider in consultation with the mother.2
(c) At the time of discharge, determination of the type and 3
location of follow-up care must be made by the attending provider in 4
consultation with the mother rather than by contract or agreement 5
between the hospital and the insurer. These decisions must be based 6
on accepted medical practice. 7
(d) Covered eligible services may not be denied for follow-up 8
care, including in-person care, as ordered by the attending provider 9
in consultation with the mother. Coverage for providers of follow-up 10
services must include, but need not be limited to, attending 11
providers as defined in this section, home health agencies licensed 12
under chapter 70.127 RCW, and registered nurses licensed under 13
chapter 18.79 RCW. 14
(e) This section does not require attending providers to 15
authorize care they believe to be medically unnecessary.16
(f) Coverage for the newly born child must be no less than the 17
coverage of the child's mother for no less than three weeks, even if 18
there are separate hospital admissions. 19
(4) A carrier that provides coverage for maternity services may 20
not deselect, terminate the services of, require additional 21
documentation from, require additional utilization review of, reduce 22
payments to, or otherwise provide financial disincentives to any 23
attending provider or health care facility solely as a result of the 24
attending provider or health care facility ordering care consistent 25
with this section. This section does not prevent any insurer from 26
reimbursing an attending provider or health care facility on a 27
capitated, case rate, or other financial incentive basis.28
(5) Every carrier that provides coverage for maternity services 29
must provide notice to policyholders regarding the coverage required 30
under this section. The notice must be in writing and must be 31
transmitted at the earliest of the next mailing to the policyholder, 32
the yearly summary of benefits sent to the policyholder, or January 1 33
of the year following June 6, 1996. 34
(6) This section does not establish a standard of medical care.35
(7) This section applies to coverage for maternity services under 36
a contract issued or renewed by a health carrier after June 6, 1996, 37
and applies to plans operating under the health care authority under 38
chapter 41.05 RCW beginning January 1, 1998. 39
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Sec. 5106. RCW 48.44.325 and 2023 c 366 s 5 are each amended to 1
read as follows: 2
Each health care service contract issued or renewed after January 3
1, 1990, that provides benefits for hospital or medical care shall 4
provide benefits for screening or diagnostic mammography services, 5
provided that such services are delivered upon the recommendation of 6
the patient's physician or advanced ((registered nurse practitioner)) 7
practice registered nurse as authorized by the ((nursing care quality 8
assurance commission )) state board of nursing pursuant to chapter 9
18.79 RCW or physician assistant pursuant to chapter 18.71A RCW.10
This section shall not be construed to prevent the application of 11
standard contract provisions, other than the cost-sharing prohibition 12
provided in RCW 48.43.076, that are applicable to other benefits. 13
This section does not limit the authority of a contractor to 14
negotiate rates and contract with specific providers for the delivery 15
of mammography services. This section shall not apply to medicare 16
supplement policies or supplemental contracts covering a specified 17
disease or other limited benefits. 18
Sec. 5107. RCW 48.44.327 and 2006 c 367 s 4 are each amended to 19
read as follows: 20
(1) Each health care service contract issued or renewed after 21
December 31, 2006, that provides coverage for hospital or medical 22
expenses shall provide coverage for prostate cancer screening, 23
provided that the screening is delivered upon the recommendation of 24
the patient's physician, advanced ((registered nurse practitioner )) 25
practice registered nurse, or physician assistant.26
(2) This section shall not be construed to prevent the 27
application of standard policy provisions applicable to other 28
benefits, such as deductible or copayment provisions. This section 29
does not limit the authority of a contractor to negotiate rates and 30
contract with specific providers for the delivery of prostate cancer 31
screening services. This section shall not apply to medicare 32
supplemental policies or supplemental contracts covering a specified 33
disease or other limited benefits. 34
Sec. 5108. RCW 48.46.275 and 2023 c 366 s 6 are each amended to 35
read as follows: 36
Each health maintenance agreement issued or renewed after January 37
1, 1990, that provides benefits for hospital or medical care shall 38
p. 225 HB 1281
provide benefits for screening or diagnostic mammography services, 1
provided that such services are delivered upon the recommendation of 2
the patient's physician or advanced ((registered nurse practitioner)) 3
practice registered nurse as authorized by the ((nursing care quality 4
assurance commission )) state board of nursing pursuant to chapter 5
18.79 RCW or physician assistant pursuant to chapter 18.71A RCW.6
All services must be provided by the health maintenance 7
organization or rendered upon referral by the health maintenance 8
organization. This section shall not be construed to prevent the 9
application of standard agreement provisions, other than the cost-10
sharing prohibition provided in RCW 48.43.076, that are applicable to 11
other benefits. This section does not limit the authority of a health 12
maintenance organization to negotiate rates and contract with 13
specific providers for the delivery of mammography services. This 14
section shall not apply to medicare supplement policies or 15
supplemental contracts covering a specified disease or other limited 16
benefits. 17
Sec. 5109. RCW 48.46.277 and 2006 c 367 s 5 are each amended to 18
read as follows: 19
(1) Each health maintenance agreement issued or renewed after 20
December 31, 2006, that provides coverage for hospital or medical 21
expenses shall provide coverage for prostate cancer screening, 22
provided that the screening is delivered upon the recommendation of 23
the patient's physician, advanced ((registered nurse practitioner )) 24
practice registered nurse, or physician assistant.25
(2) All services must be provided by the health maintenance 26
organization or rendered upon a referral by the health maintenance 27
organization. 28
(3) This section shall not be construed to prevent the 29
application of standard policy provisions applicable to other 30
benefits, such as deductible or copayment provisions. This section 31
does not limit the authority of a health maintenance organization to 32
negotiate rates and contract with specific providers for the delivery 33
of prostate cancer screening services. This section shall not apply 34
to medicare supplemental policies or supplemental contracts covering 35
a specified disease or other limited benefits. 36
Sec. 5110. RCW 48.125.200 and 2006 c 367 s 6 are each amended to 37
read as follows: 38
p. 226 HB 1281
(1) Each self-funded multiple employer welfare arrangement 1
established, operated, providing benefits, or maintained in this 2
state after December 31, 2006, that provides coverage for hospital or 3
medical expenses shall provide coverage for prostate cancer 4
screening, provided that the screening is delivered upon the 5
recommendation of the patient's physician, advanced ((registered 6
nurse practitioner )) practice registered nurse , or physician 7
assistant. 8
(2) This section shall not be construed to prevent the 9
application of standard policy provisions applicable to other 10
benefits, such as deductible or copayment provisions. This section 11
does not limit the authority of a self-funded multiple employer 12
welfare arrangement to negotiate rates and contract with specific 13
providers for the delivery of prostate cancer screening services.14
Sec. 5111. RCW 50A.05.010 and 2023 c 25 s 2 are each amended to 15
read as follows: 16
Unless the context clearly requires otherwise, the definitions in 17
this section apply throughout this title. 18
(1)(a) "Casual labor" means work that: 19
(i) Is performed infrequently and irregularly; and20
(ii) If performed for an employer, does not promote or advance 21
the employer's customary trade or business. 22
(b) For purposes of casual labor: 23
(i) "Infrequently" means work performed twelve or fewer times per 24
calendar quarter; and 25
(ii) "Irregularly" means work performed not on a consistent 26
cadence. 27
(2) "Child" includes a biological, adopted, or foster child, a 28
stepchild, a child's spouse, or a child to whom the employee stands 29
in loco parentis, is a legal guardian, or is a de facto parent, 30
regardless of age or dependency status. 31
(3) "Commissioner" means the commissioner of the department or 32
the commissioner's designee. 33
(4) "Department" means the employment security department.34
(5)(a) "Employee" means an individual who is in the employment of 35
an employer. 36
(b) "Employee" does not include employees of the United States of 37
America. 38
p. 227 HB 1281
(6) "Employee's average weekly wage" means the quotient derived 1
by dividing the employee's total wages during the two quarters of the 2
employee's qualifying period in which total wages were highest by 3
twenty-six. If the result is not a multiple of one dollar, the 4
department must round the result to the next lower multiple of one 5
dollar. 6
(7)(a) "Employer" means: (i) Any individual or type of 7
organization, including any partnership, association, trust, estate, 8
joint stock company, insurance company, limited liability company, or 9
corporation, whether domestic or foreign, or the receiver, trustee in 10
bankruptcy, trustee, or the legal representative of a deceased 11
person, having any person in employment or, having become an 12
employer, has not ceased to be an employer as provided in this title; 13
(ii) the state, state institutions, and state agencies; and (iii) any 14
unit of local government including, but not limited to, a county, 15
city, town, municipal corporation, quasi -municipal corporation, or 16
political subdivision. 17
(b) "Employer" does not include the United States of America.18
(8)(a) "Employment" means personal service, of whatever nature, 19
unlimited by any employment relationship as known to the common law 20
or any other legal relationship performed for wages or under any 21
contract calling for the performance of personal services, written or 22
oral, express or implied. The term "employment" includes an 23
individual's entire service performed within or without or both 24
within and without this state, if: 25
(i) The service is localized in this state; or26
(ii) The service is not localized in any state, but some of the 27
service is performed in this state; and 28
(A) The base of operations of the employee is in the state, or if 29
there is no base of operations, then the place from which such 30
service is directed or controlled is in this state; or31
(B) The base of operations or place from which such service is 32
directed or controlled is not in any state in which some part of the 33
service is performed, but the individual's residence is in this 34
state. 35
(b) "Employment" does not include: 36
(i) Self-employed individuals; 37
(ii) Casual labor; 38
(iii) Services for remuneration when it is shown to the 39
satisfaction of the commissioner that: 40
p. 228 HB 1281
(A)(I) Such individual has been and will continue to be free from 1
control or direction over the performance of such service, both under 2
his or her contract of service and in fact; and 3
(II) Such service is either outside the usual course of business 4
for which such service is performed, or that such service is 5
performed outside of all the places of business of the enterprises 6
for which such service is performed; and 7
(III) Such individual is customarily engaged in an independently 8
established trade, occupation, profession, or business, of the same 9
nature as that involved in the contract of service; or10
(B) As a separate alternative: 11
(I) Such individual has been and will continue to be free from 12
control or direction over the performance of such service, both under 13
his or her contract of service and in fact; and 14
(II) Such service is either outside the usual course of business 15
for which such service is performed, or that such service is 16
performed outside of all the places of business of the enterprises 17
for which such service is performed, or the individual is 18
responsible, both under the contract and in fact, for the costs of 19
the principal place of business from which the service is performed; 20
and 21
(III) Such individual is customarily engaged in an independently 22
established trade, occupation, profession, or business, of the same 23
nature as that involved in the contract of service, or such 24
individual has a principal place of business for the work the 25
individual is conducting that is eligible for a business deduction 26
for federal income tax purposes; and 27
(IV) On the effective date of the contract of service, such 28
individual is responsible for filing at the next applicable filing 29
period, both under the contract of service and in fact, a schedule of 30
expenses with the internal revenue service for the type of business 31
the individual is conducting; and 32
(V) On the effective date of the contract of service, or within a 33
reasonable period after the effective date of the contract, such 34
individual has established an account with the department of revenue, 35
and other state agencies as required by the particular case, for the 36
business the individual is conducting for the payment of all state 37
taxes normally paid by employers and businesses and has registered 38
for and received a unified business identifier number from the state 39
of Washington; and 40
p. 229 HB 1281
(VI) On the effective date of the contract of service, such 1
individual is maintaining a separate set of books or records that 2
reflect all items of income and expenses of the business which the 3
individual is conducting; or 4
(iv) Services that require registration under chapter 18.27 RCW 5
or licensing under chapter 19.28 RCW rendered by an individual when:6
(A) The individual has been and will continue to be free from 7
control or direction over the performance of the service, both under 8
the contract of service and in fact; 9
(B) The service is either outside the usual course of business 10
for which the service is performed, or the service is performed 11
outside of all the places of business of the enterprise for which the 12
service is performed, or the individual is responsible, both under 13
the contract and in fact, for the costs of the principal place of 14
business from which the service is performed; 15
(C) The individual is customarily engaged in an independently 16
established trade, occupation, profession, or business, of the same 17
nature as that involved in the contract of service, or the individual 18
has a principal place of business for the business the individual is 19
conducting that is eligible for a business deduction for federal 20
income tax purposes, other than that furnished by the employer for 21
which the business has contracted to furnish services;22
(D) On the effective date of the contract of service, the 23
individual is responsible for filing at the next applicable filing 24
period, both under the contract of service and in fact, a schedule of 25
expenses with the internal revenue service for the type of business 26
the individual is conducting; 27
(E) On the effective date of the contract of service, or within a 28
reasonable period after the effective date of the contract, the 29
individual has an active and valid certificate of registration with 30
the department of revenue, and an active and valid account with any 31
other state agencies as required by the particular case, for the 32
business the individual is conducting for the payment of all state 33
taxes normally paid by employers and businesses and has registered 34
for and received a unified business identifier number from the state 35
of Washington; 36
(F) On the effective date of the contract of service, the 37
individual is maintaining a separate set of books or records that 38
reflect all items of income and expenses of the business that the 39
individual is conducting; and 40
p. 230 HB 1281
(G) On the effective date of the contract of service, the 1
individual has a valid contractor registration pursuant to chapter 2
18.27 RCW or an electrical contractor license pursuant to chapter 3
19.28 RCW. 4
(9) "Employment benefits" means all benefits provided or made 5
available to employees by an employer, including group life 6
insurance, health insurance, disability insurance, sick leave, annual 7
leave, educational benefits, and pensions. 8
(10) "Family leave" means any leave taken by an employee from 9
work: 10
(a) To participate in providing care, including physical or 11
psychological care, for a family member of the employee made 12
necessary by a serious health condition of the family member;13
(b) To bond with the employee's child during the first twelve 14
months after the child's birth, or the first twelve months after the 15
placement of a child under the age of eighteen with the employee;16
(c) Because of any qualifying exigency as permitted under the 17
federal family and medical leave act, 29 U.S.C. Sec. 2612 (a)(1)(E) 18
and 29 C.F.R. Sec. 825.126 (b)(1) through (9), as they existed on 19
October 19, 2017, for family members as defined in subsection (11) of 20
this section; or 21
(d) During the seven calendar days following the death of the 22
family member for whom the employee: 23
(i) Would have qualified for medical leave under subsection (15) 24
of this section for the birth of their child; or 25
(ii) Would have qualified for family leave under (b) of this 26
subsection. 27
(11) "Family member" means a child, grandchild, grandparent, 28
parent, sibling, or spouse of an employee, and also includes any 29
individual who regularly resides in the employee's home or where the 30
relationship creates an expectation that the employee care for the 31
person, and that individual depends on the employee for care. "Family 32
member" includes any individual who regularly resides in the 33
employee's home, except that it does not include an individual who 34
simply resides in the same home with no expectation that the employee 35
care for the individual. 36
(12) "Grandchild" means a child of the employee's child.37
(13) "Grandparent" means a parent of the employee's parent.38
(14) "Health care provider" means: (a) A person licensed as a 39
physician under chapter 18.71 RCW or an osteopathic physician and 40
p. 231 HB 1281
surgeon under chapter 18.57 RCW; (b) a person licensed as an advanced 1
((registered nurse practitioner )) practice registered nurse under 2
chapter 18.79 RCW; or (c) any other person determined by the 3
commissioner to be capable of providing health care services.4
(15) "Medical leave" means any leave taken by an employee from 5
work made necessary by the employee's own serious health condition.6
(16) "Paid time off" includes vacation leave, personal leave, 7
medical leave, sick leave, compensatory leave, or any other paid 8
leave offered by an employer under the employer's established policy.9
(17) "Parent" means the biological, adoptive, de facto, or foster 10
parent, stepparent, or legal guardian of an employee or the 11
employee's spouse, or an individual who stood in loco parentis to an 12
employee when the employee was a child. 13
(18) "Period of incapacity" means an inability to work, attend 14
school, or perform other regular daily activities because of a 15
serious health condition, treatment of that condition or recovery 16
from it, or subsequent treatment in connection with such inpatient 17
care. 18
(19) "Postnatal" means the first six weeks after birth.19
(20) "Premium" or "premiums" means the payments required by RCW 20
50A.10.030 and paid to the department for deposit in the family and 21
medical leave insurance account under RCW 50A.05.070.22
(21) "Qualifying period" means the first four of the last five 23
completed calendar quarters or, if eligibility is not established, 24
the last four completed calendar quarters immediately preceding the 25
application for leave. 26
(22)(a) "Remuneration" means all compensation paid for personal 27
services including commissions and bonuses and the cash value of all 28
compensation paid in any medium other than cash. 29
(b) Previously accrued compensation, other than severance pay or 30
payments received pursuant to plant closure agreements, when assigned 31
to a specific period of time by virtue of a collective bargaining 32
agreement, individual employment contract, customary trade practice, 33
or request of the individual compensated, is considered remuneration 34
for the period to which it is assigned. Assignment clearly occurs 35
when the compensation serves to make the individual eligible for all 36
regular fringe benefits for the period to which the compensation is 37
assigned. 38
(c) Remuneration also includes settlements or other proceeds 39
received by an individual as a result of a negotiated settlement for 40
p. 232 HB 1281
termination of an individual written employment contract prior to its 1
expiration date. The proceeds are deemed assigned in the same 2
intervals and in the same amount for each interval as compensation 3
was allocated under the contract. 4
(d) Remuneration does not include: 5
(i) The payment of tips; 6
(ii) Supplemental benefit payments made by an employer to an 7
employee in addition to any paid family or medical leave benefits 8
received by the employee; or 9
(iii) Payments to members of the armed forces of the United 10
States, including the organized militia of the state of Washington, 11
for the performance of duty for periods not exceeding seventy-two 12
hours at a time. 13
(23)(a) "Serious health condition" means an illness, injury, 14
impairment, or physical or mental condition that involves:15
(i) Inpatient care in a hospital, hospice, or residential medical 16
care facility, including any period of incapacity; or17
(ii) Continuing treatment by a health care provider. A serious 18
health condition involving continuing treatment by a health care 19
provider includes any one or more of the following:20
(A) A period of incapacity of more than three consecutive, full 21
calendar days, and any subsequent treatment or period of incapacity 22
relating to the same condition, that also involves:23
(I) Treatment two or more times, within thirty days of the first 24
day of incapacity, unless extenuating circumstances exist, by a 25
health care provider, by a nurse or physician's assistant under 26
direct supervision of a health care provider, or by a provider of 27
health care services, such as a physical therapist, under orders of, 28
or on referral by, a health care provider; or 29
(II) Treatment by a health care provider on at least one occasion 30
which results in a regimen of continuing treatment under the 31
supervision of the health care provider; 32
(B) Any period of incapacity due to pregnancy, or for prenatal 33
care; 34
(C) Any period of incapacity or treatment for such incapacity due 35
to a chronic serious health condition. A chronic serious health 36
condition is one which: 37
(I) Requires periodic visits, defined as at least twice a year, 38
for treatment by a health care provider, or by a nurse under direct 39
supervision of a health care provider; 40
p. 233 HB 1281
(II) Continues over an extended period of time, including 1
recurring episodes of a single underlying condition; and2
(III) May cause episodic rather than a continuing period of 3
incapacity, including asthma, diabetes, and epilepsy;4
(D) A period of incapacity which is permanent or long term due to 5
a condition for which treatment may not be effective. The employee or 6
family member must be under the continuing supervision of, but need 7
not be receiving active treatment by, a health care provider, 8
including Alzheimer's, a severe stroke, or the terminal stages of a 9
disease; or 10
(E) Any period of absence to receive multiple treatments, 11
including any period of recovery from the treatments, by a health 12
care provider or by a provider of health care services under orders 13
of, or on referral by, a health care provider, either for: (I) 14
Restorative surgery after an accident or other injury; or (II) a 15
condition that would likely result in a period of incapacity of more 16
than three consecutive, full calendar days in the absence of medical 17
intervention or treatment, such as cancer, severe arthritis, or 18
kidney disease. 19
(b) The requirement in (a)(i) and (ii) of this subsection for 20
treatment by a health care provider means an in-person visit to a 21
health care provider. The first, or only, in-person treatment visit 22
must take place within seven days of the first day of incapacity.23
(c) Whether additional treatment visits or a regimen of 24
continuing treatment is necessary within the thirty-day period shall 25
be determined by the health care provider. 26
(d) The term extenuating circumstances in (a)(ii)(A)(I) of this 27
subsection means circumstances beyond the employee's control that 28
prevent the follow-up visit from occurring as planned by the health 29
care provider. Whether a given set of circumstances are extenuating 30
depends on the facts. For example, extenuating circumstances exist if 31
a health care provider determines that a second in-person visit is 32
needed within the thirty-day period, but the health care provider 33
does not have any available appointments during that time period.34
(e) Treatment for purposes of (a) of this subsection includes, 35
but is not limited to, examinations to determine if a serious health 36
condition exists and evaluations of the condition. Treatment does not 37
include routine physical examinations, eye examinations, or dental 38
examinations. Under (a)(ii)(A)(II) of this subsection, a regimen of 39
continuing treatment includes, but is not limited to, a course of 40
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prescription medication, such as an antibiotic, or therapy requiring 1
special equipment to resolve or alleviate the health condition, such 2
as oxygen. A regimen of continuing treatment that includes taking 3
over-the-counter medications, such as aspirin, antihistamines, or 4
salves, or bed rest, drinking fluids, exercise, and other similar 5
activities that can be initiated without a visit to a health care 6
provider, is not, by itself, sufficient to constitute a regimen of 7
continuing treatment for purposes of this title. 8
(f) Conditions for which cosmetic treatments are administered, 9
such as most treatments for acne or plastic surgery, are not serious 10
health conditions unless inpatient hospital care is required or 11
unless complications develop. Ordinarily, unless complications arise, 12
the common cold, the flu, ear aches, upset stomach, minor ulcers, 13
headaches other than migraines, routine dental or orthodontia 14
problems, and periodontal disease are examples of conditions that are 15
not serious health conditions and do not qualify for leave under this 16
title. Restorative dental or plastic surgery after an injury or 17
removal of cancerous growths are serious health conditions provided 18
all the other conditions of this section are met. Mental illness 19
resulting from stress or allergies may be serious health conditions, 20
but only if all the conditions of this section are met.21
(g)(i) Substance abuse may be a serious health condition if the 22
conditions of this section are met. However, leave may only be taken 23
for treatment for substance abuse by a health care provider or by a 24
licensed substance abuse treatment provider. Absence because of the 25
employee's use of the substance, rather than for treatment, does not 26
qualify for leave under this title. 27
(ii) Treatment for substance abuse does not prevent an employer 28
from taking employment action against an employee. The employer may 29
not take action against the employee because the employee has 30
exercised his or her right to take medical leave for treatment. 31
However, if the employer has an established policy, applied in a 32
nondiscriminatory manner that has been communicated to all employees, 33
that provides under certain circumstances an employee may be 34
terminated for substance abuse, pursuant to that policy the employee 35
may be terminated whether or not the employee is presently taking 36
medical leave. An employee may also take family leave to care for a 37
covered family member who is receiving treatment for substance abuse. 38
The employer may not take action against an employee who is providing 39
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care for a covered family member receiving treatment for substance 1
abuse. 2
(h) Absences attributable to incapacity under (a)(ii)(B) or (C) 3
of this subsection qualify for leave under this title even though the 4
employee or the family member does not receive treatment from a 5
health care provider during the absence, and even if the absence does 6
not last more than three consecutive, full calendar days. For 7
example, an employee with asthma may be unable to report for work due 8
to the onset of an asthma attack or because the employee's health 9
care provider has advised the employee to stay home when the pollen 10
count exceeds a certain level. An employee who is pregnant may be 11
unable to report to work because of severe morning sickness.12
(24) "Service is localized in this state" has the same meaning as 13
described in RCW 50.04.120. 14
(25) "Spouse" means a husband or wife, as the case may be, or 15
state registered domestic partner. 16
(26) "State average weekly wage" means the most recent average 17
weekly wage calculated under RCW 50.04.355 and available on January 18
1st of each year. 19
(27) "Supplemental benefit payments" means payments made by an 20
employer to an employee as salary continuation or as paid time off. 21
Such payments must be in addition to any paid family or medical leave 22
benefits the employee is receiving. 23
(28) "Typical workweek hours" means: 24
(a) For an hourly employee, the average number of hours worked 25
per week by an employee within the qualifying period; and26
(b) Forty hours for a salaried employee, regardless of the number 27
of hours the salaried employee typically works. 28
(29) "Wage" or "wages" means: 29
(a) For the purpose of premium assessment, the remuneration paid 30
by an employer to an employee. The maximum wages subject to a premium 31
assessment are those wages as set by the commissioner under RCW 32
50A.10.030; 33
(b) For the purpose of payment of benefits, the remuneration paid 34
by one or more employers to an employee for employment during the 35
employee's qualifying period. At the request of an employee, wages 36
may be calculated on the basis of remuneration payable. The 37
department shall notify each employee that wages are calculated on 38
the basis of remuneration paid, but at the employee's request a 39
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redetermination may be performed and based on remuneration payable; 1
and 2
(c) For the purpose of a self-employed person electing coverage 3
under RCW 50A.10.010, the meaning is defined by rule.4
Sec. 5112. RCW 51.04.030 and 2024 c 62 s 16 are each amended to 5
read as follows: 6
(1) The director shall supervise the providing of prompt and 7
efficient care and treatment, including care provided by physician 8
assistants governed by the provisions of chapter 18.71A RCW, 9
including chiropractic care, and including care provided by licensed 10
advanced ((registered nurse practitioners )) practice registered 11
nurses, to workers injured during the course of their employment at 12
the least cost consistent with promptness and efficiency, without 13
discrimination or favoritism, and with as great uniformity as the 14
various and diverse surrounding circumstances and locations of 15
industries will permit and to that end shall, from time to time, 16
establish and adopt and supervise the administration of printed 17
forms, rules, regulations, and practices for the furnishing of such 18
care and treatment: PROVIDED, That the medical coverage decisions of 19
the department do not constitute a "rule" as used in RCW 20
34.05.010(16), nor are such decisions subject to the rule-making 21
provisions of chapter 34.05 RCW except that criteria for establishing 22
medical coverage decisions shall be adopted by rule after 23
consultation with the workers' compensation advisory committee 24
established in RCW 51.04.110: PROVIDED FURTHER, That the department 25
may recommend to an injured worker particular health care services 26
and providers where specialized treatment is indicated or where cost-27
effective payment levels or rates are obtained by the department: AND 28
PROVIDED FURTHER, That the department may enter into contracts for 29
goods and services including, but not limited to, durable medical 30
equipment so long as statewide access to quality service is 31
maintained for injured workers. 32
(2) The director shall, in consultation with interested persons, 33
establish and, in his or her discretion, periodically change as may 34
be necessary, and make available a fee schedule of the maximum 35
charges to be made by any physician, surgeon, chiropractor, hospital, 36
druggist, licensed advanced ((registered nurse practitioner )) 37
practice registered nurse, physician assistants as defined in chapter 38
18.71A RCW, acting under the supervision of or in coordination with a 39
p. 237 HB 1281
participating physician, as defined in RCW 18.71A.010, or other 1
agency or person rendering services to injured workers. The 2
department shall coordinate with other state purchasers of health 3
care services to establish as much consistency and uniformity in 4
billing and coding practices as possible, taking into account the 5
unique requirements and differences between programs. No service 6
covered under this title, including services provided to injured 7
workers, whether aliens or other injured workers, who are not 8
residing in the United States at the time of receiving the services, 9
shall be charged or paid at a rate or rates exceeding those specified 10
in such fee schedule, and no contract providing for greater fees 11
shall be valid as to the excess. The establishment of such a 12
schedule, exclusive of conversion factors, does not constitute 13
"agency action" as used in RCW 34.05.010(3), nor does such a fee 14
schedule and its associated billing or payment instructions and 15
policies constitute a "rule" as used in RCW 34.05.010(16).16
(3) The director or self-insurer, as the case may be, shall make 17
a record of the commencement of every disability and the termination 18
thereof and, when bills are rendered for the care and treatment of 19
injured workers, shall approve and pay those which conform to the 20
adopted rules, regulations, established fee schedules, and practices 21
of the director and may reject any bill or item thereof incurred in 22
violation of the principles laid down in this section or the rules, 23
regulations, or the established fee schedules and rules and 24
regulations adopted under it. 25
Sec. 5113. RCW 51.28.010 and 2023 c 171 s 3 are each amended to 26
read as follows: 27
(1) Whenever any accident occurs to any worker it shall be the 28
duty of such worker or someone in his or her behalf to forthwith 29
report such accident to his or her employer, superintendent, or 30
supervisor in charge of the work, and of the employer to at once 31
report such accident and the injury resulting therefrom to the 32
department pursuant to RCW 51.28.025 where the worker has received 33
treatment from a physician, osteopathic physician, chiropractor, 34
naturopath, podiatric physician, optometrist, dentist, licensed 35
advanced ((registered nurse practitioner )) practice registered nurse , 36
physician assistant, or psychologist in claims solely for mental 37
health conditions, has been hospitalized, disabled from work, or has 38
died as the apparent result of such accident and injury.39
p. 238 HB 1281
(2) Upon receipt of such notice of accident, the department shall 1
immediately forward to the worker or his or her beneficiaries or 2
dependents notification, in nontechnical language, of their rights 3
under this title. The notice must specify the worker's right to 4
receive health services from a provider of the worker's choice under 5
RCW 51.36.010(2)(a), including chiropractic services under RCW 6
51.36.015, and must list the types of providers authorized to provide 7
these services. 8
(3) Employers shall not engage in claim suppression.9
(4) For the purposes of this section, "claim suppression" means 10
intentionally: 11
(a) Inducing employees to fail to report injuries;12
(b) Inducing employees to treat injuries in the course of 13
employment as off-the-job injuries; or 14
(c) Acting otherwise to suppress legitimate industrial insurance 15
claims. 16
(5) In determining whether an employer has engaged in claim 17
suppression, the department shall consider the employer's history of 18
compliance with industrial insurance reporting requirements, and 19
whether the employer has discouraged employees from reporting 20
injuries or filing claims. The department has the burden of proving 21
claim suppression by a preponderance of the evidence.22
(6) Claim suppression does not include bona fide workplace safety 23
and accident prevention programs or an employer's provision at the 24
worksite of first aid as defined by the department. The department 25
shall adopt rules defining bona fide workplace safety and accident 26
prevention programs and defining first aid. 27
Sec. 5114. RCW 51.28.020 and 2023 c 171 s 4 are each amended to 28
read as follows: 29
(1)(a) Where a worker is entitled to compensation under this 30
title he or she shall file with the department or his or her self-31
insured employer, as the case may be, his or her application for 32
such, together with the certificate of the physician, osteopathic 33
physician, chiropractor, naturopath, podiatric physician, 34
optometrist, dentist, licensed advanced ((registered nurse 35
practitioner)) practice registered nurse , physician assistant, or 36
psychologist in claims solely for mental health conditions, who 37
attended him or her. An application form developed by the department 38
shall include a notice specifying the worker's right to receive 39
p. 239 HB 1281
health services from a provider of the worker's choice under RCW 1
51.36.010(2)(a), and listing the types of providers authorized to 2
provide these services. 3
(b) The physician, osteopathic physician, chiropractor, 4
naturopath, podiatric physician, optometrist, dentist, licensed 5
advanced ((registered nurse practitioner )) practice registered nurse , 6
physician assistant, or psychologist in claims solely for mental 7
health conditions, who attended the injured worker shall inform the 8
injured worker of his or her rights under this title and lend all 9
necessary assistance in making this application for compensation and 10
such proof of other matters as required by the rules of the 11
department without charge to the worker. The department shall provide 12
a manual which outlines the procedures to be followed in applications 13
for compensation involving occupational diseases, and which describes 14
claimants' rights and responsibilities related to occupational 15
disease claims. 16
(2) If the application required by this section is:17
(a) Made to the department and the employer has not received a 18
copy of the application, the department shall immediately send a copy 19
of the application to the employer; or 20
(b) Made to a self-insured employer, the employer shall forthwith 21
send a copy of the application to the department. 22
(3) The application required by this section may be transmitted 23
to the department electronically. 24
Sec. 5115. RCW 51.28.025 and 2007 c 77 s 2 are each amended to 25
read as follows: 26
(1) Whenever an employer has notice or knowledge of an injury or 27
occupational disease sustained by any worker in his or her employment 28
who has received treatment from a physician or a licensed advanced 29
((registered nurse practitioner)) practice registered nurse, has been 30
hospitalized, disabled from work or has died as the apparent result 31
of such injury or occupational disease, the employer shall 32
immediately report the same to the department on forms prescribed by 33
it. The report shall include: 34
(a) The name, address, and business of the employer;35
(b) The name, address, and occupation of the worker;36
(c) The date, time, cause, and nature of the injury or 37
occupational disease; 38
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(d) Whether the injury or occupational disease arose in the 1
course of the injured worker's employment; 2
(e) All available information pertaining to the nature of the 3
injury or occupational disease including but not limited to any 4
visible signs, any complaints of the worker, any time lost from work, 5
and the observable effect on the worker's bodily functions, so far as 6
is known; and 7
(f) Such other pertinent information as the department may 8
prescribe by regulation. 9
(2) The employer shall not engage in claim suppression. An 10
employer found to have engaged in claim suppression shall be subject 11
to a penalty of at least two hundred fifty dollars, not to exceed two 12
thousand five hundred dollars, for each offense. The penalty shall be 13
payable to the supplemental pension fund. The department shall adopt 14
rules establishing the amount of penalties, taking into account the 15
size of the employer and whether there are prior findings of claim 16
suppression. When a determination of claim suppression has been made, 17
the employer shall be prohibited from any current or future 18
participation in a retrospective rating program. If self -insured, the 19
director shall withdraw certification as provided in RCW 51.14.080.20
(3) When a determination of claim suppression is made and the 21
penalty is assessed, the department shall serve the employer and any 22
affected retrospective rating group with a determination as provided 23
in RCW 51.52.050. The determination may be protested to the 24
department or appealed to the board of industrial insurance appeals. 25
Once the order is final, the amount due shall be collected in 26
accordance with the provisions of RCW 51.48.140 and 51.48.150.27
(4) The director, or the director's designee, shall investigate 28
reports or complaints that an employer has engaged in claim 29
suppression as prohibited in RCW 51.28.010(3). The complaints or 30
allegations must be received in writing, and must include the name or 31
names of the individuals or organizations submitting the complaint. 32
In cases where the department can show probable cause, the director 33
may subpoena records from the employer, medical providers, and any 34
other entity that the director believes may have relevant 35
information. The director's investigative and subpoena authority in 36
this subsection is limited solely to investigations into allegations 37
of claim suppression or where the director has probable cause that 38
claim suppression might have occurred. 39
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(5) If the director determines that an employer has engaged in 1
claim suppression and, as a result, the worker has not filed a claim 2
for industrial insurance benefits as prescribed by law, then the 3
director in his or her sole discretion may waive the time limits for 4
filing a claim provided in RCW 51.28.050, if the complaint or 5
allegation of claim suppression is received within two years of the 6
worker's accident or exposure. For the director to exercise this 7
discretion, the claim must be filed with the department within ninety 8
days of the date the determination of claim suppression is issued.9
(6) For the purposes of this section, "claim suppression" has the 10
same meaning as in RCW 51.28.010(4). 11
Sec. 5116. RCW 51.28.055 and 2004 c 65 s 7 are each amended to 12
read as follows: 13
(1) Except as provided in subsection (2) of this section for 14
claims filed for occupational hearing loss, claims for occupational 15
disease or infection to be valid and compensable must be filed within 16
two years following the date the worker had written notice from a 17
physician or a licensed advanced ((registered nurse practitioner )) 18
practice registered nurse : (a) Of the existence of his or her 19
occupational disease, and (b) that a claim for disability benefits 20
may be filed. The notice shall also contain a statement that the 21
worker has two years from the date of the notice to file a claim. The 22
physician or licensed advanced ((registered nurse practitioner )) 23
practice registered nurse shall file the notice with the department. 24
The department shall send a copy to the worker and to the self-25
insurer if the worker's employer is self-insured. However, a claim is 26
valid if it is filed within two years from the date of death of the 27
worker suffering from an occupational disease. 28
(2)(a) Except as provided in (b) of this subsection, to be valid 29
and compensable, claims for hearing loss due to occupational noise 30
exposure must be filed within two years of the date of the worker's 31
last injurious exposure to occupational noise in employment covered 32
under this title or within one year of September 10, 2003, whichever 33
is later. 34
(b) A claim for hearing loss due to occupational noise exposure 35
that is not timely filed under (a) of this subsection can only be 36
allowed for medical aid benefits under chapter 51.36 RCW.37
(3) The department may adopt rules to implement this section.38
p. 242 HB 1281
Sec. 5117. RCW 51.36.010 and 2023 c 171 s 9 are each amended to 1
read as follows: 2
(1) The legislature finds that high quality medical treatment and 3
adherence to occupational health best practices can prevent 4
disability and reduce loss of family income for workers, and lower 5
labor and insurance costs for employers. Injured workers deserve high 6
quality medical care in accordance with current health care best 7
practices. To this end, the department shall establish minimum 8
standards for providers who treat workers from both state fund and 9
self-insured employers. The department shall establish a health care 10
provider network to treat injured workers, and shall accept providers 11
into the network who meet those minimum standards. The department 12
shall convene an advisory group made up of representatives from or 13
designees of the workers' compensation advisory committee and the 14
industrial insurance medical and chiropractic advisory committees to 15
consider and advise the department related to implementation of this 16
section, including development of best practices treatment guidelines 17
for providers in the network. The department shall also seek the 18
input of various health care provider groups and associations 19
concerning the network's implementation. Network providers must be 20
required to follow the department's evidence-based coverage decisions 21
and treatment guidelines, policies, and must be expected to follow 22
other national treatment guidelines appropriate for their patient. 23
The department, in collaboration with the advisory group, shall also 24
establish additional best practice standards for providers to qualify 25
for a second tier within the network, based on demonstrated use of 26
occupational health best practices. This second tier is separate from 27
and in addition to the centers for occupational health and education 28
established under subsection (5) of this section. 29
(2)(a) Upon the occurrence of any injury to a worker entitled to 30
compensation under the provisions of this title, he or she shall 31
receive proper and necessary medical and surgical services at the 32
hands of a physician, osteopathic physician, chiropractor, 33
naturopath, podiatric physician, optometrist, dentist, licensed 34
advanced ((registered nurse practitioner )) practice registered nurse , 35
physician assistant, or psychologist in claims solely for mental 36
health conditions, of his or her own choice, if conveniently located, 37
except as provided in (b) of this subsection, and proper and 38
necessary hospital care and services during the period of his or her 39
disability from such injury. 40
p. 243 HB 1281
(b) Once the provider network is established in the worker's 1
geographic area, an injured worker may receive care from a nonnetwork 2
provider only for an initial office or emergency room visit. However, 3
the department or self-insurer may limit reimbursement to the 4
department's standard fee for the services. The provider must comply 5
with all applicable billing policies and must accept the department's 6
fee schedule as payment in full. 7
(c) The department, in collaboration with the advisory group, 8
shall adopt policies for the development, credentialing, 9
accreditation, and continued oversight of a network of health care 10
providers approved to treat injured workers. Health care providers 11
shall apply to the network by completing the department's provider 12
application which shall have the force of a contract with the 13
department to treat injured workers. The advisory group shall 14
recommend minimum network standards for the department to approve a 15
provider's application, to remove a provider from the network, or to 16
require peer review such as, but not limited to: 17
(i) Current malpractice insurance coverage exceeding a dollar 18
amount threshold, number, or seriousness of malpractice suits over a 19
specific time frame; 20
(ii) Previous malpractice judgments or settlements that do not 21
exceed a dollar amount threshold recommended by the advisory group, 22
or a specific number or seriousness of malpractice suits over a 23
specific time frame; 24
(iii) No licensing or disciplinary action in any jurisdiction or 25
loss of treating or admitting privileges by any board, commission, 26
agency, public or private health care payer, or hospital;27
(iv) For some specialties such as surgeons, privileges in at 28
least one hospital; 29
(v) Whether the provider has been credentialed by another health 30
plan that follows national quality assurance guidelines; and31
(vi) Alternative criteria for providers that are not credentialed 32
by another health plan. 33
The department shall develop alternative criteria for providers 34
that are not credentialed by another health plan or as needed to 35
address access to care concerns in certain regions.36
(d) Network provider contracts will automatically renew at the 37
end of the contract period unless the department provides written 38
notice of changes in contract provisions or the department or 39
provider provides written notice of contract termination. The 40
p. 244 HB 1281
industrial insurance medical advisory committee shall develop 1
criteria for removal of a provider from the network to be presented 2
to the department and advisory group for consideration in the 3
development of contract terms. 4
(e) In order to monitor quality of care and assure efficient 5
management of the provider network, the department shall establish 6
additional criteria and terms for network participation including, 7
but not limited to, requiring compliance with administrative and 8
billing policies. 9
(f) The advisory group shall recommend best practices standards 10
to the department to use in determining second tier network 11
providers. The department shall develop and implement financial and 12
nonfinancial incentives for network providers who qualify for the 13
second tier. The department is authorized to certify and decertify 14
second tier providers. 15
(3) The department shall work with self-insurers and the 16
department utilization review provider to implement utilization 17
review for the self-insured community to ensure consistent quality, 18
cost-effective care for all injured workers and employers, and to 19
reduce administrative burden for providers. 20
(4) The department for state fund claims shall pay, in accordance 21
with the department's fee schedule, for any alleged injury for which 22
a worker files a claim, any initial prescription drugs provided in 23
relation to that initial visit, without regard to whether the 24
worker's claim for benefits is allowed. In all accepted claims, 25
treatment shall be limited in point of duration as follows:26
In the case of permanent partial disability, not to extend beyond 27
the date when compensation shall be awarded him or her, except when 28
the worker returned to work before permanent partial disability award 29
is made, in such case not to extend beyond the time when monthly 30
allowances to him or her shall cease; in case of temporary disability 31
not to extend beyond the time when monthly allowances to him or her 32
shall cease: PROVIDED, That after any injured worker has returned to 33
his or her work his or her medical and surgical treatment may be 34
continued if, and so long as, such continuation is deemed necessary 35
by the supervisor of industrial insurance to be necessary to his or 36
her more complete recovery; in case of a permanent total disability 37
not to extend beyond the date on which a lump sum settlement is made 38
with him or her or he or she is placed upon the permanent pension 39
roll: PROVIDED, HOWEVER, That the supervisor of industrial insurance, 40
p. 245 HB 1281
solely in his or her discretion, may authorize continued medical and 1
surgical treatment for conditions previously accepted by the 2
department when such medical and surgical treatment is deemed 3
necessary by the supervisor of industrial insurance to protect such 4
worker's life or provide for the administration of medical and 5
therapeutic measures including payment of prescription medications, 6
but not including those controlled substances currently scheduled by 7
the pharmacy quality assurance commission as Schedule I, II, III, or 8
IV substances under chapter 69.50 RCW, which are necessary to 9
alleviate continuing pain which results from the industrial injury. 10
In order to authorize such continued treatment the written order of 11
the supervisor of industrial insurance issued in advance of the 12
continuation shall be necessary. 13
The supervisor of industrial insurance, the supervisor's 14
designee, or a self-insurer, in his or her sole discretion, may 15
authorize inoculation or other immunological treatment in cases in 16
which a work-related activity has resulted in probable exposure of 17
the worker to a potential infectious occupational disease. 18
Authorization of such treatment does not bind the department or self-19
insurer in any adjudication of a claim by the same worker or the 20
worker's beneficiary for an occupational disease. 21
(5)(a) The legislature finds that the department and its business 22
and labor partners have collaborated in establishing centers for 23
occupational health and education to promote best practices and 24
prevent preventable disability by focusing additional provider-based 25
resources during the first twelve weeks following an injury. The 26
centers for occupational health and education represent innovative 27
accountable care systems in an early stage of development consistent 28
with national health care reform efforts. Many Washington workers do 29
not yet have access to these innovative health care delivery models.30
(b) To expand evidence-based occupational health best practices, 31
the department shall establish additional centers for occupational 32
health and education, with the goal of extending access to at least 33
fifty percent of injured and ill workers by December 2013 and to all 34
injured workers by December 2015. The department shall also develop 35
additional best practices and incentives that span the entire period 36
of recovery, not only the first twelve weeks. 37
(c) The department shall certify and decertify centers for 38
occupational health and education based on criteria including 39
institutional leadership and geographic areas covered by the center 40
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for occupational health and education, occupational health leadership 1
and education, mix of participating health care providers necessary 2
to address the anticipated needs of injured workers, health services 3
coordination to deliver occupational health best practices, 4
indicators to measure the success of the center for occupational 5
health and education, and agreement that the center's providers 6
shall, if feasible, treat certain injured workers if referred by the 7
department or a self-insurer. 8
(d) Health care delivery organizations may apply to the 9
department for certification as a center for occupational health and 10
education. These may include, but are not limited to, hospitals and 11
affiliated clinics and providers, multispecialty clinics, health 12
maintenance organizations, and organized systems of network 13
physicians. 14
(e) The centers for occupational health and education shall 15
implement benchmark quality indicators of occupational health best 16
practices for individual providers, developed in collaboration with 17
the department. A center for occupational health and education shall 18
remove individual providers who do not consistently meet these 19
quality benchmarks. 20
(f) The department shall develop and implement financial and 21
nonfinancial incentives for center for occupational health and 22
education providers that are based on progressive and measurable 23
gains in occupational health best practices, and that are applicable 24
throughout the duration of an injured or ill worker's episode of 25
care. 26
(g) The department shall develop electronic methods of tracking 27
evidence-based quality measures to identify and improve outcomes for 28
injured workers at risk of developing prolonged disability. In 29
addition, these methods must be used to provide systematic feedback 30
to physicians regarding quality of care, to conduct appropriate 31
objective evaluation of progress in the centers for occupational 32
health and education, and to allow efficient coordination of 33
services. 34
(6) If a provider fails to meet the minimum network standards 35
established in subsection (2) of this section, the department is 36
authorized to remove the provider from the network or take other 37
appropriate action regarding a provider's participation. The 38
department may also require remedial steps as a condition for a 39
provider to participate in the network. The department, with input 40
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from the advisory group, shall establish waiting periods that may be 1
imposed before a provider who has been denied or removed from the 2
network may reapply. 3
(7) The department may permanently remove a provider from the 4
network or take other appropriate action when the provider exhibits a 5
pattern of conduct of low quality care that exposes patients to risk 6
of physical or psychiatric harm or death. Patterns that qualify as 7
risk of harm include, but are not limited to, poor health care 8
outcomes evidenced by increased, chronic, or prolonged pain or 9
decreased function due to treatments that have not been shown to be 10
curative, safe, or effective or for which it has been shown that the 11
risks of harm exceed the benefits that can be reasonably expected 12
based on peer-reviewed opinion. 13
(8) The department may not remove a health care provider from the 14
network for an isolated instance of poor health and recovery outcomes 15
due to treatment by the provider. 16
(9) When the department terminates a provider from the network, 17
the department or self-insurer shall assist an injured worker 18
currently under the provider's care in identifying a new network 19
provider or providers from whom the worker can select an attending or 20
treating provider. In such a case, the department or self-insurer 21
shall notify the injured worker that he or she must choose a new 22
attending or treating provider. 23
(10) The department may adopt rules related to this section.24
(11) The department shall report to the workers' compensation 25
advisory committee and to the appropriate committees of the 26
legislature on each December 1st, beginning in 2012 and ending in 27
2016, on the implementation of the provider network and expansion of 28
the centers for occupational health and education. The reports must 29
include a summary of actions taken, progress toward long-term goals, 30
outcomes of key initiatives, access to care issues, results of 31
disputes or controversies related to new provisions, and whether any 32
changes are needed to further improve the occupational health best 33
practices care of injured workers. 34
Sec. 5118. RCW 51.36.110 and 2004 c 243 s 6 and 2004 c 65 s 13 35
are each reenacted and amended to read as follows:36
The director of the department of labor and industries or the 37
director's authorized representative shall have the authority to:38
p. 248 HB 1281
(1) Conduct audits and investigations of providers of medical, 1
chiropractic, dental, vocational, and other health services furnished 2
to industrially injured workers pursuant to Title 51 RCW. In the 3
conduct of such audits or investigations, the director or the 4
director's authorized representatives may examine all records, or 5
portions thereof, including patient records, for which services were 6
rendered by a health services provider and reimbursed by the 7
department, notwithstanding the provisions of any other statute which 8
may make or purport to make such records privileged or confidential: 9
PROVIDED, That no original patient records shall be removed from the 10
premises of the health services provider, and that the disclosure of 11
any records or information obtained under authority of this section 12
by the department of labor and industries is prohibited and 13
constitutes a violation of RCW 42.52.050, unless such disclosure is 14
directly connected to the official duties of the department: AND 15
PROVIDED FURTHER, That the disclosure of patient information as 16
required under this section shall not subject any physician, licensed 17
advanced ((registered nurse practitioner )) practice registered nurse , 18
or other health services provider to any liability for breach of any 19
confidential relationships between the provider and the patient: AND 20
PROVIDED FURTHER, That the director or the director's authorized 21
representative shall destroy all copies of patient medical records in 22
their possession upon completion of the audit, investigation, or 23
proceedings; 24
(2) Approve or deny applications to participate as a provider of 25
services furnished to industrially injured workers pursuant to Title 26
51 RCW; 27
(3) Terminate or suspend eligibility to participate as a provider 28
of services furnished to industrially injured workers pursuant to 29
Title 51 RCW; and 30
(4) Pursue collection of unpaid overpayments and/or penalties 31
plus interest accrued from health care providers pursuant to RCW 32
51.32.240(6). 33
Sec. 5119. RCW 51.48.060 and 2020 c 277 s 5 are each amended to 34
read as follows: 35
Any physician or licensed advanced ((registered nurse 36
practitioner)) practice registered nurse who fails, neglects or 37
refuses to file a report with the director, as required by this 38
title, within five days of the date of treatment, showing the 39
p. 249 HB 1281
condition of the injured worker at the time of treatment, a 1
description of the treatment given, and an estimate of the probable 2
duration of the injury, or who fails or refuses to render all 3
necessary assistance to the injured worker, as required by this 4
title, shall be subject to a civil penalty determined by the director 5
but not to exceed five hundred dollars. 6
Sec. 5120. RCW 51.52.010 and 2004 c 65 s 15 are each amended to 7
read as follows: 8
There shall be a "board of industrial insurance appeals," 9
hereinafter called the "board," consisting of three members appointed 10
by the governor, with the advice and consent of the senate, as 11
hereinafter provided. One shall be a representative of the public and 12
a lawyer, appointed from a mutually agreed to list of not less than 13
three active or judicial members of the Washington state bar 14
association, submitted to the governor by the two organizations 15
defined below, and such member shall be the chairperson of said 16
board. The second member shall be a representative of the majority of 17
workers engaged in employment under this title and selected from a 18
list of not less than three names submitted to the governor by an 19
organization, statewide in scope, which through its affiliates 20
embraces a cross section and a majority of the organized labor of the 21
state. The third member shall be a representative of employers under 22
this title, and appointed from a list of at least three names 23
submitted to the governor by a recognized statewide organization of 24
employers, representing a majority of employers. The initial terms of 25
office of the members of the board shall be for six, four, and two 26
years respectively. Thereafter all terms shall be for a period of six 27
years. Each member of the board shall be eligible for reappointment 28
and shall hold office until his or her successor is appointed and 29
qualified. In the event of a vacancy the governor is authorized to 30
appoint a successor to fill the unexpired term of his or her 31
predecessor. All appointments to the board shall be made in 32
conformity with the foregoing plan. In the event a board member 33
becomes incapacitated in excess of thirty days either due to his or 34
her illness or that of an immediate family member as determined by a 35
request for family leave or as certified by the affected member's 36
treating physician or licensed advanced ((registered nurse 37
practitioner)) practice registered nurse , the governor shall appoint 38
an acting member to serve pro tem. Such an appointment shall be made 39
p. 250 HB 1281
in conformity with the foregoing plan, except that the list of 1
candidates shall be submitted to the governor not more than fifteen 2
days after the affected organizations are notified of the incapacity 3
and the governor shall make the appointment within fifteen days after 4
the list is submitted. The temporary member shall serve until such 5
time as the affected member is able to reassume his or her duties by 6
returning from requested family leave or as determined by the 7
treating physician or licensed advanced ((registered nurse 8
practitioner)) practice registered nurse or until the affected 9
member's term expires, whichever occurs first. Whenever the workload 10
of the board and its orderly and expeditious disposition shall 11
necessitate, the governor may appoint two additional pro-tem members 12
in addition to the regular members. Such appointments shall be for a 13
definite period of time, and shall be made from lists submitted 14
respectively by labor and industry as in the case of regular members. 15
One pro-tem member shall be a representative of labor and one shall 16
be a representative of industry. Members shall devote their entire 17
time to the duties of the board and shall receive for their services 18
a salary as fixed by the governor in accordance with the provisions 19
of RCW 43.03.040 which shall be in addition to travel expenses in 20
accordance with RCW 43.03.050 and 43.03.060 as now existing or 21
hereafter amended. Headquarters for the board shall be located in 22
Olympia. The board shall adopt a seal which shall be judicially 23
recognized. 24
Sec. 5121. RCW 68.50.105 and 2023 c 44 s 4 are each amended to 25
read as follows: 26
(1) Reports and records of autopsies or postmortems shall be 27
confidential, except that the following persons may examine and 28
obtain copies of any such report or record: The personal 29
representative of the decedent as defined in RCW 11.02.005, any 30
family member, the attending physician or advanced ((registered nurse 31
practitioner)) practice registered nurse, the prosecuting attorney or 32
law enforcement agencies having jurisdiction, public health 33
officials, the department of labor and industries in cases in which 34
it has an interest under RCW 68.50.103, the secretary of the 35
department of children, youth, and families or his or her designee in 36
cases being reviewed under RCW 74.13.640, or the secretary of the 37
department of social and health services or his or her designee under 38
chapter 74.34 RCW. 39
p. 251 HB 1281
(2)(a) Notwithstanding the restrictions contained in this section 1
regarding the dissemination of records and reports of autopsies or 2
postmortems, nor the exemptions referenced under RCW 42.56.240(1), 3
nothing in this chapter prohibits a coroner, medical examiner, or his 4
or her designee, from publicly discussing his or her findings as to 5
any death subject to the jurisdiction of his or her office where 6
actions of a law enforcement officer or corrections officer have been 7
determined to be a proximate cause of the death, except as provided 8
in (b) of this subsection. 9
(b) A coroner, medical examiner, or his or her designee may not 10
publicly discuss his or her findings outside of formal court or 11
inquest proceedings if there is a pending or active criminal 12
investigation, or a criminal or civil action, concerning a death that 13
has commenced prior to January 1, 2014. 14
(3) The coroner, the medical examiner, or the attending physician 15
shall, upon request, meet with the family of the decedent to discuss 16
the findings of the autopsy or postmortem. For the purposes of this 17
section, the term "family" means the surviving spouse, state 18
registered domestic partner, or any child, parent, grandparent, 19
grandchild, brother, or sister of the decedent, or any person who was 20
guardian of the decedent at the time of death. 21
Sec. 5122. RCW 69.41.010 and 2024 c 102 s 1 are each amended to 22
read as follows: 23
As used in this chapter, the following terms have the meanings 24
indicated unless the context clearly requires otherwise:25
(1) "Administer" means the direct application of a legend drug 26
whether by injection, inhalation, ingestion, or any other means, to 27
the body of a patient or research subject by: 28
(a) A practitioner; or 29
(b) The patient or research subject at the direction of the 30
practitioner. 31
(2) "Commission" means the pharmacy quality assurance commission.32
(3) "Community-based care settings" include: Community 33
residential programs for persons with developmental disabilities, 34
certified by the department of social and health services under 35
chapter 71A.12 RCW; adult family homes licensed under chapter 70.128 36
RCW; and assisted living facilities licensed under chapter 18.20 RCW. 37
Community-based care settings do not include acute care or skilled 38
nursing facilities. 39
p. 252 HB 1281
(4) "Deliver" or "delivery" means the actual, constructive, or 1
attempted transfer from one person to another of a legend drug, 2
whether or not there is an agency relationship. 3
(5) "Department" means the department of health.4
(6) "Dispense" means the interpretation of a prescription or 5
order for a legend drug and, pursuant to that prescription or order, 6
the proper selection, measuring, compounding, labeling, or packaging 7
necessary to prepare that prescription or order for delivery.8
(7) "Dispenser" means a practitioner who dispenses.9
(8) "Distribute" means to deliver other than by administering or 10
dispensing a legend drug. 11
(9) "Distributor" means a person who distributes.12
(10) "Drug" means: 13
(a) Substances recognized as drugs in the official United States 14
pharmacopoeia, official homeopathic pharmacopoeia of the United 15
States, or official national formulary, or any supplement to any of 16
them; 17
(b) Substances intended for use in the diagnosis, cure, 18
mitigation, treatment, or prevention of disease in human beings or 19
animals; 20
(c) Substances (other than food, minerals or vitamins) intended 21
to affect the structure or any function of the body of human beings 22
or animals; and 23
(d) Substances intended for use as a component of any article 24
specified in (a), (b), or (c) of this subsection. It does not include 25
devices or their components, parts, or accessories.26
(11) "Electronic communication of prescription information" means 27
the transmission of a prescription or refill authorization for a drug 28
of a practitioner using computer systems. The term does not include a 29
prescription or refill authorization transmitted verbally by 30
telephone nor a facsimile manually signed by the practitioner.31
(12) "In-home care settings" include an individual's place of 32
temporary and permanent residence, but does not include acute care or 33
skilled nursing facilities, and does not include community-based care 34
settings. 35
(13) "Legend drugs" means any drugs which are required by state 36
law or regulation of the pharmacy quality assurance commission to be 37
dispensed on prescription only or are restricted to use by 38
practitioners only. 39
p. 253 HB 1281
(14) "Legible prescription" means a prescription or medication 1
order issued by a practitioner that is capable of being read and 2
understood by the pharmacist filling the prescription or the nurse or 3
other practitioner implementing the medication order. A prescription 4
must be hand printed, typewritten, or electronically generated.5
(15) "Medication assistance" means assistance rendered by a 6
nonpractitioner to an individual residing in a community-based care 7
setting or in-home care setting to facilitate the individual's self-8
administration of a legend drug or controlled substance. It includes 9
reminding or coaching the individual, handing the medication 10
container to the individual, opening the individual's medication 11
container, using an enabler, or placing the medication in the 12
individual's hand, and such other means of medication assistance as 13
defined by rule adopted by the department. A nonpractitioner may help 14
in the preparation of legend drugs or controlled substances for self-15
administration where a practitioner has determined and communicated 16
orally or by written direction that such medication preparation 17
assistance is necessary and appropriate. Medication assistance shall 18
not include assistance with intravenous medications or injectable 19
medications, except prefilled insulin syringes. 20
(16) "Person" means individual, corporation, government or 21
governmental subdivision or agency, business trust, estate, trust, 22
partnership or association, or any other legal entity.23
(17) "Practitioner" means: 24
(a) A physician under chapter 18.71 RCW, an osteopathic physician 25
or an osteopathic physician and surgeon under chapter 18.57 RCW, a 26
dentist under chapter 18.32 RCW, a podiatric physician and surgeon 27
under chapter 18.22 RCW, an acupuncturist or acupuncture and Eastern 28
medicine practitioner to the extent authorized under chapter 18.06 29
RCW and the rules adopted under RCW 18.06.010(1)(m), a veterinarian 30
under chapter 18.92 RCW, a registered nurse, advanced ((registered 31
nurse practitioner)) practice registered nurse, or licensed practical 32
nurse under chapter 18.79 RCW, an optometrist under chapter 18.53 RCW 33
who is certified by the optometry board under RCW 18.53.010, a 34
physician assistant under chapter 18.71A RCW, a naturopath licensed 35
under chapter 18.36A RCW, a licensed athletic trainer to the extent 36
authorized under chapter 18.250 RCW, a pharmacist under chapter 18.64 37
RCW, when acting under the required supervision of a dentist licensed 38
under chapter 18.32 RCW, a dental hygienist licensed under chapter 39
18.29 RCW, a licensed dental therapist to the extent authorized under 40
p. 254 HB 1281
chapter 18.265 RCW, or a licensed midwife to the extent authorized 1
under chapter 18.50 RCW; 2
(b) A pharmacy, hospital, or other institution licensed, 3
registered, or otherwise permitted to distribute, dispense, conduct 4
research with respect to, or to administer a legend drug in the 5
course of professional practice or research in this state; and6
(c) A physician licensed to practice medicine and surgery or a 7
physician licensed to practice osteopathic medicine and surgery in 8
any state, or province of Canada, which shares a common border with 9
the state of Washington. 10
(18) "Secretary" means the secretary of health or the secretary's 11
designee. 12
Sec. 5123. RCW 69.41.030 and 2024 c 102 s 2 are each amended to 13
read as follows: 14
(1) It shall be unlawful for any person to sell or deliver any 15
legend drug, or knowingly possess any legend drug, or knowingly use 16
any legend drug in a public place, except upon the order or 17
prescription of a physician under chapter 18.71 RCW, an osteopathic 18
physician and surgeon under chapter 18.57 RCW, an optometrist 19
licensed under chapter 18.53 RCW who is certified by the optometry 20
board under RCW 18.53.010, a dentist under chapter 18.32 RCW, a 21
podiatric physician and surgeon under chapter 18.22 RCW, a licensed 22
midwife to the extent authorized under chapter 18.50 RCW, a 23
veterinarian under chapter 18.92 RCW, a commissioned medical or 24
dental officer in the United States armed forces or public health 25
service in the discharge of his or her official duties, a duly 26
licensed physician or dentist employed by the veterans administration 27
in the discharge of his or her official duties, a registered nurse or 28
advanced ((registered nurse practitioner )) practice registered nurse 29
under chapter 18.79 RCW when authorized by the board of nursing, a 30
pharmacist licensed under chapter 18.64 RCW to the extent permitted 31
by drug therapy guidelines or protocols established under RCW 32
18.64.011 and authorized by the commission and approved by a 33
practitioner authorized to prescribe drugs, a physician assistant 34
under chapter 18.71A RCW when authorized by the Washington medical 35
commission, or any of the following professionals in any province of 36
Canada that shares a common border with the state of Washington or in 37
any state of the United States: A physician licensed to practice 38
medicine and surgery or a physician licensed to practice osteopathic 39
p. 255 HB 1281
medicine and surgery, a dentist licensed to practice dentistry, a 1
podiatric physician and surgeon licensed to practice podiatric 2
medicine and surgery, a licensed advanced ((registered nurse 3
practitioner)) practice registered nurse , a licensed physician 4
assistant, or a veterinarian licensed to practice veterinary 5
medicine: PROVIDED, HOWEVER, That the above provisions shall not 6
apply to sale, delivery, or possession by drug wholesalers or drug 7
manufacturers, or their agents or employees, or to any practitioner 8
acting within the scope of his or her license, or to a common or 9
contract carrier or warehouse operator, or any employee thereof, 10
whose possession of any legend drug is in the usual course of 11
business or employment: PROVIDED FURTHER, That nothing in this 12
chapter or chapter 18.64 RCW shall prevent a family planning clinic 13
that is under contract with the health care authority from selling, 14
delivering, possessing, and dispensing commercially prepackaged oral 15
contraceptives prescribed by authorized, licensed health care 16
practitioners: PROVIDED FURTHER, That nothing in this chapter 17
prohibits possession or delivery of legend drugs by an authorized 18
collector or other person participating in the operation of a drug 19
take-back program authorized in chapter 69.48 RCW.20
(2)(a) A violation of this section involving the sale, delivery, 21
or possession with intent to sell or deliver is a class B felony 22
punishable according to chapter 9A.20 RCW. 23
(b) A violation of this section involving knowing possession is a 24
misdemeanor. The prosecutor is encouraged to divert such cases for 25
assessment, treatment, or other services. 26
(c) A violation of this section involving knowing use in a public 27
place is a misdemeanor. The prosecutor is encouraged to divert such 28
cases for assessment, treatment, or other services.29
(d) No person may be charged with both knowing possession and 30
knowing use in a public place under this section relating to the same 31
course of conduct. 32
(e) In lieu of jail booking and referral to the prosecutor for a 33
violation of this section involving knowing possession, or knowing 34
use in a public place, law enforcement is encouraged to offer a 35
referral to assessment and services available under RCW 10.31.110 or 36
other program or entity responsible for receiving referrals in lieu 37
of legal system involvement, which may include, but are not limited 38
to, arrest and jail alternative programs established under RCW 39
36.28A.450, law enforcement assisted diversion programs established 40
p. 256 HB 1281
under RCW 71.24.589, and the recovery navigator program established 1
under RCW 71.24.115. 2
(3) For the purposes of this section, "public place" has the same 3
meaning as defined in RCW 66.04.010, but the exclusions in RCW 4
66.04.011 do not apply. 5
(4) For the purposes of this section, "use any legend drug" means 6
to introduce the drug into the human body by injection, inhalation, 7
ingestion, or any other means. 8
Sec. 5124. RCW 69.43.135 and 2011 c 336 s 838 are each amended 9
to read as follows: 10
(1) The definitions in this subsection apply throughout this 11
section unless the context clearly requires otherwise.12
(a) "Iodine matrix" means iodine at a concentration greater than 13
two percent by weight in a matrix or solution. 14
(b) "Matrix" means something, as a substance, in which something 15
else originates, develops, or is contained. 16
(c) "Methylsulfonylmethane" means methylsulfonylmethane in its 17
powder form only, and does not include products containing 18
methylsulfonylmethane in other forms such as liquids, tablets, 19
capsules not containing methylsulfonylmethane in pure powder form, 20
ointments, creams, cosmetics, foods, and beverages.21
(2) Any person who knowingly purchases in a thirty-day period or 22
possesses any quantity of iodine in its elemental form, an iodine 23
matrix, or more than two pounds of methylsulfonylmethane is guilty of 24
a gross misdemeanor, except as provided in subsection (3) of this 25
section. 26
(3) Subsection (2) of this section does not apply to:27
(a) A person who possesses iodine in its elemental form or an 28
iodine matrix as a prescription drug, under a prescription issued by 29
a licensed veterinarian, physician, or advanced ((registered nurse 30
practitioner)) practice registered nurse; 31
(b) A person who possesses iodine in its elemental form, an 32
iodine matrix, or any quantity of methylsulfonylmethane in its powder 33
form and is actively engaged in the practice of animal husbandry of 34
livestock; 35
(c) A person who possesses iodine in its elemental form or an 36
iodine matrix in conjunction with experiments conducted in a 37
chemistry or chemistry-related laboratory maintained by a:38
(i) Public or private secondary school; 39
p. 257 HB 1281
(ii) Public or private institution of higher education that is 1
accredited by a regional or national accrediting agency recognized by 2
the United States department of education; 3
(iii) Manufacturing facility, government agency, or research 4
facility in the course of lawful business activities;5
(d) A veterinarian, physician, advanced ((registered nurse 6
practitioner)) practice registered nurse , pharmacist, retail 7
distributor, wholesaler, manufacturer, warehouse operator, or common 8
carrier, or an agent of any of these persons who possesses iodine in 9
its elemental form, an iodine matrix, or methylsulfonylmethane in its 10
powder form in the regular course of lawful business activities; or11
(e) A person working in a general hospital who possesses iodine 12
in its elemental form or an iodine matrix in the regular course of 13
employment at the hospital. 14
(4) Any person who purchases any quantity of iodine in its 15
elemental form, an iodine matrix, or any quantity of 16
methylsulfonylmethane must present an identification card or driver's 17
license issued by any state in the United States or jurisdiction of 18
another country before purchasing the item. 19
(5) The Washington state patrol shall develop a form to be used 20
in recording transactions involving iodine in its elemental form, an 21
iodine matrix, or methylsulfonylmethane. A person who sells or 22
otherwise transfers any quantity of iodine in its elemental form, an 23
iodine matrix, or any quantity of methylsulfonylmethane to a person 24
for any purpose authorized in subsection (3) of this section must 25
record each sale or transfer. The record must be made on the form 26
developed by the Washington state patrol and must be retained by the 27
person for at least three years. The Washington state patrol or any 28
local law enforcement agency may request access to the records.29
(a) Failure to make or retain a record required under this 30
subsection is a misdemeanor. 31
(b) Failure to comply with a request for access to records 32
required under this subsection to the Washington state patrol or a 33
local law enforcement agency is a misdemeanor. 34
Sec. 5125. RCW 69.45.010 and 2020 c 80 s 42 are each amended to 35
read as follows: 36
The definitions in this section apply throughout this chapter.37
(1) "Commission" means the pharmacy quality assurance commission.38
p. 258 HB 1281
(2) "Controlled substance" means a drug, substance, or immediate 1
precursor of such drug or substance, so designated under or pursuant 2
to chapter 69.50 RCW, the uniform controlled substances act.3
(3) "Deliver" or "delivery" means the actual, constructive, or 4
attempted transfer from one person to another of a drug or device, 5
whether or not there is an agency relationship. 6
(4) "Department" means the department of health.7
(5) "Dispense" means the interpretation of a prescription or 8
order for a drug, biological, or device and, pursuant to that 9
prescription or order, the proper selection, measuring, compounding, 10
labeling, or packaging necessary to prepare that prescription or 11
order for delivery. 12
(6) "Distribute" means to deliver, other than by administering or 13
dispensing, a legend drug. 14
(7) "Drug samples" means any federal food and drug administration 15
approved controlled substance, legend drug, or products requiring 16
prescriptions in this state, which is distributed at no charge to a 17
practitioner by a manufacturer or a manufacturer's representative, 18
exclusive of drugs under clinical investigations approved by the 19
federal food and drug administration. 20
(8) "Legend drug" means any drug that is required by state law or 21
by regulations of the commission to be dispensed on prescription only 22
or is restricted to use by practitioners only. 23
(9) "Manufacturer" means a person or other entity engaged in the 24
manufacture or distribution of drugs or devices, but does not include 25
a manufacturer's representative. 26
(10) "Manufacturer's representative" means an agent or employee 27
of a drug manufacturer who is authorized by the drug manufacturer to 28
possess drug samples for the purpose of distribution in this state to 29
appropriately authorized health care practitioners.30
(11) "Person" means any individual, corporation, government or 31
governmental subdivision or agency, business trust, estate, trust, 32
partnership, association, or any other legal entity.33
(12) "Practitioner" means a physician under chapter 18.71 RCW, an 34
osteopathic physician or an osteopathic physician and surgeon under 35
chapter 18.57 RCW, a dentist under chapter 18.32 RCW, a podiatric 36
physician and surgeon under chapter 18.22 RCW, a veterinarian under 37
chapter 18.92 RCW, a pharmacist under chapter 18.64 RCW, a 38
commissioned medical or dental officer in the United States armed 39
forces or the public health service in the discharge of his or her 40
p. 259 HB 1281
official duties, a duly licensed physician or dentist employed by the 1
veterans administration in the discharge of his or her official 2
duties, a registered nurse or advanced ((registered nurse 3
practitioner)) practice registered nurse under chapter 18.79 RCW when 4
authorized to prescribe by the ((nursing care quality assurance 5
commission)) state board of nursing , or a physician assistant under 6
chapter 18.71A RCW when authorized by the Washington medical 7
commission. 8
(13) "Reasonable cause" means a state of facts found to exist 9
that would warrant a reasonably intelligent and prudent person to 10
believe that a person has violated state or federal drug laws or 11
regulations. 12
(14) "Secretary" means the secretary of health or the secretary's 13
designee. 14
Sec. 5126. RCW 69.50.101 and 2024 c 62 s 17 are each amended to 15
read as follows: 16
The definitions in this section apply throughout this chapter 17
unless the context clearly requires otherwise. 18
(1) "Administer" means to apply a controlled substance, whether 19
by injection, inhalation, ingestion, or any other means, directly to 20
the body of a patient or research subject by: 21
(a) a practitioner authorized to prescribe (or, by the 22
practitioner's authorized agent); or 23
(b) the patient or research subject at the direction and in the 24
presence of the practitioner. 25
(2) "Agent" means an authorized person who acts on behalf of or 26
at the direction of a manufacturer, distributor, or dispenser. It 27
does not include a common or contract carrier, public 28
warehouseperson, or employee of the carrier or warehouseperson.29
(3) "Board" means the Washington state liquor and cannabis board.30
(4) "Cannabis" means all parts of the plant Cannabis, whether 31
growing or not, with a THC concentration greater than 0.3 percent on 32
a dry weight basis during the growing cycle through harvest and 33
usable cannabis. "Cannabis" does not include hemp or industrial hemp 34
as defined in RCW 15.140.020, or seeds used for licensed hemp 35
production under chapter 15.140 RCW. 36
(5) "Cannabis concentrates" means products consisting wholly or 37
in part of the resin extracted from any part of the plant Cannabis 38
and having a THC concentration greater than ten percent.39
p. 260 HB 1281
(6) "Cannabis processor" means a person licensed by the board to 1
process cannabis into cannabis concentrates, useable cannabis, and 2
cannabis-infused products, package and label cannabis concentrates, 3
useable cannabis, and cannabis-infused products for sale in retail 4
outlets, and sell cannabis concentrates, useable cannabis, and 5
cannabis-infused products at wholesale to cannabis retailers.6
(7) "Cannabis producer" means a person licensed by the board to 7
produce and sell cannabis at wholesale to cannabis processors and 8
other cannabis producers. 9
(8)(a) "Cannabis products" means useable cannabis, cannabis 10
concentrates, and cannabis-infused products as defined in this 11
section, including any product intended to be consumed or absorbed 12
inside the body by any means including inhalation, ingestion, or 13
insertion, with any detectable amount of THC. 14
(b) "Cannabis products" also means any product containing only 15
THC content. 16
(c) "Cannabis products" does not include cannabis health and 17
beauty aids as defined in RCW 69.50.575 or products approved by the 18
United States food and drug administration. 19
(9) "Cannabis researcher" means a person licensed by the board to 20
produce, process, and possess cannabis for the purposes of conducting 21
research on cannabis and cannabis-derived drug products.22
(10) "Cannabis retailer" means a person licensed by the board to 23
sell cannabis concentrates, useable cannabis, and cannabis-infused 24
products in a retail outlet. 25
(11) "Cannabis-infused products" means products that contain 26
cannabis or cannabis extracts, are intended for human use, are 27
derived from cannabis as defined in subsection (4) of this section, 28
and have a THC concentration no greater than ten percent. The term 29
"cannabis-infused products" does not include either useable cannabis 30
or cannabis concentrates. 31
(12) "CBD concentration" has the meaning provided in RCW 32
69.51A.010. 33
(13) "CBD product" means any product containing or consisting of 34
cannabidiol. 35
(14) "Commission" means the pharmacy quality assurance 36
commission. 37
(15) "Controlled substance" means a drug, substance, or immediate 38
precursor included in Schedules I through V as set forth in federal 39
p. 261 HB 1281
or state laws, or federal or commission rules, but does not include 1
hemp or industrial hemp as defined in RCW 15.140.020.2
(16)(a) "Controlled substance analog" means a substance the 3
chemical structure of which is substantially similar to the chemical 4
structure of a controlled substance in Schedule I or II and:5
(i) that has a stimulant, depressant, or hallucinogenic effect on 6
the central nervous system substantially similar to the stimulant, 7
depressant, or hallucinogenic effect on the central nervous system of 8
a controlled substance included in Schedule I or II; or9
(ii) with respect to a particular individual, that the individual 10
represents or intends to have a stimulant, depressant, or 11
hallucinogenic effect on the central nervous system substantially 12
similar to the stimulant, depressant, or hallucinogenic effect on the 13
central nervous system of a controlled substance included in Schedule 14
I or II. 15
(b) The term does not include: 16
(i) a controlled substance; 17
(ii) a substance for which there is an approved new drug 18
application; 19
(iii) a substance with respect to which an exemption is in effect 20
for investigational use by a particular person under Section 505 of 21
the federal food, drug, and cosmetic act, 21 U.S.C. Sec. 355, or 22
chapter 69.77 RCW to the extent conduct with respect to the substance 23
is pursuant to the exemption; or 24
(iv) any substance to the extent not intended for human 25
consumption before an exemption takes effect with respect to the 26
substance. 27
(17) "Deliver" or "delivery" means the actual or constructive 28
transfer from one person to another of a substance, whether or not 29
there is an agency relationship. 30
(18) "Department" means the department of health.31
(19) "Designated provider" has the meaning provided in RCW 32
69.51A.010. 33
(20) "Dispense" means the interpretation of a prescription or 34
order for a controlled substance and, pursuant to that prescription 35
or order, the proper selection, measuring, compounding, labeling, or 36
packaging necessary to prepare that prescription or order for 37
delivery. 38
(21) "Dispenser" means a practitioner who dispenses.39
p. 262 HB 1281
(22) "Distribute" means to deliver other than by administering or 1
dispensing a controlled substance. 2
(23) "Distributor" means a person who distributes.3
(24) "Drug" means (a) a controlled substance recognized as a drug 4
in the official United States pharmacopoeia/national formulary or the 5
official homeopathic pharmacopoeia of the United States, or any 6
supplement to them; (b) controlled substances intended for use in the 7
diagnosis, cure, mitigation, treatment, or prevention of disease in 8
individuals or animals; (c) controlled substances (other than food) 9
intended to affect the structure or any function of the body of 10
individuals or animals; and (d) controlled substances intended for 11
use as a component of any article specified in (a), (b), or (c) of 12
this subsection. The term does not include devices or their 13
components, parts, or accessories. 14
(25) "Drug enforcement administration" means the drug enforcement 15
administration in the United States Department of Justice, or its 16
successor agency. 17
(26) "Electronic communication of prescription information" means 18
the transmission of a prescription or refill authorization for a drug 19
of a practitioner using computer systems. The term does not include a 20
prescription or refill authorization verbally transmitted by 21
telephone nor a facsimile manually signed by the practitioner.22
(27) "Immature plant or clone" means a plant or clone that has no 23
flowers, is less than twelve inches in height, and is less than 24
twelve inches in diameter. 25
(28) "Immediate precursor" means a substance: 26
(a) that the commission has found to be and by rule designates as 27
being the principal compound commonly used, or produced primarily for 28
use, in the manufacture of a controlled substance;29
(b) that is an immediate chemical intermediary used or likely to 30
be used in the manufacture of a controlled substance; and31
(c) the control of which is necessary to prevent, curtail, or 32
limit the manufacture of the controlled substance.33
(29) "Isomer" means an optical isomer, but in subsection (33)(e) 34
of this section, RCW 69.50.204(1) (l) and (hh), and 69.50.206(2)(d), 35
the term includes any geometrical isomer; in RCW 69.50.204(1) (h) and 36
(pp)((,)) and 69.50.210(3)(([,])), the term includes any positional 37
isomer; and in RCW 69.50.204(1)(ii), 69.50.204(3), and 69.50.208(1)38
(([,])), the term includes any positional or geometric isomer.39
p. 263 HB 1281
(30) "Lot" means a definite quantity of cannabis, cannabis 1
concentrates, useable cannabis, or cannabis-infused product 2
identified by a lot number, every portion or package of which is 3
uniform within recognized tolerances for the factors that appear in 4
the labeling. 5
(31) "Lot number" must identify the licensee by business or trade 6
name and Washington state unified business identifier number, and the 7
date of harvest or processing for each lot of cannabis, cannabis 8
concentrates, useable cannabis, or cannabis-infused product.9
(32) "Manufacture" means the production, preparation, 10
propagation, compounding, conversion, or processing of a controlled 11
substance, either directly or indirectly or by extraction from 12
substances of natural origin, or independently by means of chemical 13
synthesis, or by a combination of extraction and chemical synthesis, 14
and includes any packaging or repackaging of the substance or 15
labeling or relabeling of its container. The term does not include 16
the preparation, compounding, packaging, repackaging, labeling, or 17
relabeling of a controlled substance: 18
(a) by a practitioner as an incident to the practitioner's 19
administering or dispensing of a controlled substance in the course 20
of the practitioner's professional practice; or 21
(b) by a practitioner, or by the practitioner's authorized agent 22
under the practitioner's supervision, for the purpose of, or as an 23
incident to, research, teaching, or chemical analysis and not for 24
sale. 25
(33) "Narcotic drug" means any of the following, whether produced 26
directly or indirectly by extraction from substances of vegetable 27
origin, or independently by means of chemical synthesis, or by a 28
combination of extraction and chemical synthesis: 29
(a) Opium, opium derivative, and any derivative of opium or opium 30
derivative, including their salts, isomers, and salts of isomers, 31
whenever the existence of the salts, isomers, and salts of isomers is 32
possible within the specific chemical designation. The term does not 33
include the isoquinoline alkaloids of opium. 34
(b) Synthetic opiate and any derivative of synthetic opiate, 35
including their isomers, esters, ethers, salts, and salts of isomers, 36
esters, and ethers, whenever the existence of the isomers, esters, 37
ethers, and salts is possible within the specific chemical 38
designation. 39
(c) Poppy straw and concentrate of poppy straw.40
p. 264 HB 1281
(d) Coca leaves, except coca leaves and extracts of coca leaves 1
from which cocaine, ecgonine, and derivatives or ecgonine or their 2
salts have been removed. 3
(e) Cocaine, or any salt, isomer, or salt of isomer thereof.4
(f) Cocaine base. 5
(g) Ecgonine, or any derivative, salt, isomer, or salt of isomer 6
thereof. 7
(h) Any compound, mixture, or preparation containing any quantity 8
of any substance referred to in (a) through (g) of this subsection.9
(34) "Opiate" means any substance having an addiction-forming or 10
addiction-sustaining liability similar to morphine or being capable 11
of conversion into a drug having addiction-forming or addiction-12
sustaining liability. The term includes opium, substances derived 13
from opium (opium derivatives), and synthetic opiates. The term does 14
not include, unless specifically designated as controlled under RCW 15
69.50.201, the dextrorotatory isomer of 3-methoxy-n-methylmorphinan 16
and its salts (dextromethorphan). The term includes the racemic and 17
levorotatory forms of dextromethorphan. 18
(35) "Opium poppy" means the plant of the species Papaver 19
somniferum L., except its seeds. 20
(36) "Package" means a container that has a single unit or group 21
of units. 22
(37) "Person" means individual, corporation, business trust, 23
estate, trust, partnership, association, joint venture, government, 24
governmental subdivision or agency, or any other legal or commercial 25
entity. 26
(38) "Plant" has the meaning provided in RCW 69.51A.010.27
(39) "Poppy straw" means all parts, except the seeds, of the 28
opium poppy, after mowing. 29
(40) "Practitioner" means: 30
(a) A physician under chapter 18.71 RCW; a physician assistant 31
under chapter 18.71A RCW; an osteopathic physician and surgeon under 32
chapter 18.57 RCW; an optometrist licensed under chapter 18.53 RCW 33
who is certified by the optometry board under RCW 18.53.010 subject 34
to any limitations in RCW 18.53.010; a dentist under chapter 18.32 35
RCW; a podiatric physician and surgeon under chapter 18.22 RCW; a 36
veterinarian under chapter 18.92 RCW; a registered nurse, advanced 37
((registered nurse practitioner )) practice registered nurse , or 38
licensed practical nurse under chapter 18.79 RCW; a naturopathic 39
physician under chapter 18.36A RCW who is licensed under RCW 40
p. 265 HB 1281
18.36A.030 subject to any limitations in RCW 18.36A.040; a pharmacist 1
under chapter 18.64 RCW or a scientific investigator under this 2
chapter, licensed, registered or otherwise permitted insofar as is 3
consistent with those licensing laws to distribute, dispense, conduct 4
research with respect to or administer a controlled substance in the 5
course of their professional practice or research in this state.6
(b) A pharmacy, hospital or other institution licensed, 7
registered, or otherwise permitted to distribute, dispense, conduct 8
research with respect to or to administer a controlled substance in 9
the course of professional practice or research in this state.10
(c) A physician licensed to practice medicine and surgery, a 11
physician licensed to practice osteopathic medicine and surgery, a 12
dentist licensed to practice dentistry, a podiatric physician and 13
surgeon licensed to practice podiatric medicine and surgery, a 14
licensed physician assistant or a licensed osteopathic physician 15
assistant specifically approved to prescribe controlled substances by 16
his or her state's medical commission or equivalent and his or her 17
participating physician as defined in RCW 18.71A.010, an advanced 18
((registered nurse practitioner )) practice registered nurse licensed 19
to prescribe controlled substances, or a veterinarian licensed to 20
practice veterinary medicine in any state of the United States.21
(41) "Prescription" means an order for controlled substances 22
issued by a practitioner duly authorized by law or rule in the state 23
of Washington to prescribe controlled substances within the scope of 24
his or her professional practice for a legitimate medical purpose.25
(42) "Production" includes the manufacturing, planting, 26
cultivating, growing, or harvesting of a controlled substance.27
(43) "Qualifying patient" has the meaning provided in RCW 28
69.51A.010. 29
(44) "Recognition card" has the meaning provided in RCW 30
69.51A.010. 31
(45) "Retail outlet" means a location licensed by the board for 32
the retail sale of cannabis concentrates, useable cannabis, and 33
cannabis-infused products. 34
(46) "Secretary" means the secretary of health or the secretary's 35
designee. 36
(47) "Social equity plan" means a plan that addresses at least 37
some of the elements outlined in this subsection (47), along with any 38
additional plan components or requirements approved by the board 39
p. 266 HB 1281
following consultation with the task force created in RCW 69.50.336. 1
The plan may include: 2
(a) A statement that indicates how the cannabis licensee will 3
work to promote social equity goals in their community;4
(b) A description of how the cannabis licensee will meet social 5
equity goals as defined in RCW 69.50.335; 6
(c) The composition of the workforce the licensee has employed or 7
intends to hire; and 8
(d) Business plans involving partnerships or assistance to 9
organizations or residents with connections to populations with a 10
history of high rates of enforcement of cannabis prohibition.11
(48) "State," unless the context otherwise requires, means a 12
state of the United States, the District of Columbia, the 13
Commonwealth of Puerto Rico, or a territory or insular possession 14
subject to the jurisdiction of the United States. 15
(49) "THC concentration" means percent of tetrahydrocannabinol 16
content of any part of the plant Cannabis, or per volume or weight of 17
cannabis product, or the combined percent of tetrahydrocannabinol and 18
tetrahydrocannabinolic acid in any part of the plant Cannabis 19
regardless of moisture content. 20
(50) "Ultimate user" means an individual who lawfully possesses a 21
controlled substance for the individual's own use or for the use of a 22
member of the individual's household or for administering to an 23
animal owned by the individual or by a member of the individual's 24
household. 25
(51) "Unit" means an individual consumable item within a package 26
of one or more consumable items in solid, liquid, gas, or any form 27
intended for human consumption. 28
(52) "Useable cannabis" means dried cannabis flowers. The term 29
"useable cannabis" does not include either cannabis-infused products 30
or cannabis concentrates. 31
(53) "Youth access" means the level of interest persons under the 32
age of twenty-one may have in a vapor product, as well as the degree 33
to which the product is available or appealing to such persons, and 34
the likelihood of initiation, use, or addiction by adolescents and 35
young adults. 36
Sec. 5127. RCW 69.51A.010 and 2022 c 16 s 116 are each reenacted 37
and amended to read as follows: 38
p. 267 HB 1281
The definitions in this section apply throughout this chapter 1
unless the context clearly requires otherwise. 2
(1)(a) "Authorization" means a form developed by the department 3
that is completed and signed by a qualifying patient's health care 4
professional and printed on tamper-resistant paper.5
(b) An authorization is not a prescription as defined in RCW 6
69.50.101. 7
(2) "Cannabis" has the meaning provided in RCW 69.50.101.8
(3) "Cannabis concentrates" has the meaning provided in RCW 9
69.50.101. 10
(4) "Cannabis processor" has the meaning provided in RCW 11
69.50.101. 12
(5) "Cannabis producer" has the meaning provided in RCW 13
69.50.101. 14
(6) "Cannabis retailer" has the meaning provided in RCW 15
69.50.101. 16
(7) "Cannabis retailer with a medical cannabis endorsement" means 17
a cannabis retailer that has been issued a medical cannabis 18
endorsement by the state liquor and cannabis board pursuant to RCW 19
69.50.375. 20
(8) "Cannabis-infused products" has the meaning provided in RCW 21
69.50.101. 22
(9) "CBD concentration" means the percent of cannabidiol content 23
per dry weight of any part of the plant Cannabis, or per volume or 24
weight of cannabis product. 25
(10) "Department" means the department of health.26
(11) "Designated provider" means a person who is twenty-one years 27
of age or older and: 28
(a)(i) Is the parent or guardian of a qualifying patient who is 29
under the age of eighteen and holds a recognition card; or30
(ii) Has been designated in writing by a qualifying patient to 31
serve as the designated provider for that patient;32
(b)(i) Has an authorization from the qualifying patient's health 33
care professional; or 34
(ii)(A) Has been entered into the medical cannabis authorization 35
database as being the designated provider to a qualifying patient; 36
and 37
(B) Has been provided a recognition card; 38
p. 268 HB 1281
(c) Is prohibited from consuming cannabis obtained for the 1
personal, medical use of the qualifying patient for whom the 2
individual is acting as designated provider; 3
(d) Provides cannabis to only the qualifying patient that has 4
designated him or her; 5
(e) Is in compliance with the terms and conditions of this 6
chapter; and 7
(f) Is the designated provider to only one patient at any one 8
time. 9
(12) "Health care professional," for purposes of this chapter 10
only, means a physician licensed under chapter 18.71 RCW, a physician 11
assistant licensed under chapter 18.71A RCW, an osteopathic physician 12
licensed under chapter 18.57 RCW, a naturopath licensed under chapter 13
18.36A RCW, or an advanced ((registered nurse practitioner)) practice 14
registered nurse licensed under chapter 18.79 RCW.15
(13) "Housing unit" means a house, an apartment, a mobile home, a 16
group of rooms, or a single room that is occupied as separate living 17
quarters, in which the occupants live and eat separately from any 18
other persons in the building, and which have direct access from the 19
outside of the building or through a common hall. 20
(14) "Low THC, high CBD" means products determined by the 21
department to have a low THC, high CBD ratio under RCW 69.50.375. Low 22
THC, high CBD products must be inhalable, ingestible, or absorbable.23
(15) "Medical cannabis authorization database" means the secure 24
and confidential database established in RCW 69.51A.230.25
(16) "Medical use of cannabis" means the manufacture, production, 26
possession, transportation, delivery, ingestion, application, or 27
administration of cannabis for the exclusive benefit of a qualifying 28
patient in the treatment of his or her terminal or debilitating 29
medical condition. 30
(17) "Plant" means a cannabis plant having at least three 31
distinguishable and distinct leaves, each leaf being at least three 32
centimeters in diameter, and a readily observable root formation 33
consisting of at least two separate and distinct roots, each being at 34
least two centimeters in length. Multiple stalks emanating from the 35
same root ball or root system is considered part of the same single 36
plant. 37
(18) "Public place" has the meaning provided in RCW 70.160.020.38
(19) "Qualifying patient" means a person who: 39
(a)(i) Is a patient of a health care professional;40
p. 269 HB 1281
(ii) Has been diagnosed by that health care professional as 1
having a terminal or debilitating medical condition;2
(iii) Is a resident of the state of Washington at the time of 3
such diagnosis; 4
(iv) Has been advised by that health care professional about the 5
risks and benefits of the medical use of cannabis; 6
(v) Has been advised by that health care professional that they 7
may benefit from the medical use of cannabis; 8
(vi)(A) Has an authorization from his or her health care 9
professional; or 10
(B) Has been entered into the medical cannabis authorization 11
database and has been provided a recognition card; and12
(vii) Is otherwise in compliance with the terms and conditions 13
established in this chapter. 14
(b) "Qualifying patient" does not include a person who is 15
actively being supervised for a criminal conviction by a corrections 16
agency or department that has determined that the terms of this 17
chapter are inconsistent with and contrary to his or her supervision 18
and all related processes and procedures related to that supervision.19
(20) "Recognition card" means a card issued to qualifying 20
patients and designated providers by a cannabis retailer with a 21
medical cannabis endorsement that has entered them into the medical 22
cannabis authorization database. 23
(21) "Retail outlet" has the meaning provided in RCW 69.50.101.24
(22) "Secretary" means the secretary of the department of health.25
(23) "Tamper-resistant paper" means paper that meets one or more 26
of the following industry-recognized features: 27
(a) One or more features designed to prevent copying of the 28
paper; 29
(b) One or more features designed to prevent the erasure or 30
modification of information on the paper; or 31
(c) One or more features designed to prevent the use of 32
counterfeit authorization. 33
(24) "Terminal or debilitating medical condition" means a 34
condition severe enough to significantly interfere with the patient's 35
activities of daily living and ability to function, which can be 36
objectively assessed and evaluated and limited to the following:37
(a) Cancer, human immunodeficiency virus (HIV), multiple 38
sclerosis, epilepsy or other seizure disorder, or spasticity 39
disorders; 40
p. 270 HB 1281
(b) Intractable pain, limited for the purpose of this chapter to 1
mean pain unrelieved by standard medical treatments and medications;2
(c) Glaucoma, either acute or chronic, limited for the purpose of 3
this chapter to mean increased intraocular pressure unrelieved by 4
standard treatments and medications; 5
(d) Crohn's disease with debilitating symptoms unrelieved by 6
standard treatments or medications; 7
(e) Hepatitis C with debilitating nausea or intractable pain 8
unrelieved by standard treatments or medications; 9
(f) Diseases, including anorexia, which result in nausea, 10
vomiting, wasting, appetite loss, cramping, seizures, muscle spasms, 11
or spasticity, when these symptoms are unrelieved by standard 12
treatments or medications; 13
(g) Posttraumatic stress disorder; or 14
(h) Traumatic brain injury. 15
(25) "THC concentration" has the meaning provided in RCW 16
69.50.101. 17
(26) "Useable cannabis" has the meaning provided in RCW 18
69.50.101. 19
Sec. 5128. RCW 70.02.010 and 2024 c 209 s 31 are each amended to 20
read as follows: 21
The definitions in this section apply throughout this chapter 22
unless the context clearly requires otherwise. 23
(1) "Admission" has the same meaning as in RCW 71.05.020.24
(2) "Audit" means an assessment, evaluation, determination, or 25
investigation of a health care provider by a person not employed by 26
or affiliated with the provider to determine compliance with:27
(a) Statutory, regulatory, fiscal, medical, or scientific 28
standards; 29
(b) A private or public program of payments to a health care 30
provider; or 31
(c) Requirements for licensing, accreditation, or certification.32
(3) "Authority" means the Washington state health care authority.33
(4) "Commitment" has the same meaning as in RCW 71.05.020.34
(5) "Custody" has the same meaning as in RCW 71.05.020.35
(6) "Deidentified" means health information that does not 36
identify an individual and with respect to which there is no 37
reasonable basis to believe that the information can be used to 38
identify an individual. 39
p. 271 HB 1281
(7) "Department" means the department of social and health 1
services. 2
(8) "Designated crisis responder" has the same meaning as in RCW 3
71.05.020 or 71.34.020, as applicable. 4
(9) "Detention" or "detain" has the same meaning as in RCW 5
71.05.020. 6
(10) "Directory information" means information disclosing the 7
presence, and for the purpose of identification, the name, location 8
within a health care facility, and the general health condition of a 9
particular patient who is a patient in a health care facility or who 10
is currently receiving emergency health care in a health care 11
facility. 12
(11) "Discharge" has the same meaning as in RCW 71.05.020.13
(12) "Evaluation and treatment facility" has the same meaning as 14
in RCW 71.05.020 or 71.34.020, as applicable. 15
(13) "Federal, state, or local law enforcement authorities" means 16
an officer of any agency or authority in the United States, a state, 17
a tribe, a territory, or a political subdivision of a state, a tribe, 18
or a territory who is empowered by law to: (a) Investigate or conduct 19
an official inquiry into a potential criminal violation of law; or 20
(b) prosecute or otherwise conduct a criminal proceeding arising from 21
an alleged violation of law. 22
(14) "General health condition" means the patient's health status 23
described in terms of "critical," "poor," "fair," "good," 24
"excellent," or terms denoting similar conditions.25
(15) "Health care" means any care, service, or procedure provided 26
by a health care provider: 27
(a) To diagnose, treat, or maintain a patient's physical or 28
mental condition; or 29
(b) That affects the structure or any function of the human body.30
(16) "Health care facility" means a hospital, clinic, nursing 31
home, laboratory, office, or similar place where a health care 32
provider provides health care to patients. 33
(17) "Health care information" means any information, whether 34
oral or recorded in any form or medium, that identifies or can 35
readily be associated with the identity of a patient and directly 36
relates to the patient's health care, including a patient's 37
deoxyribonucleic acid and identified sequence of chemical base pairs. 38
The term includes any required accounting of disclosures of health 39
care information. 40
p. 272 HB 1281
(18) "Health care operations" means any of the following 1
activities of a health care provider, health care facility, or third-2
party payor to the extent that the activities are related to 3
functions that make an entity a health care provider, a health care 4
facility, or a third-party payor: 5
(a) Conducting: Quality assessment and improvement activities, 6
including outcomes evaluation and development of clinical guidelines, 7
if the obtaining of generalizable knowledge is not the primary 8
purpose of any studies resulting from such activities; population-9
based activities relating to improving health or reducing health care 10
costs, protocol development, case management and care coordination, 11
contacting of health care providers and patients with information 12
about treatment alternatives; and related functions that do not 13
include treatment; 14
(b) Reviewing the competence or qualifications of health care 15
professionals, evaluating practitioner and provider performance and 16
third-party payor performance, conducting training programs in which 17
students, trainees, or practitioners in areas of health care learn 18
under supervision to practice or improve their skills as health care 19
providers, training of nonhealth care professionals, accreditation, 20
certification, licensing, or credentialing activities;21
(c) Underwriting, premium rating, and other activities relating 22
to the creation, renewal, or replacement of a contract of health 23
insurance or health benefits, and ceding, securing, or placing a 24
contract for reinsurance of risk relating to claims for health care, 25
including stop-loss insurance and excess of loss insurance, if any 26
applicable legal requirements are met; 27
(d) Conducting or arranging for medical review, legal services, 28
and auditing functions, including fraud and abuse detection and 29
compliance programs; 30
(e) Business planning and development, such as conducting cost-31
management and planning-related analyses related to managing and 32
operating the health care facility or third-party payor, including 33
formulary development and administration, development, or improvement 34
of methods of payment or coverage policies; and 35
(f) Business management and general administrative activities of 36
the health care facility, health care provider, or third-party payor 37
including, but not limited to: 38
(i) Management activities relating to implementation of and 39
compliance with the requirements of this chapter; 40
p. 273 HB 1281
(ii) Customer service, including the provision of data analyses 1
for policyholders, plan sponsors, or other customers, provided that 2
health care information is not disclosed to such policyholder, plan 3
sponsor, or customer; 4
(iii) Resolution of internal grievances; 5
(iv) The sale, transfer, merger, or consolidation of all or part 6
of a health care provider, health care facility, or third-party payor 7
with another health care provider, health care facility, or third-8
party payor or an entity that following such activity will become a 9
health care provider, health care facility, or third-party payor, and 10
due diligence related to such activity; and 11
(v) Consistent with applicable legal requirements, creating 12
deidentified health care information or a limited data set for the 13
benefit of the health care provider, health care facility, or third-14
party payor. 15
(19) "Health care provider" means a person who is licensed, 16
certified, registered, or otherwise authorized by the law of this 17
state to provide health care in the ordinary course of business or 18
practice of a profession. 19
(20) "Human immunodeficiency virus" or "HIV" has the same meaning 20
as in RCW 70.24.017. 21
(21) "Imminent" has the same meaning as in RCW 71.05.020.22
(22) "Indian health care provider" has the same meaning as in RCW 23
43.71B.010(11). 24
(23) "Information and records related to mental health services" 25
means a type of health care information that relates to all 26
information and records compiled, obtained, or maintained in the 27
course of providing services by a mental health service agency or 28
mental health professional to persons who are receiving or have 29
received services for mental illness. The term includes mental health 30
information contained in a medical bill, registration records, and 31
all other records regarding the person maintained by the department, 32
by the authority, by behavioral health administrative services 33
organizations and their staff, managed care organizations contracted 34
with the authority under chapter 74.09 RCW and their staff, and by 35
treatment facilities. The term further includes documents of legal 36
proceedings under chapter 71.05, 71.34, or 10.77 RCW, or somatic 37
health care information. For health care information maintained by a 38
hospital as defined in RCW 70.41.020 or a health care facility or 39
health care provider that participates with a hospital in an 40
p. 274 HB 1281
organized health care arrangement defined under federal law, 1
"information and records related to mental health services" is 2
limited to information and records of services provided by a mental 3
health professional or information and records of services created by 4
a hospital-operated community behavioral health program as defined in 5
RCW 71.24.025. The term does not include psychotherapy notes.6
(24) "Information and records related to sexually transmitted 7
diseases" means a type of health care information that relates to the 8
identity of any person upon whom an HIV antibody test or other 9
sexually transmitted infection test is performed, the results of such 10
tests, and any information relating to diagnosis of or treatment for 11
any confirmed sexually transmitted infections. 12
(25) "Institutional review board" means any board, committee, or 13
other group formally designated by an institution, or authorized 14
under federal or state law, to review, approve the initiation of, or 15
conduct periodic review of research programs to assure the protection 16
of the rights and welfare of human research subjects.17
(26) "Legal counsel" has the same meaning as in RCW 71.05.020.18
(27) "Local public health officer" has the same meaning as the 19
term "local health officer" as defined in RCW 70.24.017.20
(28) "Maintain," as related to health care information, means to 21
hold, possess, preserve, retain, store, or control that information.22
(29) "Managed care organization" has the same meaning as provided 23
in RCW 71.24.025. 24
(30) "Mental health professional" means a psychiatrist, 25
psychologist, psychiatric advanced ((registered nurse practitioner )) 26
practice registered nurse , psychiatric nurse, or social worker, and 27
such other mental health professionals as may be defined by rules 28
adopted by the secretary of health under chapter 71.05 RCW, whether 29
that person works in a private or public setting. 30
(31) "Mental health service agency" means a public or private 31
agency that provides services to persons with mental disorders as 32
defined under RCW 71.05.020 or 71.34.020 and receives funding from 33
public sources. This includes evaluation and treatment facilities as 34
defined in RCW 71.34.020, community mental health service delivery 35
systems, or community behavioral health programs, as defined in RCW 36
71.24.025, and facilities conducting competency evaluations and 37
restoration under chapter 10.77 RCW. 38
(32) "Minor" has the same meaning as in RCW 71.34.020.39
(33) "Parent" has the same meaning as in RCW 71.34.020.40
p. 275 HB 1281
(34) "Patient" means an individual who receives or has received 1
health care. The term includes a deceased individual who has received 2
health care. 3
(35) "Payment" means: 4
(a) The activities undertaken by: 5
(i) A third-party payor to obtain premiums or to determine or 6
fulfill its responsibility for coverage and provision of benefits by 7
the third-party payor; or 8
(ii) A health care provider, health care facility, or third-party 9
payor, to obtain or provide reimbursement for the provision of health 10
care; and 11
(b) The activities in (a) of this subsection that relate to the 12
patient to whom health care is provided and that include, but are not 13
limited to: 14
(i) Determinations of eligibility or coverage, including 15
coordination of benefits or the determination of cost-sharing 16
amounts, and adjudication or subrogation of health benefit claims;17
(ii) Risk adjusting amounts due based on enrollee health status 18
and demographic characteristics; 19
(iii) Billing, claims management, collection activities, 20
obtaining payment under a contract for reinsurance, including stop-21
loss insurance and excess of loss insurance, and related health care 22
data processing; 23
(iv) Review of health care services with respect to medical 24
necessity, coverage under a health plan, appropriateness of care, or 25
justification of charges; 26
(v) Utilization review activities, including precertification and 27
preauthorization of services, and concurrent and retrospective review 28
of services; and 29
(vi) Disclosure to consumer reporting agencies of any of the 30
following health care information relating to collection of premiums 31
or reimbursement: 32
(A) Name and address; 33
(B) Date of birth; 34
(C) Social security number; 35
(D) Payment history; 36
(E) Account number; and 37
(F) Name and address of the health care provider, health care 38
facility, and/or third-party payor. 39
p. 276 HB 1281
(36) "Person" means an individual, corporation, business trust, 1
estate, trust, partnership, association, joint venture, government, 2
governmental subdivision or agency, or any other legal or commercial 3
entity. 4
(37) "Professional person" has the same meaning as in RCW 5
71.05.020. 6
(38) "Psychiatric advanced ((registered nurse practitioner )) 7
practice registered nurse" has the same meaning as in RCW 71.05.020.8
(39) "Psychotherapy notes" means notes recorded, in any medium, 9
by a mental health professional documenting or analyzing the contents 10
of conversations during a private counseling session or group, joint, 11
or family counseling session, and that are separated from the rest of 12
the individual's medical record. The term excludes mediation 13
prescription and monitoring, counseling session start and stop times, 14
the modalities and frequencies of treatment furnished, results of 15
clinical tests, and any summary of the following items: Diagnosis, 16
functional status, the treatment plan, symptoms, prognosis, and 17
progress to date. 18
(40) "Reasonable fee" means the charges for duplicating or 19
searching the record, but shall not exceed 65 cents per page for the 20
first 30 pages and 50 cents per page for all other pages. In 21
addition, a clerical fee for searching and handling may be charged 22
not to exceed $15. These amounts shall be adjusted biennially in 23
accordance with changes in the consumer price index, all consumers, 24
for Seattle-Tacoma metropolitan statistical area as determined by the 25
secretary of health. However, where editing of records by a health 26
care provider is required by statute and is done by the provider 27
personally, the fee may be the usual and customary charge for a basic 28
office visit. 29
(41) "Release" has the same meaning as in RCW 71.05.020.30
(42) "Resource management services" has the same meaning as in 31
RCW 71.05.020. 32
(43) "Serious violent offense" has the same meaning as in RCW 33
9.94A.030. 34
(44) "Sexually transmitted infection" or "sexually transmitted 35
disease" has the same meaning as "sexually transmitted disease" in 36
RCW 70.24.017. 37
(45) "Test for a sexually transmitted disease" has the same 38
meaning as in RCW 70.24.017. 39
p. 277 HB 1281
(46) "Third-party payor" means an insurer regulated under Title 1
48 RCW authorized to transact business in this state or other 2
jurisdiction, including a health care service contractor, and health 3
maintenance organization; or an employee welfare benefit plan, 4
excluding fitness or wellness plans; or a state or federal health 5
benefit program. 6
(47) "Treatment" means the provision, coordination, or management 7
of health care and related services by one or more health care 8
providers or health care facilities, including the coordination or 9
management of health care by a health care provider or health care 10
facility with a third party; consultation between health care 11
providers or health care facilities relating to a patient; or the 12
referral of a patient for health care from one health care provider 13
or health care facility to another. 14
(48) "Tribal public health authority" means a tribe that is 15
responsible for public health matters as a part of its official 16
mandate. 17
(49) "Tribal public health officer" means the individual 18
appointed as the health officer for the tribe. 19
(50) "Tribe" has the same meaning as in RCW 71.24.025.20
Sec. 5129. RCW 70.02.230 and 2024 c 209 s 32 are each amended to 21
read as follows: 22
(1) The fact of admission to a provider for mental health 23
services and all information and records compiled, obtained, or 24
maintained in the course of providing mental health services to 25
either voluntary or involuntary recipients of services at public or 26
private agencies may not be disclosed except as provided in this 27
section, RCW 70.02.050, 71.05.445, 74.09.295, 70.02.210, 70.02.240, 28
70.02.250, 70.02.260, and 70.02.265, or pursuant to a valid 29
authorization under RCW 70.02.030. 30
(2) Information and records related to mental health services, 31
other than those obtained through treatment under chapter 71.34 RCW, 32
may be disclosed: 33
(a) In communications between qualified professional persons to 34
meet the requirements of chapter 71.05 RCW, including Indian health 35
care providers, in the provision of services or appropriate 36
referrals, or in the course of guardianship proceedings if provided 37
to a professional person: 38
(i) Employed by the facility; 39
p. 278 HB 1281
(ii) Who has medical responsibility for the patient's care;1
(iii) Who is a designated crisis responder; 2
(iv) Who is providing services under chapter 71.24 RCW;3
(v) Who is employed by a state or local correctional facility 4
where the person is confined or supervised; or 5
(vi) Who is providing evaluation, treatment, or follow-up 6
services under chapter 10.77 RCW; 7
(b) When the communications regard the special needs of a patient 8
and the necessary circumstances giving rise to such needs and the 9
disclosure is made by a facility providing services to the operator 10
of a facility in which the patient resides or will reside;11
(c)(i) When the person receiving services, or his or her 12
guardian, designates persons to whom information or records may be 13
released, or if the person is a minor, when his or her parents make 14
such a designation; 15
(ii) A public or private agency shall release to a person's next 16
of kin, attorney, personal representative, guardian, or conservator, 17
if any: 18
(A) The information that the person is presently a patient in the 19
facility or that the person is seriously physically ill;20
(B) A statement evaluating the mental and physical condition of 21
the patient, and a statement of the probable duration of the 22
patient's confinement, if such information is requested by the next 23
of kin, attorney, personal representative, guardian, or conservator; 24
and 25
(iii) Other information requested by the next of kin or attorney 26
as may be necessary to decide whether or not proceedings should be 27
instituted to appoint a guardian or conservator; 28
(d)(i) To the courts, including tribal courts, as necessary to 29
the administration of chapter 71.05 RCW, or equivalent proceedings in 30
tribal courts, or to a court ordering an evaluation or treatment 31
under chapter 10.77 RCW solely for the purpose of preventing the 32
entry of any evaluation or treatment order that is inconsistent with 33
any order entered under chapter 71.05 RCW. 34
(ii) To a court or its designee in which a motion under chapter 35
10.77 RCW has been made for involuntary medication of a defendant for 36
the purpose of competency restoration. 37
(iii) Disclosure under this subsection is mandatory for the 38
purpose of the federal health insurance portability and 39
accountability act; 40
p. 279 HB 1281
(e)(i) When a mental health professional or designated crisis 1
responder is requested by a representative of a law enforcement or 2
corrections agency, including a police officer, sheriff, community 3
corrections officer, a municipal attorney, or prosecuting attorney to 4
undertake an investigation or provide treatment under RCW 71.05.150, 5
10.31.110, or 71.05.153, the mental health professional or designated 6
crisis responder shall, if requested to do so, advise the 7
representative in writing of the results of the investigation 8
including a statement of reasons for the decision to detain or 9
release the person investigated. The written report must be submitted 10
within 72 hours of the completion of the investigation or the request 11
from the law enforcement or corrections representative, whichever 12
occurs later. 13
(ii) Disclosure under this subsection is mandatory for the 14
purposes of the federal health insurance portability and 15
accountability act; 16
(f) To the attorney of the detained person; 17
(g) To the prosecuting attorney, including tribal prosecuting 18
attorney, as necessary to carry out the responsibilities of the 19
office under RCW 71.05.330(2), 71.05.340(1)(b), and 71.05.335. The 20
prosecutor, including tribal prosecutor, must be provided access to 21
records regarding the committed person's treatment and prognosis, 22
medication, behavior problems, and other records relevant to the 23
issue of whether treatment less restrictive than inpatient treatment 24
is in the best interest of the committed person or others. 25
Information must be disclosed only after giving notice to the 26
committed person and the person's counsel; 27
(h)(i) To appropriate law enforcement agencies, including tribal 28
law enforcement agencies, and to a person, when the identity of the 29
person is known to the public or private agency, whose health and 30
safety has been threatened, or who is known to have been repeatedly 31
harassed, by the patient. The person may designate a representative 32
to receive the disclosure. The disclosure must be made by the 33
professional person in charge of the public or private agency or his 34
or her designee and must include the dates of commitment, admission, 35
discharge, or release, authorized or unauthorized absence from the 36
agency's facility, and only any other information that is pertinent 37
to the threat or harassment. The agency or its employees are not 38
civilly liable for the decision to disclose or not, so long as the 39
decision was reached in good faith and without gross negligence. 40
p. 280 HB 1281
Nothing in this section shall be interpreted as a waiver of sovereign 1
immunity by a tribe. 2
(ii) Disclosure under this subsection is mandatory for the 3
purposes of the federal health insurance portability and 4
accountability act; 5
(i)(i) To appropriate corrections and law enforcement agencies, 6
including tribal corrections and law enforcement agencies, all 7
necessary and relevant information in the event of a crisis or 8
emergent situation that poses a significant and imminent risk to the 9
public. The mental health service agency or its employees are not 10
civilly liable for the decision to disclose or not so long as the 11
decision was reached in good faith and without gross negligence.12
(ii) Disclosure under this subsection is mandatory for the 13
purposes of the health insurance portability and accountability act;14
(j) To the persons designated in RCW 71.05.425 for the purposes 15
described in those sections; 16
(k) By a care coordinator, including an Indian health care 17
provider, under RCW 71.05.585 or 10.77.175 assigned to a person 18
ordered to receive less restrictive alternative treatment for the 19
purpose of sharing information to parties necessary for the 20
implementation of proceedings under chapter 71.05 or 10.77 RCW;21
(l) Upon the death of a person. The person's next of kin, 22
personal representative, guardian, or conservator, if any, must be 23
notified. Next of kin who are of legal age and competent must be 24
notified under this section in the following order: Spouse, parents, 25
children, brothers and sisters, and other relatives according to the 26
degree of relation. Access to all records and information compiled, 27
obtained, or maintained in the course of providing services to a 28
deceased patient are governed by RCW 70.02.140; 29
(m) To mark headstones or otherwise memorialize patients interred 30
at state hospital cemeteries. The department of social and health 31
services shall make available the name, date of birth, and date of 32
death of patients buried in state hospital cemeteries fifty years 33
after the death of a patient; 34
(n) To law enforcement officers and to prosecuting attorneys as 35
are necessary to enforce RCW 9.41.040(2)(a)(iii). The extent of 36
information that may be released is limited as follows:37
(i) Only the fact, place, and date of involuntary commitment, an 38
official copy of any order or orders of commitment, and an official 39
copy of any written or oral notice of ineligibility to possess a 40
p. 281 HB 1281
firearm that was provided to the person pursuant to RCW 9.41.047(1), 1
must be disclosed upon request; 2
(ii) The law enforcement and prosecuting attorneys may only 3
release the information obtained to the person's attorney as required 4
by court rule and to a jury or judge, if a jury is waived, that 5
presides over any trial at which the person is charged with violating 6
RCW 9.41.040(2)(a)(iii); 7
(iii) Tribal law enforcement officers and tribal prosecuting 8
attorneys who enforce tribal laws or tribal court orders similar to 9
RCW 9.41.040(2)(a)(v) may also receive confidential information in 10
accordance with this subsection; 11
(iv) Disclosure under this subsection is mandatory for the 12
purposes of the federal health insurance portability and 13
accountability act; 14
(o) When a patient would otherwise be subject to the provisions 15
of this section and disclosure is necessary for the protection of the 16
patient or others due to his or her unauthorized disappearance from 17
the facility, and his or her whereabouts is unknown, notice of the 18
disappearance, along with relevant information, may be made to 19
relatives, the department of corrections when the person is under the 20
supervision of the department, and governmental law enforcement 21
agencies designated by the physician or psychiatric advanced 22
((registered nurse practitioner)) practice registered nurse in charge 23
of the patient or the professional person in charge of the facility, 24
or his or her professional designee; 25
(p) Pursuant to lawful order of a court, including a tribal 26
court; 27
(q) To qualified staff members of the department, to the 28
authority, to behavioral health administrative services 29
organizations, to managed care organizations, to resource management 30
services responsible for serving a patient, or to service providers 31
designated by resource management services as necessary to determine 32
the progress and adequacy of treatment and to determine whether the 33
person should be transferred to a less restrictive or more 34
appropriate treatment modality or facility; 35
(r) Within the mental health service agency or Indian health care 36
provider facility where the patient is receiving treatment, 37
confidential information may be disclosed to persons employed, 38
serving in bona fide training programs, or participating in 39
p. 282 HB 1281
supervised volunteer programs, at the facility when it is necessary 1
to perform their duties; 2
(s) Within the department and the authority as necessary to 3
coordinate treatment for mental illness, developmental disabilities, 4
or substance use disorder of persons who are under the supervision of 5
the department; 6
(t) Between the department of social and health services, the 7
department of children, youth, and families, and the health care 8
authority as necessary to coordinate treatment for mental illness, 9
developmental disabilities, or substance use disorder of persons who 10
are under the supervision of the department of social and health 11
services or the department of children, youth, and families;12
(u) To a licensed physician or psychiatric advanced ((registered 13
nurse practitioner )) practice registered nurse who has determined 14
that the life or health of the person is in danger and that treatment 15
without the information and records related to mental health services 16
could be injurious to the patient's health. Disclosure must be 17
limited to the portions of the records necessary to meet the medical 18
emergency; 19
(v)(i) Consistent with the requirements of the federal health 20
insurance portability and accountability act, to: 21
(A) A health care provider, including an Indian health care 22
provider, who is providing care to a patient, or to whom a patient 23
has been referred for evaluation or treatment; or 24
(B) Any other person who is working in a care coordinator role 25
for a health care facility, health care provider, or Indian health 26
care provider, or is under an agreement pursuant to the federal 27
health insurance portability and accountability act with a health 28
care facility or a health care provider and requires the information 29
and records to assure coordinated care and treatment of that patient.30
(ii) A person authorized to use or disclose information and 31
records related to mental health services under this subsection 32
(2)(v) must take appropriate steps to protect the information and 33
records relating to mental health services. 34
(iii) Psychotherapy notes may not be released without 35
authorization of the patient who is the subject of the request for 36
release of information; 37
(w) To administrative and office support staff designated to 38
obtain medical records for those licensed professionals listed in (v) 39
of this subsection; 40
p. 283 HB 1281
(x) To a facility that is to receive a person who is 1
involuntarily committed under chapter 71.05 RCW, or upon transfer of 2
the person from one evaluation and treatment facility to another. The 3
release of records under this subsection is limited to the 4
information and records related to mental health services required by 5
law, a record or summary of all somatic treatments, and a discharge 6
summary. The discharge summary may include a statement of the 7
patient's problem, the treatment goals, the type of treatment which 8
has been provided, and recommendation for future treatment, but may 9
not include the patient's complete treatment record;10
(y) To the person's counsel or guardian ad litem, without 11
modification, at any time in order to prepare for involuntary 12
commitment or recommitment proceedings, reexaminations, appeals, or 13
other actions relating to detention, admission, commitment, or 14
patient's rights under chapter 71.05 RCW; 15
(z) To staff members of the protection and advocacy agency or to 16
staff members of a private, nonprofit corporation for the purpose of 17
protecting and advocating the rights of persons with mental disorders 18
or developmental disabilities. Resource management services may limit 19
the release of information to the name, birthdate, and county of 20
residence of the patient, information regarding whether the patient 21
was voluntarily admitted, or involuntarily committed, the date and 22
place of admission, placement, or commitment, the name and address of 23
a guardian of the patient, and the date and place of the guardian's 24
appointment. Any staff member who wishes to obtain additional 25
information must notify the patient's resource management services in 26
writing of the request and of the resource management services' right 27
to object. The staff member shall send the notice by mail to the 28
guardian's address. If the guardian does not object in writing within 29
fifteen days after the notice is mailed, the staff member may obtain 30
the additional information. If the guardian objects in writing within 31
fifteen days after the notice is mailed, the staff member may not 32
obtain the additional information; 33
(aa) To all current treating providers, including Indian health 34
care providers, of the patient with prescriptive authority who have 35
written a prescription for the patient within the last twelve months. 36
For purposes of coordinating health care, the department or the 37
authority may release without written authorization of the patient, 38
information acquired for billing and collection purposes as described 39
in RCW 70.02.050(1)(d). The department, or the authority, if 40
p. 284 HB 1281
applicable, shall notify the patient that billing and collection 1
information has been released to named providers, and provide the 2
substance of the information released and the dates of such release. 3
Neither the department nor the authority may release counseling, 4
inpatient psychiatric hospitalization, or drug and alcohol treatment 5
information without a signed written release from the client;6
(bb)(i) To the secretary of social and health services and the 7
director of the health care authority for either program evaluation 8
or research, or both so long as the secretary or director, where 9
applicable, adopts rules for the conduct of the evaluation or 10
research, or both. Such rules must include, but need not be limited 11
to, the requirement that all evaluators and researchers sign an oath 12
of confidentiality substantially as follows: 13
"As a condition of conducting evaluation or research concerning 14
persons who have received services from (fill in the facility, 15
agency, or person) I, . . . . . ., agree not to divulge, publish, or 16
otherwise make known to unauthorized persons or the public any 17
information obtained in the course of such evaluation or research 18
regarding persons who have received services such that the person who 19
received such services is identifiable. 20
I recognize that unauthorized release of confidential information 21
may subject me to civil liability under the provisions of state law.22
/s/ . . . . . ."23
(ii) Nothing in this chapter may be construed to prohibit the 24
compilation and publication of statistical data for use by government 25
or researchers under standards, including standards to assure 26
maintenance of confidentiality, set forth by the secretary, or 27
director, where applicable; 28
(cc) To any person if the conditions in RCW 70.02.205 are met;29
(dd) To the secretary of health for the purposes of the maternal 30
mortality review panel established in RCW 70.54.450; or31
(ee) To a tribe or Indian health care provider to carry out the 32
requirements of RCW 71.05.150(5). 33
(3) Whenever federal law or federal regulations restrict the 34
release of information contained in the information and records 35
related to mental health services of any patient who receives 36
treatment for a substance use disorder, the department or the 37
authority may restrict the release of the information as necessary to 38
comply with federal law and regulations. 39
p. 285 HB 1281
(4) Civil liability and immunity for the release of information 1
about a particular person who is committed to the department of 2
social and health services or the authority under RCW 71.05.280(3) 3
and 71.05.320(4)(c) after dismissal of a sex offense as defined in 4
RCW 9.94A.030, is governed by RCW 4.24.550. 5
(5) The fact of admission to a provider of mental health 6
services, as well as all records, files, evidence, findings, or 7
orders made, prepared, collected, or maintained pursuant to chapter 8
71.05 RCW are not admissible as evidence in any legal proceeding 9
outside that chapter without the written authorization of the person 10
who was the subject of the proceeding except as provided in RCW 11
70.02.260, in a subsequent criminal prosecution of a person committed 12
pursuant to RCW 71.05.280(3) or 71.05.320(4)(c) on charges that were 13
dismissed pursuant to chapter 10.77 RCW due to incompetency to stand 14
trial, in a civil commitment proceeding pursuant to chapter 71.09 15
RCW, or, in the case of a minor, a guardianship or dependency 16
proceeding. The records and files maintained in any court proceeding 17
pursuant to chapter 71.05 RCW must be confidential and available 18
subsequent to such proceedings in accordance with RCW 71.05.620. In 19
addition, the court may order the subsequent release or use of such 20
records or files only upon good cause shown if the court finds that 21
appropriate safeguards for strict confidentiality are and will be 22
maintained. 23
(6)(a) Except as provided in RCW 4.24.550, any person may bring 24
an action against an individual who has willfully released 25
confidential information or records concerning him or her in 26
violation of the provisions of this section, for the greater of the 27
following amounts: 28
(i) One thousand dollars; or 29
(ii) Three times the amount of actual damages sustained, if any.30
(b) It is not a prerequisite to recovery under this subsection 31
that the plaintiff suffered or was threatened with special, as 32
contrasted with general, damages. 33
(c) Any person may bring an action to enjoin the release of 34
confidential information or records concerning him or her or his or 35
her ward, in violation of the provisions of this section, and may in 36
the same action seek damages as provided in this subsection.37
(d) The court may award to the plaintiff, should he or she 38
prevail in any action authorized by this subsection, reasonable 39
attorney fees in addition to those otherwise provided by law.40
p. 286 HB 1281
(e) If an action is brought under this subsection, no action may 1
be brought under RCW 70.02.170. 2
Sec. 5130. RCW 70.24.115 and 2024 c 248 s 4 are each amended to 3
read as follows: 4
(1) Notwithstanding any other law, a health care provider who 5
diagnoses a case of sexually transmitted chlamydia, gonorrhea, 6
trichomoniasis, or other sexually transmitted infection, as 7
determined by the department or recommended in the most recent 8
federal centers for disease control and prevention guidelines for the 9
prevention or treatment of sexually transmitted diseases, in an 10
individual patient may prescribe, dispense, furnish, or otherwise 11
provide prescription antibiotic drugs to the individual patient's 12
sexual partner or partners without examination of that patient's 13
partner or partners or having an established provider and patient 14
relationship with the partner or partners. This practice shall be 15
known as expedited partner therapy. 16
(2) A health care provider may provide expedited partner therapy 17
as outlined in subsection (1) of this section if all the following 18
requirements are met: 19
(a) The patient has a confirmed laboratory test result, or direct 20
observation of clinical signs or assessment of clinical data by a 21
health care provider confirming the person has, or is likely to have, 22
a sexually transmitted infection; 23
(b) The patient indicates that the individual has a partner or 24
partners with whom the patient has engaged in sexual activity within 25
the 60-day period immediately before the diagnosis of a sexually 26
transmitted infection; and 27
(c) The patient indicates that the partner or partners of the 28
individual are unable or unlikely to seek clinical services in a 29
timely manner. 30
(3) A prescribing health care provider may prescribe, dispense, 31
furnish, or otherwise provide medication to the diagnosed patient as 32
outlined in subsection (1) of this section for the patient to deliver 33
to the exposed sexual partner or partners of the patient in order to 34
prevent reinfection in the diagnosed patient. 35
(4) If a health care provider does not have the name of a 36
patient's sexual partner for a drug prescribed under subsection (1) 37
of this section, the prescription shall include the words "expedited 38
partner therapy" or "EPT." 39
p. 287 HB 1281
(5) A health care provider shall not be liable in a medical 1
malpractice action or professional disciplinary action if the health 2
care provider's use of expedited partner therapy is in compliance 3
with this section, except in cases of intentional misconduct, gross 4
negligence, or wanton or reckless activity. 5
(6) The department may adopt rules necessary to implement this 6
section. 7
(7) For the purpose of this section, "health care provider" means 8
a physician under chapter 18.71 RCW, an osteopathic physician or an 9
osteopathic physician and surgeon under chapter 18.57 RCW, or a 10
registered nurse, advanced ((registered nurse practitioner )) practice 11
registered nurse , or licensed practical nurse under chapter 18.79 12
RCW. 13
Sec. 5131. RCW 70.30.061 and 1999 c 172 s 5 are each amended to 14
read as follows: 15
Any person residing in the state and needing treatment for 16
tuberculosis may apply in person to the local health officer or to 17
any licensed physician, advanced ((registered nurse practitioner )) 18
practice registered nurse , or licensed physician assistant for 19
examination and if that health care provider has reasonable cause to 20
believe that the person is suffering from tuberculosis in any form he 21
or she may apply to the local health officer or designee for 22
admission of the person to an appropriate facility for the care and 23
treatment of tuberculosis. 24
Sec. 5132. RCW 70.41.230 and 2019 c 104 s 1, 2019 c 55 s 15, and 25
2019 c 49 s 1 are each reenacted and amended to read as follows:26
(1) Except as provided in subsection (3) of this section, prior 27
to granting or renewing clinical privileges or association of any 28
physician, physician assistant, or advanced ((registered nurse 29
practitioner)) practice registered nurse or hiring a physician, 30
physician assistant, or advanced ((registered nurse practitioner )) 31
practice registered nurse who will provide clinical care under his or 32
her license, a hospital or facility approved pursuant to this chapter 33
shall request from the physician, physician assistant, or advanced 34
((registered nurse practitioner )) practice registered nurse and the 35
physician, physician assistant, or advanced ((registered nurse 36
practitioner)) practice registered nurse shall provide the following 37
information: 38
p. 288 HB 1281
(a) The name of any hospital or facility with or at which the 1
physician, physician assistant, or advanced ((registered nurse 2
practitioner)) practice registered nurse had or has any association, 3
employment, privileges, or practice during the prior five years: 4
PROVIDED, That the hospital may request additional information going 5
back further than five years, and the physician, physician assistant, 6
or advanced ((registered nurse practitioner )) practice registered 7
nurse shall use his or her best efforts to comply with such a request 8
for additional information; 9
(b) Whether the physician, physician assistant, or advanced 10
((registered nurse practitioner )) practice registered nurse has ever 11
been or is in the process of being denied, revoked, terminated, 12
suspended, restricted, reduced, limited, sanctioned, placed on 13
probation, monitored, or not renewed for any professional activity 14
listed in (b)(i) through (x) of this subsection, or has ever 15
voluntarily or involuntarily relinquished, withdrawn, or failed to 16
proceed with an application for any professional activity listed in 17
(b)(i) through (x) of this subsection in order to avoid an adverse 18
action or to preclude an investigation or while under investigation 19
relating to professional competence or conduct: 20
(i) License to practice any profession in any jurisdiction;21
(ii) Other professional registration or certification in any 22
jurisdiction; 23
(iii) Specialty or subspecialty board certification;24
(iv) Membership on any hospital medical staff;25
(v) Clinical privileges at any facility, including hospitals, 26
ambulatory surgical centers, or skilled nursing facilities;27
(vi) Medicare, medicaid, the food and drug administration, the 28
national institute (([s]))s of health (office of human research 29
protection), governmental, national, or international regulatory 30
agency, or any public program; 31
(vii) Professional society membership or fellowship;32
(viii) Participation or membership in a health maintenance 33
organization, preferred provider organization, independent practice 34
association, physician-hospital organization, or other entity;35
(ix) Academic appointment; 36
(x) Authority to prescribe controlled substances (drug 37
enforcement agency or other authority); 38
(c) Any pending professional medical misconduct proceedings or 39
any pending medical malpractice actions in this state or another 40
p. 289 HB 1281
state, the substance of the allegations in the proceedings or 1
actions, and any additional information concerning the proceedings or 2
actions as the physician, physician assistant, or advanced 3
((registered nurse practitioner )) practice registered nurse deems 4
appropriate; 5
(d) The substance of the findings in the actions or proceedings 6
and any additional information concerning the actions or proceedings 7
as the physician, physician assistant, or advanced ((registered nurse 8
practitioner)) practice registered nurse deems appropriate;9
(e) A waiver by the physician, physician assistant, or advanced 10
((registered nurse practitioner )) practice registered nurse of any 11
confidentiality provisions concerning the information required to be 12
provided to hospitals pursuant to this subsection; and13
(f) A verification by the physician, physician assistant, or 14
advanced ((registered nurse practitioner )) practice registered nurse 15
that the information provided by the physician, physician assistant, 16
or advanced ((registered nurse practitioner )) practice registered 17
nurse is accurate and complete. 18
(2) Except as provided in subsection (3) of this section, prior 19
to granting privileges or association to any physician, physician 20
assistant, or advanced ((registered nurse practitioner )) practice 21
registered nurse or hiring a physician, physician assistant, or 22
advanced ((registered nurse practitioner )) practice registered nurse 23
who will provide clinical care under his or her license, a hospital 24
or facility approved pursuant to this chapter shall request from any 25
hospital with or at which the physician, physician assistant, or 26
advanced ((registered nurse practitioner )) practice registered nurse 27
had or has privileges, was associated, or was employed, during the 28
preceding five years, the following information concerning the 29
physician, physician assistant, or advanced ((registered nurse 30
practitioner)) practice registered nurse: 31
(a) Any pending professional medical misconduct proceedings or 32
any pending medical malpractice actions, in this state or another 33
state; 34
(b) Any judgment or settlement of a medical malpractice action 35
and any finding of professional misconduct in this state or another 36
state by a licensing or disciplinary board; and 37
(c) Any information required to be reported by hospitals pursuant 38
to RCW 18.71.0195. 39
p. 290 HB 1281
(3) In lieu of the requirements of subsections (1) and (2) of 1
this section, when granting or renewing credentials and privileges or 2
association of any physician, physician assistant, or advanced 3
((registered nurse practitioner )) practice registered nurse providing 4
telemedicine or store and forward services, an originating site 5
hospital may rely on a distant site hospital's decision to grant or 6
renew credentials and clinical privileges or association of the 7
physician, physician assistant, or advanced ((registered nurse 8
practitioner)) practice registered nurse if the originating site 9
hospital obtains reasonable assurances, through a written agreement 10
with the distant site hospital, that all of the following provisions 11
are met: 12
(a) The distant site hospital providing the telemedicine or store 13
and forward services is a medicare participating hospital;14
(b) Any physician, physician assistant, or advanced ((registered 15
nurse practitioner)) practice registered nurse providing telemedicine 16
or store and forward services at the distant site hospital will be 17
fully credentialed and privileged to provide such services by the 18
distant site hospital; 19
(c) Any physician, physician assistant, or advanced ((registered 20
nurse practitioner)) practice registered nurse providing telemedicine 21
or store and forward services will hold and maintain a valid license 22
to perform such services issued or recognized by the state of 23
Washington; and 24
(d) With respect to any distant site physician, physician 25
assistant, or advanced ((registered nurse practitioner )) practice 26
registered nurse who holds current credentials and privileges at the 27
originating site hospital whose patients are receiving the 28
telemedicine or store and forward services, the originating site 29
hospital has evidence of an internal review of the distant site 30
physician's, physician assistant's, or advanced ((registered nurse 31
practitioner's)) practice registered nurse's performance of these 32
credentials and privileges and sends the distant site hospital such 33
performance information for use in the periodic appraisal of the 34
distant site physician, physician assistant, or advanced ((registered 35
nurse practitioner )) practice registered nurse . At a minimum, this 36
information must include all adverse events, as defined in RCW 37
70.56.010, that result from the telemedicine or store and forward 38
services provided by the distant site physician, physician assistant, 39
or advanced ((registered nurse practitioner )) practice registered 40
p. 291 HB 1281
nurse to the originating site hospital's patients and all complaints 1
the originating site hospital has received about the distant site 2
physician, physician assistant, or advanced ((registered nurse 3
practitioner)) practice registered nurse. 4
(4)(a) The Washington medical commission or the board of 5
osteopathic medicine and surgery shall be advised within thirty days 6
of the name of any physician or physician assistant denied staff 7
privileges, association, or employment on the basis of adverse 8
findings under subsection (1) of this section. 9
(b) The ((nursing care quality assurance commission )) state board 10
of nursing shall be advised within thirty days of the name of any 11
advanced ((registered nurse practitioner )) practice registered nurse 12
denied staff privileges, association, or employment on the basis of 13
adverse findings under subsection (1) of this section.14
(5) A hospital or facility that receives a request for 15
information from another hospital or facility pursuant to subsections 16
(1) through (3) of this section shall provide such information 17
concerning the physician, physician assistant, or advanced 18
((registered nurse practitioner )) practice registered nurse in 19
question to the extent such information is known to the hospital or 20
facility receiving such a request, including the reasons for 21
suspension, termination, or curtailment of employment or privileges 22
at the hospital or facility. A hospital, facility, or other person 23
providing such information in good faith is not liable in any civil 24
action for the release of such information. 25
(6) Information and documents, including complaints and incident 26
reports, created specifically for, and collected, and maintained by a 27
quality improvement committee are not subject to discovery or 28
introduction into evidence in any civil action, and no person who was 29
in attendance at a meeting of such committee or who participated in 30
the creation, collection, or maintenance of information or documents 31
specifically for the committee shall be permitted or required to 32
testify in any civil action as to the content of such proceedings or 33
the documents and information prepared specifically for the 34
committee. This subsection does not preclude: (a) In any civil 35
action, the discovery of the identity of persons involved in the 36
medical care that is the basis of the civil action whose involvement 37
was independent of any quality improvement activity; (b) in any civil 38
action, the testimony of any person concerning the facts which form 39
the basis for the institution of such proceedings of which the person 40
p. 292 HB 1281
had personal knowledge acquired independently of such proceedings; 1
(c) in any civil action by a health care provider regarding the 2
restriction or revocation of that individual's clinical or staff 3
privileges, introduction into evidence information collected and 4
maintained by quality improvement committees regarding such health 5
care provider; (d) in any civil action, disclosure of the fact that 6
staff privileges were terminated or restricted, including the 7
specific restrictions imposed, if any and the reasons for the 8
restrictions; or (e) in any civil action, discovery and introduction 9
into evidence of the patient's medical records required by regulation 10
of the department of health to be made regarding the care and 11
treatment received. 12
(7) Hospitals shall be granted access to information held by the 13
Washington medical commission, the board of osteopathic medicine and 14
surgery, and the ((nursing care quality assurance commission )) state 15
board of nursing pertinent to decisions of the hospital regarding 16
credentialing and recredentialing of practitioners.17
(8) Violation of this section shall not be considered negligence 18
per se. 19
Sec. 5133. RCW 70.41.410 and 2023 c 114 s 2 are each amended to 20
read as follows: 21
The definitions in this section apply throughout this 22
section((,)) and RCW 70.41.420((,)) and 70.41.425 unless the context 23
clearly requires otherwise. 24
(1) "Hospital" has the same meaning as defined in RCW 70.41.020, 25
and also includes state hospitals as defined in RCW 72.23.010.26
(2) "Hospital staffing committee" means the committee established 27
by a hospital under RCW 70.41.420. 28
(3) "Intensity" means the level of patient need for nursing care, 29
as determined by the nursing assessment. 30
(4) "Nursing assistant-certified" means an individual certified 31
under chapter 18.88A RCW who provides direct care to patients.32
(5) "Nursing staff" means registered nurses, licensed practical 33
nurses, nursing assistants-certified, and unlicensed assistive 34
nursing personnel providing direct patient care. 35
(6) "Patient care staff" means a person who is providing direct 36
care or supportive services to patients but who is not:37
(a) Nursing staff as defined in this section; 38
(b) A physician licensed under chapter 18.71 or 18.57 RCW;39
p. 293 HB 1281
(c) A physician's assistant licensed under chapter 18.71A RCW; or1
(d) An advanced ((registered nurse practitioner )) practice 2
registered nurse licensed under RCW 18.79.250, unless working as a 3
direct care registered nurse. 4
(7) "Patient care unit" means any unit or area of the hospital 5
that provides patient care by registered nurses. 6
(8) "Reasonable efforts" means that the employer exhausts and 7
documents all of the following but is unable to obtain staffing 8
coverage: 9
(a) Seeks individuals to consent to work additional time from all 10
available qualified staff who are working; 11
(b) Contacts qualified employees who have made themselves 12
available to work additional time; 13
(c) Seeks the use of per diem staff; and 14
(d) When practical, seeks personnel from a contracted temporary 15
agency when such staffing is permitted by law or an applicable 16
collective bargaining agreement, and when the employer regularly uses 17
a contracted temporary agency. 18
(9) "Registered nurse" means an individual licensed as a nurse 19
under chapter 18.79 RCW who provides direct care to patients.20
(10) "Skill mix" means the experience of, and number and relative 21
percentages of, nursing and patient care staff. 22
(11) "Unforeseeable emergent circumstance" means:23
(a) Any unforeseen declared national, state, or municipal 24
emergency; 25
(b) When a hospital disaster plan is activated;26
(c) Any unforeseen disaster or other catastrophic event that 27
substantially affects or increases the need for health care services; 28
or 29
(d) When a hospital is diverting patients to another hospital or 30
hospitals for treatment. 31
Sec. 5134. RCW 70.47.210 and 2006 c 367 s 7 are each amended to 32
read as follows: 33
(1) Any schedule of benefits established or renewed by the 34
Washington basic health plan after December 31, 2006, shall provide 35
coverage for prostate cancer screening, provided that the screening 36
is delivered upon the recommendation of the patient's physician, 37
advanced ((registered nurse practitioner )) practice registered nurse , 38
or physician assistant. 39
p. 294 HB 1281
(2) This section shall not be construed to prevent the 1
application of standard policy provisions applicable to other 2
benefits, such as deductible or copayment provisions. This section 3
does not limit the authority of the health care authority to 4
negotiate rates and contract with specific providers for the delivery 5
of prostate cancer screening services. 6
Sec. 5135. RCW 70.48.135 and 2018 c 41 s 2 are each amended to 7
read as follows: 8
(1) Jails must make reasonable accommodations for the provision 9
of available midwifery or doula services to inmates who are pregnant 10
or who have given birth in the last six weeks. Persons providing 11
midwifery or doula services must be granted appropriate facility 12
access, must be allowed to attend and provide assistance during labor 13
and childbirth where feasible, and must have access to the inmate's 14
relevant health care information, as defined in RCW 70.02.010, if the 15
inmate authorizes disclosure. 16
(2) For purposes of this section, the following definitions 17
apply: 18
(a) "Doula services" are services provided by a trained doula and 19
designed to provide physical, emotional, or informational support to 20
a pregnant woman before, during, and after delivery of a child. Doula 21
services may include, but are not limited to: Support and assistance 22
during labor and childbirth; prenatal and postpartum education; 23
breastfeeding assistance; parenting education; and support in the 24
event that a woman has been or will become separated from her child.25
(b) "Midwifery services" means medical aid rendered by a midwife 26
to a woman during prenatal, intrapartum, or postpartum stages or to a 27
woman's newborn up to two weeks of age. 28
(c) "Midwife" means a midwife licensed under chapter 18.50 RCW or 29
an advanced ((registered nurse practitioner )) practice registered 30
nurse licensed under chapter 18.79 RCW. 31
(3) Nothing in this section requires governing units to establish 32
or provide funding for midwifery or doula services, or prevents the 33
adoption of policy guidelines for the delivery of midwifery or doula 34
services to inmates. Services provided under this section may not 35
supplant health care services routinely provided to the inmate.36
Sec. 5136. RCW 70.48.490 and 2009 c 411 s 4 are each amended to 37
read as follows: 38
p. 295 HB 1281
Jails may provide for the delivery and administration of 1
medications and medication assistance for inmates in their custody by 2
nonpractitioner jail personnel, subject to the following conditions:3
(1) The jail administrator or his or her designee, or chief law 4
enforcement executive or his or her designee, shall enter into an 5
agreement between the jail and a licensed pharmacist, pharmacy, or 6
other licensed practitioner or health care facility to ensure access 7
to pharmaceutical services on a twenty -four hour a day basis, 8
including consultation and dispensing services. 9
(2) The jail administrator or chief law enforcement executive 10
shall adopt policies which address the designation and training of 11
nonpractitioner jail personnel who may deliver and administer 12
medications or provide medication assistance to inmates as provided 13
in this chapter. The policies must address the administration of 14
prescriptions from licensed practitioners prescribing within the 15
scope of their prescriptive authority, the identification of 16
medication to be delivered and administered or administered through 17
medication assistance, the means of securing medication with 18
attention to the safeguarding of legend drugs, and the means of 19
maintaining a record of the delivery, administration, self-20
administration, or medication assistance of all medication. The jail 21
administrator or chief law enforcement executive shall designate a 22
physician licensed under chapter 18.71 RCW, or a registered nurse or 23
advanced ((registered nurse practitioner )) practice registered nurse 24
licensed under chapter 18.79 RCW, to train the designated 25
nonpractitioner jail personnel in proper medication procedures and 26
monitor their compliance with the procedures. 27
(3) The jail administrator or chief law enforcement executive 28
shall consult with one or more pharmacists, and one or more licensed 29
physicians or nurses, in the course of developing the policies 30
described in subsections (1) and (2) of this section. A jail shall 31
provide the Washington association of sheriffs and police chiefs with 32
a copy of the jail's current policies regarding medication 33
management. 34
(4) The practitioner or nonpractitioner jail personnel 35
delivering, administering, or providing medication assistance is in 36
receipt of (a) for prescription drugs, a written, current, and 37
unexpired prescription, and instructions for administration from a 38
licensed practitioner prescribing within the scope of his or her 39
prescriptive authority for administration of the prescription drug; 40
p. 296 HB 1281
(b) for nonprescription drugs, a written, current, and unexpired 1
instruction from a licensed practitioner regarding the administration 2
of the nonprescription drug; and (c) for minors under the age of 3
eighteen, a written, current consent from the minor's parent, legal 4
guardian, or custodian consenting to the administration of the 5
medication. 6
(5) Nonpractitioner jail personnel may help in the preparation of 7
legend drugs or controlled substances for self-administration where a 8
practitioner has determined and communicated orally or by written 9
direction that the medication preparation assistance is necessary and 10
appropriate. Medication assistance shall not include assistance with 11
intravenous medications or injectable medications.12
(6) Nonpractitioner jail personnel shall not include inmates.13
(7) All medication is delivered and administered and all 14
medication assistance is provided by a practitioner or 15
nonpractitioner jail personnel pursuant to the policies adopted in 16
this section, and in compliance with the prescription of a 17
practitioner prescribing within the scope of his or her prescriptive 18
authority, or the written instructions as provided in this section.19
(8) The jail administrator or the chief law enforcement executive 20
shall ensure that all nonpractitioner jail personnel authorized to 21
deliver, administer, and provide medication assistance are trained 22
pursuant to the policies adopted in this section prior to being 23
permitted to deliver, administer, or provide medication assistance to 24
an inmate. 25
Sec. 5137. RCW 70.54.400 and 2020 c 80 s 46 are each amended to 26
read as follows: 27
(1) For purposes of this section: 28
(a) "Customer" means an individual who is lawfully on the 29
premises of a retail establishment. 30
(b) "Eligible medical condition" means: 31
(i) Crohn's disease, ulcerative colitis, or any other 32
inflammatory bowel disease; 33
(ii) Irritable bowel syndrome; 34
(iii) Any condition requiring use of an ostomy device; or35
(iv) Any permanent or temporary medical condition that requires 36
immediate access to a restroom. 37
(c) "Employee restroom" means a restroom intended for employees 38
only in a retail facility and not intended for customers.39
p. 297 HB 1281
(d) "Health care provider" means an advanced ((registered nurse 1
practitioner)) practice registered nurse licensed under chapter 18.79 2
RCW, an osteopathic physician or surgeon licensed under chapter 18.57 3
RCW, a physician or surgeon licensed under chapter 18.71 RCW, or a 4
physician assistant licensed under chapter 18.71A RCW.5
(e) "Retail establishment" means a place of business open to the 6
general public for the sale of goods or services. Retail 7
establishment does not include any structure such as a filling 8
station, service station, or restaurant of eight hundred square feet 9
or less that has an employee restroom located within that structure.10
(2) A retail establishment that has an employee restroom must 11
allow a customer with an eligible medical condition to use that 12
employee restroom during normal business hours if:13
(a) The customer requesting the use of the employee restroom 14
provides in writing either: 15
(i) A signed statement by the customer's health care provider on 16
a form that has been prepared by the department of health under 17
subsection (4) of this section; or 18
(ii) An identification card that is issued by a nonprofit 19
organization whose purpose includes serving individuals who suffer 20
from an eligible medical condition; and 21
(b) One of the following conditions are met: 22
(i) The employee restroom is reasonably safe and is not located 23
in an area where providing access would create an obvious health or 24
safety risk to the customer; or 25
(ii) Allowing the customer to access the restroom facility does 26
not pose a security risk to the retail establishment or its 27
employees. 28
(3) A retail establishment that has an employee restroom must 29
allow a customer to use that employee restroom during normal business 30
hours if: 31
(a)(i) Three or more employees of the retail establishment are 32
working at the time the customer requests use of the employee 33
restroom; and 34
(ii) The retail establishment does not normally make a restroom 35
available to the public; and 36
(b)(i) The employee restroom is reasonably safe and is not 37
located in an area where providing access would create an obvious 38
health or safety risk to the customer; or 39
p. 298 HB 1281
(ii) Allowing the customer to access the employee restroom does 1
not pose a security risk to the retail establishment or its 2
employees. 3
(4) The department of health shall develop a standard electronic 4
form that may be signed by a health care provider as evidence of the 5
existence of an eligible medical condition as required by subsection 6
(2) of this section. The form shall include a brief description of a 7
customer's rights under this section and shall be made available for 8
a customer or his or her health care provider to access by computer. 9
Nothing in this section requires the department to distribute printed 10
versions of the form. 11
(5) Fraudulent use of a form as evidence of the existence of an 12
eligible medical condition is a misdemeanor punishable under RCW 13
9A.20.010. 14
(6) For a first violation of this section, the city or county 15
attorney shall issue a warning letter to the owner or operator of the 16
retail establishment, and to any employee of a retail establishment 17
who denies access to an employee restroom in violation of this 18
section, informing the owner or operator of the establishment and 19
employee of the requirements of this section. A retail establishment 20
or an employee of a retail establishment that violates this section 21
after receiving a warning letter is guilty of a class 2 civil 22
infraction under chapter 7.80 RCW. 23
(7) A retail establishment is not required to make any physical 24
changes to an employee restroom under this section and may require 25
that an employee accompany a customer or a customer with an eligible 26
medical condition to the employee restroom. 27
(8) A retail establishment or an employee of a retail 28
establishment is not civilly liable for any act or omission in 29
allowing a customer or a customer with an eligible medical condition 30
to use an employee restroom if the act or omission meets all of the 31
following: 32
(a) It is not willful or grossly negligent; 33
(b) It occurs in an area of the retail establishment that is not 34
accessible to the public; and 35
(c) It results in an injury to or death of the customer or the 36
customer with an eligible medical condition or any individual other 37
than an employee accompanying the customer or the customer with an 38
eligible medical condition. 39
p. 299 HB 1281
Sec. 5138. RCW 70.58A.010 and 2020 c 312 s 729 are each amended 1
to read as follows: 2
The definitions in this section apply throughout this chapter 3
unless the context clearly requires otherwise. 4
(1) "Adult" means a person who is at least eighteen years of age, 5
or an emancipated minor under chapter 13.64 RCW. 6
(2) "Amendment" means a change to a certification item on the 7
vital record. 8
(3) "Authorized representative" means a person permitted to 9
receive a certification who is: 10
(a) Identified in a notarized statement signed by a qualified 11
applicant; or 12
(b) An agent identified in a power of attorney as defined in 13
chapter 11.125 RCW. 14
(4) "Certification" means the document, in either paper or 15
electronic format, containing all or part of the information 16
contained in the original vital record from which the document is 17
derived, and is issued from the central vital records system. A 18
certification includes an attestation by the state or local registrar 19
to the accuracy of information, and has the full force and effect of 20
the original vital record. 21
(5) "Certification item" means any item of information that 22
appears on certifications. 23
(6) "Coroner" means the person elected or appointed in a county 24
under chapter 36.16 RCW to serve as the county coroner and fulfill 25
the responsibilities established under chapter 36.24 RCW.26
(7) "Cremated remains" has the same meaning as "cremated human 27
remains" in chapter 68.04 RCW. 28
(8) "Delayed report of live birth" means the report submitted to 29
the department for the purpose of registering the live birth of a 30
person born in state that was not registered within one year of the 31
date of live birth. 32
(9) "Department" means the department of health.33
(10) "Domestic partner" means a party to a state registered 34
domestic partnership established under chapter 26.60 RCW.35
(11) "Facility" means any licensed establishment, public or 36
private, located in state, which provides inpatient or outpatient 37
medical, surgical, or diagnostic care or treatment; or nursing, 38
custodial, or domiciliary care. The term also includes establishments 39
to which persons are committed by law including, but not limited to:40
p. 300 HB 1281
(a) Mental illness detention facilities designated to assess, 1
diagnose, and treat individuals detained or committed, under chapter 2
71.05 RCW; 3
(b) City and county jails; 4
(c) State department of corrections facilities; and5
(d) Juvenile correction centers governed by Title 72 RCW.6
(12) "Fetal death" means any product of conception that shows no 7
evidence of life, such as breathing, beating of the heart, pulsation 8
of the umbilical cord, or definite movement of voluntary muscles 9
after complete expulsion or extraction from the individual who gave 10
birth that is not an induced termination of pregnancy and:11
(a) Has completed twenty or more weeks of gestation as calculated 12
from the date the last menstrual period of the individual who gave 13
birth began, to the date of expulsion or extraction; or14
(b) Weighs three hundred fifty grams or more, if weeks of 15
gestation are not known. 16
(13) "Final disposition" means the burial, interment, entombment, 17
cremation, removal from the state, or other manner of disposing of 18
human remains as authorized under chapter 68.50 RCW.19
(14) "Funeral director" means a person licensed under chapter 20
18.39 RCW as a funeral director. 21
(15) "Funeral establishment" means a place of business licensed 22
under chapter 18.39 RCW as a funeral establishment.23
(16) "Government agencies" include state boards, commissions, 24
committees, departments, educational institutions, or other state 25
agencies which are created by or pursuant to statute, other than 26
courts and the legislature; county or city agencies, United States 27
federal agencies, and federally recognized tribes and tribal 28
organizations. 29
(17) "Human remains" means the body of a deceased person, 30
includes the body in any stage of decomposition, and includes 31
cremated human remains, but does not include human remains that are 32
or were at any time under the jurisdiction of the state physical 33
anthropologist under chapter 27.44 RCW. 34
(18) "Individual" means a natural person. 35
(19) "Induced termination of pregnancy" means the purposeful 36
interruption of an intrauterine pregnancy with an intention other 37
than to produce a live-born infant, and which does not result in a 38
live birth. 39
p. 301 HB 1281
(20) "Informational copy" means a birth or death record issued 1
from the central vital records system, containing all or part of the 2
information contained in the original vital record from which the 3
document is derived, and indicating it cannot be used for legal 4
purposes on its face. 5
(21) "Legal guardian" means a person who serves as a guardian for 6
the purpose of either legal or custodial matters, or both, relating 7
to the person for whom the guardian is appointed. The term legal 8
guardian includes, but is not limited to, guardians appointed 9
pursuant to chapters 11.130 and 13.36 RCW. 10
(22) "Legal representative" means a licensed attorney 11
representing either the subject of the record or qualified applicant.12
(23) "Live birth" means the complete expulsion or extraction of a 13
product of human conception from the individual who gave birth, 14
irrespective of the duration of pregnancy, which, after such 15
expulsion or extraction, breathes or shows any other evidence of 16
life, such as beating of the heart, pulsation of the umbilical cord, 17
or definite movement of voluntary muscles. 18
(24) "Local health officer" has the same meaning as in chapter 19
70.05 RCW. 20
(25) "Medical certifier" for a death or fetal death means an 21
individual required to attest to the cause of death information 22
provided on a report of death or fetal death. Each individual 23
certifying cause of death or fetal death may certify cause of death 24
only as permitted by that individual's professional scope of 25
practice. These individuals include: 26
(a) A physician, physician's assistant, or an advanced 27
((registered nurse practitioner )) practice registered nurse last in 28
attendance at death or who treated the decedent through examination, 29
medical advice, or medications within the twelve months preceding the 30
death; 31
(b) A midwife, only in cases of fetal death; and32
(c) A physician performing an autopsy, when the decedent was not 33
treated within the last twelve months and the person died a natural 34
death. 35
(26) "Medical examiner" means the person appointed under chapter 36
36.24 RCW to fulfill the responsibilities established under chapter 37
36.24 RCW. 38
(27) "Midwife" means a person licensed to practice midwifery 39
pursuant to chapter 18.50 RCW. 40
p. 302 HB 1281
(28) "Physician" means a person licensed to practice medicine, 1
naturopathy, or osteopathy pursuant to Title 18 RCW.2
(29) "Registration" or "register" means the process by which a 3
report is approved and incorporated as a vital record into the vital 4
records system. 5
(30) "Registration date" means the month, day, and year a report 6
is incorporated into the vital records system. 7
(31) "Report" means an electronic or paper document containing 8
information related to a vital life event for the purpose of 9
registering the vital life event. 10
(32) "Sealed record" means the original record of a vital life 11
event and the evidence submitted to support a change to the original 12
record. 13
(33) "Secretary" means the secretary of the department of health.14
(34) "State" means Washington state unless otherwise specified.15
(35) "State registrar" means the person appointed by the 16
secretary to administer the vital records system under RCW 17
70.58A.030. 18
(36) "Territory of the United States" means American Samoa, the 19
Commonwealth of the Northern Mariana Islands, the Commonwealth of 20
Puerto Rico, Guam, and the United States Virgin Islands.21
(37) "Vital life event" means a birth, death, fetal death, 22
marriage, dissolution of marriage, dissolution of domestic 23
partnership, declaration of invalidity of marriage, declaration of 24
invalidity of domestic partnership, and legal separation.25
(38) "Vital record" or "record" means a report of a vital life 26
event that has been registered and supporting documentation.27
(39) "Vital records system" means the statewide system created, 28
operated, and maintained by the department under this chapter.29
(40) "Vital statistics" means the aggregated data derived from 30
vital records, including related reports, and supporting 31
documentation. 32
Sec. 5139. RCW 70.122.051 and 2006 c 108 s 6 are each amended to 33
read as follows: 34
(1) For the purposes of this section, "provider" means a 35
physician, advanced ((registered nurse practitioner )) practice 36
registered nurse, health care provider acting under the direction of 37
a physician or an advanced ((registered nurse practitioner)) practice 38
p. 303 HB 1281
registered nurse, or health care facility, as defined in this chapter 1
or in chapter 71.32 RCW, and its personnel. 2
(2) Any provider who participates in good faith in the 3
withholding or withdrawal of life-sustaining treatment from a 4
qualified patient in accordance with the requirements of this 5
chapter, shall be immune from legal liability, including civil, 6
criminal, or professional conduct sanctions, unless otherwise 7
negligent. 8
(3) The establishment of a health care declarations registry does 9
not create any new or distinct obligation for a provider to determine 10
whether a patient has a health care declaration. 11
(4) A provider is not subject to civil or criminal liability or 12
sanctions for unprofessional conduct under the uniform disciplinary 13
act, chapter 18.130 RCW, when in good faith and without negligence:14
(a) The provider provides, does not provide, withdraws, or 15
withholds treatment to a patient in the absence of actual knowledge 16
of the existence of a health care declaration stored in the health 17
care declarations registry established in RCW 70.122.130;18
(b) The provider provides, does not provide, withdraws, or 19
withholds treatment pursuant to a health care declaration stored in 20
the health care declarations registry established in RCW 70.122.130 21
in the absence of actual knowledge of the revocation of the 22
declaration; 23
(c) The provider provides, does not provide, withdraws, or 24
withholds treatment according to a health care declaration stored in 25
the health care declarations registry established in RCW 70.122.130 26
in good faith reliance upon the validity of the health care 27
declaration and the declaration is subsequently found to be invalid; 28
or 29
(d) The provider provides, does not provide, withdraws, or 30
withholds treatment according to the patient's health care 31
declaration stored in the health care declarations registry 32
established in RCW 70.122.130. 33
(5) Except for acts of gross negligence, willful misconduct, or 34
intentional wrongdoing, the department of health is not subject to 35
civil liability for any claims or demands arising out of the 36
administration or operation of the health care declarations registry 37
established in RCW 70.122.130. 38
p. 304 HB 1281
Sec. 5140. RCW 70.122.130 and 2016 c 209 s 406 are each amended 1
to read as follows: 2
(1) The department of health shall establish and maintain a 3
statewide health care declarations registry containing the health 4
care declarations identified in subsection (2) of this section as 5
submitted by residents of Washington. The department shall digitally 6
reproduce and store health care declarations in the registry. The 7
department may establish standards for individuals to submit 8
digitally reproduced health care declarations directly to the 9
registry, but is not required to review the health care declarations 10
that it receives to ensure they comply with the particular statutory 11
requirements applicable to the document. The department may contract 12
with an organization that meets the standards identified in this 13
section. 14
(2)(a) An individual may submit any of the following health care 15
declarations to the department of health to be digitally reproduced 16
and stored in the registry: 17
(i) A directive, as defined by this chapter; 18
(ii) A durable power of attorney for health care, as authorized 19
in chapter 11.125 RCW; 20
(iii) A mental health advance directive, as defined by chapter 21
71.32 RCW; or 22
(iv) A form adopted pursuant to the department of health's 23
authority in RCW 43.70.480. 24
(b) Failure to submit a health care declaration to the department 25
of health does not affect the validity of the declaration.26
(c) Failure to notify the department of health of a valid 27
revocation of a health care declaration does not affect the validity 28
of the revocation. 29
(d) The entry of a health care directive in the registry under 30
this section does not: 31
(i) Affect the validity of the document; 32
(ii) Take the place of any requirements in law necessary to make 33
the submitted document legal; or 34
(iii) Create a presumption regarding the validity of the 35
document. 36
(3) The department of health shall prescribe a procedure for an 37
individual to revoke a health care declaration contained in the 38
registry. 39
(4) The registry must: 40
p. 305 HB 1281
(a) Be maintained in a secure database that is accessible through 1
a website maintained by the department of health; 2
(b) Send annual electronic messages to individuals that have 3
submitted health care declarations to request that they review the 4
registry materials to ensure that it is current; 5
(c) Provide individuals who have submitted one or more health 6
care declarations with access to their documents and the ability to 7
revoke their documents at all times; and 8
(d) Provide the personal representatives of individuals who have 9
submitted one or more health care declarations to the registry, 10
attending physicians, advanced ((registered nurse practitioners )) 11
practice registered nurses , health care providers licensed by a 12
disciplining authority identified in RCW 18.130.040 who is acting 13
under the direction of a physician or an advanced ((registered nurse 14
practitioner)) practice registered nurse, and health care facilities, 15
as defined in this chapter or in chapter 71.32 RCW, access to the 16
registry at all times. 17
(5) In designing the registry and website, the department of 18
health shall ensure compliance with state and federal requirements 19
related to patient confidentiality. 20
(6) The department shall provide information to health care 21
providers and health care facilities on the registry website 22
regarding the different federal and Washington state requirements to 23
ascertain and document whether a patient has an advance directive.24
(7) The department of health may accept donations, grants, gifts, 25
or other forms of voluntary contributions to support activities 26
related to the creation and maintenance of the health care 27
declarations registry and statewide public education campaigns 28
related to the existence of the registry. All receipts from donations 29
made under this section, and other contributions and appropriations 30
specifically made for the purposes of creating and maintaining the 31
registry established under this section and statewide public 32
education campaigns related to the existence of the registry, shall 33
be deposited into the general fund. These moneys in the general fund 34
may be spent only after appropriation. 35
(8) The department of health may adopt rules as necessary to 36
implement chapter 108, Laws of 2006. 37
(9) By December 1, 2008, the department shall report to the house 38
and senate committees on health care the following information:39
(a) Number of participants in the registry; 40
p. 306 HB 1281
(b) Number of health care declarations submitted by type of 1
declaration as defined in this section; 2
(c) Number of health care declarations revoked and the method of 3
revocation; 4
(d) Number of providers and facilities, by type, that have been 5
provided access to the registry; 6
(e) Actual costs of operation of the registry. 7
Sec. 5141. RCW 70.128.120 and 2021 c 219 s 6 are each amended to 8
read as follows: 9
Each adult family home provider, applicant, and each resident 10
manager shall have the following minimum qualifications, except that 11
only applicants are required to meet the provisions of subsections 12
(10) and (11) of this section: 13
(1) Twenty-one years of age or older; 14
(2) For those applying after September 1, 2001, to be licensed as 15
providers, and for resident managers whose employment begins after 16
September 1, 2001, a United States high school diploma or high school 17
equivalency certificate as provided in RCW 28B.50.536 or any English 18
or translated government documentation of the following:19
(a) Successful completion of government-approved public or 20
private school education in a foreign country that includes an annual 21
average of one thousand hours of instruction over twelve years or no 22
less than twelve thousand hours of instruction; 23
(b) A foreign college, foreign university, or United States 24
community college two-year diploma; 25
(c) Admission to, or completion of coursework at, a foreign 26
university or college for which credit was granted;27
(d) Admission to, or completion of coursework at, a United States 28
college or university for which credits were awarded;29
(e) Admission to, or completion of postgraduate coursework at, a 30
United States college or university for which credits were awarded; 31
or 32
(f) Successful passage of the United States board examination for 33
registered nursing, or any professional medical occupation for which 34
college or university education preparation was required;35
(3) Good moral and responsible character and reputation;36
(4) Literacy and the ability to communicate in the English 37
language; 38
p. 307 HB 1281
(5) Management and administrative ability to carry out the 1
requirements of this chapter; 2
(6) Satisfactory completion of department-approved basic training 3
and continuing education training as required by RCW 74.39A.074, and 4
in rules adopted by the department; 5
(7) Satisfactory completion of department-approved, or 6
equivalent, special care training before a provider may provide 7
special care services to a resident; 8
(8) Not be disqualified by a department background check;9
(9) For those applying to be licensed as providers, and for 10
resident managers whose employment begins after August 24, 2011, at 11
least one thousand hours in the previous sixty months of successful, 12
direct caregiving experience obtained after age eighteen to 13
vulnerable adults in a licensed or contracted setting prior to 14
operating or managing an adult family home. The applicant or resident 15
manager must have credible evidence of the successful, direct 16
caregiving experience or, currently hold one of the following 17
professional licenses: Physician licensed under chapter 18.71 RCW; 18
osteopathic physician licensed under chapter 18.57 RCW; physician 19
assistant licensed under chapter 18.71A RCW; registered nurse, 20
advanced ((registered nurse practitioner )) practice registered nurse , 21
or licensed practical nurse licensed under chapter 18.79 RCW;22
(10) For applicants, proof of financial solvency, as defined in 23
rule; and 24
(11) Applicants must successfully complete an adult family home 25
administration and business planning class, prior to being granted a 26
license. The class must be a minimum of forty-eight hours of 27
classroom time and approved by the department. The department shall 28
promote and prioritize bilingual capabilities within available 29
resources and when materials are available for this purpose. Under 30
exceptional circumstances, such as the sudden and unexpected death of 31
a provider, the department may consider granting a license to an 32
applicant who has not completed the class but who meets all other 33
requirements. If the department decides to grant the license due to 34
exceptional circumstances, the applicant must have enrolled in or 35
completed the class within four months of licensure.36
Sec. 5142. RCW 70.180.020 and 1994 c 103 s 1 are each amended to 37
read as follows: 38
p. 308 HB 1281
The department shall establish or contract for a health 1
professional temporary substitute resource pool. The purpose of the 2
pool is to provide short-term physician, physician assistant, 3
pharmacist, and advanced ((registered nurse practitioner )) practice 4
registered nurse personnel to rural communities where these health 5
care providers: 6
(1) Are unavailable due to provider shortages; 7
(2) Need time off from practice to attend continuing education 8
and other training programs; and 9
(3) Need time off from practice to attend to personal matters or 10
recover from illness. 11
The health professional temporary substitute resource pool is 12
intended to provide short-term assistance and should complement 13
active health provider recruitment efforts by rural communities where 14
shortages exist. 15
Sec. 5143. RCW 70.180.040 and 1994 c 103 s 3 are each amended to 16
read as follows: 17
(1) Requests for a temporary substitute health care professional 18
may be made to the department by the certified health plan, local 19
rural hospital, public health department or district, community 20
health clinic, local practicing physician, physician assistant, 21
pharmacist, or advanced ((registered nurse practitioner )) practice 22
registered nurse, or local city or county government.23
(2) The department may provide directly or contract for services 24
to: 25
(a) Establish a manner and form for receiving requests;26
(b) Minimize paperwork and compliance requirements for 27
participant health care professionals and entities requesting 28
assistance; and 29
(c) Respond promptly to all requests for assistance.30
(3) The department may apply for, receive, and accept gifts and 31
other payments, including property and services, from any 32
governmental or other public or private entity or person, and may 33
make arrangements as to the use of these receipts to operate the 34
pool. The department shall make available upon request to the 35
appropriate legislative committees information concerning the source, 36
amount, and use of such gifts or payments. 37
p. 309 HB 1281
Sec. 5144. RCW 70.245.010 and 2023 c 38 s 1 are each amended to 1
read as follows: 2
The definitions in this section apply throughout this chapter 3
unless the context clearly requires otherwise. 4
(1) "Adult" means an individual who is 18 years of age or older.5
(2) "Attending qualified medical provider" means the qualified 6
medical provider who has primary responsibility for the care of the 7
patient and treatment of the patient's terminal disease.8
(3) "Competent" means that, in the opinion of a court or in the 9
opinion of the patient's attending qualified medical provider, 10
consulting qualified medical provider, psychiatrist, or psychologist, 11
a patient has the ability to make and communicate an informed 12
decision to health care providers, including communication through 13
persons familiar with the patient's manner of communicating if those 14
persons are available. 15
(4) "Consulting qualified medical provider" means a qualified 16
medical provider who is qualified by specialty or experience to make 17
a professional diagnosis and prognosis regarding the patient's 18
disease. 19
(5) "Counseling" means one or more consultations as necessary 20
between a state licensed psychiatrist, psychologist, independent 21
clinical social worker, advanced social worker, mental health 22
counselor, or psychiatric advanced ((registered nurse practitioner )) 23
practice registered nurse and a patient for the purpose of 24
determining that the patient is competent and not suffering from a 25
psychiatric or psychological disorder or depression causing impaired 26
judgment. 27
(6) "Health care provider" means a person licensed, certified, or 28
otherwise authorized or permitted by law to administer health care or 29
dispense medication in the ordinary course of business or practice of 30
a profession, and includes a health care facility.31
(7) "Informed decision" means a decision by a qualified patient, 32
to request and obtain a prescription for medication that the 33
qualified patient may self-administer to end his or her life in a 34
humane and dignified manner, that is based on an appreciation of the 35
relevant facts and after being fully informed by the attending 36
qualified medical provider of: 37
(a) His or her medical diagnosis; 38
(b) His or her prognosis; 39
p. 310 HB 1281
(c) The potential risks associated with taking the medication to 1
be prescribed; 2
(d) The probable result of taking the medication to be 3
prescribed; and 4
(e) The feasible alternatives including, but not limited to, 5
comfort care, hospice care, and pain control. 6
(8) "Medically confirmed" means the medical opinion of the 7
attending qualified medical provider has been confirmed by a 8
consulting qualified medical provider who has examined the patient 9
and the patient's relevant medical records. 10
(9) "Patient" means a person who is under the care of an 11
attending qualified medical provider. 12
(10) "Qualified medical provider" means a physician licensed 13
under chapter 18.57 or 18.71 RCW, a physician assistant licensed 14
under chapter 18.71A RCW, or an advanced ((registered nurse 15
practitioner)) practice registered nurse licensed under chapter 18.79 16
RCW. 17
(11) "Qualified patient" means a competent adult who is a 18
resident of Washington state and has satisfied the requirements of 19
this chapter in order to obtain a prescription for medication that 20
the qualified patient may self-administer to end his or her life in a 21
humane and dignified manner. 22
(12) "Self-administer" means a qualified patient's act of 23
ingesting medication to end his or her life in a humane and dignified 24
manner. 25
(13) "Terminal disease" means an incurable and irreversible 26
disease that has been medically confirmed and will, within reasonable 27
medical judgment, produce death within six months.28
Sec. 5145. RCW 71.05.148 and 2024 c 209 s 9 are each amended to 29
read as follows: 30
(1) A person is in need of assisted outpatient treatment if the 31
court finds by clear, cogent, and convincing evidence pursuant to a 32
petition filed under this section that: 33
(a) The person has a behavioral health disorder;34
(b) Based on a clinical determination and in view of the person's 35
treatment history and current behavior, at least one of the following 36
is true: 37
p. 311 HB 1281
(i) The person is unlikely to survive safely in the community 1
without supervision and the person's condition is substantially 2
deteriorating; or 3
(ii) The person is in need of assisted outpatient treatment in 4
order to prevent a relapse or deterioration that would be likely to 5
result in grave disability or a likelihood of serious harm to the 6
person or to others; 7
(c) The person has a history of lack of compliance with treatment 8
for his or her behavioral health disorder that has:9
(i) At least twice within the 36 months prior to the filing of 10
the petition been a significant factor in necessitating 11
hospitalization of the person, or the person's receipt of services in 12
a forensic or other mental health unit of a state or tribal 13
correctional facility or local correctional facility, provided that 14
the 36-month period shall be extended by the length of any 15
hospitalization or incarceration of the person that occurred within 16
the 36-month period; 17
(ii) At least twice within the 36 months prior to the filing of 18
the petition been a significant factor in necessitating emergency 19
medical care or hospitalization for behavioral health-related medical 20
conditions including overdose, infected abscesses, sepsis, 21
endocarditis, or other maladies, or a significant factor in behavior 22
which resulted in the person's incarceration in a state, tribal, or 23
local correctional facility; or 24
(iii) Resulted in one or more violent acts, threats, or attempts 25
to cause serious physical harm to the person or another within the 48 26
months prior to the filing of the petition, provided that the 48-27
month period shall be extended by the length of any hospitalization 28
or incarceration of the person that occurred during the 48-month 29
period; 30
(d) Participation in an assisted outpatient treatment program 31
would be the least restrictive alternative necessary to ensure the 32
person's recovery and stability; and 33
(e) The person will benefit from assisted outpatient treatment.34
(2) The following individuals may directly file a petition for 35
less restrictive alternative treatment on the basis that a person is 36
in need of assisted outpatient treatment: 37
(a) The director of a hospital where the person is hospitalized 38
or the director's designee; 39
p. 312 HB 1281
(b) The director of a behavioral health service provider 1
providing behavioral health care or residential services to the 2
person or the director's designee; 3
(c) The person's treating mental health professional or substance 4
use disorder professional or one who has evaluated the person;5
(d) A designated crisis responder; 6
(e) A release planner from a corrections facility; or7
(f) An emergency room physician. 8
(3) A court order for less restrictive alternative treatment on 9
the basis that the person is in need of assisted outpatient treatment 10
may be effective for up to 18 months. The petitioner must personally 11
interview the person, unless the person refuses an interview, to 12
determine whether the person will voluntarily receive appropriate 13
treatment. 14
(4) The petitioner must allege specific facts based on personal 15
observation, evaluation, or investigation, and must consider the 16
reliability or credibility of any person providing information 17
material to the petition. 18
(5) The petition must include: 19
(a) A statement of the circumstances under which the person's 20
condition was made known and the basis for the opinion, from personal 21
observation or investigation, that the person is in need of assisted 22
outpatient treatment. The petitioner must state which specific facts 23
come from personal observation and specify what other sources of 24
information the petitioner has relied upon to form this belief;25
(b) A declaration from a physician, physician assistant, advanced 26
((registered nurse practitioner )) practice registered nurse , or the 27
person's treating mental health professional or substance use 28
disorder professional, who has examined the person no more than 10 29
days prior to the submission of the petition and who is willing to 30
testify in support of the petition, or who alternatively has made 31
appropriate attempts to examine the person within the same period but 32
has not been successful in obtaining the person's cooperation, and 33
who is willing to testify to the reasons they believe that the person 34
meets the criteria for assisted outpatient treatment. If the 35
declaration is provided by the person's treating mental health 36
professional or substance use disorder professional, it must be 37
cosigned by a supervising physician, physician assistant, or advanced 38
((registered nurse practitioner )) practice registered nurse who 39
certifies that they have reviewed the declaration;40
p. 313 HB 1281
(c) The declarations of additional witnesses, if any, supporting 1
the petition for assisted outpatient treatment; 2
(d) The name of an agency, provider, or facility that agrees to 3
provide less restrictive alternative treatment if the petition is 4
granted by the court; and 5
(e) If the person is detained in a state hospital, inpatient 6
treatment facility, jail, or correctional facility at the time the 7
petition is filed, the anticipated release date of the person and any 8
other details needed to facilitate successful reentry and transition 9
into the community. 10
(6)(a) Upon receipt of a petition meeting all requirements of 11
this section, the court shall fix a date for a hearing:12
(i) No sooner than three days or later than seven days after the 13
date of service or as stipulated by the parties or, upon a showing of 14
good cause, no later than 30 days after the date of service; or15
(ii) If the respondent is hospitalized at the time of filing of 16
the petition, before discharge of the respondent and in sufficient 17
time to arrange for a continuous transition from inpatient treatment 18
to assisted outpatient treatment. 19
(b) A copy of the petition and notice of hearing shall be served, 20
in the same manner as a summons, on the petitioner, the respondent, 21
the qualified professional whose affidavit accompanied the petition, 22
a current provider, if any, and a surrogate decision maker or agent 23
under chapter 71.32 RCW, if any. 24
(c) If the respondent has a surrogate decision maker or agent 25
under chapter 71.32 RCW who wishes to provide testimony at the 26
hearing, the court shall afford the surrogate decision maker or agent 27
an opportunity to testify. 28
(d) The respondent shall be represented by counsel at all stages 29
of the proceedings. 30
(e) If the respondent fails to appear at the hearing after 31
notice, the court may conduct the hearing in the respondent's 32
absence; provided that the respondent's counsel is present.33
(f) If the respondent has refused to be examined by the qualified 34
professional whose affidavit accompanied the petition, the court may 35
order a mental examination of the respondent. The examination of the 36
respondent may be performed by the qualified professional whose 37
affidavit accompanied the petition. If the examination is performed 38
by another qualified professional, the examining qualified 39
p. 314 HB 1281
professional shall be authorized to consult with the qualified 1
professional whose affidavit accompanied the petition.2
(g) If the respondent has refused to be examined by a qualified 3
professional and the court finds reasonable grounds to believe that 4
the allegations of the petition are true, the court may issue a 5
written order directing a peace officer who has completed crisis 6
intervention training to detain and transport the respondent to a 7
provider for examination by a qualified professional. A respondent 8
detained pursuant to this subsection shall be detained no longer than 9
necessary to complete the examination and in no event longer than 24 10
hours. 11
(7) If the petition involves a person whom the petitioner or 12
behavioral health administrative services organization knows, or has 13
reason to know, is an American Indian or Alaska Native who receives 14
medical or behavioral health services from a tribe within this state, 15
the petitioner or behavioral health administrative services 16
organization shall notify the tribe and Indian health care provider. 17
Notification shall be made in person or by telephonic or electronic 18
communication to the tribal contact listed in the authority's tribal 19
crisis coordination plan as soon as possible, but before the hearing 20
and no later than 24 hours from the time the petition is served upon 21
the person and the person's guardian. The notice to the tribe or 22
Indian health care provider must include a copy of the petition, 23
together with any orders issued by the court and a notice of the 24
tribe's right to intervene. The court clerk shall provide copies of 25
any court orders necessary for the petitioner or the behavioral 26
health administrative services organization to provide notice to the 27
tribe or Indian health care provider under this section.28
(8) A petition for assisted outpatient treatment filed under this 29
section shall be adjudicated under RCW 71.05.240. 30
(9) After January 1, 2023, a petition for assisted outpatient 31
treatment must be filed on forms developed by the administrative 32
office of the courts. 33
Sec. 5146. RCW 71.05.154 and 2017 3rd sp.s. c 14 s 12 are each 34
amended to read as follows: 35
If a person subject to evaluation under RCW 71.05.150 or 36
71.05.153 is located in an emergency room at the time of evaluation, 37
the designated crisis responder conducting the evaluation shall take 38
serious consideration of observations and opinions by an examining 39
p. 315 HB 1281
emergency room physician, advanced ((registered nurse practitioner )) 1
practice registered nurse , or physician assistant in determining 2
whether detention under this chapter is appropriate. The designated 3
crisis responder must document his or her consultation with this 4
professional, if the professional is available, or his or her review 5
of the professional's written observations or opinions regarding 6
whether detention of the person is appropriate. 7
Sec. 5147. RCW 71.05.210 and 2021 c 264 s 7 are each amended to 8
read as follows: 9
(1) Each person involuntarily detained and accepted or admitted 10
at an evaluation and treatment facility, secure withdrawal management 11
and stabilization facility, or approved substance use disorder 12
treatment program: 13
(a) Shall, within twenty-four hours of his or her admission or 14
acceptance at the facility, not counting time periods prior to 15
medical clearance, be examined and evaluated by: 16
(i) One physician, physician assistant, or advanced ((registered 17
nurse practitioner)) practice registered nurse; and18
(ii) One mental health professional. If the person is detained 19
for substance use disorder evaluation and treatment, the person may 20
be examined by a substance use disorder professional instead of a 21
mental health professional; and 22
(b) Shall receive such treatment and care as his or her condition 23
requires including treatment on an outpatient basis for the period 24
that he or she is detained, except that, beginning twenty-four hours 25
prior to a trial or hearing pursuant to RCW 71.05.215, 71.05.240, 26
71.05.310, 71.05.320, 71.05.590, or 71.05.217, the individual may 27
refuse psychiatric medications, but may not refuse: (i) Any other 28
medication previously prescribed by a person licensed under Title 18 29
RCW; or (ii) emergency lifesaving treatment, and the individual shall 30
be informed at an appropriate time of his or her right of such 31
refusal. The person shall be detained up to one hundred twenty hours, 32
if, in the opinion of the professional person in charge of the 33
facility, or his or her professional designee, the person presents a 34
likelihood of serious harm, or is gravely disabled. A person who has 35
been detained for one hundred twenty hours shall no later than the 36
end of such period be released, unless referred for further care on a 37
voluntary basis, or detained pursuant to court order for further 38
treatment as provided in this chapter. 39
p. 316 HB 1281
(2) If, at any time during the involuntary treatment hold and 1
following the initial examination and evaluation, the mental health 2
professional or substance use disorder professional and licensed 3
physician, physician assistant, or psychiatric advanced ((registered 4
nurse practitioner )) practice registered nurse determine that the 5
initial needs of the person, if detained to an evaluation and 6
treatment facility, would be better served by placement in a secure 7
withdrawal management and stabilization facility or approved 8
substance use disorder treatment program, or, if detained to a secure 9
withdrawal management and stabilization facility or approved 10
substance use disorder treatment program, would be better served in 11
an evaluation and treatment facility then the person shall be 12
referred to the more appropriate placement for the remainder of the 13
current commitment period without any need for further court review.14
(3) An evaluation and treatment center, secure withdrawal 15
management and stabilization facility, or approved substance use 16
disorder treatment program admitting or accepting any person pursuant 17
to this chapter whose physical condition reveals the need for 18
hospitalization shall assure that such person is transferred to an 19
appropriate hospital for evaluation or admission for treatment. 20
Notice of such fact shall be given to the court, the designated 21
attorney, and the designated crisis responder and the court shall 22
order such continuance in proceedings under this chapter as may be 23
necessary, but in no event may this continuance be more than fourteen 24
days. 25
Sec. 5148. RCW 71.05.215 and 2024 c 62 s 20 are each amended to 26
read as follows: 27
(1) A person found to be gravely disabled or to present a 28
likelihood of serious harm as a result of a behavioral health 29
disorder has a right to refuse antipsychotic medication unless it is 30
determined that the failure to medicate may result in a likelihood of 31
serious harm or substantial deterioration or substantially prolong 32
the length of involuntary commitment and there is no less intrusive 33
course of treatment than medication in the best interest of that 34
person. 35
(2) The authority shall adopt rules to carry out the purposes of 36
this chapter. These rules shall include: 37
(a) An attempt to obtain the informed consent of the person prior 38
to administration of antipsychotic medication. 39
p. 317 HB 1281
(b) For short-term treatment up to thirty days, the right to 1
refuse antipsychotic medications unless there is an additional 2
concurring medical opinion approving medication by a psychiatrist, 3
physician assistant working with a psychiatrist who is acting as a 4
participating physician as defined in RCW 18.71A.010, psychiatric 5
advanced ((registered nurse practitioner )) practice registered nurse , 6
or physician or physician assistant in consultation with a mental 7
health professional with prescriptive authority. 8
(c) For continued treatment beyond thirty days through the 9
hearing on any petition filed under RCW 71.05.217, the right to 10
periodic review of the decision to medicate by the medical director 11
or designee. 12
(d) Administration of antipsychotic medication in an emergency 13
and review of this decision within twenty-four hours. An emergency 14
exists if the person presents an imminent likelihood of serious harm, 15
and medically acceptable alternatives to administration of 16
antipsychotic medications are not available or are unlikely to be 17
successful; and in the opinion of the physician, physician assistant, 18
or psychiatric advanced ((registered nurse practitioner )) practice 19
registered nurse , the person's condition constitutes an emergency 20
requiring the treatment be instituted prior to obtaining a second 21
medical opinion. 22
(e) Documentation in the medical record of the attempt by the 23
physician, physician assistant, or psychiatric advanced ((registered 24
nurse practitioner )) practice registered nurse to obtain informed 25
consent and the reasons why antipsychotic medication is being 26
administered over the person's objection or lack of consent.27
Sec. 5149. RCW 71.05.217 and 2024 c 209 s 20 and 2024 c 62 s 21 28
are each reenacted and amended to read as follows:29
(1) Insofar as danger to the individual or others is not created, 30
each person involuntarily detained, treated in a less restrictive 31
alternative course of treatment, or committed for treatment and 32
evaluation pursuant to this chapter shall have, in addition to other 33
rights not specifically withheld by law, the following rights, a list 34
of which shall be prominently posted in all facilities, institutions, 35
and hospitals providing such services: 36
(a) To wear his or her own clothes and to keep and use his or her 37
own personal possessions, except when deprivation of same is 38
essential to protect the safety of the resident or other persons;39
p. 318 HB 1281
(b) To keep and be allowed to spend a reasonable sum of his or 1
her own money for canteen expenses and small purchases;2
(c) To have access to individual storage space for his or her 3
private use; 4
(d) To have visitors at reasonable times; 5
(e) To have reasonable access to a telephone, both to make and 6
receive confidential calls; 7
(f) To have ready access to letter writing materials, including 8
stamps, and to send and receive uncensored correspondence through the 9
mails; 10
(g) To have the right to individualized care and adequate 11
treatment; 12
(h) To discuss treatment plans and decisions with professional 13
persons; 14
(i) To not be denied access to treatment by spiritual means 15
through prayer in accordance with the tenets and practices of a 16
church or religious denomination in addition to the treatment 17
otherwise proposed; 18
(j) Not to consent to the administration of antipsychotic 19
medications beyond the hearing conducted pursuant to RCW 71.05.320(4) 20
or the performance of electroconvulsant therapy or surgery, except 21
emergency lifesaving surgery, unless ordered by a court of competent 22
jurisdiction pursuant to the following standards and procedures:23
(i) The administration of antipsychotic medication or 24
electroconvulsant therapy shall not be ordered unless the petitioning 25
party proves by clear, cogent, and convincing evidence that there 26
exists a compelling state interest that justifies overriding the 27
patient's lack of consent to the administration of antipsychotic 28
medications or electroconvulsant therapy, that the proposed treatment 29
is necessary and effective, and that medically acceptable alternative 30
forms of treatment are not available, have not been successful, or 31
are not likely to be effective. 32
(ii) The court shall make specific findings of fact concerning: 33
(A) The existence of one or more compelling state interests; (B) the 34
necessity and effectiveness of the treatment; and (C) the person's 35
desires regarding the proposed treatment. If the patient is unable to 36
make a rational and informed decision about consenting to or refusing 37
the proposed treatment, the court shall make a substituted judgment 38
for the patient as if he or she were competent to make such a 39
determination. 40
p. 319 HB 1281
(iii) The person shall be present at any hearing on a request to 1
administer antipsychotic medication or electroconvulsant therapy 2
filed pursuant to this subsection. The person has the right: (A) To 3
be represented by an attorney; (B) to present evidence; (C) to cross-4
examine witnesses; (D) to have the rules of evidence enforced; (E) to 5
remain silent; (F) to view and copy all petitions and reports in the 6
court file; and (G) to be given reasonable notice and an opportunity 7
to prepare for the hearing. The court may appoint a psychiatrist, 8
physician assistant working with a psychiatrist who is acting as a 9
participating physician as defined in RCW 18.71A.010, psychiatric 10
advanced ((registered nurse practitioner )) practice registered nurse , 11
psychologist within their scope of practice, physician assistant, or 12
physician to examine and testify on behalf of such person. The court 13
shall appoint a psychiatrist, physician assistant working with a 14
psychiatrist who is acting as a participating physician as defined in 15
RCW 18.71A.010, psychiatric advanced ((registered nurse 16
practitioner)) practice registered nurse , psychologist within their 17
scope of practice, physician assistant, or physician designated by 18
such person or the person's counsel to testify on behalf of the 19
person in cases where an order for electroconvulsant therapy is 20
sought. 21
(iv) An order for the administration of antipsychotic medications 22
entered following a hearing conducted pursuant to this section shall 23
be effective for the period of the current involuntary treatment 24
order, and any interim period during which the person is awaiting 25
trial or hearing on a new petition for involuntary treatment or 26
involuntary medication. 27
(v) Any person detained pursuant to RCW 71.05.320(4), who 28
subsequently refuses antipsychotic medication, shall be entitled to 29
the procedures set forth in this subsection. 30
(vi) Antipsychotic medication may be administered to a 31
nonconsenting person detained or committed pursuant to this chapter 32
without a court order pursuant to RCW 71.05.215(2) or under the 33
following circumstances: 34
(A) A person presents an imminent likelihood of serious harm;35
(B) Medically acceptable alternatives to administration of 36
antipsychotic medications are not available, have not been 37
successful, or are not likely to be effective; and38
(C)(I) In the opinion of the physician, physician assistant, or 39
psychiatric advanced ((registered nurse practitioner )) practice 40
p. 320 HB 1281
registered nurse with responsibility for treatment of the person, or 1
his or her designee, the person's condition constitutes an emergency 2
requiring the treatment be instituted before a judicial hearing as 3
authorized pursuant to this section can be held. 4
(II) If antipsychotic medications are administered over a 5
person's lack of consent pursuant to this subsection, a petition for 6
an order authorizing the administration of antipsychotic medications 7
shall be filed on the next judicial day. The hearing shall be held 8
within two judicial days. If deemed necessary by the physician, 9
physician assistant, or psychiatric advanced ((registered nurse 10
practitioner)) practice registered nurse with responsibility for the 11
treatment of the person, administration of antipsychotic medications 12
may continue until the hearing is held; 13
(k) To dispose of property and sign contracts unless such person 14
has been adjudicated an incompetent in a court proceeding directed to 15
that particular issue; 16
(l) Not to have psychosurgery performed on him or her under any 17
circumstances; 18
(m) To not be denied access to treatment by cultural or spiritual 19
means through practices that are in accordance with a tribal or 20
cultural tradition in addition to the treatment otherwise proposed.21
(2) Every person involuntarily detained or committed under the 22
provisions of this chapter is entitled to all the rights set forth in 23
this chapter and retains all rights not denied him or her under this 24
chapter except as limited by chapter 9.41 RCW. 25
(3) No person may be presumed incompetent as a consequence of 26
receiving evaluation or treatment for a behavioral health disorder. 27
Competency may not be determined or withdrawn except under the 28
provisions of chapter 10.77 RCW. 29
(4) Subject to RCW 71.05.745 and related regulations, persons 30
receiving evaluation or treatment under this chapter must be given a 31
reasonable choice of an available physician, physician assistant, 32
psychiatric advanced ((registered nurse practitioner )) practice 33
registered nurse , or other professional person qualified to provide 34
such services. 35
(5) Whenever any person is detained under this chapter, the 36
person must be advised that unless the person is released or 37
voluntarily admits himself or herself for treatment within 120 hours 38
of the initial detention, a judicial hearing must be held in a 39
superior court within 120 hours to determine whether there is 40
p. 321 HB 1281
probable cause to detain the person for up to an additional 14 days 1
based on an allegation that because of a behavioral health disorder 2
the person presents a likelihood of serious harm or is gravely 3
disabled, and that at the probable cause hearing the person has the 4
following rights: 5
(a) To communicate immediately with an attorney; to have an 6
attorney appointed if the person is indigent; and to be told the name 7
and address of the attorney that has been designated;8
(b) To remain silent, and to know that any statement the person 9
makes may be used against him or her; 10
(c) To present evidence on the person's behalf;11
(d) To cross-examine witnesses who testify against him or her;12
(e) To be proceeded against by the rules of evidence;13
(f) To have the court appoint a reasonably available independent 14
professional person to examine the person and testify in the hearing, 15
at public expense unless the person is able to bear the cost;16
(g) To view and copy all petitions and reports in the court file; 17
and 18
(h) To refuse psychiatric medications, including antipsychotic 19
medication beginning 24 hours prior to the probable cause hearing.20
(6) The judicial hearing described in subsection (5) of this 21
section must be held according to the provisions of subsection (5) of 22
this section and rules promulgated by the supreme court.23
(7)(a) Privileges between patients and physicians, physician 24
assistants, psychologists, or psychiatric advanced ((registered nurse 25
practitioners)) practice registered nurses are deemed waived in 26
proceedings under this chapter relating to the administration of 27
antipsychotic medications. As to other proceedings under this 28
chapter, the privileges are waived when a court of competent 29
jurisdiction in its discretion determines that such waiver is 30
necessary to protect either the detained person or the public.31
(b) The waiver of a privilege under this section is limited to 32
records or testimony relevant to evaluation of the detained person 33
for purposes of a proceeding under this chapter. Upon motion by the 34
detained person or on its own motion, the court shall examine a 35
record or testimony sought by a petitioner to determine whether it is 36
within the scope of the waiver. 37
(c) The record maker may not be required to testify in order to 38
introduce medical or psychological records of the detained person so 39
long as the requirements of RCW 5.45.020 are met except that portions 40
p. 322 HB 1281
of the record which contain opinions as to the detained person's 1
mental state must be deleted from such records unless the person 2
making such conclusions is available for cross-examination.3
(8) Nothing contained in this chapter prohibits the patient from 4
petitioning by writ of habeas corpus for release. 5
(9) Nothing in this section permits any person to knowingly 6
violate a no-contact order or a condition of an active judgment and 7
sentence or an active condition of supervision by the department of 8
corrections. 9
(10) The rights set forth under this section apply equally to 90-10
day or 180-day hearings under RCW 71.05.310. 11
Sec. 5150. RCW 71.05.230 and 2022 c 210 s 11 are each amended to 12
read as follows: 13
A person detained for one hundred twenty hours of evaluation and 14
treatment may be committed for not more than fourteen additional days 15
of involuntary intensive treatment or ninety additional days of a 16
less restrictive alternative treatment. A petition may only be filed 17
if the following conditions are met: 18
(1) The professional staff of the facility providing evaluation 19
services has analyzed the person's condition and finds that the 20
condition is caused by a behavioral health disorder and results in: 21
(a) A likelihood of serious harm; or (b) the person being gravely 22
disabled; and are prepared to testify those conditions are met; and23
(2) The person has been advised of the need for voluntary 24
treatment and the professional staff of the facility has evidence 25
that he or she has not in good faith volunteered; and26
(3) The facility providing intensive treatment is certified to 27
provide such treatment by the department or under RCW 71.05.745; and28
(4)(a)(i) The professional staff of the facility or the 29
designated crisis responder has filed a petition with the court for a 30
fourteen day involuntary detention or a ninety day less restrictive 31
alternative. The petition must be signed by: 32
(A) One physician, physician assistant, or psychiatric advanced 33
((registered nurse practitioner)) practice registered nurse; and34
(B) One physician, physician assistant, psychiatric advanced 35
((registered nurse practitioner )) practice registered nurse , or 36
mental health professional. 37
(ii) If the petition is for substance use disorder treatment, the 38
petition may be signed by a substance use disorder professional 39
p. 323 HB 1281
instead of a mental health professional and by an advanced 1
((registered nurse practitioner )) practice registered nurse instead 2
of a psychiatric advanced ((registered nurse practitioner )) practice 3
registered nurse. The persons signing the petition must have examined 4
the person. 5
(b) If involuntary detention is sought the petition shall state 6
facts that support the finding that such person, as a result of a 7
behavioral health disorder, presents a likelihood of serious harm, or 8
is gravely disabled and that there are no less restrictive 9
alternatives to detention in the best interest of such person or 10
others. The petition shall state specifically that less restrictive 11
alternative treatment was considered and specify why treatment less 12
restrictive than detention is not appropriate. If an involuntary less 13
restrictive alternative is sought, the petition shall state facts 14
that support the finding that such person, as a result of a 15
behavioral health disorder, presents a likelihood of serious harm or 16
is gravely disabled and shall set forth any recommendations for less 17
restrictive alternative treatment services; and 18
(5) A copy of the petition has been served on the detained 19
person, his or her attorney, and his or her guardian, if any, prior 20
to the probable cause hearing; and 21
(6) The court at the time the petition was filed and before the 22
probable cause hearing has appointed counsel to represent such person 23
if no other counsel has appeared; and 24
(7) The petition reflects that the person was informed of the 25
loss of firearm rights if involuntarily committed for mental health 26
treatment; and 27
(8) At the conclusion of the initial commitment period, the 28
professional staff of the agency or facility or the designated crisis 29
responder may petition for an additional period of either 90 days of 30
less restrictive alternative treatment or 90 days of involuntary 31
intensive treatment as provided in RCW 71.05.290; and32
(9) If the hospital or facility designated to provide less 33
restrictive alternative treatment is other than the facility 34
providing involuntary treatment, the outpatient facility so 35
designated to provide less restrictive alternative treatment has 36
agreed to assume such responsibility. 37
Sec. 5151. RCW 71.05.290 and 2023 c 453 s 23 are each amended to 38
read as follows: 39
p. 324 HB 1281
(1) At any time during a person's 14-day intensive treatment 1
period, the professional person in charge of a treatment facility or 2
his or her professional designee or the designated crisis responder 3
may petition the superior court for an order requiring such person to 4
undergo an additional period of treatment. Such petition must be 5
based on one or more of the grounds set forth in RCW 71.05.280.6
(2)(a)(i) The petition shall summarize the facts which support 7
the need for further commitment and shall be supported by affidavits 8
based on an examination of the patient and signed by:9
(A) One physician, physician assistant, or psychiatric advanced 10
((registered nurse practitioner)) practice registered nurse; and11
(B) One physician, physician assistant, psychiatric advanced 12
((registered nurse practitioner )) practice registered nurse , or 13
mental health professional. 14
(ii) If the petition is for substance use disorder treatment, the 15
petition may be signed by a substance use disorder professional 16
instead of a mental health professional and by an advanced 17
((registered nurse practitioner )) practice registered nurse instead 18
of a psychiatric advanced ((registered nurse practitioner )) practice 19
registered nurse. 20
(b) The affidavits shall describe in detail the behavior of the 21
detained person which supports the petition and shall explain what, 22
if any, less restrictive treatments which are alternatives to 23
detention are available to such person, and shall state the 24
willingness of the affiant to testify to such facts in subsequent 25
judicial proceedings under this chapter. If less restrictive 26
alternative treatment is sought, the petition shall set forth any 27
recommendations for less restrictive alternative treatment services.28
(3) If a person has been determined to be incompetent pursuant to 29
RCW 10.77.086(7), then the professional person in charge of the 30
treatment facility or his or her professional designee or the 31
designated crisis responder may directly file a petition for 180-day 32
treatment under RCW 71.05.280(3), or for 90-day treatment under RCW 33
71.05.280 (1), (2), or (4). No petition for initial detention or 14-34
day detention is required before such a petition may be filed.35
Sec. 5152. RCW 71.05.300 and 2023 c 453 s 24 are each amended to 36
read as follows: 37
(1) The petition for ninety day treatment shall be filed with the 38
clerk of the superior court at least three days before expiration of 39
p. 325 HB 1281
the fourteen-day period of intensive treatment. The clerk shall set a 1
trial setting date as provided in RCW 71.05.310 on the next judicial 2
day after the date of filing the petition and notify the designated 3
crisis responder. The designated crisis responder shall immediately 4
notify the person detained, his or her attorney, if any, and his or 5
her guardian or conservator, if any, the prosecuting attorney, and 6
the behavioral health administrative services organization 7
administrator, and provide a copy of the petition to such persons as 8
soon as possible. The behavioral health administrative services 9
organization administrator or designee may review the petition and 10
may appear and testify at the full hearing on the petition.11
(2) The attorney for the detained person shall advise him or her 12
of his or her right to be represented by an attorney, his or her 13
right to a jury trial, and, if the petition is for commitment for 14
mental health treatment, his or her loss of firearm rights if 15
involuntarily committed. If the detained person is not represented by 16
an attorney, or is indigent or is unwilling to retain an attorney, 17
the court shall immediately appoint an attorney to represent him or 18
her. The court shall, if requested, appoint a reasonably available 19
licensed physician, physician assistant, psychiatric advanced 20
((registered nurse practitioner )) practice registered nurse , 21
psychologist, psychiatrist, or other professional person, designated 22
by the detained person to examine and testify on behalf of the 23
detained person. 24
(3) The court may, if requested, also appoint a professional 25
person as defined in RCW 71.05.020 to seek less restrictive 26
alternative courses of treatment and to testify on behalf of the 27
detained person. In the case of a person with a developmental 28
disability who has been determined to be incompetent pursuant to RCW 29
10.77.086(7), the appointed professional person under this section 30
shall be a developmental disabilities professional.31
Sec. 5153. RCW 71.05.585 and 2024 c 62 s 22 are each amended to 32
read as follows: 33
(1) Less restrictive alternative treatment, at a minimum, 34
includes the following services: 35
(a) Assignment of a care coordinator; 36
(b) An intake evaluation with the provider of the less 37
restrictive alternative treatment; 38
p. 326 HB 1281
(c) A psychiatric evaluation, a substance use disorder 1
evaluation, or both; 2
(d) A schedule of regular contacts with the provider of the 3
treatment services for the duration of the order; 4
(e) A transition plan addressing access to continued services at 5
the expiration of the order; 6
(f) An individual crisis plan; 7
(g) Consultation about the formation of a mental health advance 8
directive under chapter 71.32 RCW; and 9
(h) Notification to the care coordinator assigned in (a) of this 10
subsection if reasonable efforts to engage the client fail to produce 11
substantial compliance with court-ordered treatment conditions.12
(2) Less restrictive alternative treatment may additionally 13
include requirements to participate in the following services:14
(a) Medication management; 15
(b) Psychotherapy; 16
(c) Nursing; 17
(d) Substance use disorder counseling; 18
(e) Residential treatment; 19
(f) Partial hospitalization; 20
(g) Intensive outpatient treatment; 21
(h) Support for housing, benefits, education, and employment; and22
(i) Periodic court review. 23
(3) If the person was provided with involuntary medication under 24
RCW 71.05.215 or pursuant to a judicial order during the involuntary 25
commitment period, the less restrictive alternative treatment order 26
may authorize the less restrictive alternative treatment provider or 27
its designee to administer involuntary antipsychotic medication to 28
the person if the provider has attempted and failed to obtain the 29
informed consent of the person and there is a concurring medical 30
opinion approving the medication by a psychiatrist, physician 31
assistant working with a psychiatrist who is acting as a 32
participating physician as defined in RCW 18.71A.010, psychiatric 33
advanced ((registered nurse practitioner )) practice registered nurse , 34
or physician or physician assistant in consultation with an 35
independent mental health professional with prescribing authority.36
(4) Less restrictive alternative treatment must be administered 37
by a provider that is certified or licensed to provide or coordinate 38
the full scope of services required under the less restrictive 39
alternative order and that has agreed to assume this responsibility.40
p. 327 HB 1281
(5) The care coordinator assigned to a person ordered to less 1
restrictive alternative treatment must submit an individualized plan 2
for the person's treatment services to the court that entered the 3
order. An initial plan must be submitted as soon as possible 4
following the intake evaluation and a revised plan must be submitted 5
upon any subsequent modification in which a type of service is 6
removed from or added to the treatment plan. 7
(6) A care coordinator may disclose information and records 8
related to mental health services pursuant to RCW 70.02.230(2)(k) for 9
purposes of implementing less restrictive alternative treatment.10
(7) For the purpose of this section, "care coordinator" means a 11
clinical practitioner who coordinates the activities of less 12
restrictive alternative treatment. The care coordinator coordinates 13
activities with the designated crisis responders that are necessary 14
for enforcement and continuation of less restrictive alternative 15
orders and is responsible for coordinating service activities with 16
other agencies and establishing and maintaining a therapeutic 17
relationship with the individual on a continuing basis.18
Sec. 5154. RCW 71.12.540 and 2016 c 155 s 11 are each amended to 19
read as follows: 20
The authorities of each establishment as defined in this chapter 21
shall place on file in the office of the establishment the 22
recommendations made by the department of health as a result of such 23
visits, for the purpose of consultation by such authorities, and for 24
reference by the department representatives upon their visits. Every 25
such establishment shall keep records of every person admitted 26
thereto as follows and shall furnish to the department, when 27
required, the following data: Name, age, sex, marital status, date of 28
admission, voluntary or other commitment, name of physician, 29
physician assistant, or psychiatric advanced ((registered nurse 30
practitioner)) practice registered nurse , diagnosis, and date of 31
discharge. 32
Sec. 5155. RCW 71.32.020 and 2021 c 287 s 4 are each reenacted 33
and amended to read as follows: 34
The definitions in this section apply throughout this chapter 35
unless the context clearly requires otherwise. 36
(1) "Adult" means any individual who has attained the age of 37
majority or is an emancipated minor. 38
p. 328 HB 1281
(2) "Agent" has the same meaning as an attorney-in-fact or agent 1
as provided in chapter 11.125 RCW. 2
(3) "Behavioral health disorder" means a mental disorder, a 3
substance use disorder, or a co-occurring mental health and substance 4
use disorder. 5
(4) "Capacity" means that a person has not been found to be 6
incapacitated pursuant to this chapter or subject to a guardianship 7
under RCW 11.130.265. 8
(5) "Court" means a superior court under chapter 2.08 RCW.9
(6) "Health care facility" means a hospital, as defined in RCW 10
70.41.020; an institution, as defined in RCW 71.12.455; a state 11
hospital, as defined in RCW 72.23.010; a nursing home, as defined in 12
RCW 18.51.010; or a clinic that is part of a community behavioral 13
health service delivery system, as defined in RCW 71.24.025.14
(7) "Health care provider" means an osteopathic physician 15
licensed under chapter 18.57 RCW, a physician or physician's 16
assistant licensed under chapter 18.71 or 18.71A RCW, or an advanced 17
((registered nurse practitioner )) practice registered nurse licensed 18
under RCW 18.79.050. 19
(8) "Incapacitated" means a person who: (a) Is unable to 20
understand the nature, character, and anticipated results of proposed 21
treatment or alternatives; understand the recognized serious possible 22
risks, complications, and anticipated benefits in treatments and 23
alternatives, including nontreatment; or communicate his or her 24
understanding or treatment decisions; or (b) has been found to be 25
subject to a guardianship under RCW 11.130.265. 26
(9) "Informed consent" means consent that is given after a 27
person: (a) Is provided with a description of the nature, character, 28
and anticipated results of proposed treatments and alternatives, and 29
the recognized serious possible risks, complications, and anticipated 30
benefits in the treatments and alternatives, including nontreatment, 31
in language that the person can reasonably be expected to understand; 32
or (b) elects not to be given the information included in (a) of this 33
subsection. 34
(10) "Long-term care facility" has the same meaning as defined in 35
RCW 43.190.020. 36
(11) "Mental disorder" means any organic, mental, or emotional 37
impairment which has substantial adverse effects on an individual's 38
cognitive or volitional functions. 39
p. 329 HB 1281
(12) "Mental health advance directive" or "directive" means a 1
written document in which the principal makes a declaration of 2
instructions or preferences or appoints an agent to make decisions on 3
behalf of the principal regarding the principal's mental health 4
treatment, or both, and that is consistent with the provisions of 5
this chapter. 6
(13) "Mental health professional" means a psychiatrist, 7
psychologist, psychiatric nurse, or social worker, and such other 8
mental health professionals as may be defined by rules adopted by the 9
secretary pursuant to the provisions of chapter 71.05 RCW.10
(14) "Principal" means a person who has executed a mental health 11
advance directive. 12
(15) "Professional person" means a mental health professional and 13
shall also mean a physician, registered nurse, and such others as may 14
be defined by rules adopted by the secretary pursuant to the 15
provisions of chapter 71.05 RCW. 16
(16) "Social worker" means a person with a master's or further 17
advanced degree from a social work educational program accredited and 18
approved as provided in RCW 18.320.010. 19
(17) "Substance use disorder" means a cluster of cognitive, 20
behavioral, and physiological symptoms indicating that an individual 21
continues using the substance despite significant substance-related 22
problems. The diagnosis of a substance use disorder is based on a 23
pathological pattern of behaviors related to the use of the 24
substances. 25
Sec. 5156. RCW 71.32.110 and 2024 c 62 s 23 are each amended to 26
read as follows: 27
(1) For the purposes of this chapter, a principal, agent, 28
professional person, or health care provider may seek a determination 29
whether the principal is incapacitated or has regained capacity.30
(2)(a) For the purposes of this chapter, no adult may be declared 31
an incapacitated person except by: 32
(i) A court, if the request is made by the principal or the 33
principal's agent; 34
(ii) One mental health professional or substance use disorder 35
professional and one health care provider; or 36
(iii) Two health care providers. 37
(b) One of the persons making the determination under (a)(ii) or 38
(iii) of this subsection must be a psychiatrist, physician assistant 39
p. 330 HB 1281
working with a psychiatrist who is acting as a participating 1
physician as defined in RCW 18.71A.010, psychologist, or a 2
psychiatric advanced ((registered nurse practitioner )) practice 3
registered nurse. 4
(3) When a professional person or health care provider requests a 5
capacity determination, he or she shall promptly inform the principal 6
that: 7
(a) A request for capacity determination has been made; and8
(b) The principal may request that the determination be made by a 9
court. 10
(4) At least one mental health professional, substance use 11
disorder professional, or health care provider must personally 12
examine the principal prior to making a capacity determination.13
(5)(a) When a court makes a determination whether a principal has 14
capacity, the court shall, at a minimum, be informed by the testimony 15
of one mental health professional or substance use disorder 16
professional familiar with the principal and shall, except for good 17
cause, give the principal an opportunity to appear in court prior to 18
the court making its determination. 19
(b) To the extent that local court rules permit, any party or 20
witness may testify telephonically. 21
(6) When a court has made a determination regarding a principal's 22
capacity and there is a subsequent change in the principal's 23
condition, subsequent determinations whether the principal is 24
incapacitated may be made in accordance with any of the provisions of 25
subsection (2) of this section. 26
Sec. 5157. RCW 71.32.140 and 2024 c 62 s 24 are each amended to 27
read as follows: 28
(1) A principal who: 29
(a) Chose not to be able to revoke his or her directive during 30
any period of incapacity; 31
(b) Consented to voluntary admission to inpatient behavioral 32
health treatment, or authorized an agent to consent on the 33
principal's behalf; and 34
(c) At the time of admission to inpatient treatment, refuses to 35
be admitted, may only be admitted into inpatient behavioral health 36
treatment under subsection (2) of this section. 37
(2) A principal may only be admitted to inpatient behavioral 38
health treatment under his or her directive if, prior to admission, a 39
p. 331 HB 1281
member of the treating facility's professional staff who is a 1
physician, physician assistant, or psychiatric advanced ((registered 2
nurse practitioner)) practice registered nurse: 3
(a) Evaluates the principal's mental condition, including a 4
review of reasonably available psychiatric and psychological history, 5
diagnosis, and treatment needs, and determines, in conjunction with 6
another health care provider, mental health professional, or 7
substance use disorder professional, that the principal is 8
incapacitated; 9
(b) Obtains the informed consent of the agent, if any, designated 10
in the directive; 11
(c) Makes a written determination that the principal needs an 12
inpatient evaluation or is in need of inpatient treatment and that 13
the evaluation or treatment cannot be accomplished in a less 14
restrictive setting; and 15
(d) Documents in the principal's medical record a summary of the 16
physician's, physician assistant's, or psychiatric advanced 17
((registered nurse practitioner's )) practice registered nurse's 18
findings and recommendations for treatment or evaluation.19
(3) In the event the admitting physician is not a psychiatrist, 20
the admitting physician assistant is not working with a psychiatrist 21
who is acting as a participating physician as defined in RCW 22
18.71A.010, or the advanced ((registered nurse practitioner )) 23
practice registered nurse is not a psychiatric advanced ((registered 24
nurse practitioner )) practice registered nurse , the principal shall 25
receive a complete behavioral health assessment by a mental health 26
professional or substance use disorder professional within 24 hours 27
of admission to determine the continued need for inpatient evaluation 28
or treatment. 29
(4)(a) If it is determined that the principal has capacity, then 30
the principal may only be admitted to, or remain in, inpatient 31
treatment if he or she consents at the time, is admitted for family-32
initiated treatment under chapter 71.34 RCW, or is detained under the 33
involuntary treatment provisions of chapter 71.05 or 71.34 RCW.34
(b) If a principal who is determined by two health care providers 35
or one mental health professional or substance use disorder 36
professional and one health care provider to be incapacitated 37
continues to refuse inpatient treatment, the principal may 38
immediately seek injunctive relief for release from the facility.39
p. 332 HB 1281
(5) If, at the end of the period of time that the principal or 1
the principal's agent, if any, has consented to voluntary inpatient 2
treatment, but no more than 14 days after admission, the principal 3
has not regained capacity or has regained capacity but refuses to 4
consent to remain for additional treatment, the principal must be 5
released during reasonable daylight hours, unless detained under 6
chapter 71.05 or 71.34 RCW. 7
(6)(a) Except as provided in (b) of this subsection, any 8
principal who is voluntarily admitted to inpatient behavioral health 9
treatment under this chapter shall have all the rights provided to 10
individuals who are voluntarily admitted to inpatient treatment under 11
chapter 71.05, 71.34, or 72.23 RCW. 12
(b) Notwithstanding RCW 71.05.050 regarding consent to inpatient 13
treatment for a specified length of time, the choices an 14
incapacitated principal expressed in his or her directive shall 15
control, provided, however, that a principal who takes action 16
demonstrating a desire to be discharged, in addition to making 17
statements requesting to be discharged, shall be discharged, and no 18
principal shall be restrained in any way in order to prevent his or 19
her discharge. Nothing in this subsection shall be construed to 20
prevent detention and evaluation for civil commitment under chapter 21
71.05 RCW. 22
(7) Consent to inpatient admission in a directive is effective 23
only while the professional person, health care provider, and health 24
care facility are in substantial compliance with the material 25
provisions of the directive related to inpatient treatment.26
Sec. 5158. RCW 71.32.250 and 2024 c 62 s 25 are each amended to 27
read as follows: 28
(1) If a principal who is a resident of a long-term care facility 29
is admitted to inpatient behavioral health treatment pursuant to his 30
or her directive, the principal shall be allowed to be readmitted to 31
the same long-term care facility as if his or her inpatient admission 32
had been for a physical condition on the same basis that the 33
principal would be readmitted under state or federal statute or rule 34
when: 35
(a) The treating facility's professional staff determine that 36
inpatient behavioral health treatment is no longer medically 37
necessary for the resident. The determination shall be made in 38
writing by a psychiatrist, physician assistant working with a 39
p. 333 HB 1281
psychiatrist who is acting as a participating physician as defined in 1
RCW 18.71A.010, or a psychiatric advanced ((registered nurse 2
practitioner)) practice registered nurse , or (i) one physician and a 3
mental health professional or substance use disorder professional; 4
(ii) one physician assistant and a mental health professional or 5
substance use disorder professional; or (iii) one psychiatric 6
advanced ((registered nurse practitioner )) practice registered nurse 7
and a mental health professional or substance use disorder 8
professional; or 9
(b) The person's consent to admission in his or her directive has 10
expired. 11
(2)(a) If the long-term care facility does not have a bed 12
available at the time of discharge, the treating facility may 13
discharge the resident, in consultation with the resident and agent 14
if any, and in accordance with a medically appropriate discharge 15
plan, to another long-term care facility. 16
(b) This section shall apply to inpatient behavioral health 17
treatment admission of long-term care facility residents, regardless 18
of whether the admission is directly from a facility, hospital 19
emergency room, or other location. 20
(c) This section does not restrict the right of the resident to 21
an earlier release from the inpatient treatment facility. This 22
section does not restrict the right of a long-term care facility to 23
initiate transfer or discharge of a resident who is readmitted 24
pursuant to this section, provided that the facility has complied 25
with the laws governing the transfer or discharge of a resident.26
(3) The joint legislative audit and review committee shall 27
conduct an evaluation of the operation and impact of this section. 28
The committee shall report its findings to the appropriate committees 29
of the legislature by December 1, 2004. 30
Sec. 5159. RCW 71.32.260 and 2021 c 287 s 19 and 2021 c 215 s 31
159 are each reenacted and amended to read as follows:32
The directive shall be in substantially the following form:33
34
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36
Mental Health Advance Directive of (client name)
With Appointment of (agent name) as
Agent for Mental Health Decisions
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p. 334 HB 1281
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PART I.
STATEMENT OF INTENT TO CREATE A
MENTAL HEALTH ADV ANCE DIRECTIVE
I, (Client name), being a person with capacity, willfully and voluntarily execute this mental health advance directive so that
my choices regarding my mental health care will be carried out in circumstances when I am unable to express my
instructions and preferences regarding my mental health care.
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PART II.
MY CARE NEEDS – WHAT WORKS FOR ME
In order to assist in carrying out my directive I would like my providers and my agent to know the following information:
I have been diagnosed with (client illnesses both mental health and physical diagnoses) for which I take (list medications).
I am also on the following other medications: (list any other medications for other conditions).
The best treatment method for my illness is (give general overview of what works best for client).
I have/do not have a history of substance abuse. My preferences and treatment options around medication management
related to substance abuse are:
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PART III.
WHEN THIS DIRECTIVE IS EFFECTIVE
(You must complete this part for your directive to be valid.)
I intend that this directive become effective (YOU MUST CHOOSE ONLY ONE):
. . . . . . Immediately upon my signing of this directive.
. . . . . . If I become incapacitated.
. . . . . . When the following circumstances, symptoms, or behaviors occur:
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PART IV .
DURATION OF THIS DIRECTIVE
(You must complete this part for your directive to be valid.)
I want this directive to (YOU MUST CHOOSE ONLY ONE):
. . . . . . Remain valid and in effect for an indefinite period of time.
. . . . . . Automatically expire . . . . . . years from the date it was created.
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PART V .
WHEN I MAY REVOKE THIS DIRECTIVE
(You must complete this part for this directive to be valid.)
I intend that I be able to revoke this directive (YOU MUST CHOOSE ONLY ONE):
. . . . . . Only when I have capacity.
I understand that choosing this option means I may only revoke this directive if I have capacity. I further understand that if
I choose this option and become incapacitated while this directive is in effect, I may receive treatment that I specify in this
directive, even if I object at the time.
. . . . . . Even if I am incapacitated.
I understand that choosing this option means that I may revoke this directive even if I am incapacitated. I further
understand that if I choose this option and revoke this directive while I am incapacitated I may not receive treatment that I
specify in this directive, even if I want the treatment.
p. 335 HB 1281
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PART VI.
PREFERENCES AND INSTRUCTIONS ABOUT TREATMENT, FACILITIES, AND PHYSICIANS, PHYSICIAN
ASSISTANTS, OR ADV ANCED ((REGISTERED NURSE PRACTITIONERS)) PRACTICE REGISTERED
NURSES
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6
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A. Preferences and Instructions About Physician (s), Physician Assistant (s), or Advanced ((Registered Nurse
Practitioner(s))) Practice Registered Nurse(s) to be Involved in My Treatment
I would like the physician (s), physician assistant (s), or advanced ((registered nurse practitioner (s))) practice registered
nurse(s) named below to be involved in my treatment decisions:
I do not wish to be treated by
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B. Preferences and Instructions About Other Providers
I am receiving other treatment or care from providers who I feel have an impact on my mental health care. I would like the
following treatment provider(s) to be contacted when this directive is effective:
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C. Preferences and Instructions About Medications for Psychiatric Treatment (check all that apply)
. . . . . . I consent, and authorize my agent (if appointed) to consent, to the following medications:
. . . . . . I do not consent, and I do not authorize my agent (if appointed) to consent, to the administration of the following
medications:
. . . . . . I am willing to take the medications excluded above if my only reason for excluding them is the side effects which
include:
and these side effects can be eliminated by dosage adjustment or other means
. . . . . . I am willing to try any other medication the hospital doctor, physician assistant, or advanced ((registered nurse
practitioner)) practice registered nurse recommends.
. . . . . . I am willing to try any other medications my outpatient doctor, physician assistant, or advanced ((registered nurse
practitioner)) practice registered nurse recommends.
. . . . . . I do not want to try any other medications.
Medication Allergies.
I have allergies to, or severe side effects from, the following:
Other Medication Preferences or Instructions
. . . . . . I have the following other preferences or instructions about medications:
p. 336 HB 1281
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D. Preferences and Instructions About Hospitalization and Alternatives
(check all that apply and, if desired, rank "1" for first choice, "2" for second choice, and so on)
. . . . . . In the event my psychiatric condition is serious enough to require 24-hour care and I have no physical conditions
that require immediate access to emergency medical care, I prefer to receive this care in programs/facilities designed as
alternatives to psychiatric hospitalizations.
. . . . . . I would also like the interventions below to be tried before hospitalization is considered:
. . . . . . Calling someone or having someone call me when needed.
Name:. . . . . . . . . . . . . . . . . . . . . . . . Telephone/text:. . . . . . . . . . . . . . . . . . . . . . . . Email:. . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . Staying overnight with someone
Name:. . . . . . . . . . . . . . . . . . . . . . . . Telephone/text:. . . . . . . . . . . . . . . . . . . . . . . . Email:. . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . Having a mental health service provider come to see me.
. . . . . . Going to a crisis triage center or emergency room.
. . . . . . Staying overnight at a crisis respite (temporary) bed.
. . . . . . Seeing a service provider for help with psychiatric medications.
. . . . . . Other, specify:
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Authority to Consent to Inpatient Treatment
I consent, and authorize my agent (if appointed) to consent, to voluntary admission to inpatient mental health treatment
for ...... days (not to exceed 14 days).
19 (Sign one): . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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. . . . . . If deemed appropriate by my agent (if appointed) and treating physician, physician assistant, or advanced
((registered nurse practitioner)) practice registered nurse
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signature)

24 Or
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. . . . . . Under the following circumstances (specify symptoms, behaviors, or circumstances that indicate the need for
hospitalization)
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signature)

29 . . . . . . I do not consent, or authorize my agent (if appointed) to consent, to inpatient treatment
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signature)

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Hospital Preferences and Instructions
If hospitalization is required, I prefer the following hospitals:
I do not consent to be admitted to the following hospitals:
p. 337 HB 1281
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E. Preferences and Instructions About Preemergency
I would like the interventions below to be tried before use of seclusion or restraint is considered (check all that apply):
. . . . . . "Talk me down" one-on-one
. . . . . . More medication
. . . . . . Time out/privacy
. . . . . . Show of authority/force
. . . . . . Shift my attention to something else
. . . . . . Set firm limits on my behavior
. . . . . . Help me to discuss/vent feelings
. . . . . . Decrease stimulation
. . . . . . Offer to have neutral person settle dispute
. . . . . . Other:
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F. Preferences and Instructions About Seclusion, Restraint, and Emergency Medications
If it is determined that I am engaging in behavior that requires seclusion, physical restraint, and/or emergency use of
medication, I prefer these interventions in the order I have chosen (choose "1" for first choice, "2" for second choice, and so
on):
. . . . . . Seclusion
. . . . . . Seclusion and physical restraint (combined)
. . . . . . Medication by injection
. . . . . . Medication in pill or liquid form
In the event that my attending physician, physician assistant, or advanced ((registered nurse practitioner )) practice
registered nurse decides to use medication in response to an emergency situation after due consideration of my preferences
and instructions for emergency treatments stated above, I expect the choice of medication to reflect any preferences and
instructions I have expressed in Part VI C. of this form. The preferences and instructions I express in this section regarding
medication in emergency situations do not constitute consent to use of the medication for nonemergency treatment.
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G. Preferences and Instructions About Electroconvulsive Therapy
(ECT or Shock Therapy)
My wishes regarding electroconvulsive therapy are (sign one):
. . . . . .I do not consent, nor authorize my agent (if appointed) to consent, to the administration of electroconvulsive therapy
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signature)

32 . . . . . . I consent, and authorize my agent (if appointed) to consent, to the administration of electroconvulsive therapy
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signature)

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. . . . . . I consent, and authorize my agent (if appointed) to consent, to the administration of electroconvulsive therapy, but
only under the following conditions:
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signature)

p. 338 HB 1281
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H. Preferences and Instructions About Who is Permitted to Visit
If I have been admitted to a mental health treatment facility, the following people are not permitted to visit me there:
4 Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 I understand that persons not listed above may be permitted to visit me.
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I. Additional Instructions About My Mental Health Care
Other instructions about my mental health care:
In case of emergency, please contact:
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Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Work telephone: . . . . . . . . . . . . . . . . . . . . . . . .
Physician, physician assistant, or advanced
((registered nurse practitioner )) practice
registered nurse: . . . . . . . . . . . . . . . . . . . . . . . .
Telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Home telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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The following may help me to avoid a hospitalization:
I generally react to being hospitalized as follows:
Staff of the hospital or crisis unit can help me by doing the following:
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J. Refusal of Treatment
I do not consent to any mental health treatment.
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signature)

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PART VII.
DURABLE POWER OF ATTORNEY (APPOINTMENT OF MY AGENT)
25 (Fill out this part only if you wish to appoint an agent or nominate a guardian.)
p. 339 HB 1281
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I authorize an agent to make mental health treatment decisions on my behalf. The authority granted to my agent includes
the right to consent, refuse consent, or withdraw consent to any mental health care, treatment, service, or procedure,
consistent with any instructions and/or limitations I have set forth in this directive. I intend that those decisions should be
made in accordance with my expressed wishes as set forth in this document. If I have not expressed a choice in this
document and my agent does not otherwise know my wishes , I authorize my agent to make the decision that my agent
determines is in my best interest. This agency shall not be affected by my incapacity. Unless I state otherwise in this
durable power of attorney, I may revoke it unless prohibited by other state law.

HIPAA Release Authority. In addition to the other powers granted by this document, I grant to my Attorney-in-Fact the
power and authority to serve as my personal representative for all purposes under the Health Insurance Portability and
Accountability Act (HIPAA) of 1996, as amended from time to time, and its regulations. My Attorney-in-Fact will serve as
my "HIPAA personal representative" and will exercise this authority at any time that my Attorney-in-Fact is exercising
authority under this document.
14 A. Designation of an Agent
15 Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16 Work phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . Home/cell phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17 Relationship: . . . . . . . . . . . . . . . . . . . . . . . . . . . Email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18 B. Designation of Alternate Agent
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If the person named above is unavailable, unable, or refuses to serve as my agent, or I revoke that person's authority to
serve as my agent, I hereby appoint the following person as my alternate agent and request that this person be notified
immediately when this directive becomes effective or when my original agent is no longer my agent:
22 Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23 Work phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . Home phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24 Relationship: . . . . . . . . . . . . . . . . . . . . . . . . . . . Email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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C. Limitations on My Agent's Authority
I do not grant my agent the authority to consent on my behalf to the following:
D. Limitations on My Ability to Revoke this Durable Power of Attorney
I choose to limit my ability to revoke this durable power of attorney as follows:
E. Preference as to Court-Appointed Guardian
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In the event a court appoints a guardian who will make decisions regarding my mental health treatment, I nominate my
then-serving agent (or name someone else) as my guardian:
32 Name and contact information (if someone other than agent or alternate):
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35
The appointment of a guardian of my estate or my person or any other decision maker shall not give the guardian or
decision maker the power to revoke, suspend, or terminate this directive or the powers of my agent, except as authorized by
law.
p. 340 HB 1281
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4

PART VIII.
OTHER DOCUMENTS
5 (Initial all that apply)
6
7
I have executed the following documents that include the power to make decisions regarding health care services for
myself:
8 . . . . . . Health care power of attorney (chapter 11.125 RCW)
9 . . . . . . "Living will" (Health care directive; chapter 70.122 RCW)
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11
. . . . . . I have appointed more than one agent. I understand that the most recently appointed agent controls except as stated
below:
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PART IX.
NOTIFICATION OF OTHERS AND CARE OF PERSONAL AFFAIRS
14 (Fill out this part only if you wish to provide nontreatment instructions.)
15
16
I understand the preferences and instructions in this part are NOT the responsibility of my treatment provider and that no
treatment provider is required to act on them.
17 A. Who Should Be Notified
18 I desire my agent to notify the following individuals as soon as possible if I am admitted to a mental health facility:
19 Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20 Day telephone: . . . . . . . . . . . . . . . . . . . . . . . . . Evening telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21 Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22 Day telephone: . . . . . . . . . . . . . . . . . . . . . . . . . Evening telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23 Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24 Day telephone: . . . . . . . . . . . . . . . . . . . . . . . . . Evening telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25 B. Preferences or Instructions About Personal Affairs
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I have the following preferences or instructions about my personal affairs (e.g., care of dependents, pets, household) if I am
admitted to a mental health treatment facility:
28 C. Additional Preferences and Instructions:
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PART X.
SIGNATURE
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By signing here, I indicate that I understand the purpose and effect of this document and that I am giving my informed
consent to the treatments and/or admission to which I have consented or authorized my agent to consent in this directive. I
intend that my consent in this directive be construed as being consistent with the elements of informed consent under
chapter 7.70 RCW.
p. 341 HB 1281
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In witness of this, I have signed on this . . . . . . day of . . . . . ., 20. . . .
Signature: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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STATE OF WASHINGTON )
) ss.
COUNTY OF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . )
I certify that I know or have satisfactory evidence that (client name) is
the person who appeared before me, and said person acknowledged that
he or she signed this Durable Power of Attorney and acknowledged it to
be his or her free and voluntary act for the uses and purposes mentioned
in this instrument.
SUBSCRIBED and SWORN to before me this . . . . . . day of . . . . . .,
20. . . .

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SIGNATURE OF NOTARY

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PRINT NAME OF NOTARY

NOTARY PUBLIC for the State of Washington at . . . . . . . . . . . . . . . . .
My commission expires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
OR have two witnesses:
Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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This directive was signed and declared by the "Principal," to be his or her directive, in our presence who, at his or her
request, have signed our names below as witnesses. We declare that, at the time of the creation of this instrument, the
Principal is personally known to us, and, according to our best knowledge and belief, has capacity at this time and does not
appear to be acting under duress, undue influence, or fraud. We further declare that none of us is:
27 (A) A person designated to make medical decisions on the principal's behalf;
28
29
(B) A health care provider or professional person directly involved with the provision of care to the principal at the time the
directive is executed;
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31
(C) An owner, operator, employee, or relative of an owner or operator of a health care facility or long-term care facility in
which the principal is a patient or resident;
32
33
(D) A person who is related by blood, marriage, or adoption to the person, or with whom the principal has a dating
relationship as defined in RCW 7.105.010;
34 (E) An incapacitated person;
35 (F) A person who would benefit financially if the principal undergoes mental health treatment; or
36 (G) A minor.
p. 342 HB 1281
1 Witness 1 Signature: . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Printed Name: . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Witness 2 Signature: . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Printed Name: . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
8
PART XI.
RECORD OF DIRECTIVE
9 I have given a copy of this directive to the following persons:
10
11 Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12 Day telephone: . . . . . . . . . . . . . . . . . . . . . . . . . Evening telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13 Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14 Day telephone: . . . . . . . . . . . . . . . . . . . . . . . . . Evening telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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DO NOT FILL OUT PART XII UNLESS YOU INTEND TO REVOKE
THIS DIRECTIVE IN PART OR IN WHOLE

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PART XII.
REVOCATION OF THIS DIRECTIVE
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21
(Initial any that apply):
. . . . . . I am revoking the following part(s) of this directive (specify):
22 Date: . . . . . . . . .
23 . . . . . . I am revoking all of this directive.
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25
26
By signing here, I indicate that I understand the purpose and effect of my revocation and that no person is bound by any
revoked provision(s). I intend this revocation to be interpreted as if I had never completed the revoked provision(s).

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signature)

29 Printed Name: . . . . . . . . . . . . . . . . . . . . . . . . . .
30
31
DO NOT SIGN THIS PART UNLESS YOU INTEND TO REVOKE THIS
DIRECTIVE IN PART OR IN WHOLE
Sec. 5160. RCW 71.34.720 and 2021 c 264 s 34 are each amended to 32
read as follows: 33
p. 343 HB 1281
(1) Each minor approved by the facility for inpatient admission 1
shall be examined and evaluated by a children's mental health 2
specialist, for minors admitted as a result of a mental disorder, or 3
by a substance use disorder professional or co-occurring disorder 4
specialist, for minors admitted as a result of a substance use 5
disorder, as to the child's mental condition and by a physician, 6
physician assistant, or psychiatric advanced ((registered nurse 7
practitioner)) practice registered nurse as to the child's physical 8
condition within twenty-four hours of admission. Reasonable measures 9
shall be taken to ensure medical treatment is provided for any 10
condition requiring immediate medical attention. 11
(2) If, at any time during the involuntary treatment hold and 12
following the initial examination and evaluation, the children's 13
mental health specialist or substance use disorder specialist and the 14
physician, physician assistant, or psychiatric advanced ((registered 15
nurse practitioner )) practice registered nurse determine that the 16
initial needs of the minor, if detained to an evaluation and 17
treatment facility, would be better served by placement in a secure 18
withdrawal management and stabilization facility or approved 19
substance use disorder treatment program or, if detained to a secure 20
withdrawal management and stabilization facility or approved 21
substance use disorder treatment program, would be better served in 22
an evaluation and treatment facility, then the minor shall be 23
referred to the more appropriate placement for the remainder of the 24
current commitment period without any need for further court review.25
(3) The admitting facility shall take reasonable steps to notify 26
immediately the minor's parent of the admission. 27
(4) During the initial one hundred twenty hour treatment period, 28
the minor has a right to associate or receive communications from 29
parents or others unless the professional person in charge determines 30
that such communication would be seriously detrimental to the minor's 31
condition or treatment and so indicates in the minor's clinical 32
record, and notifies the minor's parents of this determination. A 33
minor must not be denied the opportunity to consult an attorney 34
unless there is an immediate risk of harm to the minor or others.35
(5) If the evaluation and treatment facility, secure withdrawal 36
management and stabilization facility, or approved substance use 37
disorder treatment program admits the minor, it may detain the minor 38
for evaluation and treatment for a period not to exceed one hundred 39
twenty hours from the time of provisional acceptance. The computation 40
p. 344 HB 1281
of such one hundred twenty hour period shall exclude Saturdays, 1
Sundays, and holidays. This initial treatment period shall not exceed 2
one hundred twenty hours except when an application for voluntary 3
inpatient treatment is received or a petition for fourteen-day 4
commitment is filed. 5
(6) Within twelve hours of the admission, the facility shall 6
advise the minor of his or her rights as set forth in this chapter.7
Sec. 5161. RCW 71.34.730 and 2020 c 302 s 89 and 2020 c 185 s 5 8
are each reenacted and amended to read as follows: 9
(1) The professional person in charge of an evaluation and 10
treatment facility, secure withdrawal management and stabilization 11
facility, or approved substance use disorder treatment program where 12
a minor has been admitted involuntarily for the initial one hundred 13
twenty hour treatment period under this chapter may petition to have 14
a minor committed to an evaluation and treatment facility, a secure 15
withdrawal management and stabilization facility, or an approved 16
substance use disorder treatment program for fourteen-day diagnosis, 17
evaluation, and treatment. 18
If the professional person in charge of the facility does not 19
petition to have the minor committed, the parent who has custody of 20
the minor may seek review of that decision in court. The parent shall 21
file notice with the court and provide a copy of the treatment and 22
evaluation facility's report. 23
(2) A petition for commitment of a minor under this section shall 24
be filed with the superior court in the county where the minor is 25
being detained. 26
(a) A petition for a fourteen-day commitment shall be signed by:27
(i) One physician, physician assistant, or psychiatric advanced 28
((registered nurse practitioner)) practice registered nurse; and29
(ii) One physician, physician assistant, psychiatric advanced 30
((registered nurse practitioner )) practice registered nurse , or 31
mental health professional. 32
(b) If the petition is for substance use disorder treatment, the 33
petition may be signed by a substance use disorder professional 34
instead of a mental health professional and by an advanced 35
((registered nurse practitioner )) practice registered nurse instead 36
of a psychiatric advanced ((registered nurse practitioner )) practice 37
registered nurse. The person signing the petition must have examined 38
the minor, and the petition must contain the following:39
p. 345 HB 1281
(i) The name and address of the petitioner; 1
(ii) The name of the minor alleged to meet the criteria for 2
fourteen-day commitment; 3
(iii) The name, telephone number, and address if known of every 4
person believed by the petitioner to be legally responsible for the 5
minor; 6
(iv) A statement that the petitioner has examined the minor and 7
finds that the minor's condition meets required criteria for 8
fourteen-day commitment and the supporting facts therefor;9
(v) A statement that the minor has been advised of the need for 10
voluntary treatment but has been unwilling or unable to consent to 11
necessary treatment; 12
(vi) If the petition is for mental health treatment, a statement 13
that the minor has been advised of the loss of firearm rights if 14
involuntarily committed; 15
(vii) A statement recommending the appropriate facility or 16
facilities to provide the necessary treatment; and17
(viii) A statement concerning whether a less restrictive 18
alternative to inpatient treatment is in the best interests of the 19
minor. 20
(c) A copy of the petition shall be personally served on the 21
minor by the petitioner or petitioner's designee. A copy of the 22
petition shall be provided to the minor's attorney and the minor's 23
parent. 24
Sec. 5162. RCW 71.34.750 and 2024 c 62 s 29 are each amended to 25
read as follows: 26
(1) At any time during the minor's period of fourteen-day 27
commitment, the professional person in charge may petition the court 28
for an order requiring the minor to undergo an additional one hundred 29
eighty-day period of treatment. The evidence in support of the 30
petition shall be presented by the county prosecutor unless the 31
petition is filed by the professional person in charge of a state-32
operated facility in which case the evidence shall be presented by 33
the attorney general. 34
(2) The petition for one hundred eighty-day commitment shall 35
contain the following: 36
(a) The name and address of the petitioner or petitioners;37
(b) The name of the minor alleged to meet the criteria for one 38
hundred eighty-day commitment; 39
p. 346 HB 1281
(c) A statement that the petitioner is the professional person in 1
charge of the evaluation and treatment facility, secure withdrawal 2
management and stabilization facility, or approved substance use 3
disorder treatment program responsible for the treatment of the 4
minor; 5
(d) The date of the fourteen-day commitment order; and6
(e) A summary of the facts supporting the petition.7
(3) The petition shall be supported by accompanying affidavits 8
signed by: (a) Two examining physicians, one of whom shall be a child 9
psychiatrist, or two psychiatric advanced ((registered nurse 10
practitioners)) practice registered nurses , one of whom shall be a 11
child and adolescent or family psychiatric advanced ((registered 12
nurse practitioner )) practice registered nurse . If the petition is 13
for substance use disorder treatment, the petition may be signed by a 14
substance use disorder professional instead of a mental health 15
professional and by an advanced ((registered nurse practitioner )) 16
practice registered nurse instead of a psychiatric advanced 17
((registered nurse practitioner )) practice registered nurse , or two 18
physician assistants, one of whom must be supervised by or 19
collaborating with a child psychiatrist; (b) one children's mental 20
health specialist and either an examining physician, physician 21
assistant, or a psychiatric advanced ((registered nurse 22
practitioner)) practice registered nurse ; or (c) two among an 23
examining physician, physician assistant, and a psychiatric advanced 24
((registered nurse practitioner )) practice registered nurse , one of 25
which needs to be a child psychiatrist, a physician assistant 26
supervised by or collaborating with a child psychiatrist, or a child 27
and adolescent psychiatric nurse practitioner. The affidavits shall 28
describe in detail the behavior of the detained minor which supports 29
the petition and shall state whether a less restrictive alternative 30
to inpatient treatment is in the best interests of the minor.31
(4) The petition for one hundred eighty-day commitment shall be 32
filed with the clerk of the court at least three days before the 33
expiration of the fourteen-day commitment period. The petitioner or 34
the petitioner's designee shall within twenty-four hours of filing 35
serve a copy of the petition on the minor and notify the minor's 36
attorney and the minor's parent. A copy of the petition shall be 37
provided to such persons at least twenty-four hours prior to the 38
hearing. 39
p. 347 HB 1281
(5) At the time of filing, the court shall set a date within 1
seven days for the hearing on the petition. If the hearing is not 2
commenced within thirty days after the filing of the petition, 3
including extensions of time requested by the detained person or his 4
or her attorney or the court in the administration of justice under 5
RCW 71.34.735, the minor must be released. The minor or the parents 6
shall be afforded the same rights as in a fourteen-day commitment 7
hearing. Treatment of the minor shall continue pending the 8
proceeding. 9
(6) For one hundred eighty-day commitment, the court must find by 10
clear, cogent, and convincing evidence that the minor:11
(a) Is suffering from a mental disorder or substance use 12
disorder; 13
(b) Presents a likelihood of serious harm or is gravely disabled; 14
and 15
(c) Is in need of further treatment that only can be provided in 16
a one hundred eighty-day commitment. 17
(7) In determining whether an inpatient or less restrictive 18
alternative commitment is appropriate, great weight must be given to 19
evidence of a prior history or pattern of decompensation and 20
discontinuation of treatment resulting in: (a) Repeated 21
hospitalizations; or (b) repeated peace officer interventions 22
resulting in juvenile charges. Such evidence may be used to provide a 23
factual basis for concluding that the minor would not receive, if 24
released, such care as is essential for his or her health or safety.25
(8)(a) If the court finds that the criteria for commitment are 26
met and that less restrictive treatment in a community setting is not 27
appropriate or available, the court shall order the minor committed 28
to the custody of the director for further inpatient mental health 29
treatment, to an approved substance use disorder treatment program 30
for further substance use disorder treatment, or to a private 31
treatment and evaluation facility for inpatient mental health or 32
substance use disorder treatment if the minor's parents have assumed 33
responsibility for payment for the treatment. If the court finds that 34
a less restrictive alternative is in the best interest of the minor, 35
the court shall order less restrictive alternative treatment upon 36
such conditions as necessary. 37
(b) If the court determines that the minor does not meet the 38
criteria for one hundred eighty-day commitment, the minor shall be 39
released. 40
p. 348 HB 1281
(9) Successive one hundred eighty-day commitments are permissible 1
on the same grounds and under the same procedures as the original one 2
hundred eighty-day commitment. Such petitions shall be filed at least 3
three days prior to the expiration of the previous one hundred 4
eighty-day commitment order. 5
Sec. 5163. RCW 71.34.755 and 2024 c 62 s 30 are each amended to 6
read as follows: 7
(1) Less restrictive alternative treatment, at a minimum, must 8
include the following services: 9
(a) Assignment of a care coordinator; 10
(b) An intake evaluation with the provider of the less 11
restrictive alternative treatment; 12
(c) A psychiatric evaluation, a substance use disorder 13
evaluation, or both; 14
(d) A schedule of regular contacts with the provider of the less 15
restrictive alternative treatment services for the duration of the 16
order; 17
(e) A transition plan addressing access to continued services at 18
the expiration of the order; 19
(f) An individual crisis plan; 20
(g) Consultation about the formation of a mental health advance 21
directive under chapter 71.32 RCW; and 22
(h) Notification to the care coordinator assigned in (a) of this 23
subsection if reasonable efforts to engage the client fail to produce 24
substantial compliance with court-ordered treatment conditions.25
(2) Less restrictive alternative treatment may include the 26
following additional services: 27
(a) Medication management; 28
(b) Psychotherapy; 29
(c) Nursing; 30
(d) Substance use disorder counseling; 31
(e) Residential treatment; 32
(f) Partial hospitalization; 33
(g) Intensive outpatient treatment; 34
(h) Support for housing, benefits, education, and employment; and35
(i) Periodic court review. 36
(3) If the minor was provided with involuntary medication during 37
the involuntary commitment period, the less restrictive alternative 38
treatment order may authorize the less restrictive alternative 39
p. 349 HB 1281
treatment provider or its designee to administer involuntary 1
antipsychotic medication to the person if the provider has attempted 2
and failed to obtain the informed consent of the person and there is 3
a concurring medical opinion approving the medication by a 4
psychiatrist, physician assistant working with a psychiatrist who is 5
acting as a participating physician as defined in RCW 18.71A.010, 6
psychiatric advanced ((registered nurse practitioner )) practice 7
registered nurse, or physician or physician assistant in consultation 8
with an independent mental health professional with prescribing 9
authority. 10
(4) Less restrictive alternative treatment must be administered 11
by a provider that is certified or licensed to provide or coordinate 12
the full scope of services required under the less restrictive 13
alternative order and that has agreed to assume this responsibility.14
(5) The care coordinator assigned to a minor ordered to less 15
restrictive alternative treatment must submit an individualized plan 16
for the minor's treatment services to the court that entered the 17
order. An initial plan must be submitted as soon as possible 18
following the intake evaluation and a revised plan must be submitted 19
upon any subsequent modification in which a type of service is 20
removed from or added to the treatment plan. 21
(6) A care coordinator may disclose information and records 22
related to mental health services pursuant to RCW 70.02.230(2)(k) for 23
purposes of implementing less restrictive alternative treatment.24
(7) For the purpose of this section, "care coordinator" means a 25
clinical practitioner who coordinates the activities of less 26
restrictive alternative treatment. The care coordinator coordinates 27
activities with the designated crisis responders that are necessary 28
for enforcement and continuation of less restrictive alternative 29
treatment orders and is responsible for coordinating service 30
activities with other agencies and establishing and maintaining a 31
therapeutic relationship with the individual on a continuing basis.32
Sec. 5164. RCW 71.34.770 and 2016 c 155 s 22 are each amended to 33
read as follows: 34
(1) The professional person in charge of the inpatient treatment 35
facility may authorize release for the minor under such conditions as 36
appropriate. Conditional release may be revoked pursuant to RCW 37
71.34.780 if leave conditions are not met or the minor's functioning 38
substantially deteriorates. 39
p. 350 HB 1281
(2) Minors may be discharged prior to expiration of the 1
commitment period if the treating physician, physician assistant, 2
psychiatric advanced ((registered nurse practitioner )) practice 3
registered nurse, or professional person in charge concludes that the 4
minor no longer meets commitment criteria. 5
Sec. 5165. RCW 71.34.815 and 2024 c 209 s 10 are each amended to 6
read as follows: 7
(1) An adolescent is in need of assisted outpatient treatment if 8
the court finds by clear, cogent, and convincing evidence in response 9
to a petition filed under this section that: 10
(a) The adolescent has a behavioral health disorder;11
(b) Based on a clinical determination and in view of the 12
adolescent's treatment history and current behavior, at least one of 13
the following is true: 14
(i) The adolescent is unlikely to survive safely in the community 15
without supervision and the adolescent's condition is substantially 16
deteriorating; or 17
(ii) The adolescent is in need of assisted outpatient treatment 18
in order to prevent a relapse or deterioration that would be likely 19
to result in grave disability or a likelihood of serious harm to the 20
adolescent or to others; 21
(c) The adolescent has a history of lack of compliance with 22
treatment for his or her behavioral health disorder that has:23
(i) At least twice within the 36 months prior to the filing of 24
the petition been a significant factor in necessitating 25
hospitalization of the adolescent, or the adolescent's receipt of 26
services in a forensic or other mental health unit of a state, local, 27
or tribal correctional facility, provided that the 36-month period 28
shall be extended by the length of any hospitalization or 29
incarceration of the adolescent that occurred within the 36-month 30
period; 31
(ii) At least twice within the 36 months prior to the filing of 32
the petition been a significant factor in necessitating emergency 33
medical care or hospitalization for behavioral health-related medical 34
conditions including overdose, infected abscesses, sepsis, 35
endocarditis, or other maladies, or a significant factor in behavior 36
which resulted in the adolescent's incarceration in a state, local, 37
or tribal correctional facility; or 38
p. 351 HB 1281
(iii) Resulted in one or more violent acts, threats, or attempts 1
to cause serious physical harm to the adolescent or another within 2
the 48 months prior to the filing of the petition, provided that the 3
48-month period shall be extended by the length of any 4
hospitalization or incarceration of the person that occurred during 5
the 48-month period; 6
(d) Participation in an assisted outpatient treatment program 7
would be the least restrictive alternative necessary to ensure the 8
adolescent's recovery and stability; and 9
(e) The adolescent will benefit from assisted outpatient 10
treatment. 11
(2) The following individuals may directly file a petition for 12
less restrictive alternative treatment on the basis that an 13
adolescent is in need of assisted outpatient treatment:14
(a) The director of a hospital where the adolescent is 15
hospitalized or the director's designee; 16
(b) The director of a behavioral health service provider 17
providing behavioral health care or residential services to the 18
adolescent or the director's designee; 19
(c) The adolescent's treating mental health professional or 20
substance use disorder professional or one who has evaluated the 21
person; 22
(d) A designated crisis responder; 23
(e) A release planner from a juvenile detention or rehabilitation 24
facility; or 25
(f) An emergency room physician. 26
(3) A court order for less restrictive alternative treatment on 27
the basis that the adolescent is in need of assisted outpatient 28
treatment may be effective for up to 18 months. The petitioner must 29
personally interview the adolescent, unless the adolescent refuses an 30
interview, to determine whether the adolescent will voluntarily 31
receive appropriate treatment. 32
(4) The petitioner must allege specific facts based on personal 33
observation, evaluation, or investigation, and must consider the 34
reliability or credibility of any person providing information 35
material to the petition. 36
(5) The petition must include: 37
(a) A statement of the circumstances under which the adolescent's 38
condition was made known and the basis for the opinion, from personal 39
observation or investigation, that the adolescent is in need of 40
p. 352 HB 1281
assisted outpatient treatment. The petitioner must state which 1
specific facts come from personal observation and specify what other 2
sources of information the petitioner has relied upon to form this 3
belief; 4
(b) A declaration from a physician, physician assistant, or 5
advanced ((registered nurse practitioner )) practice registered nurse , 6
or the adolescent's treating mental health professional or substance 7
use disorder professional, who has examined the adolescent no more 8
than 10 days prior to the submission of the petition and who is 9
willing to testify in support of the petition, or who alternatively 10
has made appropriate attempts to examine the adolescent within the 11
same period but has not been successful in obtaining the adolescent's 12
cooperation, and who is willing to testify to the reasons they 13
believe that the adolescent meets the criteria for assisted 14
outpatient treatment. If the declaration is provided by the 15
adolescent's treating mental health professional or substance use 16
disorder professional, it must be cosigned by a supervising 17
physician, physician assistant, or advanced ((registered nurse 18
practitioner)) practice registered nurse who certifies that they have 19
reviewed the declaration; 20
(c) The declarations of additional witnesses, if any, supporting 21
the petition for assisted outpatient treatment; 22
(d) The name of an agency, provider, or facility that agrees to 23
provide less restrictive alternative treatment if the petition is 24
granted by the court; and 25
(e) If the adolescent is detained in a state hospital, inpatient 26
treatment facility, or juvenile detention or rehabilitation facility 27
at the time the petition is filed, the anticipated release date of 28
the adolescent and any other details needed to facilitate successful 29
reentry and transition into the community. 30
(6)(a) Upon receipt of a petition meeting all requirements of 31
this section, the court shall fix a date for a hearing:32
(i) No sooner than three days or later than seven days after the 33
date of service or as stipulated by the parties or, upon a showing of 34
good cause, no later than 30 days after the date of service; or35
(ii) If the adolescent is hospitalized at the time of filing of 36
the petition, before discharge of the adolescent and in sufficient 37
time to arrange for a continuous transition from inpatient treatment 38
to assisted outpatient treatment. 39
p. 353 HB 1281
(b) A copy of the petition and notice of hearing shall be served, 1
in the same manner as a summons, on the petitioner, the adolescent, 2
the qualified professional whose affidavit accompanied the petition, 3
a current provider, if any, and a surrogate decision maker or agent 4
under chapter 71.32 RCW, if any. 5
(c) If the adolescent has a surrogate decision maker or agent 6
under chapter 71.32 RCW who wishes to provide testimony at the 7
hearing, the court shall afford the surrogate decision maker or agent 8
an opportunity to testify. 9
(d) The adolescent shall be represented by counsel at all stages 10
of the proceedings. 11
(e) If the adolescent fails to appear at the hearing after 12
notice, the court may conduct the hearing in the adolescent's 13
absence; provided that the adolescent's counsel is present.14
(f) If the adolescent has refused to be examined by the qualified 15
professional whose affidavit accompanied the petition, the court may 16
order a mental examination of the adolescent. The examination of the 17
adolescent may be performed by the qualified professional whose 18
affidavit accompanied the petition. If the examination is performed 19
by another qualified professional, the examining qualified 20
professional shall be authorized to consult with the qualified 21
professional whose affidavit accompanied the petition.22
(g) If the adolescent has refused to be examined by a qualified 23
professional and the court finds reasonable grounds to believe that 24
the allegations of the petition are true, the court may issue a 25
written order directing a peace officer who has completed crisis 26
intervention training to detain and transport the adolescent to a 27
provider for examination by a qualified professional. An adolescent 28
detained pursuant to this subsection shall be detained no longer than 29
necessary to complete the examination and in no event longer than 24 30
hours. All papers in the court file must be provided to the 31
adolescent's designated attorney. 32
(7) If the petition involves an adolescent whom the petitioner or 33
behavioral health administrative services organization knows, or has 34
reason to know, is an American Indian or Alaska Native who receives 35
medical or behavioral health services from a tribe within this state, 36
the petitioner or behavioral health administrative services 37
organization shall notify the tribe and Indian health care provider. 38
Notification shall be made in person or by telephonic or electronic 39
communication to the tribal contact listed in the authority's tribal 40
p. 354 HB 1281
crisis coordination plan as soon as possible, but before the hearing 1
and no later than 24 hours from the time the petition is served upon 2
the person and the person's guardian. The notice to the tribe or 3
Indian health care provider must include a copy of the petition, 4
together with any orders issued by the court and a notice of the 5
tribe's right to intervene. The court clerk shall provide copies of 6
any court orders necessary for the petitioner or the behavioral 7
health administrative services organization to provide notice to the 8
tribe or Indian health care provider under this section.9
(8) A petition for assisted outpatient treatment filed under this 10
section shall be adjudicated under RCW 71.34.740. 11
(9) After January 1, 2023, a petition for assisted outpatient 12
treatment must be filed on forms developed by the administrative 13
office of the courts. 14
Sec. 5166. RCW 72.09.588 and 2018 c 41 s 1 are each amended to 15
read as follows: 16
(1) The department must make reasonable accommodations for the 17
provision of available midwifery or doula services to inmates who are 18
pregnant or who have given birth in the last six weeks. Persons 19
providing midwifery or doula services must be granted appropriate 20
facility access, must be allowed to attend and provide assistance 21
during labor and childbirth where feasible, and must have access to 22
the inmate's relevant health care information, as defined in RCW 23
70.02.010, if the inmate authorizes disclosure. 24
(2) For purposes of this section, the following definitions 25
apply: 26
(a) "Doula services" are services provided by a trained doula and 27
designed to provide physical, emotional, or informational support to 28
a pregnant woman before, during, and after delivery of a child. Doula 29
services may include, but are not limited to: Support and assistance 30
during labor and childbirth; prenatal and postpartum education; 31
breastfeeding assistance; parenting education; and support in the 32
event that a woman has been or will become separated from her child.33
(b) "Midwifery services" means medical aid rendered by a midwife 34
to a woman during prenatal, intrapartum, or postpartum stages or to a 35
woman's newborn up to two weeks of age. 36
(c) "Midwife" means a midwife licensed under chapter 18.50 RCW or 37
an advanced ((registered nurse practitioner )) practice registered 38
nurse licensed under chapter 18.79 RCW. 39
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(3) Nothing in this section requires the department to establish 1
or provide funding for midwifery or doula services, or prevents the 2
department from adopting policy guidelines for the delivery of 3
midwifery or doula services to inmates. Services provided under this 4
section may not supplant health care services routinely provided to 5
the inmate. 6
Sec. 5167. RCW 74.09.010 and 2023 c 51 s 33 are each amended to 7
read as follows: 8
The definitions in this section apply throughout this chapter 9
unless the context clearly requires otherwise. 10
(1) "Authority" means the Washington state health care authority.11
(2) "Bidirectional integration" means integrating behavioral 12
health services into primary care settings and integrating primary 13
care services into behavioral health settings. 14
(3) "Children's health program" means the health care services 15
program provided to children under eighteen years of age and in 16
households with incomes at or below the federal poverty level as 17
annually defined by the federal department of health and human 18
services as adjusted for family size, and who are not otherwise 19
eligible for medical assistance or the limited casualty program for 20
the medically needy. 21
(4) "Chronic care management" means the health care management 22
within a health home of persons identified with, or at high risk for, 23
one or more chronic conditions. Effective chronic care management:24
(a) Actively assists patients to acquire self-care skills to 25
improve functioning and health outcomes, and slow the progression of 26
disease or disability; 27
(b) Employs evidence-based clinical practices;28
(c) Coordinates care across health care settings and providers, 29
including tracking referrals; 30
(d) Provides ready access to behavioral health services that are, 31
to the extent possible, integrated with primary care; and32
(e) Uses appropriate community resources to support individual 33
patients and families in managing chronic conditions.34
(5) "Chronic condition" means a prolonged condition and includes, 35
but is not limited to: 36
(a) A mental health condition; 37
(b) A substance use disorder; 38
(c) Asthma; 39
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(d) Diabetes; 1
(e) Heart disease; and 2
(f) Being overweight, as evidenced by a body mass index over 3
twenty-five. 4
(6) "County" means the board of county commissioners, county 5
council, county executive, or tribal jurisdiction, or its designee.6
(7) "Department" means the department of social and health 7
services. 8
(8) "Department of health" means the Washington state department 9
of health created pursuant to RCW 43.70.020. 10
(9) "Director" means the director of the Washington state health 11
care authority. 12
(10) "Full benefit dual eligible beneficiary" means an individual 13
who, for any month: Has coverage for the month under a medicare 14
prescription drug plan or medicare advantage plan with part D 15
coverage; and is determined eligible by the state for full medicaid 16
benefits for the month under any eligibility category in the state's 17
medicaid plan or a section 1115 demonstration waiver that provides 18
pharmacy benefits. 19
(11) "Health home" or "primary care health home" means 20
coordinated health care provided by a licensed primary care provider 21
coordinating all medical care services, and a multidisciplinary 22
health care team comprised of clinical and nonclinical staff. The 23
term "coordinating all medical care services" shall not be construed 24
to require prior authorization by a primary care provider in order 25
for a patient to receive treatment for covered services by an 26
optometrist licensed under chapter 18.53 RCW. Primary care health 27
home services shall include those services defined as health home 28
services in 42 U.S.C. Sec. 1396w-4 and, in addition, may include, but 29
are not limited to: 30
(a) Comprehensive care management including, but not limited to, 31
chronic care treatment and management; 32
(b) Extended hours of service; 33
(c) Multiple ways for patients to communicate with the team, 34
including electronically and by phone; 35
(d) Education of patients on self-care, prevention, and health 36
promotion, including the use of patient decision aids;37
(e) Coordinating and assuring smooth transitions and follow-up 38
from inpatient to other settings; 39
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(f) Individual and family support including authorized 1
representatives; 2
(g) The use of information technology to link services, track 3
tests, generate patient registries, and provide clinical data; and4
(h) Ongoing performance reporting and quality improvement.5
(12) "Limited casualty program" means the medical care program 6
provided to medically needy persons as defined under Title XIX of the 7
federal social security act, and to medically indigent persons who 8
are without income or resources sufficient to secure necessary 9
medical services. 10
(13) "Managed care organization" means any health care 11
organization, including health care providers, insurers, health care 12
service contractors, health maintenance organizations, health 13
insuring organizations, or any other entity or combination thereof, 14
that provides directly or by contract health care services covered 15
under this chapter and rendered by licensed providers, on a prepaid 16
capitated basis and that meets the requirements of section 17
1903(m)(1)(A) of Title XIX of the federal social security act or 18
federal demonstration waivers granted under section 1115 (a) of Title 19
XI of the federal social security act. 20
(14) "Medical assistance" means the federal aid medical care 21
program provided to categorically needy persons as defined under 22
Title XIX of the federal social security act. 23
(15) "Medical care services" means the limited scope of care 24
financed by state funds and provided to persons who are not eligible 25
for medicaid under RCW 74.09.510 and who are eligible for the aged, 26
blind, or disabled assistance program authorized in RCW 74.62.030 or 27
the essential needs and housing support program pursuant to RCW 28
74.04.805. 29
(16) "Multidisciplinary health care team" means an 30
interdisciplinary team of health professionals which may include, but 31
is not limited to, medical specialists, nurses, pharmacists, 32
nutritionists, dieticians, social workers, behavioral and mental 33
health providers including substance use disorder prevention and 34
treatment providers, doctors of chiropractic, physical therapists, 35
licensed complementary and alternative medicine practitioners, home 36
care and other long-term care providers, and physicians' assistants.37
(17) "Nursing home" means nursing home as defined in RCW 38
18.51.010. 39
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(18) "Poverty" means the federal poverty level determined 1
annually by the United States department of health and human 2
services, or successor agency. 3
(19) "Primary care behavioral health" means a health care 4
integration model in which behavioral health care is colocated, 5
collaborative, and integrated within a primary care setting.6
(20) "Primary care provider" means a general practice physician, 7
family practitioner, internist, pediatrician, osteopathic physician, 8
naturopath, physician assistant, and advanced ((registered nurse 9
practitioner)) practice registered nurse licensed under Title 18 RCW.10
(21) "Secretary" means the secretary of social and health 11
services. 12
(22) "Whole-person care in behavioral health" means a health care 13
integration model in which primary care services are integrated into 14
a behavioral health setting either through colocation or community-15
based care management. 16
Sec. 5168. RCW 74.09.725 and 2011 1st sp.s. c 15 s 46 are each 17
amended to read as follows: 18
The authority shall provide coverage for prostate cancer 19
screening under this chapter, provided that the screening is 20
delivered upon the recommendation of the patient's physician, 21
advanced ((registered nurse practitioner )) practice registered nurse , 22
or physician assistant. 23
Sec. 5169. RCW 74.42.010 and 2020 c 80 s 56 are each amended to 24
read as follows: 25
Unless the context clearly requires otherwise, the definitions in 26
this section apply throughout this chapter. 27
(1) "Department" means the department of social and health 28
services and the department's employees. 29
(2) "Direct care staff" means the staffing domain identified and 30
defined in the center (([s]))s for medicare and medicaid services' 31
five-star quality rating system and as reported through the 32
center(([s]))s for medicare and medicaid services' payroll-based 33
journal. For purposes of calculating hours per resident day minimum 34
staffing standards for facilities with sixty-one or more licensed 35
beds, the director of nursing services classification (job title code 36
five), as identified in the centers for medicare and medicaid 37
services' payroll-based journal, shall not be used. For facilities 38
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with sixty or fewer beds the director of nursing services 1
classification (job title code five) shall be included in calculating 2
hours per resident day minimum staffing standards. 3
(3) "Facility" refers to a nursing home as defined in RCW 4
18.51.010. 5
(4) "Geriatric behavioral health worker" means a person with a 6
bachelor's or master's degree in social work, behavioral health, or 7
other related areas, or a person who has received specialized 8
training devoted to mental illness and treatment of older adults.9
(5) "Licensed practical nurse" means a person licensed to 10
practice practical nursing under chapter 18.79 RCW.11
(6) "Medicaid" means Title XIX of the Social Security Act enacted 12
by the social security amendments of 1965 (42 U.S.C. Sec. 1396; 79 13
Stat. 343), as amended. 14
(7) "Nurse practitioner" means a person licensed to practice 15
advanced practice registered nursing under chapter 18.79 RCW.16
(8) "Nursing care" means that care provided by a registered 17
nurse, an advanced ((registered nurse practitioner )) practice 18
registered nurse, a licensed practical nurse, or a nursing assistant 19
in the regular performance of their duties. 20
(9) "Physician" means a person practicing pursuant to chapter 21
18.57 or 18.71 RCW, including, but not limited to, a physician 22
employed by the facility as provided in chapter 18.51 RCW.23
(10) "Physician assistant" means a person practicing pursuant to 24
chapter 18.71A RCW. 25
(11) "Qualified therapist" means: 26
(a) An activities specialist who has specialized education, 27
training, or experience specified by the department.28
(b) An audiologist who is eligible for a certificate of clinical 29
competence in audiology or who has the equivalent education and 30
clinical experience. 31
(c) A mental health professional as defined in chapter 71.05 RCW.32
(d) An intellectual disabilities professional who is a qualified 33
therapist or a therapist approved by the department and has 34
specialized training or one year experience in treating or working 35
with persons with intellectual or developmental disabilities.36
(e) An occupational therapist who is a graduate of a program in 37
occupational therapy or who has equivalent education or training.38
(f) A physical therapist as defined in chapter 18.74 RCW.39
(g) A social worker as defined in RCW 18.320.010(2).40
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(h) A speech pathologist who is eligible for a certificate of 1
clinical competence in speech pathology or who has equivalent 2
education and clinical experience. 3
(12) "Registered nurse" means a person licensed to practice 4
registered nursing under chapter 18.79 RCW. 5
(13) "Resident" means an individual residing in a nursing home, 6
as defined in RCW 18.51.010. 7
Sec. 5170. RCW 74.42.380 and 1994 sp.s. c 9 s 753 are each 8
amended to read as follows: 9
(1) The facility shall have a director of nursing services. The 10
director of nursing services shall be a registered nurse or an 11
advanced ((registered nurse practitioner)) practice registered nurse.12
(2) The director of nursing services is responsible for:13
(a) Coordinating the plan of care for each resident;14
(b) Permitting only licensed personnel to administer medications: 15
PROVIDED, That nothing herein shall be construed as prohibiting 16
graduate nurses or student nurses from administering medications when 17
permitted to do so under chapter 18.79 RCW and rules adopted under 18
it: PROVIDED FURTHER, That nothing herein shall be construed as 19
prohibiting persons certified under chapter 18.135 RCW from 20
practicing pursuant to the delegation and supervision requirements of 21
chapter 18.135 RCW and rules adopted under it; and22
(c) Insuring that the licensed practical nurses and the 23
registered nurses comply with chapter 18.79 RCW, and persons 24
certified under chapter 18.135 RCW comply with the provisions of that 25
chapter and rules adopted under it. 26
NEW SECTION. Sec. 5171. Sections 5004, 5005, 5006, 5010, 5012, 27
5013, 5014, 5016, 5017, 5018, 5019, 5020, 5024, 5029, 5030, 5043, 28
5044, 5045, 5047, 5048, 5049, 5051, 5052, 5053, and 5055 of this act 29
expire June 30, 2027.30
NEW SECTION. Sec. 5172. Sections 5058 through 5170 of this act 31
take effect June 30, 2027.32
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