Pharmacist scope of practice

AN ACT Relating to expanding pharmacists' scope of practice to 1
improve access to health care and the management of chronic diseases; 2
amending RCW 69.41.030; reenacting and amending RCW 18.64.011; adding 3
a new section to chapter 18.64 RCW; creating new sections; and 4
providing an expiration date. 5
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:6
NEW SECTION. Sec. 1. The legislature recognizes pharmacists as 7
highly educated health care professionals uniquely qualified to 8
prescribe medications and devices to improve patient outcomes. Being 9
deeply concerned about provider shortages in Washington, particularly 10
in rural and underserved communities, the legislature seeks to expand 11
access to care by leveraging pharmacists' expertise. It is the intent 12
of the legislature to improve patient outcomes for behavioral and 13
physical health by permitting pharmacists to practice at the top of 14
their education, training, and experience.15
Sec. 2. RCW 18.64.011 and 2024 c 121 s 30 are each reenacted and 16
amended to read as follows: 17
The definitions in this section apply throughout this chapter 18
unless the context clearly requires otherwise. 19
H-0603.3
HOUSE BILL 1520
State of Washington 69th Legislature 2025 Regular Session
By Representatives Thai, Reed, Simmons, and Macri
Read first time 01/22/25. Referred to Committee on Health Care &
Wellness.
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(1) "Administer" means the direct application of a drug or 1
device, whether by injection, inhalation, ingestion, or any other 2
means, to the body of a patient or research subject.3
(2) "Business licensing system" means the mechanism established 4
by chapter 19.02 RCW by which business licenses, endorsed for 5
individual state-issued licenses, are issued and renewed utilizing a 6
business license application and a business license expiration date 7
common to each renewable license endorsement. 8
(3) "Chart order" means a lawful order for a drug or device 9
entered on the chart or medical record of an inpatient or resident of 10
an institutional facility by a practitioner or his or her designated 11
agent. 12
(4) "Closed door long-term care pharmacy" means a pharmacy that 13
provides pharmaceutical care to a defined and exclusive group of 14
patients who have access to the services of the pharmacy because they 15
are treated by or have an affiliation with a long-term care facility 16
or hospice program, and that is not a retailer of goods to the 17
general public. 18
(5) "Commission" means the pharmacy quality assurance commission.19
(6) "Compounding" means the act of combining two or more 20
ingredients in the preparation of a prescription. Reconstitution and 21
mixing of (a) sterile products according to federal food and drug 22
administration-approved labeling does not constitute compounding if 23
prepared pursuant to a prescription and administered immediately or 24
in accordance with package labeling, and (b) nonsterile products 25
according to federal food and drug administration-approved labeling 26
does not constitute compounding if prepared pursuant to a 27
prescription. 28
(7) "Controlled substance" means a drug or substance, or an 29
immediate precursor of such drug or substance, so designated under or 30
pursuant to the provisions of chapter 69.50 RCW. 31
(8) "Deliver" or "delivery" means the actual, constructive, or 32
attempted transfer from one person to another of a drug or device, 33
whether or not there is an agency relationship. 34
(9) "Department" means the department of health.35
(10) "Device" means instruments, apparatus, and contrivances, 36
including their components, parts, and accessories, intended (a) for 37
use in the diagnosis, cure, mitigation, treatment, or prevention of 38
disease in human beings or other animals, or (b) to affect the 39
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structure or any function of the body of human beings or other 1
animals. 2
(11) "Directed plan of correction" means a plan devised by the 3
commission that includes specific actions that must be taken to 4
correct identified unresolved deficiencies with time frames to 5
complete them. 6
(12) "Dispense" means the interpretation of a prescription or 7
order for a drug, biological, or device and, pursuant to that 8
prescription or order, the proper selection, measuring, compounding, 9
labeling, or packaging necessary to prepare that prescription or 10
order for delivery. 11
(13) "Distribute" means the delivery of a drug or device other 12
than by administering or dispensing. 13
(14) "Drug" and "devices" do not include surgical or dental 14
instruments or laboratory materials, gas and oxygen, therapy 15
equipment, X-ray apparatus or therapeutic equipment, their component 16
parts or accessories, or equipment, instruments, apparatus, or 17
contrivances used to render such articles effective in medical, 18
surgical, or dental treatment, or for use or consumption in or for 19
mechanical, industrial, manufacturing, or scientific applications or 20
purposes. "Drug" also does not include any article or mixture covered 21
by the Washington pesticide control act ( chapter 15.58 RCW), as 22
enacted or hereafter amended, nor medicated feed intended for and 23
used exclusively as a feed for animals other than human beings.24
(15) "Drugs" means: 25
(a) Articles recognized in the official United States 26
pharmacopoeia or the official homeopathic pharmacopoeia of the United 27
States; 28
(b) Substances intended for use in the diagnosis, cure, 29
mitigation, treatment, or prevention of disease in human beings or 30
other animals; 31
(c) Substances (other than food) intended to affect the structure 32
or any function of the body of human beings or other animals; or33
(d) Substances intended for use as a component of any substances 34
specified in (a), (b), or (c) of this subsection, but not including 35
devices or their component parts or accessories. 36
(16) "Health care entity" means an organization that provides 37
health care services in a setting that is not otherwise licensed by 38
the state to acquire or possess legend drugs. Health care entity 39
includes a freestanding outpatient surgery center, a residential 40
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treatment facility, and a freestanding cardiac care center. "Health 1
care entity" does not include an individual practitioner's office or 2
a multipractitioner clinic, regardless of ownership, unless the owner 3
elects licensure as a health care entity. "Health care entity" also 4
does not include an individual practitioner's office or 5
multipractitioner clinic identified by a hospital on a pharmacy 6
application or renewal pursuant to RCW 18.64.043. 7
(17) "Hospice program" means a hospice program certified or paid 8
by medicare under Title XVIII of the federal social security act, or 9
a hospice program licensed under chapter 70.127 RCW.10
(18) "Immediate jeopardy" means a situation in which a licensee's 11
noncompliance with one or more statutory or regulatory requirements 12
has placed the health and safety of individuals or animals at risk 13
for serious injury, serious harm, serious impairment, or death.14
(19) "Institutional facility" means any organization whose 15
primary purpose is to provide a physical environment for patients to 16
obtain health care services including, but not limited to, services 17
in a hospital, long-term care facility, hospice program, mental 18
health facility, drug abuse treatment center, residential 19
habilitation center, or a local, state, or federal correction 20
facility. 21
(20) "Labeling" means the process of preparing and affixing a 22
label to any drug or device container. The label must include all 23
information required by current federal and state law and pharmacy 24
rules. 25
(21) "Legend drugs" means any drugs which are required by any 26
applicable federal or state law or regulation to be dispensed on 27
prescription only or are restricted to use by practitioners only.28
(22) "License," "licensing," and "licensure" shall be deemed 29
equivalent to the terms "approval," "credential," "certificate," 30
"certification," "permit," and "registration" and an "exemption" 31
issued under chapter 69.50 RCW. 32
(23) "Long-term care facility" means a nursing home licensed 33
under chapter 18.51 RCW, an assisted living facility licensed under 34
chapter 18.20 RCW, or an adult family home licensed under chapter 35
70.128 RCW. 36
(24) "Manufacture" means the production, preparation, 37
propagation, compounding, or processing of a drug or other substance 38
or device or the packaging or repackaging of such substance or 39
device, or the labeling or relabeling of the commercial container of 40
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such substance or device, but does not include the activities of a 1
practitioner who, as an incident to his or her administration or 2
dispensing such substance or device in the course of his or her 3
professional practice, personally prepares, compounds, packages, or 4
labels such substance or device. "Manufacture" includes the 5
distribution of a licensed pharmacy compounded drug product to other 6
state licensed persons or commercial entities for subsequent resale 7
or distribution, unless a specific product item has approval of the 8
commission. The term does not include: 9
(a) The activities of a licensed pharmacy that compounds a 10
product on or in anticipation of an order of a licensed practitioner 11
for use in the course of their professional practice to administer to 12
patients, either personally or under their direct supervision;13
(b) The practice of a licensed pharmacy when repackaging 14
commercially available medication in small, reasonable quantities for 15
a practitioner legally authorized to prescribe the medication for 16
office use only; 17
(c) The distribution of a drug product that has been compounded 18
by a licensed pharmacy to other appropriately licensed entities under 19
common ownership or control of the facility in which the compounding 20
takes place; or 21
(d) The delivery of finished and appropriately labeled compounded 22
products dispensed pursuant to a valid prescription to alternate 23
delivery locations, other than the patient's residence, when 24
requested by the patient, or the prescriber to administer to the 25
patient, or to another licensed pharmacy to dispense to the patient.26
(25) "Manufacturer" means a person, corporation, or other entity 27
engaged in the manufacture of drugs or devices. 28
(26) "Nonlegend" or "nonprescription" drugs means any drugs which 29
may be lawfully sold without a prescription. 30
(27) "Person" means an individual, corporation, government, 31
governmental subdivision or agency, business trust, estate, trust, 32
partnership or association, or any other legal entity.33
(28) "Pharmacist" means a person duly licensed by the commission 34
to engage in the practice of pharmacy. 35
(29) "Pharmacy" means every place properly licensed by the 36
commission where the practice of pharmacy is conducted.37
(30) "Plan of correction" means a proposal devised by the 38
applicant or licensee that includes specific actions that must be 39
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taken to correct identified unresolved deficiencies with the time 1
frames to complete them. 2
(31) "Poison" does not include any article or mixture covered by 3
the Washington pesticide control act ( chapter 15.58 RCW), as enacted 4
or hereafter amended. 5
(32) "Practice of pharmacy" includes the practice of and 6
responsibility for: Interpreting prescription orders; the 7
compounding, dispensing, labeling, administering, and distributing of 8
drugs and devices; the monitoring of drug therapy and use; the 9
initiating or modifying of drug therapy in accordance with written 10
guidelines or protocols previously established and approved for his 11
or her practice by a practitioner authorized to prescribe drugs; the 12
diagnosing of conditions and diseases as authorized by this chapter 13
and commission rules; the prescribing or ordering of drugs and 14
devices as authorized by this chapter and commission rules; the 15
participating in drug utilization reviews and drug product selection; 16
the proper and safe storing and distributing of drugs and devices and 17
maintenance of proper records thereof; the providing of information 18
on legend drugs which may include, but is not limited to, the 19
advising of therapeutic values, hazards, and the uses of drugs and 20
devices. 21
(33) "Practitioner" means a physician, dentist, veterinarian, 22
nurse, or other person duly authorized by law or rule in the state of 23
Washington to prescribe drugs. 24
(34) "Prescription" means an order for drugs or devices issued by 25
a practitioner duly authorized by law or rule in the state of 26
Washington to prescribe drugs or devices in the course of his or her 27
professional practice for a legitimate medical purpose.28
(35) "Secretary" means the secretary of health or the secretary's 29
designee. 30
(36) "Shared pharmacy services" means a system that allows a 31
participating pharmacist or pharmacy pursuant to a request from 32
another participating pharmacist or pharmacy to process or fill a 33
prescription or drug order, which may include but is not necessarily 34
limited to preparing, packaging, labeling, data entry, compounding 35
for specific patients, dispensing, performing drug utilization 36
reviews, conducting claims adjudication, obtaining refill 37
authorizations, reviewing therapeutic interventions, or reviewing 38
chart orders. 39
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(37) "Statement of deficiency" means a written statement of the 1
deficiencies prepared by the commission, or its designee, identifying 2
one or more violations of law. The report clearly identifies the 3
specific law or rule that has been violated along with a description 4
of the reasons for noncompliance. 5
(38) "Wholesaler" means a corporation, individual, or other 6
entity which buys drugs or devices for resale and distribution to 7
corporations, individuals, or entities other than consumers.8
NEW SECTION. Sec. 3. A new section is added to chapter 18.64 9
RCW to read as follows: 10
(1) Beginning December 1, 2026, a pharmacist may prescribe the 11
following: 12
(a) Immunizations; 13
(b) Opioid antagonists and treatments for addiction;14
(c) Epinephrine autoinjectors; 15
(d) Antihistamine agents; 16
(e) Tobacco cessation products; 17
(f) Medications to prevent human immunodeficiency virus;18
(g) Tuberculin purified protein derivative products;19
(h) Hormonal contraception; 20
(i) Medications to treat or prevent diseases related to travel; 21
and 22
(j) Drugs, drug categories, or devices that are limited to 23
conditions that: 24
(i) Do not require a new diagnosis; 25
(ii) Are minor and generally self-limiting; 26
(iii) Have a test that is used to guide diagnosis or clinical 27
decision making and are waived under the federal clinical laboratory 28
improvement amendments of 1988; 29
(iv) Are devices waived under the federal clinical laboratory 30
improvement amendments of 1988; or 31
(v) Are prescribed in team-based practices with a shared medical 32
record. 33
(2) This section expires January 1, 2030. 34
Sec. 4. RCW 69.41.030 and 2024 c 102 s 2 are each amended to 35
read as follows: 36
(1) It shall be unlawful for any person to sell or deliver any 37
legend drug, or knowingly possess any legend drug, or knowingly use 38
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any legend drug in a public place, except upon the order or 1
prescription of a physician under chapter 18.71 RCW, an osteopathic 2
physician and surgeon under chapter 18.57 RCW, an optometrist 3
licensed under chapter 18.53 RCW who is certified by the optometry 4
board under RCW 18.53.010, a dentist under chapter 18.32 RCW, a 5
podiatric physician and surgeon under chapter 18.22 RCW, a licensed 6
midwife to the extent authorized under chapter 18.50 RCW, a 7
veterinarian under chapter 18.92 RCW, a commissioned medical or 8
dental officer in the United States armed forces or public health 9
service in the discharge of his or her official duties, a duly 10
licensed physician or dentist employed by the veterans administration 11
in the discharge of his or her official duties, a registered nurse or 12
advanced registered nurse practitioner under chapter 18.79 RCW when 13
authorized by the board of nursing, a pharmacist licensed under 14
chapter 18.64 RCW to the extent permitted ((by drug therapy 15
guidelines or protocols established under RCW 18.64.011 and 16
authorized by the commission and approved by a practitioner 17
authorized to prescribe drugs )) under chapter 18.64 RCW, a physician 18
assistant under chapter 18.71A RCW when authorized by the Washington 19
medical commission, or any of the following professionals in any 20
province of Canada that shares a common border with the state of 21
Washington or in any state of the United States: A physician licensed 22
to practice medicine and surgery or a physician licensed to practice 23
osteopathic medicine and surgery, a dentist licensed to practice 24
dentistry, a podiatric physician and surgeon licensed to practice 25
podiatric medicine and surgery, a licensed advanced registered nurse 26
practitioner, a licensed physician assistant, or a veterinarian 27
licensed to practice veterinary medicine: PROVIDED, HOWEVER, That the 28
above provisions shall not apply to sale, delivery, or possession by 29
drug wholesalers or drug manufacturers, or their agents or employees, 30
or to any practitioner acting within the scope of his or her license, 31
or to a common or contract carrier or warehouse operator, or any 32
employee thereof, whose possession of any legend drug is in the usual 33
course of business or employment: PROVIDED FURTHER, That nothing in 34
this chapter or chapter 18.64 RCW shall prevent a family planning 35
clinic that is under contract with the health care authority from 36
selling, delivering, possessing, and dispensing commercially 37
prepackaged oral contraceptives prescribed by authorized, licensed 38
health care practitioners: PROVIDED FURTHER, That nothing in this 39
chapter prohibits possession or delivery of legend drugs by an 40
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authorized collector or other person participating in the operation 1
of a drug take-back program authorized in chapter 69.48 RCW.2
(2)(a) A violation of this section involving the sale, delivery, 3
or possession with intent to sell or deliver is a class B felony 4
punishable according to chapter 9A.20 RCW. 5
(b) A violation of this section involving knowing possession is a 6
misdemeanor. The prosecutor is encouraged to divert such cases for 7
assessment, treatment, or other services. 8
(c) A violation of this section involving knowing use in a public 9
place is a misdemeanor. The prosecutor is encouraged to divert such 10
cases for assessment, treatment, or other services.11
(d) No person may be charged with both knowing possession and 12
knowing use in a public place under this section relating to the same 13
course of conduct. 14
(e) In lieu of jail booking and referral to the prosecutor for a 15
violation of this section involving knowing possession, or knowing 16
use in a public place, law enforcement is encouraged to offer a 17
referral to assessment and services available under RCW 10.31.110 or 18
other program or entity responsible for receiving referrals in lieu 19
of legal system involvement, which may include, but are not limited 20
to, arrest and jail alternative programs established under RCW 21
36.28A.450, law enforcement assisted diversion programs established 22
under RCW 71.24.589, and the recovery navigator program established 23
under RCW 71.24.115. 24
(3) For the purposes of this section, "public place" has the same 25
meaning as defined in RCW 66.04.010, but the exclusions in RCW 26
66.04.011 do not apply. 27
(4) For the purposes of this section, "use any legend drug" means 28
to introduce the drug into the human body by injection, inhalation, 29
ingestion, or any other means. 30
NEW SECTION. Sec. 5. The pharmacy quality assurance commission 31
may adopt rules to administer and implement this act.32
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