Pharmacist prescriptive auth

AN ACT Relating to expanding prescriptive authority for 1
pharmacists; amending RCW 69.41.030 and 69.41.030; reenacting and 2
amending RCW 18.64.011; creating a new section; providing an 3
effective date; and providing an expiration date. 4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:5
NEW SECTION. Sec. 1. (1) The legislature is deeply concerned 6
about Washington's provider shortage, particularly in rural and 7
underserved communities. Pharmacists are highly trained health care 8
professionals who are uniquely qualified to prescribe medications and 9
devices that improve patient access and outcomes. They practice 10
across many health care settings and routinely prescribe and manage 11
therapies for chronic conditions, including behavioral health, 12
addiction, cardiovascular disease, diabetes, and autoimmune 13
disorders.14
(2) The legislature recognizes that pharmacists earn a doctor of 15
pharmacy degree, the required standard since 2000, which includes 16
extensive education focused on medications and the conditions they 17
treat with a minimum of 1,740 hours of direct patient care in both 18
community and inpatient settings. Despite over 25 years of advanced 19
training, the scope of practice for pharmacists in Washington has 20
remained unchanged. Health care relies upon medications that have 21
H-2566.1
HOUSE BILL 2302
State of Washington 69th Legislature 2026 Regular Session
By Representatives Thai, Macri, Reed, Zahn, Thomas, Stonier, Ormsby,
and Hill
Prefiled 01/07/26. Read first time 01/12/26. Referred to Committee
on Health Care & Wellness.
p. 1 HB 2302
grown in complexity and quantity. Pharmacists are highly trained 1
health care providers that are underutilized. Pharmacists have 2
extensive training to ensure that complex and expensive medications 3
are optimally used to improve outcomes. 4
(3) The legislature affirms that pharmacists in Washington have 5
been prescribing and diagnosing under collaborative drug therapy 6
agreements since 1979. The 2020 opinion of the Washington state 7
attorney general confirmed that pharmacists may diagnose pursuant to 8
these protocols. The Washington state pharmacy quality assurance 9
commission has no record of patient harm related to pharmacists 10
prescribing or diagnosing under collaborative drug therapy 11
agreements, and the legislature finds that pharmacists provide safe, 12
accessible care. 13
(4) However, the legislature finds that maintaining and filing 14
the collaborative drug therapy agreements have become an 15
administrative burden that does not improve oversight or patient 16
care. To expand access and fully leverage pharmacists' expertise, it 17
is the intent of the legislature to improve outcomes in both 18
behavioral and physical health by authorizing pharmacists to practice 19
to the full extent of their education, training, and experience.20
Sec. 2. RCW 18.64.011 and 2024 c 121 s 30 are each reenacted and 21
amended to read as follows: 22
The definitions in this section apply throughout this chapter 23
unless the context clearly requires otherwise. 24
(1) "Administer" means the direct application of a drug or 25
device, whether by injection, inhalation, ingestion, or any other 26
means, to the body of a patient or research subject.27
(2) "Business licensing system" means the mechanism established 28
by chapter 19.02 RCW by which business licenses, endorsed for 29
individual state-issued licenses, are issued and renewed utilizing a 30
business license application and a business license expiration date 31
common to each renewable license endorsement. 32
(3) "Chart order" means a lawful order for a drug or device 33
entered on the chart or medical record of an inpatient or resident of 34
an institutional facility by a practitioner or his or her designated 35
agent. 36
(4) "Closed door long-term care pharmacy" means a pharmacy that 37
provides pharmaceutical care to a defined and exclusive group of 38
patients who have access to the services of the pharmacy because they 39
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are treated by or have an affiliation with a long-term care facility 1
or hospice program, and that is not a retailer of goods to the 2
general public. 3
(5) "Commission" means the pharmacy quality assurance commission.4
(6) "Compounding" means the act of combining two or more 5
ingredients in the preparation of a prescription. Reconstitution and 6
mixing of (a) sterile products according to federal food and drug 7
administration-approved labeling does not constitute compounding if 8
prepared pursuant to a prescription and administered immediately or 9
in accordance with package labeling, and (b) nonsterile products 10
according to federal food and drug administration-approved labeling 11
does not constitute compounding if prepared pursuant to a 12
prescription. 13
(7) "Controlled substance" means a drug or substance, or an 14
immediate precursor of such drug or substance, so designated under or 15
pursuant to the provisions of chapter 69.50 RCW. 16
(8) "Deliver" or "delivery" means the actual, constructive, or 17
attempted transfer from one person to another of a drug or device, 18
whether or not there is an agency relationship. 19
(9) "Department" means the department of health.20
(10) "Device" means instruments, apparatus, and contrivances, 21
including their components, parts, and accessories, intended (a) for 22
use in the diagnosis, cure, mitigation, treatment, or prevention of 23
disease in human beings or other animals, or (b) to affect the 24
structure or any function of the body of human beings or other 25
animals. 26
(11) "Directed plan of correction" means a plan devised by the 27
commission that includes specific actions that must be taken to 28
correct identified unresolved deficiencies with time frames to 29
complete them. 30
(12) "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
(13) "Distribute" means the delivery of a drug or device other 36
than by administering or dispensing. 37
(14) "Drug" and "devices" do not include surgical or dental 38
instruments or laboratory materials, gas and oxygen, therapy 39
equipment, X-ray apparatus or therapeutic equipment, their component 40
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parts or accessories, or equipment, instruments, apparatus, or 1
contrivances used to render such articles effective in medical, 2
surgical, or dental treatment, or for use or consumption in or for 3
mechanical, industrial, manufacturing, or scientific applications or 4
purposes. "Drug" also does not include any article or mixture covered 5
by the Washington pesticide control act ( chapter 15.58 RCW), as 6
enacted or hereafter amended, nor medicated feed intended for and 7
used exclusively as a feed for animals other than human beings.8
(15) "Drugs" means: 9
(a) Articles recognized in the official United States 10
pharmacopoeia or the official homeopathic pharmacopoeia of the United 11
States; 12
(b) Substances intended for use in the diagnosis, cure, 13
mitigation, treatment, or prevention of disease in human beings or 14
other animals; 15
(c) Substances (other than food) intended to affect the structure 16
or any function of the body of human beings or other animals; or17
(d) Substances intended for use as a component of any substances 18
specified in (a), (b), or (c) of this subsection, but not including 19
devices or their component parts or accessories. 20
(16) "Health care entity" means an organization that provides 21
health care services in a setting that is not otherwise licensed by 22
the state to acquire or possess legend drugs. Health care entity 23
includes a freestanding outpatient surgery center, a residential 24
treatment facility, and a freestanding cardiac care center. "Health 25
care entity" does not include an individual practitioner's office or 26
a multipractitioner clinic, regardless of ownership, unless the owner 27
elects licensure as a health care entity. "Health care entity" also 28
does not include an individual practitioner's office or 29
multipractitioner clinic identified by a hospital on a pharmacy 30
application or renewal pursuant to RCW 18.64.043. 31
(17) "Hospice program" means a hospice program certified or paid 32
by medicare under Title XVIII of the federal social security act, or 33
a hospice program licensed under chapter 70.127 RCW.34
(18) "Immediate jeopardy" means a situation in which a licensee's 35
noncompliance with one or more statutory or regulatory requirements 36
has placed the health and safety of individuals or animals at risk 37
for serious injury, serious harm, serious impairment, or death.38
(19) "Institutional facility" means any organization whose 39
primary purpose is to provide a physical environment for patients to 40
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obtain health care services including, but not limited to, services 1
in a hospital, long-term care facility, hospice program, mental 2
health facility, drug abuse treatment center, residential 3
habilitation center, or a local, state, or federal correction 4
facility. 5
(20) "Labeling" means the process of preparing and affixing a 6
label to any drug or device container. The label must include all 7
information required by current federal and state law and pharmacy 8
rules. 9
(21) "Legend drugs" means any drugs which are required by any 10
applicable federal or state law or regulation to be dispensed on 11
prescription only or are restricted to use by practitioners only.12
(22) "License," "licensing," and "licensure" shall be deemed 13
equivalent to the terms "approval," "credential," "certificate," 14
"certification," "permit," and "registration" and an "exemption" 15
issued under chapter 69.50 RCW. 16
(23) "Long-term care facility" means a nursing home licensed 17
under chapter 18.51 RCW, an assisted living facility licensed under 18
chapter 18.20 RCW, or an adult family home licensed under chapter 19
70.128 RCW. 20
(24) "Manufacture" means the production, preparation, 21
propagation, compounding, or processing of a drug or other substance 22
or device or the packaging or repackaging of such substance or 23
device, or the labeling or relabeling of the commercial container of 24
such substance or device, but does not include the activities of a 25
practitioner who, as an incident to his or her administration or 26
dispensing such substance or device in the course of his or her 27
professional practice, personally prepares, compounds, packages, or 28
labels such substance or device. "Manufacture" includes the 29
distribution of a licensed pharmacy compounded drug product to other 30
state licensed persons or commercial entities for subsequent resale 31
or distribution, unless a specific product item has approval of the 32
commission. The term does not include: 33
(a) The activities of a licensed pharmacy that compounds a 34
product on or in anticipation of an order of a licensed practitioner 35
for use in the course of their professional practice to administer to 36
patients, either personally or under their direct supervision;37
(b) The practice of a licensed pharmacy when repackaging 38
commercially available medication in small, reasonable quantities for 39
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a practitioner legally authorized to prescribe the medication for 1
office use only; 2
(c) The distribution of a drug product that has been compounded 3
by a licensed pharmacy to other appropriately licensed entities under 4
common ownership or control of the facility in which the compounding 5
takes place; or 6
(d) The delivery of finished and appropriately labeled compounded 7
products dispensed pursuant to a valid prescription to alternate 8
delivery locations, other than the patient's residence, when 9
requested by the patient, or the prescriber to administer to the 10
patient, or to another licensed pharmacy to dispense to the patient.11
(25) "Manufacturer" means a person, corporation, or other entity 12
engaged in the manufacture of drugs or devices. 13
(26) "Nonlegend" or "nonprescription" drugs means any drugs which 14
may be lawfully sold without a prescription. 15
(27) "Person" means an individual, corporation, government, 16
governmental subdivision or agency, business trust, estate, trust, 17
partnership or association, or any other legal entity.18
(28) "Pharmacist" means a person duly licensed by the commission 19
to engage in the practice of pharmacy. 20
(29) "Pharmacy" means every place properly licensed by the 21
commission where the practice of pharmacy is conducted.22
(30) "Plan of correction" means a proposal devised by the 23
applicant or licensee that includes specific actions that must be 24
taken to correct identified unresolved deficiencies with the time 25
frames to complete them. 26
(31) "Poison" does not include any article or mixture covered by 27
the Washington pesticide control act ( chapter 15.58 RCW), as enacted 28
or hereafter amended. 29
(32) "Practice of pharmacy" includes the practice of and 30
responsibility for: Interpreting prescription orders; the 31
compounding, dispensing, labeling, administering, and distributing of 32
drugs and devices; the monitoring of drug therapy and use; the 33
initiating or modifying of drug therapy in accordance with written 34
guidelines or protocols previously established and approved for his 35
or her practice by a practitioner authorized to prescribe drugs; 36
diagnosing and the prescribing or ordering of drugs and devices based 37
on his or her education, training, and experience; the participating 38
in drug utilization reviews and drug product selection; the proper 39
and safe storing and distributing of drugs and devices and 40
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maintenance of proper records thereof; the providing of information 1
on legend drugs which may include, but is not limited to, the 2
advising of therapeutic values, hazards, and the uses of drugs and 3
devices. 4
(33) "Practitioner" means a physician, dentist, veterinarian, 5
nurse, or other person duly authorized by law or rule in the state of 6
Washington to prescribe drugs. 7
(34) "Prescription" means an order for drugs or devices issued by 8
a practitioner duly authorized by law or rule in the state of 9
Washington to prescribe drugs or devices in the course of his or her 10
professional practice for a legitimate medical purpose.11
(35) "Secretary" means the secretary of health or the secretary's 12
designee. 13
(36) "Shared pharmacy services" means a system that allows a 14
participating pharmacist or pharmacy pursuant to a request from 15
another participating pharmacist or pharmacy to process or fill a 16
prescription or drug order, which may include but is not necessarily 17
limited to preparing, packaging, labeling, data entry, compounding 18
for specific patients, dispensing, performing drug utilization 19
reviews, conducting claims adjudication, obtaining refill 20
authorizations, reviewing therapeutic interventions, or reviewing 21
chart orders. 22
(37) "Statement of deficiency" means a written statement of the 23
deficiencies prepared by the commission, or its designee, identifying 24
one or more violations of law. The report clearly identifies the 25
specific law or rule that has been violated along with a description 26
of the reasons for noncompliance. 27
(38) "Wholesaler" means a corporation, individual, or other 28
entity which buys drugs or devices for resale and distribution to 29
corporations, individuals, or entities other than consumers.30
Sec. 3. RCW 69.41.030 and 2024 c 102 s 2 are each amended to 31
read as follows: 32
(1) It shall be unlawful for any person to sell or deliver any 33
legend drug, or knowingly possess any legend drug, or knowingly use 34
any legend drug in a public place, except upon the order or 35
prescription of a physician under chapter 18.71 RCW, an osteopathic 36
physician and surgeon under chapter 18.57 RCW, an optometrist 37
licensed under chapter 18.53 RCW who is certified by the optometry 38
board under RCW 18.53.010, a dentist under chapter 18.32 RCW, a 39
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podiatric physician and surgeon under chapter 18.22 RCW, a licensed 1
midwife to the extent authorized under chapter 18.50 RCW, a 2
veterinarian under chapter 18.92 RCW, a commissioned medical or 3
dental officer in the United States armed forces or public health 4
service in the discharge of his or her official duties, a duly 5
licensed physician or dentist employed by the veterans administration 6
in the discharge of his or her official duties, a registered nurse or 7
advanced registered nurse practitioner under chapter 18.79 RCW when 8
authorized by the board of nursing, a pharmacist licensed under 9
chapter 18.64 RCW ((to the extent permitted by drug therapy 10
guidelines or protocols established under RCW 18.64.011 and 11
authorized by the commission and approved by a practitioner 12
authorized to prescribe drugs )), a physician assistant under chapter 13
18.71A RCW when authorized by the Washington medical commission, or 14
any of the following professionals in any province of Canada that 15
shares a common border with the state of Washington or in any state 16
of the United States: A physician licensed to practice medicine and 17
surgery or a physician licensed to practice osteopathic medicine and 18
surgery, a dentist licensed to practice dentistry, a podiatric 19
physician and surgeon licensed to practice podiatric medicine and 20
surgery, a licensed advanced registered nurse practitioner, a 21
licensed physician assistant, or a veterinarian licensed to practice 22
veterinary medicine: PROVIDED, HOWEVER, That the above provisions 23
shall not apply to sale, delivery, or possession by drug wholesalers 24
or drug manufacturers, or their agents or employees, or to any 25
practitioner acting within the scope of his or her license, or to a 26
common or contract carrier or warehouse operator, or any employee 27
thereof, whose possession of any legend drug is in the usual course 28
of business or employment: PROVIDED FURTHER, That nothing in this 29
chapter or chapter 18.64 RCW shall prevent a family planning clinic 30
that is under contract with the health care authority from selling, 31
delivering, possessing, and dispensing commercially prepackaged oral 32
contraceptives prescribed by authorized, licensed health care 33
practitioners: PROVIDED FURTHER, That nothing in this chapter 34
prohibits possession or delivery of legend drugs by an authorized 35
collector or other person participating in the operation of a drug 36
take-back program authorized in chapter 69.48 RCW.37
(2)(a) A violation of this section involving the sale, delivery, 38
or possession with intent to sell or deliver is a class B felony 39
punishable according to chapter 9A.20 RCW. 40
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(b) A violation of this section involving knowing possession is a 1
misdemeanor. The prosecutor is encouraged to divert such cases for 2
assessment, treatment, or other services. 3
(c) A violation of this section involving knowing use in a public 4
place is a misdemeanor. The prosecutor is encouraged to divert such 5
cases for assessment, treatment, or other services.6
(d) No person may be charged with both knowing possession and 7
knowing use in a public place under this section relating to the same 8
course of conduct. 9
(e) In lieu of jail booking and referral to the prosecutor for a 10
violation of this section involving knowing possession, or knowing 11
use in a public place, law enforcement is encouraged to offer a 12
referral to assessment and services available under RCW 10.31.110 or 13
other program or entity responsible for receiving referrals in lieu 14
of legal system involvement, which may include, but are not limited 15
to, arrest and jail alternative programs established under RCW 16
36.28A.450, law enforcement assisted diversion programs established 17
under RCW 71.24.589, and the recovery navigator program established 18
under RCW 71.24.115. 19
(3) For the purposes of this section, "public place" has the same 20
meaning as defined in RCW 66.04.010, but the exclusions in RCW 21
66.04.011 do not apply. 22
(4) For the purposes of this section, "use any legend drug" means 23
to introduce the drug into the human body by injection, inhalation, 24
ingestion, or any other means. 25
Sec. 4. RCW 69.41.030 and 2025 c 58 s 5123 are each amended to 26
read as follows: 27
(1) It shall be unlawful for any person to sell or deliver any 28
legend drug, or knowingly possess any legend drug, or knowingly use 29
any legend drug in a public place, except upon the order or 30
prescription of a physician under chapter 18.71 RCW, an osteopathic 31
physician and surgeon under chapter 18.57 RCW, an optometrist 32
licensed under chapter 18.53 RCW who is certified by the optometry 33
board under RCW 18.53.010, a dentist under chapter 18.32 RCW, a 34
podiatric physician and surgeon under chapter 18.22 RCW, a licensed 35
midwife to the extent authorized under chapter 18.50 RCW, a 36
veterinarian under chapter 18.92 RCW, a commissioned medical or 37
dental officer in the United States armed forces or public health 38
service in the discharge of his or her official duties, a duly 39
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licensed physician or dentist employed by the veterans administration 1
in the discharge of his or her official duties, a registered nurse or 2
advanced practice registered nurse under chapter 18.79 RCW when 3
authorized by the board of nursing, a pharmacist licensed under 4
chapter 18.64 RCW ((to the extent permitted by drug therapy 5
guidelines or protocols established under RCW 18.64.011 and 6
authorized by the commission and approved by a practitioner 7
authorized to prescribe drugs )), a physician assistant under chapter 8
18.71A RCW when authorized by the Washington medical commission, or 9
any of the following professionals in any province of Canada that 10
shares a common border with the state of Washington or in any state 11
of the United States: A physician licensed to practice medicine and 12
surgery or a physician licensed to practice osteopathic medicine and 13
surgery, a dentist licensed to practice dentistry, a podiatric 14
physician and surgeon licensed to practice podiatric medicine and 15
surgery, a licensed advanced practice registered nurse, a licensed 16
physician assistant, or a veterinarian licensed to practice 17
veterinary medicine: PROVIDED, HOWEVER, That the above provisions 18
shall not apply to sale, delivery, or possession by drug wholesalers 19
or drug manufacturers, or their agents or employees, or to any 20
practitioner acting within the scope of his or her license, or to a 21
common or contract carrier or warehouse operator, or any employee 22
thereof, whose possession of any legend drug is in the usual course 23
of business or employment: PROVIDED FURTHER, That nothing in this 24
chapter or chapter 18.64 RCW shall prevent a family planning clinic 25
that is under contract with the health care authority from selling, 26
delivering, possessing, and dispensing commercially prepackaged oral 27
contraceptives prescribed by authorized, licensed health care 28
practitioners: PROVIDED FURTHER, That nothing in this chapter 29
prohibits possession or delivery of legend drugs by an authorized 30
collector or other person participating in the operation of a drug 31
take-back program authorized in chapter 69.48 RCW.32
(2)(a) A violation of this section involving the sale, delivery, 33
or possession with intent to sell or deliver is a class B felony 34
punishable according to chapter 9A.20 RCW. 35
(b) A violation of this section involving knowing possession is a 36
misdemeanor. The prosecutor is encouraged to divert such cases for 37
assessment, treatment, or other services. 38
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(c) A violation of this section involving knowing use in a public 1
place is a misdemeanor. The prosecutor is encouraged to divert such 2
cases for assessment, treatment, or other services.3
(d) No person may be charged with both knowing possession and 4
knowing use in a public place under this section relating to the same 5
course of conduct. 6
(e) In lieu of jail booking and referral to the prosecutor for a 7
violation of this section involving knowing possession, or knowing 8
use in a public place, law enforcement is encouraged to offer a 9
referral to assessment and services available under RCW 10.31.110 or 10
other program or entity responsible for receiving referrals in lieu 11
of legal system involvement, which may include, but are not limited 12
to, arrest and jail alternative programs established under RCW 13
36.28A.450, law enforcement assisted diversion programs established 14
under RCW 71.24.589, and the recovery navigator program established 15
under RCW 71.24.115. 16
(3) For the purposes of this section, "public place" has the same 17
meaning as defined in RCW 66.04.010, but the exclusions in RCW 18
66.04.011 do not apply. 19
(4) For the purposes of this section, "use any legend drug" means 20
to introduce the drug into the human body by injection, inhalation, 21
ingestion, or any other means. 22
NEW SECTION. Sec. 5. Section 3 of this act expires June 30, 23
2027.24
NEW SECTION. Sec. 6. Section 4 of this act takes effect June 25
30, 2027.26
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