Washington Administrative Code

(1) The purpose of this rule is to set forth the duties and responsibilities of an osteopathic physician who delegates the injection of medications or substances for cosmetic purposes or the use of prescription devices for cosmetic purposes. These procedures can result in complic…

(1) Purpose. The purpose of this rule is to promote and establish consistent standards, continuing competency, and to promote patient safety. The board of osteopathic medicine and surgery establishes the following rule for physicians licensed under chapter 18.57 RCW who perform s…

(1) The purpose of this section is to govern the administration of deep sedation and general anesthesia by osteopathic physicians in dental offices. The board establishes these standards to promote effective perioperative communication and appropriately timed interventions, and m…

WAC 246-853-660 through 246-853-790 govern the prescribing of opioids in the treatment of pain. [Statutory Authority: RCW 18.57.800, 18.57A.800 and 2017 c 297. WSR 18-20-087, § 246-853-660, filed 10/1/18, effective 11/1/18. Statutory Authority: RCW 18.57.285, 18.57A.090, 18.57.00…

WAC 246-853-660 through 246-853-790 do not apply to:(1) The treatment of patients with cancer-related pain;(2) The provision of palliative, hospice, or other end-of-life care;(3) The provision of procedural premedications;(4) The treatment of patients who have been admitted to an…

The definitions in this section apply in WAC 246-853-660 through 246-853-790 unless the context clearly requires otherwise.(1) "Aberrant behavior" means behavior that indicates misuse, diversion, or substance use disorder. This includes, but is not limited to, multiple early refi…

(1) The osteopathic physician shall discuss with the patient educating them of risks associated with the use of opioids, including the risk of dependence and overdose, as appropriate to the medical condition, type of patient, and phase of treatment. The osteopathic physician shal…

The osteopathic physician shall consider multimodal pharmacologic and nonpharmacologic therapy for pain rather than defaulting to the use of opioid therapy alone whenever reasonable, evidence-based, clinically appropriate alternatives exist. An osteopathic physician may combine o…

(1) In order to prescribe an opioid in Washington state, an osteopathic physician licensed to prescribe opioids shall complete a one-time continuing education requirement regarding best practices in the prescribing of opioids and the current opioid prescribing rules in this chapt…

Prior to prescribing opioids for acute nonoperative pain or acute perioperative pain, the osteopathic physician shall:(1) Conduct and document an appropriate history and physical examination, including screening for risk factors for overdose and severe postoperative pain;(2) Eval…

The osteopathic physician shall comply with the requirements in this section when prescribing opioid analgesics for acute nonoperative pain and shall document completion of these requirements in the patient record:(1) The osteopathic physician shall consider prescribing nonopioid…

The osteopathic physician shall comply with the requirements in this section when prescribing opioid analgesics for perioperative pain and shall document completion of these requirements in the patient record:(1) The osteopathic physician shall consider prescribing nonopioid anal…

The osteopathic physician shall comply with the requirements in this section when prescribing opioid analgesics for subacute pain and shall document completion of these requirements in the patient record.(1) Prior to prescribing opioids for subacute pain, the osteopathic physicia…

(1) The osteopathic physician shall recognize the progression of a patient from the acute nonoperative or acute perioperative phase to the subacute phase and take into consideration the risks and benefits of continued opioid prescribing for the patient.(2) If tapering has not beg…

(1) For the purposes of this section, "risk assessment tool" means professionally developed, clinically accepted questionnaires appropriate for identifying a patient's level of risk for substance abuse or misuse.(2) The osteopathic physician shall evaluate and document the patien…

(1) When the patient enters the chronic pain phase, the osteopathic physician shall reevaluate the patient by treating the situation as a new disease.(2) The chronic pain treatment plan must state the objectives that will be used to determine treatment success and must include:(a…

The osteopathic physician shall use a written agreement for treatment with the patient who requires long-term opioid therapy for chronic pain that outlines the patient's responsibilities. This written agreement for treatment must include:(1) The patient's agreement to provide bio…

(1) The osteopathic physician shall periodically review the course of treatment for chronic pain. The osteopathic physician shall base the frequency of visits, biological testing, and PMP queries, in accordance with the provisions of WAC 246-853-790 on the patient's risk category…

(1) The osteopathic physician shall consider referring the patient for additional evaluation and treatment as needed to achieve treatment objectives. Special attention should be given to those chronic pain patients who are under eighteen years of age or who are potential high-ris…

An osteopathic physician is not required to consult with a pain management specialist as defined in WAC 246-853-750 when the osteopathic physician has documented adherence to all standards of practice as defined in WAC 246-853-715 through 246-853-760, and when one or more of the …

An osteopathic physician is exempt from the consultation requirement in WAC 246-853-735 if one or more of the following qualifications are met:(1) The osteopathic physician is a pain management specialist under WAC 246-853-750;(2) The osteopathic physician has successfully comple…

(1) A pain management specialist shall meet one or more of the following qualifications:(a) An osteopathic physician shall be board certified or board eligible by an American Board of Medical Specialties-approved board (ABMS) or by the American Osteopathic Association (AOA) in ph…

(1) The osteopathic physician shall assess and document the appropriateness of continued use of the current treatment plan if the patient's response to or compliance with the current treatment is unsatisfactory.(2) The osteopathic physician shall consider tapering, changing, disc…

(1) When a patient receiving chronic opioid pain medications changes to a new practitioner, it is normally appropriate for the new practitioner to initially maintain the patient's current opioid doses. Over time, the practitioner may evaluate if any tapering or other adjustments …

(1) Patients twenty-five years of age or under. In the treatment of pain for patients twenty-five years of age or under, the osteopathic physician shall treat pain in a manner equal to that of an adult but must account for the weight of the patient and reduce the dosage prescribe…

(1) When providing episodic care for a patient who the osteopathic physician knows is being treated with opioids for chronic pain, such as for emergency or urgent care, the osteopathic physician shall review the PMP to identify any Schedule II–V or drugs of concern received by th…

(1) The osteopathic physician must not knowingly prescribe opioids in combination with the following Schedule II–IV medications without documentation in the patient record of clinical judgment:(a) Benzodiazepines;(b) Barbiturates;(c) Sedatives;(d) Carisoprodol; or(e) Sleeping med…

(1) Where practicable, the osteopathic physician providing acute nonoperative pain or acute perioperative pain treatment to a patient known to be receiving MAT shall prescribe opioids for pain relief either in consultation with the MAT prescribing practitioner or pain specialist.…

(1) The osteopathic physician shall confirm or provide a current prescription for naloxone when high dose opioids are prescribed.(2) The osteopathic physician should counsel and provide an option for a current prescription for naloxone to patients being prescribed opioids as clin…

(1) The osteopathic physician shall register to access the PMP or demonstrate proof of having registered to access the PMP if they prescribe opioids in Washington state.(2) The osteopathic physician may delegate the retrieval of a required PMP query to an authorized designee, in …

(1) Licenses must be renewed every year on the physician's birthday as provided in chapter 246-12 WAC, except postgraduate training limited licenses.(2) Postgraduate training limited licenses must be renewed every year to correspond to program dates.(3) The following nonrefundabl…

(1) The purpose of this chapter is to establish requirements for the recruitment, selection, and appointment process of nonelected members of local boards of health. The processes established in this chapter are intended to be fair, unbiased, and ensure to the extent practicable …

The following definitions apply throughout this chapter unless the context clearly requires otherwise:(1) "Board" means the Washington state board of health.(2) "Consumers of public health" means the category of persons consisting of county or health district residents who have s…

(1) The number of nonelected members, as defined in WAC 246-90-010, on a local board of health, including any tribal representative as described in subsection (2) of this section, must equal the number of elected officials on a local board of health. Elected members of the local …

(1) A local board of health must actively recruit applicants for nonelected member positions of the local board of health in a manner that solicits a broad pool of applicants that represent a diversity of expertise and lived experience.(2) A local board of health must:(a) Provide…

(1) Nonelected members of a local board of health must be selected from the following categories:(a) Public health, health care facilities, and providers;(b) Consumers of public health; and(c) Other community stakeholders.(2) If the total number of nonelected members of a local b…

(1) Nonelected members of a local board of health shall be approved and appointed by a majority vote of the board of county commissioners. If a county does not have a board of county commissioners, then the nonelected members of a local board of health shall be approved and appoi…

In accordance with RCW 70.05.030, 70.05.035, 70.46.020, and 70.46.031, the following exceptions apply to this chapter:(1) For counties with a home rule charter, counties without a home rule charter, health districts consisting of two or more counties, and health districts consist…

The definitions in this section apply throughout this chapter unless the context indicates otherwise:(1) "Board" means the Washington state board of physical therapy.(2) "CAPTE" means the commission on accreditation for physical therapy education.(3) "Close supervision" means tha…

(1) Physical therapy students in their last year of education may apply for licensure by examination prior to graduation if the department receives a letter from an official of the student's physical therapy school verifying the probability of graduation prior to the date of the …

The examination acceptable and approved for use under the provisions of RCW 18.74.035 is the NPTE.(1) For a physical therapist a passing score is considered to be one of the following:(a) Beginning November 8, 1995, the criterion referenced passing point shall be set to equal a s…

(1) An applicant for physical therapist license shall submit to the department:(a) A completed application;(b) The application and licensing fees required under WAC 246-915-990;(c) An official transcript from CAPTE; and(d) Verification of passing NPTE scores.(2) An applicant for …

(1) A physical therapist or physical therapist assistant applicant who has been licensed for two years or longer may qualify for licensure by endorsement providing the applicant meets the requirements in RCW 18.130.077 (1) and (3). A physical therapist or physical therapist assis…

To reactivate an expired license:(1) If the license has expired for one renewal cycle or less, the applicant shall meet the applicable requirements of chapter 246-12 WAC, Part 2.(2) If the license has expired for more than one renewal cycle and the applicant has been in active pr…

Fingerprint-based background checks may cause a delay in licensing. Individuals who satisfy all other licensing requirements and qualifications may receive a temporary permit while the national background check is completed.(1) A temporary permit may be issued to an applicant who…

A military spouse or state registered domestic partner of a military person may receive a temporary practice permit while completing any specific additional requirements that are not related to training or practice standards for the profession by meeting the procedural requiremen…

(1) The department, upon approval by the board, will issue an interim permit authorizing an applicant for licensure who meets the minimum qualifications stated in RCW 18.74.030 to practice physical therapy under graduate supervision pending notification of the results of the firs…

(1) Every two years, a physical therapist (PT) shall complete 32 hours of continuing education (CE) through any of the following means: CE TypeMaximum Hours AllowedDocumentation Requirementsa.Participation in a course, live or online, including recorded.No limitKeep certificates …

(1) A qualifying training in suicide assessment must:(a) Be an empirically supported training in suicide assessment that includes screening and referral;(b) Be provided by a single provider and must be at least three hours in length which may be provided in one or more sessions;(…

The board adopts the standards of the CAPTE for the approval of physical therapy schools. Individuals who have a baccalaureate degree in physical therapy or who have a baccalaureate degree and a certificate or advanced degree from an institution of higher learning accredited by t…