RCW 43.70.452
Agricultural industry workforce behavioral health improvement and suicide prevention
—
Pilot program.
(1) Subject to the availability of amounts appropriated for this specific purpose not to exceed two hundred thousand dollars per fiscal year, the department shall establish a pilot program to support behavioral health improvement and suicide prevention efforts for members of the agricultural industry workforce. By March 1, 2019, the pilot program shall be established in a county west of the Cascade crest that is reliant on the agricultural industry.
(2) When implementing the pilot program, the department shall consider the report of the task force on behavioral health and suicide prevention in the agricultural industry established in section 2, chapter 95, Laws of 2018.
(3) In implementing the pilot program, the department shall contract with an entity that has behavioral health and suicide prevention expertise to develop a free resource for workers in the agricultural industry. When selecting an entity, the department shall seek to use an entity that has an existing telephonic and web-based resource, including entities that have prepared similar resources for other states. The contracting entity must be responsible for constructing and hosting the free resource and linking the free resource to the websites of the department, the department of agriculture, and other relevant stakeholders.
(4) At a minimum, the free resource must:
(a) Be made publicly available through a web-based portal or a telephone support line;
(b) Provide a resource to train agricultural industry management, workers, and their family members in suicide risk recognition and referral skills;
(c) Provide a resource to build capacity within the agricultural industry to train individuals to deliver training in person;
(d) Contain model crisis protocols that address behavioral health crisis and suicide risk identification, intervention, reentry, and postvention;
(e) Contain model marketing materials and messages that promote behavioral health in the agricultural industry; and
(f) Be made available in English and Spanish.
(5) A preliminary report shall be made to the legislature on the elements and implementation of the pilot program by December 1, 2019. A final report containing information about results of the pilot program and recommendations for improving the pilot program and expanding its availability to other counties shall be made to the legislature by December 1, 2020.
[
2018 c 95 s 3
.]
NOTES:
Findings
—
2018 c 95:
"(1) The legislature finds that the agricultural industry is an integral part of Washington's economy and sense of common identity, and that the behavioral health of workers in the industry and their family members is a statewide concern.
(2) Several factors related to the agricultural industry may affect the behavioral health of workers in the agricultural industry, including job-related isolation and demands, stressful work environments, the heightened potential for financial losses, lack of access to behavioral health services, and barriers to or unwillingness to seek mental health services.
(3) A 2016 report from the federal centers for disease control and prevention studied suicide data from the year 2012 and found that workers in the farming, fishing, and forestry industries had the highest rate of suicide, eighty-four and one-half suicides per one hundred thousand workers, among the occupational groups that it studied.
(4) The legislature finds that there is an urgent need to develop resources and interventions specifically targeted to helping workers in the agricultural industry and their family members manage their behavioral health needs." [
2018 c 95 s 1
.]
RCW 43.70.455
Statewide forensic nurse coordination program.
(1) Subject to the availability of amounts appropriated for this specific purpose, the department of health hereby creates a program to ensure statewide forensic nurse coordination.
(2) The statewide forensic nurse coordination program shall:
(a) Provide technical assistance to adult, adolescent, and pediatric sexual assault nurse examiner programs and forensic nurse examiner programs across the state;
(b) Identify and alleviate barriers faced by hospitals relating to creating, maintaining, or operating adult adolescent, or pediatric sexual assault nurse examiner programs or forensic nurse examiner programs;
(c) Conduct a statewide needs assessment of adult, adolescent, and pediatric sexual assault nurse examiner programs and forensic nurse examiner programs;
(d) Provide and maintain centralized resources for adult, adolescent, and pediatric sexual assault nurse examiners and forensic nurse examiners;
(e) Oversee the supply, distribution, and content of Washington standardized sexual assault kits;
(f) Develop and update standards of care for forensic exams and documentation;
(g) Assess and maintain standards for forensic nurse training curriculum for ongoing and didactic training, including preceptorship, by:
(i) Providing technical assistance to promote consistent trainings across the state with variances as needed;
(ii) Providing information on trauma-informed and cultural competency standards; and
(iii) Facilitating surveys and other mechanisms to provide forensic exam patients the ability to give feedback on the patients' experiences that can be used to enhance forensic nurse training standards;
(h) Coordinate statewide forensic nurse trainings;
(i) Develop standardized forensic nurse training videos for hospitals and perform on-site trainings at hospitals;
(j) Develop plans to ensure statewide coverage and availability of adult, adolescent, and pediatric sexual assault nurse examiners and forensic nurse examiners;
(k) Maintain and collect data on the availability of adult, adolescent, and pediatric sexual assault nurse examiners and forensic nurse examiners;
(l) Coordinate with victim advocacy services;
(m) Provide organizational and capacity building support to adult, adolescent, and pediatric sexual assault nurse examiner programs and forensic nurse examiner programs; and
(n) Integrate resources for victims of sexual assault into existing local or state referral hotlines.
[
2024 c 297 s 17
.]
NOTES:
Effective date
—
2024 c 297:
See note following RCW 7.68.127
.
RCW 43.70.460
Retired primary and specialty care provider liability malpractice insurance
—
Program authorized.
(1) The department may establish a program to purchase and maintain liability malpractice insurance for retired primary and specialty care providers who provide health care services to low-income patients. The following conditions apply to the program:
(a) Health care services shall be provided at clinics serving low-income patients that are public or private tax-exempt corporations or other established practice settings as defined by the department;
(b) Health care services provided at the clinics shall be offered to low-income patients based on their ability to pay;
(c) Retired health care providers providing health care services shall not receive compensation for their services; and
(d) The department shall contract only with a liability insurer authorized to offer liability malpractice insurance in the state.
(e) Specialists in this program will be limited to those whose malpractice insurance premiums are comparable to primary care providers.
(2) This section and RCW 43.70.470
shall not be interpreted to require a liability insurer to provide coverage to a health care provider should the insurer determine that coverage should not be offered to a health care provider because of past claims experience or for other appropriate reasons.
(3) The state and its employees who operate the program shall be immune from any civil or criminal action involving claims against clinics or health care providers that provided health care services under this section and RCW 43.70.470
. This protection of immunity shall not extend to any clinic or health care provider participating in the program.
(4) The department may monitor the claims experience of retired health care providers covered by liability insurers contracting with the department.
(5) The department may provide liability insurance under chapter 113, Laws of 1992 only to the extent funds are provided for this purpose by the legislature. If there are insufficient funds to support all applications for liability insurance coverage, priority shall be given to those retired health care providers working at clinics operated by public or private tax-exempt corporations rather than clinics operated by for-profit corporations.
[
2005 c 156 s 1
;
2004 c 184 s 1
;
1993 c 492 s 276
;
1992 c 113 s 2
.]
NOTES:
Finding
—
1993 c 492:
See note following RCW 28B.115.080
.
Findings
—
Intent
—
1993 c 492:
See notes following RCW 43.20.050
.
Short title
—
Savings
—
Reservation of legislative power
—
Effective dates
—
1993 c 492:
See RCW 43.72.910
through
43.72.915
.
Legislative declaration
—
1992 c 113:
"There are a number of retired physicians who wish to provide, or are providing, health care services to low-income patients without compensation. However, the cost of obtaining malpractice insurance is a burden that is deterring them from donating their time and services in treating the health problems of the poor. The necessity of maintaining malpractice insurance for those in practice is a significant reality in today's litigious society.
A program to alleviate the onerous costs of malpractice insurance for retired physicians providing uncompensated health care services to low-income patients will encourage philanthropy and augment state resources in providing for the health care needs of those who have no access to basic health care services.
An estimated sixteen percent of the nonelderly population do not have health insurance and lack access to even basic health care services. This is especially problematic for low-income persons who are young and who are either unemployed or have entry-level jobs without health care benefits. The majority of the uninsured, however, are working adults, and some twenty-nine percent are children.
The legislature declares that this act will increase the availability of primary care to low-income persons and is in the interest of the public health and safety." [
1992 c 113 s 1
.]
RCW 43.70.470
Retired health care provider liability malpractice insurance
—
Conditions.
(Effective until June 30, 2027.)
The department may establish by rule the conditions of participation in the liability insurance program by retired health care providers at clinics utilizing retired health care providers for the purposes of this section and RCW 43.70.460
. These conditions shall include, but not be limited to, the following:
(1) The participating health care provider associated with the clinic shall hold a valid license to practice as a physician under chapter
18.71
or
18.57
RCW, a naturopath under chapter
18.36A
RCW, a physician assistant under chapter
18.71A
RCW, an *advanced registered nurse practitioner under chapter
18.79
RCW, a dentist under chapter
18.32
RCW, or other health professionals as may be deemed in short supply by the department. All health care providers must be in conformity with current requirements for licensure, including continuing education requirements;
(2) Health care shall be limited to noninvasive procedures and shall not include obstetrical care. Noninvasive procedures include injections, suturing of minor lacerations, and incisions of boils or superficial abscesses. Primary dental care shall be limited to diagnosis, oral hygiene, restoration, and extractions and shall not include orthodontia, or other specialized care and treatment;
(3) The provision of liability insurance coverage shall not extend to acts outside the scope of rendering health care services pursuant to this section and RCW 43.70.460
;
(4) The participating health care provider shall limit the provision of health care services to primarily low-income persons provided that clinics may, but are not required to, provide means tests for eligibility as a condition for obtaining health care services;
(5) The participating health care provider shall not accept compensation for providing health care services from patients served pursuant to this section and RCW 43.70.460, nor from clinics serving these patients. "Compensation" shall mean any remuneration of value to the participating health care provider for services provided by the health care provider, but shall not be construed to include any nominal copayments charged by the clinic, nor reimbursement of related expenses of a participating health care provider authorized by the clinic in advance of being incurred; and
(6) The use of mediation or arbitration for resolving questions of potential liability may be used, however any mediation or arbitration agreement format shall be expressed in terms clear enough for a person with a sixth grade level of education to understand, and on a form no longer than one page in length.
[
2020 c 80 s 31
;
2005 c 156 s 2
;
2004 c 184 s 2
;
1993 c 492 s 277
;
1992 c 113 s 3
.]
NOTES:
*Reviser's note:
The term "advanced registered nurse practitioner" was changed to "advanced practice registered nurse" by 2024 c 239 s 1, effective June 30, 2027.
Effective date
—
2020 c 80 ss 12-59:
See note following RCW 7.68.030
.
Intent
—
2020 c 80:
See note following RCW 18.71A.010
.
Finding
—
1993 c 492:
See note following RCW 28B.115.080
.
Findings
—
Intent
—
1993 c 492:
See notes following RCW 43.20.050
.
Short title
—
Savings
—
Reservation of legislative power
—
Effective dates
—
1993 c 492:
See RCW 43.72.910
through
43.72.915
.
Legislative declaration
—
1992 c 113:
See note following RCW 43.70.460
.
PDF
RCW 43.70.470
Retired health care provider liability malpractice insurance
—
Conditions.
(Effective June 30, 2027.)
The department may establish by rule the conditions of participation in the liability insurance program by retired health care providers at clinics utilizing retired health care providers for the purposes of this section and RCW 43.70.460
. These conditions shall include, but not be limited to, the following:
(1) The participating health care provider associated with the clinic shall hold a valid license to practice as a physician under chapter
18.71
or
18.57
RCW, a naturopath under chapter
18.36A
RCW, a physician assistant under chapter
18.71A
RCW, an advanced practice registered nurse under chapter
18.79
RCW, a dentist under chapter
18.32
RCW, or other health professionals as may be deemed in short supply by the department. All health care providers must be in conformity with current requirements for licensure, including continuing education requirements;
(2) Health care shall be limited to noninvasive procedures and shall not include obstetrical care. Noninvasive procedures include injections, suturing of minor lacerations, and incisions of boils or superficial abscesses. Primary dental care shall be limited to diagnosis, oral hygiene, restoration, and extractions and shall not include orthodontia, or other specialized care and treatment;
(3) The provision of liability insurance coverage shall not extend to acts outside the scope of rendering health care services pursuant to this section and RCW 43.70.460
;
(4) The participating health care provider shall limit the provision of health care services to primarily low-income persons provided that clinics may, but are not required to, provide means tests for eligibility as a condition for obtaining health care services;
(5) The participating health care provider shall not accept compensation for providing health care services from patients served pursuant to this section and RCW 43.70.460, nor from clinics serving these patients. "Compensation" shall mean any remuneration of value to the participating health care provider for services provided by the health care provider, but shall not be construed to include any nominal copayments charged by the clinic, nor reimbursement of related expenses of a participating health care provider authorized by the clinic in advance of being incurred; and
(6) The use of mediation or arbitration for resolving questions of potential liability may be used, however any mediation or arbitration agreement format shall be expressed in terms clear enough for a person with a sixth grade level of education to understand, and on a form no longer than one page in length.
[
2025 c 58 s 5095
;
2020 c 80 s 31
;
2005 c 156 s 2
;
2004 c 184 s 2
;
1993 c 492 s 277
;
1992 c 113 s 3
.]
NOTES:
Effective date
—
2025 c 58 ss 5058-5170:
See note following RCW 7.68.030
.
Explanatory note
—
2025 c 58:
See note following RCW 1.16.050
.
Effective date
—
2020 c 80 ss 12-59:
See note following RCW 7.68.030
.
Intent
—
2020 c 80:
See note following RCW 18.71A.010
.
Finding
—
1993 c 492:
See note following RCW 28B.115.080
.
Findings
—
Intent
—
1993 c 492:
See notes following RCW 43.20.050
.
Short title
—
Savings
—
Reservation of legislative power
—
Effective dates
—
1993 c 492:
See RCW 43.72.910
through
43.72.915
.
Legislative declaration
—
1992 c 113:
See note following RCW 43.70.460
.
RCW 43.70.480
Emergency medical personnel
—
Futile treatment and natural death directives
—
Guidelines.
The department of health shall adopt guidelines and protocols for how emergency medical personnel shall respond when summoned to the site of an injury or illness for the treatment of a person who has signed a written directive or durable power of attorney requesting that he or she not receive futile emergency medical treatment.
The guidelines shall include development of a simple form that shall be used statewide.
[
2000 c 70 s 1
;
1992 c 98 s 14
.]
NOTES:
Application
—
1992 c 98:
See RCW 70.122.915
.
RCW 43.70.490
Emergency medical service personnel training program
—
Assistance to persons with disabilities
—
Requirements
—
Law enforcement officer training
—
Definitions.
(1) Subject to the availability of amounts appropriated for this specific purpose, the department, in collaboration with the department of social and health services, the state fire marshal's office, the superintendent of public instruction, and the Washington state council of firefighters, must review existing local training programs and training programs being used in other states and design a statewide training program that will familiarize fire department and emergency medical service personnel with the techniques, procedures, and protocols for best handling situations in which persons with disabilities are present at the scene of an emergency in order to maximize the safety of persons with disabilities, minimize the likelihood of injury to persons with disabilities, and promote the safety of all persons present. The program must include a checklist of disabilities, symptoms of such disabilities, and things to do and not to do relevant to a particular disability so fire department and emergency medical services personnel can easily and quickly determine the specific scenario into which they are entering. The department must make the training program available on the department's website for use by all fire departments and emergency medical service agencies in the state. The department must include on its website a list of public and private nonprofit disability-related agencies and organizations and the contact information of each agency and organization. Fire departments and emergency medical service agencies must ensure their employees are adequately trained in and familiarized with techniques, procedures, and protocols for best handling situations in which persons with particular disabilities are present at the scene of an emergency.
(2) Subject to the availability of amounts appropriated for this specific purpose, the criminal justice training commission, in consultation with the Washington state patrol and other stakeholders, must examine existing training programs and curricula related to law enforcement officers responding to an emergency where a person with a disability may be present, to ensure that those programs and curricula are consistent with best practices.
(3) For purposes of this section:
(a) Both "accident" and "emergency" mean an unforeseen combination of circumstances or a resulting situation that results in a need for assistance or relief and calls for immediate action; and
(b) "Persons with disabilities" means individuals who have been diagnosed medically to have a physical, mental, emotional, intellectual, behavioral, developmental, or sensory disability.
[
2017 c 295 s 2
.]
NOTES:
Short title
—
2017 c 295:
"This act may be known and cited as the Travis alert act." [
2017 c 295 s 1
.]
RCW 43.70.495
Telemedicine training for health care professionals.
(1) The legislature finds that a large segment of Washington residents do not have access to critical health care services. Telemedicine is a way to increase access to health care services to those who would otherwise not have reasonable access. The legislature therefore intends to ensure that health care professionals who provide services through telemedicine, as defined in RCW 70.41.020, in cities and rural areas alike, have current information available, making it possible for them to provide telemedicine services to the entire state of Washington.
(2) Except as permitted under subsection (3) of this section, beginning January 1, 2021, a health care professional who provides clinical services through telemedicine, other than a physician licensed under chapter
18.71
RCW or an osteopathic physician licensed under chapter
18.57
RCW, shall complete a telemedicine training. By January 1, 2020, the telemedicine collaborative shall make a telemedicine training available on its website for use by health care professionals who use telemedicine technology. If a health care professional completes the training, the health care professional shall sign and retain an attestation. The training:
(a) Must include information on current state and federal law, liability, informed consent, and other criteria established by the collaborative for the advancement of telemedicine, in collaboration with the department and the Washington state medical quality assurance commission [medical commission];
(b) Must include a question and answer methodology to demonstrate accrual of knowledge; and
(c) May be made available in electronic format and completed over the internet.
(3) A health care professional is deemed to have met the requirements of subsection (2) of this section if the health care professional:
(a) Completes an alternative telemedicine training; and
(b) Signs and retains an attestation that he or she completed the alternative telemedicine training.
(4) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.
(a) "Alternative telemedicine training" means training that includes components that are substantively similar to the telemedicine training developed by the telemedicine collaborative under subsection (2) of this section. "Alternative telemedicine training" may include, but is not limited to:
(i) Training offered by hospitals and other health care facilities to employees of the facility;
(ii) Continuing education courses; and
(iii) Trainings developed by a health care professional board or commission.
(b) "Health care professional" means a person licensed, registered, or certified to provide health services.
[
2020 c 147 s 1
;
2019 c 48 s 1
.]
RCW 43.70.500
Health care services practice indicators and risk management protocols.
The department of health shall consult with health care providers and facilities, purchasers, health professional regulatory authorities under RCW 18.130.040, appropriate research and clinical experts, and consumers of health care services to identify specific practice areas where practice indicators and risk management protocols have been developed, including those that have been demonstrated to be effective among persons of color. Practice indicators shall be based upon expert consensus and best available scientific evidence. The department shall:
(1) Develop a definition of expert consensus and best available scientific evidence so that practice indicators can serve as a standard for excellence in the provision of health care services.
(2) Establish a process to identify and evaluate practice indicators and risk management protocols as they are developed by the appropriate professional, scientific, and clinical communities.
(3) Recommend the use of practice indicators and risk management protocols in quality assurance, utilization review, or provider payment to the health services commission.
[
1993 c 492 s 410
.]
NOTES:
Findings
—
Intent
—
1993 c 492:
See notes following RCW 43.20.050
.
Short title
—
Savings
—
Reservation of legislative power
—
Effective dates
—
1993 c 492:
See RCW 43.72.910
through
43.72.915
.
RCW 43.70.510
Health care services coordinated quality improvement program
—
Rules.
(1)(a) Health care institutions and medical facilities, other than hospitals, that are licensed by the department, professional societies or organizations, health care service contractors, health maintenance organizations, health carriers approved pursuant to chapter
48.43
RCW, and any other person or entity providing health care coverage under chapter
48.42
RCW that is subject to the jurisdiction and regulation of any state agency or any subdivision thereof may maintain a coordinated quality improvement program for the improvement of the quality of health care services rendered to patients and the identification and prevention of medical malpractice as set forth in RCW 70.41.200
.
(b) All such programs shall comply with the requirements of RCW 70.41.200
(1) (a), (c), (d), (e), (f), (g), and (h) as modified to reflect the structural organization of the institution, facility, professional societies or organizations, health care service contractors, health maintenance organizations, health carriers, or any other person or entity providing health care coverage under chapter
48.42
RCW that is subject to the jurisdiction and regulation of any state agency or any subdivision thereof, unless an alternative quality improvement program substantially equivalent to RCW 70.41.200
(1)(a) is developed. All such programs, whether complying with the requirement set forth in RCW 70.41.200
(1)(a) or in the form of an alternative program, must be approved by the department before the discovery limitations provided in subsections (3) and (4) of this section and the exemption under RCW 42.56.360
(1)(c) and subsection (5) of this section shall apply. In reviewing plans submitted by licensed entities that are associated with physicians' offices, the department shall ensure that the exemption under RCW 42.56.360
(1)(c) and the discovery limitations of this section are applied only to information and documents related specifically to quality improvement activities undertaken by the licensed entity.
(2) Health care provider groups of five or more providers may maintain a coordinated quality improvement program for the improvement of the quality of health care services rendered to patients and the identification and prevention of medical malpractice as set forth in RCW 70.41.200
. For purposes of this section, a health care provider group may be a consortium of providers consisting of five or more providers in total. All such programs shall comply with the requirements of RCW 70.41.200
(1) (a), (c), (d), (e), (f), (g), and (h) as modified to reflect the structural organization of the health care provider group. All such programs must be approved by the department before the discovery limitations provided in subsections (3) and (4) of this section and the exemption under RCW 42.56.360
(1)(c) and subsection (5) of this section shall apply.
(3) Any person who, in substantial good faith, provides information to further the purposes of the quality improvement and medical malpractice prevention program or who, in substantial good faith, participates on the quality improvement committee shall not be subject to an action for civil damages or other relief as a result of such activity. Any person or entity participating in a coordinated quality improvement program that, in substantial good faith, shares information or documents with one or more other programs, committees, or boards under subsection (6) of this section is not subject to an action for civil damages or other relief as a result of the activity or its consequences. For the purposes of this section, sharing information is presumed to be in substantial good faith. However, the presumption may be rebutted upon a showing of clear, cogent, and convincing evidence that the information shared was knowingly false or deliberately misleading.
(4) Information and documents, including complaints and incident reports, created specifically for, and collected and maintained by, a quality improvement committee are not subject to review or disclosure, except as provided in this section, or discovery or introduction into evidence in any civil action, and no person who was in attendance at a meeting of such committee or who participated in the creation, collection, or maintenance of information or documents specifically for the committee shall be permitted or required to testify in any civil action as to the content of such proceedings or the documents and information prepared specifically for the committee. This subsection does not preclude: (a) In any civil action, the discovery of the identity of persons involved in the medical care that is the basis of the civil action whose involvement was independent of any quality improvement activity; (b) in any civil action, the testimony of any person concerning the facts that form the basis for the institution of such proceedings of which the person had personal knowledge acquired independently of such proceedings; (c) in any civil action by a health care provider regarding the restriction or revocation of that individual's clinical or staff privileges, introduction into evidence information collected and maintained by quality improvement committees regarding such health care provider; (d) in any civil action challenging the termination of a contract by a state agency with any entity maintaining a coordinated quality improvement program under this section if the termination was on the basis of quality of care concerns, introduction into evidence of information created, collected, or maintained by the quality improvement committees of the subject entity, which may be under terms of a protective order as specified by the court; (e) in any civil action, disclosure of the fact that staff privileges were terminated or restricted, including the specific restrictions imposed, if any and the reasons for the restrictions; or (f) in any civil action, discovery and introduction into evidence of the patient's medical records required by rule of the department of health to be made regarding the care and treatment received.
(5) Information and documents created specifically for, and collected and maintained by, a quality improvement committee are exempt from disclosure under chapter
42.56
RCW.
(6) A coordinated quality improvement program may share information and documents, including complaints and incident reports, created specifically for, and collected and maintained by, a quality improvement committee or a peer review committee under RCW 4.24.250
with one or more other coordinated quality improvement programs maintained in accordance with this section or with RCW 70.41.200, a coordinated quality improvement committee maintained by an ambulatory surgical facility under RCW 70.230.070, a quality assurance committee maintained in accordance with RCW 18.20.390
or
74.42.640, or a peer review committee under RCW 4.24.250, for the improvement of the quality of health care services rendered to patients and the identification and prevention of medical malpractice. The privacy protections of chapter
70.02
RCW and the federal health insurance portability and accountability act of 1996 and its implementing regulations apply to the sharing of individually identifiable patient information held by a coordinated quality improvement program. Any rules necessary to implement this section shall meet the requirements of applicable federal and state privacy laws. Information and documents disclosed by one coordinated quality improvement program to another coordinated quality improvement program or a peer review committee under RCW 4.24.250
and any information and documents created or maintained as a result of the sharing of information and documents shall not be subject to the discovery process and confidentiality shall be respected as required by subsection (4) of this section and RCW 4.24.250
.
(7) The department of health shall adopt rules as are necessary to implement this section.
[
2007 c 273 s 21
. Prior:
2006 c 8 s 113
;
2005 c 291 s 2
;
2005 c 274 s 302
;
2005 c 33 s 6
;
2004 c 145 s 2
;
1995 c 267 s 7
;
1993 c 492 s 417
.]
NOTES:
Effective date
—
Implementation
—
2007 c 273:
See RCW 70.230.900
and
70.230.901
.
Findings
—
Intent
—
Part headings and subheadings not law
—
Severability
—
2006 c 8:
See notes following RCW 5.64.010
.
Findings
—
2005 c 33:
See note following RCW 18.20.390
.
Captions not law
—
Severability
—
Effective dates
—
1995 c 267:
See notes following RCW 43.70.052
.
Findings
—
Intent
—
1993 c 492:
See notes following RCW 43.20.050
.
Short title
—
Savings
—
Reservation of legislative power
—
Effective dates
—
1993 c 492:
See RCW 43.72.910
through
43.72.915
.
RCW 43.70.512
Public health system
—
Foundational public health services
—
Intent.
(1) Protecting the public's health across the state is a fundamental responsibility of the state and is accomplished through the governmental public health system. This system is comprised of the state department of health, state board of health, local health jurisdictions, sovereign tribal nations, and Indian health programs.
(2)(a) The legislature intends to define a limited statewide set of core public health services, called foundational public health services, which the governmental public health system is responsible for providing in a consistent and uniform way in every community in Washington. These services are comprised of foundational programs and cross-cutting capabilities.
(b) These governmental public health services should be delivered in ways that maximize the efficiency and effectiveness of the overall system, make best use of the public health workforce and evolving technology, and address health equity.
(c) Funding for the governmental public health system must be restructured to support foundational public health services. In restructuring, there must be efforts to both reinforce current governmental public health system capacity and implement service delivery models allowing for system stabilization and transformation.
[
2019 c 14 s 1
;
2007 c 259 s 60
.]
NOTES:
Subheadings not law
—
2007 c 259:
See note following RCW 7.70.060
.
RCW 43.70.515
Foundational public health services
—
Funding.
(1) With any state funding of foundational public health services, the state expects that measurable benefits will be realized to the health of communities in Washington as a result of the improved capacity of the governmental public health system. Close coordination and sharing of services are integral to increasing system capacity.
(2)(a) Funding for foundational public health services shall be appropriated to the office of financial management. The office of financial management may only allocate funding to the department if the department, after consultation with federally recognized Indian tribes pursuant to chapter
43.376
RCW, jointly certifies with a state association representing local health jurisdictions and the state board of health, to the office of financial management that they are in agreement on the distribution and uses of state foundational public health services funding across the public health system.
(b) If joint certification is provided, the department shall distribute foundational public health services funding according to the agreed-upon distribution and uses. If joint certification is not provided, appropriations for this purpose shall lapse.
(3) By October 1, 2020, the department, in partnership with sovereign tribal nations, local health jurisdictions, and the state board of health, shall report on:
(a) Service delivery models, and a plan for further implementation of successful models;
(b) Changes in capacity of the governmental public health system; and
(c) Progress made to improve health outcomes.
(4) For purposes of this section:
(a) "Foundational public health services" means a limited statewide set of defined public health services within the following areas:
(i) Control of communicable diseases and other notifiable conditions;
(ii) Chronic disease and injury prevention;
(iii) Environmental public health;
(iv) Maternal, child, and family health;
(v) Access to and linkage with medical, oral, and behavioral health services;
(vi) Vital records; and
(vii) Cross-cutting capabilities, including:
(A) Assessing the health of populations;
(B) Public health emergency planning;
(C) Communications;
(D) Policy development and support;
(E) Community partnership development; and
(F) Business competencies.
(b) "Governmental public health system" means the state department of health, state board of health, local health jurisdictions, sovereign tribal nations, and Indian health programs located within Washington.
(c) "Indian health programs" means tribally operated health programs, urban Indian health programs, tribal epidemiology centers, the American Indian health commission for Washington state, and the Northwest Portland area Indian health board.
(d) "Local health jurisdictions" means a public health agency organized under chapter
70.05, 70.08, or
70.46
RCW.
(e) "Service delivery models" means a systematic sharing of resources and function among state and local governmental public health entities, sovereign tribal nations, and Indian health programs to increase capacity and improve efficiency and effectiveness.
[
2019 c 14 s 2
.]
RCW 43.70.525
Immunization assessment and enhancement proposals by local jurisdictions.
(1) The department, in conjunction with local health jurisdictions, shall require each local health jurisdiction to submit an immunization assessment and enhancement proposal, consistent with the standards established in the public health [services] improvement plan, to provide immunization protection to the children of the state to further reduce vaccine-preventable diseases.
(2) These plans shall include, but not be limited to:
(a) A description of the population groups in the jurisdiction that are in the greatest need of immunizations;
(b) A description of strategies to use outreach, volunteer, and other local educational resources to enhance immunization rates; and
(c) A description of the capacity required to accomplish the enhancement proposal.
(3) This section shall be implemented consistent with available funding.
(4) The secretary shall report through the public health [services] improvement plan to the health care and fiscal committees of the legislature on the status of the program and progress made toward increasing immunization rates in population groups of greatest need.
[
1994 c 299 s 29
.]
NOTES:
Intent
—
Finding
—
Severability
—
Conflict with federal requirements
—
1994 c 299:
See notes following RCW 74.12.400
.
Immunization: RCW 28A.210.060
.
RCW 43.70.526
Childhood immunizations
—
Resources for expecting parents.
The department shall develop and make available resources for expecting parents regarding recommended childhood immunizations. The resources are intended to be provided to expecting parents by their health care providers to encourage discussion on childhood immunizations and postnatal care.
[
2016 c 141 s 1
.]
RCW 43.70.533
Chronic conditions
—
Training and technical assistance for primary care providers.
(1) The department shall conduct a program of training and technical assistance regarding care of people with chronic conditions for providers of primary care. The program shall emphasize evidence-based high quality preventive and chronic disease care and shall collaborate with the health care authority to promote the adoption of primary care health homes established under chapter 316, Laws of 2011. The department may designate one or more chronic conditions to be the subject of the program.
(2) The training and technical assistance program shall include the following elements:
(a) Clinical information systems and sharing and organization of patient data;
(b) Decision support to promote evidence-based care;
(c) Clinical delivery system design;
(d) Support for patients managing their own conditions; and
(e) Identification and use of community resources that are available in the community for patients and their families.
(3) In selecting primary care providers to participate in the program, the department shall consider the number and type of patients with chronic conditions the provider serves, and the provider's participation in the medicaid program, the basic health plan, and health plans offered through the public employees' benefits board.
(4) For the purposes of this section, "health home" and "primary care provider" have the same meaning as in RCW 74.09.010
.
[
2011 c 316 s 3
;
2007 c 259 s 5
.]
NOTES:
Subheadings not law
—
2007 c 259:
See note following RCW 7.70.060
.
RCW 43.70.540
Data collection
—
Finding
—
Intent.
The legislature recognizes that the state patrol, the administrative office of the courts, the sheriffs' and police chiefs' association, the department of social and health services, the department of commerce, the sentencing guidelines commission, the department of corrections, and the superintendent of public instruction each have comprehensive data and analysis capabilities that have contributed greatly to our current understanding of crime and violence, and their causes.
The legislature finds, however, that a single health-oriented agency must be designated to provide consistent guidelines to all these groups regarding the way in which their data systems collect this important data. It is not the intent of the legislature by RCW 43.70.545
to transfer data collection requirements from existing agencies or to require the addition of major new data systems. It is rather the intent to make only the minimum required changes in existing data systems to increase compatibility and comparability, reduce duplication, and to increase the usefulness of data collected by these agencies in developing more accurate descriptions of violence.
[
2023 c 470 s 2057
;
2005 c 282 s 45
;
1995 c 399 s 76
;
1994 sp.s. c 7 s 201
.]
NOTES:
Explanatory statement
—
2023 c 470:
See note following RCW 10.99.030
.
Legislative finding and intent
—
1994 sp.s. c 7:
"The legislature finds that the increasing violence in our society causes great concern for the immediate health and safety of our citizens and our social institutions. Youth violence is increasing at an alarming rate and young people between the ages of fifteen and twenty-four are at the highest risk of being perpetrators and victims of violence. Additionally, random violence, including homicide and the use of firearms, has dramatically increased over the last decade.
The legislature finds that violence is abhorrent to the aims of a free society and that it cannot be tolerated. State efforts at reducing violence must include changes in criminal penalties, reducing the unlawful use of and access to firearms, increasing educational efforts to encourage nonviolent means for resolving conflicts, and allowing communities to design their prevention efforts.
The legislature finds that the problem of violence can be addressed with many of the same approaches that public health programs have used to control other problems such as infectious disease, tobacco use, and traffic fatalities.
Addressing the problem of violence requires the concerted effort of all communities and all parts of state and local governments. It is the immediate purpose of chapter 7, Laws of 1994 sp. sess. to: (1) Prevent acts of violence by encouraging change in social norms and individual behaviors that have been shown to increase the risk of violence; (2) reduce the rate of at-risk children and youth, as defined in *RCW 70.190.010
; (3) increase the severity and certainty of punishment for youth and adults who commit violent acts; (4) reduce the severity of harm to individuals when violence occurs; (5) empower communities to focus their concerns and allow them to control the funds dedicated to empirically supported preventive efforts in their region; and (6) reduce the fiscal and social impact of violence on our society." [
1994 sp.s. c 7 s 101
.]
*Reviser's note:
The governor vetoed 1994 sp.s. c 7 s 302, which amended RCW 70.190.010
to define "at-risk children and youth." RCW 70.190.010
was subsequently amended by 1996 c 132 s 2, which now includes a definition for "at-risk children." RCW 70.190.010
was subsequently repealed by 2011 1st sp.s. c 32 s 13, effective June 30, 2012.
Severability
—
1994 sp.s. c 7:
"If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [
1994 sp.s. c 7 s 913
.]
Effective dates
—
Contingent expiration date
—
1994 sp.s. c 7:
"(1) Sections 201 through 204, 302, 323, 411, 412, 417, and 418 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect immediately [April 6, 1994].
(2) Sections 904 through 908 of this act shall take effect July 1, 1995.
*(3) Notwithstanding other provisions of this section, if sections 901 through 909 of this act are referred to the voters at the next succeeding general election and sections 901 through 909 of this act are rejected by the voters, then the amendments by sections 510 through 512, 519, 521, 525, and 527 of this act shall expire on July 1, 1995." [
1994 sp.s. c 7 s 915
(Referendum Bill No. 43, subsection (3) approved November 8, 1994).]
*Reviser's note:
Sections 901 through 909, chapter 7, Laws of 1994 sp. sess. were approved and ratified by the voters on November 8, 1994, in Referendum Bill No. 43. Therefore, the amendments to sections 510 through 512, 519, 521, 525, and 527, chapter 7, Laws of 1994 sp. sess. do not expire on July 1, 1995.
RCW 43.70.545
Data collection and reporting rules.
(1) The department of health shall develop, based on recommendations in the public health services improvement plan and in consultation with affected groups or agencies, comprehensive rules for the collection and reporting of data relating to acts of violence, at-risk behaviors, and risk and protective factors. The data collection and reporting rules shall be used by any public or private entity that is required to report data relating to these behaviors and conditions. The department may require any agency or program that is state-funded or that accepts state funds and any licensed or regulated person or professional to report these behaviors and conditions. To the extent possible the department shall require the reports to be filed through existing data systems. The department may also require reporting of attempted acts of violence and of nonphysical injuries. For the purposes of this section "acts of violence" means self-directed and interpersonal behaviors that can result in suicide, homicide, and nonfatal intentional injuries. "At-risk behaviors," "protective factors," and "risk factors" have the same meanings as provided in *RCW 70.190.010
. A copy of the data used by a school district to prepare and submit a report to the department shall be retained by the district and, in the copy retained by the district, identify the reported acts or behaviors by school site.
(2) The department is designated as the statewide agency for the coordination of all information relating to violence and other intentional injuries, at-risk behaviors, and risk and protective factors.
(3) The department shall provide necessary data to the local health departments for use in planning by or evaluation of any community network authorized under RCW 70.190.060
.
(4) The department shall by rule establish requirements for local health departments to perform assessment related to at-risk behaviors and risk and protective factors and to assist community networks in policy development and in planning and other duties under chapter 7, Laws of 1994 sp. sess.
(5) The department may, consistent with its general authority and directives under RCW 43.70.540
through
43.70.560, contract with a college or university that has experience in data collection relating to the health and overall welfare of children to provide assistance to:
(a) State and local health departments in developing new sources of data to track acts of violence, at-risk behaviors, and risk and protective factors; and
(b) Local health departments to compile and effectively communicate data in their communities.
[
1998 c 245 s 76
;
1994 sp.s. c 7 s 202
.]
NOTES:
*Reviser's note:
RCW 70.190.010
was repealed by 2011 1st sp.s. c 32 s 13, effective June 30, 2012.
Finding
—
Intent
—
Severability
—
Effective dates
—
Contingent expiration date
—
1994 sp.s. c 7:
See notes following RCW 43.70.540
.
RCW 43.70.550
Public health services improvement plan
—
Contents.
The public health services improvement plan developed under *RCW 43.70.520
shall include:
(1) Minimum standards for state and local public health assessment, performance measurement, policy development, and assurance regarding social development to reduce at-risk behaviors and risk and protective factors. The department in the development of data collection and reporting requirements for the superintendent of public instruction, schools, and school districts shall consult with the joint select committee on education restructuring and local school districts.
(2)(a) Measurable risk factors that are empirically linked to violent criminal acts by juveniles, teen substance abuse, teen pregnancy and male parentage, teen suicide attempts, dropping out of school, child abuse or neglect, and domestic violence; and
(b) An evaluation of other factors to determine whether they are empirically related risk factors, such as: Out-of-home placements, poverty, single-parent households, inadequate nutrition, hunger, unemployment, lack of job skills, gang affiliation, lack of recreational or cultural opportunities, school absenteeism, court-ordered parenting plans, physical, emotional, or behavioral problems requiring special needs assistance in K-12 schools, learning disabilities, and any other possible factors.
(3) Data collection and analysis standards on at-risk behaviors and risk and protective factors for use by the local public health departments and the **state council and the local community networks to ensure consistent and interchangeable data.
(4) Recommendations regarding any state or federal statutory barriers affecting data collection or reporting.
The department shall provide an annual report to the Washington state institute for public policy on the implementation of this section.
[
1994 sp.s. c 7 s 203
.]
NOTES:
Reviser's note:
*(1) RCW 43.70.520
was repealed by
2019 c 14 s 3
.
**(2) RCW 70.170.030, which created the health care access and cost control council, was repealed by
1995 c 269 s 2204
.
Finding
—
Intent
—
Severability
—
Effective dates
—
Contingent expiration date
—
1994 sp.s. c 7:
See notes following RCW 43.70.540
.
RCW 43.70.555
Assessment standards.
The department shall establish, by rule, standards for local health departments and networks to use in assessment, performance measurement, policy development, and assurance regarding social development to prevent health problems caused by risk factors empirically linked to: Violent criminal acts by juveniles, teen substance abuse, teen pregnancy and male parentage, teen suicide attempts, dropping out of school, child abuse or neglect, and domestic violence. The standards shall be based on the standards set forth in the public health services improvement plan as required by RCW 43.70.550
.
[
2011 1st sp.s. c 32 s 8
;
1998 c 245 s 77
;
1994 sp.s. c 7 s 204
.]
NOTES:
Transition plan
—
Report to the legislature
—
2011 1st sp.s. c 32:
See note following RCW 70.305.005
.
Finding
—
Intent
—
Severability
—
Effective dates
—
Contingent expiration date
—
1994 sp.s. c 7:
See notes following RCW 43.70.540
.
RCW 43.70.560
Media violence
—
Reporting reduction efforts.
The legislature encourages the use of a statewide voluntary, socially responsible policy to reduce the emphasis, amount, and type of violence in all public media. The department shall develop a suggested reporting format for use by the print, television, and radio media in reporting their voluntary violence reduction efforts. Each area of the public media may carry out the policy in whatever manner that area deems appropriate.
[
1994 sp.s. c 7 s 205
.]
NOTES:
Finding
—
Intent
—
Severability
—
1994 sp.s. c 7:
See notes following RCW 43.70.540
.
RCW 43.70.570
Intent
—
1995 c 43.
The legislature declares its intent to implement the recommendations of the public health improvement plan by initiating a program to provide the public health system with the necessary capacity to improve the health outcomes of the population of Washington state and establishing the methodology by which improvement in the health outcomes and delivery of public health activities will be assessed.
[
1995 c 43 s 1
.]
NOTES:
Severability
—
1995 c 43:
"If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [
1995 c 43 s 14
.]
Effective dates
—
Contingent effective dates
—
1995 c 43:
See note following RCW 70.05.030
.
RCW 43.70.575
Definitions.
Unless the context clearly requires otherwise, the definitions in this section apply throughout RCW 43.70.570
through *
43.70.580
.
(1) "Capacity" means actions that public health jurisdictions must do as part of ongoing daily operations to adequately protect and promote health and prevent disease, injury, and premature death. The public health improvement plan identifies capacity necessary for assessment, policy development, administration, prevention, including promotion and protection, and access and quality.
(2) "Department" means the department of health.
(3) "Local health jurisdiction" means the local health agency, either county or multicounty, operated by local government, with oversight and direction from a local board of health, that provides public health services throughout a defined geographic area.
(4) "Health outcomes" means long-term objectives that define optimal, measurable, future levels of health status, maximum acceptable levels of disease, injury, or dysfunction, or prevalence of risk factors in areas such as improving the rate of immunizations for infants and children to ninety percent and controlling and reducing the spread of tuberculosis and that are stated in the public health improvement plan.
(5) "Public health improvement plan," also known as the public health services improvement plan, means the public health services improvement plan established under *RCW 43.70.520, developed by the department, in consultation with local health departments and districts, the state board of health, the health services commission, area Indian health services, and other state agencies, health services providers, and residents concerned about public health, to provide a detailed accounting of deficits in the core functions of assessment, policy development, and assurance of the current public health system, how additional public health funding would be used, and to describe the benefits expected from expanded expenditures.
(6) "Public health" means activities that society does collectively to assure the conditions in which people can be healthy. This includes organized community efforts to prevent, identify, preempt, and counter threats to the public's health.
(7) "Public health system" means the department, the state board of health, and local health jurisdictions.
[
1995 c 43 s 2
.]
NOTES:
*Reviser's note:
RCW 43.70.580
and
43.70.520
were repealed by
2019 c 14 s 3
.
Effective dates
—
Contingent effective dates
—
1995 c 43:
See note following RCW 70.05.030
.
Severability
—
1995 c 43:
See note following RCW 43.70.570
.
RCW 43.70.590
American Indian health care delivery plan.
Consistent with funds appropriated specifically for this purpose, the department shall establish in conjunction with the area Indian health services system and providers an advisory group comprised of Indian and non-Indian health care facilities and providers to formulate an American Indian health care delivery plan. The plan shall include:
(1) Recommendations to providers and facilities methods for coordinating and joint venturing with the Indian health services for service delivery;
(2) Methods to improve American Indian-specific health programming; and
(3) Creation of co-funding recommendations and opportunities for the unmet health services programming needs of American Indians.
[
1995 c 43 s 4
;
1993 c 492 s 468
. Formerly RCW 41.05.240
.]
NOTES:
Reviser's note:
RCW 41.05.240
was amended and recodified as RCW 43.70.590
by 1995 c 43 without cognizance of the repeal by
1995 1st sp.s. c 6 s 9
. For rule of construction concerning sections amended and repealed in the same legislative session, see RCW 1.12.025
.
Effective dates
—
Contingent effective dates
—
1995 c 43:
See note following RCW 70.05.030
.
Severability
—
1995 c 43:
See note following RCW 43.70.570
.
Findings
—
Intent
—
1993 c 492:
See notes following RCW 43.20.050
.
Short title
—
Savings
—
Reservation of legislative power
—
Effective dates
—
1993 c 492:
See RCW 43.72.910
through
43.72.915
.
RCW 43.70.595
Health equity zones.
(1) Subject to the availability of amounts appropriated for this specific purpose, the department, in coordination with the governor's interagency council on health disparities, local health jurisdictions, and accountable communities of health, must share and review population health data, which may be related to chronic and infectious diseases, maternal birth complications, preterm births and other newborn health complications, and any other relevant health data, including hospital community health needs assessments, to identify, or allow communities to self-identify, potential health equity zones in the state and develop projects to meet the unique needs of each zone. The department must provide technical support to communities in the use of data to facilitate self-identification of health equity zones.
(2) Communities' uses of data must align with projects and outcomes to be measured in self-identified zones.
(3) The department must use the first 12 months following July 25, 2021, to develop a plan and process to allow communities to implement health equity zone programs statewide. The department has authority to determine the number of health equity zones and projects based on available resources.
(4) Communities that self-identify zones or the department must notify relevant community organizations in the zones of the health equity zone designation and allow those organizations to identify projects to address the zone's most urgent needs related to health disparities. Community organizations may include, but are not limited to:
(a) Community health clinics;
(b) Local health providers;
(c) Federally qualified health centers;
(d) Health systems;
(e) Local government;
(f) Public school districts;
(g) Recognized American Indian organizations and Indian health organizations;
(h) Local health jurisdictions; and
(i) Any other nonprofit organization working to address health disparities in the zone.
(5) Local organizations working within zones may form coalitions to identify the needs of the zone, design projects to address those needs, and develop an action plan to implement the projects. Local organizations may partner with state or national organizations outside the specific zone designation. Projects may include, but are not limited to:
(a) Addressing health care provider access and health service delivery;
(b) Improving information sharing and community trust in providers and services;
(c) Conducting outreach and education efforts; and
(d) Recommending systems and policy changes that will improve population health.
(6) The department must provide:
(a) Support to the coalitions in identifying and applying for resources to support projects within the zones;
(b) Technical assistance related to project management and developing health outcome and other measures to evaluate project success; and
(c) Subject to availability, funding to implement projects.
(7) Subject to the availability of amounts appropriated for this specific purpose, by December 1, 2023, and every two years thereafter, the department must submit a report to the legislature detailing the projects implemented in each zone and the outcome measures, including year-over-year health data, to demonstrate project success.
(8) For the purposes of this section "health equity zone" or "zone" means a contiguous geographic area that demonstrates measurable and documented health disparities and poor health outcomes, which may include but are not limited to high rates of maternal complications, newborn health complications, and chronic and infectious disease, is populated by communities of color, Indian communities, communities experiencing poverty, or immigrant communities, and is small enough for targeted interventions to have a significant impact on health outcomes and health disparities. Documented health disparities must be documented or identified by the department or the centers for disease control and prevention.
[
2021 c 262 s 2
.]
NOTES:
Findings
—
Intent
—
2021 c 262:
"(1) The legislature finds that people of color, Indian, people experiencing poverty, and immigrant populations experience significant health disparities compared to the general population, including more limited access to health care and poorer health outcomes. The legislature finds that these circumstances result in higher rates of morbidity and mortality for persons of color and immigrant populations than observed in the general population.
(2) Therefore, the legislature intends to create health equity zones to address significant health disparities identified by health outcome data. The state intends to work with community leaders within the health equity zones to share information and coordinate efforts with the goal of addressing the most urgent needs. Health equity zone partners shall develop, expand, and maintain positive relationships with communities of color, Indian communities, communities experiencing poverty, and immigrant communities within the zone to develop effective and sustainable programs to address health inequity." [
2021 c 262 s 1
.]
RCW 43.70.600
Survey regarding exposure to radio frequencies
—
Results.
When funds are appropriated for this purpose, the department shall conduct a survey of scientific literature regarding the possible health effects of human exposure to the radio frequency part of the electromagnetic spectrum (300Hz to 300GHz). The department may submit the survey results to the legislature, prepare a summary of that survey, and make the summary available to the public. The department may update the survey and summary periodically.
[
1998 c 245 s 78
;
1996 c 323 s 6
.]
NOTES:
Findings
—
1996 c 323:
"The legislature finds that concerns have been raised over possible health effects from exposure to some wireless telecommunications facilities, and that exposures from these facilities should be kept as low as reasonably achievable while still allowing the operation of these networks. The legislature further finds that the department of health should serve as the state agency that follows the issues and compiles information pertaining to potential health effects from wireless telecommunications facilities." [
1996 c 323 s 1
.]
RCW 43.70.605
Personal wireless services
—
Random testing on power density analysis
—
Rules.
Unless this section is preempted by applicable federal statutes, the department may require that in residential zones or areas, all providers of personal wireless services, as defined in *section 1 of this act, provide random test results on power density analysis for the provider's licensed frequencies showing radio frequency levels before and after development of the personal wireless service antenna facilities, following national standards or protocols of the federal communications commission or other federal agencies. This section shall not apply to microcells as defined in RCW 80.36.375
. The department may adopt rules to implement this section.
[
1996 c 323 s 7
.]
NOTES:
*Reviser's note:
The reference to section 1 of this act is erroneous. Section 2 of the act, codified as RCW 43.21C.0384, was apparently intended.
Findings
—
1996 c 323:
See note following RCW 43.70.600
.
RCW 43.70.610
Domestic violence education program
—
Established
—
Findings.
The legislature finds that domestic violence is the leading cause of injury among women and is linked to numerous health problems, including depression, abuse of alcohol and other drugs, and suicide. Despite the frequency of medical attention, few people are diagnosed as victims of spousal abuse. The department, in consultation with the disciplinary authorities as defined in RCW 18.130.040, shall establish, within available department general funds, an ongoing domestic violence education program as an integral part of its health professions regulation. The purpose of the education program is to raise awareness and educate health care professionals regarding the identification, appropriate treatment, and appropriate referral of victims of domestic violence. The disciplinary authorities having the authority to offer continuing education may provide training in the dynamics of domestic violence. No funds from the health professions account may be utilized to fund activities under this section unless the disciplinary authority authorizes expenditures from its proportions of the account. A disciplinary authority may defray costs by authorizing a fee to be charged for participants or materials relating to any sponsored program.
[
1996 c 191 s 89
.]
RCW 43.70.613
Health care professionals
—
Health equity continuing education.
(1) By January 1, 2024, the rule-making authority for each health profession licensed under Title
18
RCW subject to continuing education requirements must adopt rules requiring a licensee to complete health equity continuing education training at least once every four years.
(2) Health equity continuing education courses may be taken in addition to or, if a rule-making authority determines the course fulfills existing continuing education requirements, in place of other continuing education requirements imposed by the rule-making authority.
(3)(a) The secretary and the rule-making authorities must work collaboratively to provide information to licensees about available courses. The secretary and rule-making authorities shall consult with patients or communities with lived experiences of health inequities or racism in the health care system and relevant professional organizations when developing the information and must make this information available by July 1, 2023. The information should include a course option that is free of charge to licensees. It is not required that courses be included in the information in order to fulfill the health equity continuing education requirement.
(b) By January 1, 2023, the department, in consultation with the boards and commissions, shall adopt model rules establishing the minimum standards for continuing education programs meeting the requirements of this section. The department shall consult with patients or communities with lived experience of health inequities or racism in the health care system, relevant professional organizations, and the rule-making authorities in the development of these rules.
(c) The minimum standards must include instruction on skills to address the structural factors, such as bias, racism, and poverty, that manifest as health inequities. These skills include individual-level and system-level intervention, and self-reflection to assess how the licensee's social position can influence their relationship with patients and their communities. These skills enable a health care professional to care effectively for patients from diverse cultures, groups, and communities, varying in race, ethnicity, gender identity, sexuality, religion, age, ability, socioeconomic status, and other categories of identity. The courses must assess the licensee's ability to apply health equity concepts into practice. Course topics may include, but are not limited to:
(i) Strategies for recognizing patterns of health care disparities on an individual, institutional, and structural level and eliminating factors that influence them;
(ii) Intercultural communication skills training, including how to work effectively with an interpreter and how communication styles differ across cultures;
(iii) Implicit bias training to identify strategies to reduce bias during assessment and diagnosis;
(iv) Methods for addressing the emotional well-being of children and youth of diverse backgrounds;
(v) Ensuring equity and antiracism in care delivery pertaining to medical developments and emerging therapies;
(vi) Structural competency training addressing five core competencies:
(A) Recognizing the structures that shape clinical interactions;
(B) Developing an extraclinical language of structure;
(C) Rearticulating "cultural" formulations in structural terms;
(D) Observing and imagining structural interventions; and
(E) Developing structural humility; and
(vii) Cultural safety training.
(4) The rule-making authority may adopt rules to implement and administer this section, including rules to establish a process to determine if a continuing education course meets the health equity continuing education requirement established in this section.
(5) For purposes of this section the following definitions apply:
(a) "Rule-making authority" means the regulatory entities identified in RCW 18.130.040
and authorized to establish continuing education requirements for the health care professions governed by those regulatory entities.
(b) "Structural competency" means a shift in medical education away from pedagogic approaches to stigma and inequalities that emphasize cross-cultural understandings of individual patients, toward attention to forces that influence health outcomes at levels above individual interactions. Structural competency reviews existing structural approaches to stigma and health inequities developed outside of medicine and proposes changes to United States medical education that will infuse clinical training with a structural focus.
(c) "Cultural safety" means an examination by health care professionals of themselves and the potential impact of their own culture on clinical interactions and health care service delivery. This requires individual health care professionals and health care organizations to acknowledge and address their own biases, attitudes, assumptions, stereotypes, prejudices, structures, and characteristics that may affect the quality of care provided. In doing so, cultural safety encompasses a critical consciousness where health care professionals and health care organizations engage in ongoing self-reflection and self-awareness and hold themselves accountable for providing culturally safe care, as defined by the patient and their communities, and as measured through progress towards achieving health equity. Cultural safety requires health care professionals and their associated health care organizations to influence health care to reduce bias and achieve equity within the workforce and working environment.
[
2021 c 276 s 2
.]
NOTES:
Findings
—
2021 c 276:
"The legislature finds that:
(1) Healthy Washingtonians contribute to the economic and social welfare of their families and communities, and access to health services and improved health outcomes allows all Washington families to enjoy productive and satisfying lives;
(2) The COVID-19 pandemic has further exposed that health outcomes are experienced differently by different people based on discrimination and bias by the health care system. Research shows that health care resources are distributed unevenly by intersectional categories including, but not limited to, race, gender, ability status, religion, sexual orientation, socioeconomic status, and geography; and
(3) These inequities have permeated health care delivery, deepening adverse outcomes for marginalized communities. This bill aims to equip health care workers with the skills to recognize and reduce these inequities in their daily work. In addition to their individual impact, health care workers need the skills to address systemic racism and bias." [
2021 c 276 s 1
.]
RCW 43.70.614
Female genital mutilation
—
Education program.
(1) The department must establish an education program for the prevention of female genital mutilation. The program must be designed to provide information about the health risks and emotional trauma inflicted by the practice of female genital mutilation, as well as the civil and criminal penalties for committing female genital mutilation.
(2) The department must develop policies and procedures to promote partnerships with relevant stakeholders to prevent female genital mutilation and to protect and provide assistance to victims of female genital mutilation, including partnerships with:
(a) Relevant state agencies that provide services to persons at risk of female genital mutilation or persons who have been subjected to female genital mutilation;
(b) The department of children, youth, and families;
(c) The Washington state patrol;
(d) The attorney general; and
(e) Other government entities and nongovernmental organizations.
(3) The department must make recommendations and develop procedures regarding strategies and methodologies for training health care providers as defined in RCW 70.02.010
on recognizing the risk factors associated with female genital mutilation and the signs that a person may be a victim of female genital mutilation.
(4) Subject to the availability of amounts appropriated for this specific purpose, the department may contract with nongovernmental organizations, entities, or persons with experience working with victims of female genital mutilation to provide training and materials and other services as the department deems necessary.
(5) The department may adopt rules necessary to implement this section.
(6) For purposes of this section, "female genital mutilation" has the meaning provided in RCW 18.130.460
.
[
2023 c 122 s 6
.]
NOTES:
Finding
—
Intent
—
Effective date
—
2023 c 122:
See notes following RCW 9A.36.170
.
RCW 43.70.615
Multicultural health awareness and education program
—
Integration into health professions basic education preparation curriculum.
(1) For the purposes of this section, "multicultural health" means the provision of health care services with the knowledge and awareness of the causes and effects of the determinants of health that lead to disparities in health status between different genders and racial and ethnic populations and the practice skills necessary to respond appropriately.
(2) The department, in consultation with the disciplining authorities as defined in RCW 18.130.040, shall establish, within available department general funds, an ongoing multicultural health awareness and education program as an integral part of its health professions regulation. The purpose of the education program is to raise awareness and educate health care professionals regarding the knowledge, attitudes, and practice skills necessary to care for diverse populations to achieve a greater understanding of the relationship between culture and health. Any such education shall be developed in collaboration with education programs that train students in that health profession. No funds from the health professions account may be utilized to fund activities under this section unless the disciplining authority authorizes expenditures from its proportions of the account.
(3) By July 1, 2008, each education program with a curriculum to train health professionals for employment in a profession credentialed by a disciplining authority under chapter
18.130
RCW shall integrate into the curriculum instruction in multicultural health as part of its basic education preparation curriculum. The department may not deny the application of any applicant for a credential to practice a health profession on the basis that the education or training program that the applicant successfully completed did not include integrated multicultural health curriculum as part of its basic instruction.
[
2021 c 276 s 3
;
2006 c 237 s 2
.]
NOTES:
Findings
—
2021 c 276:
See note following RCW 43.70.613
.
Findings
—
2006 c 237:
"The legislature finds that women and people of color experience significant disparities from the general population in education, employment, healthy living conditions, access to health care, and other social determinants of health. The legislature finds that it shall be a priority for the state to develop the knowledge, attitudes, and practice skills of health professionals and those working with diverse populations to achieve a greater understanding of the relationship between culture and health and gender and health." [
2006 c 237 s 1
.]
RCW 43.70.616
Health education
—
Funding to support promotoras.
(1) Subject to the availability of funds for this specific purpose, the department of health shall provide funding to support promotoras in at least two communities. These promotoras shall provide culturally sensitive, lay health education for the Latinx community, and act as liaisons between their community, health professionals, and human and social service organizations.
(2) In determining which communities will be served by the promotoras under this section, the department of health shall provide funding to support one community west of the crest of the Cascade mountain range and one community east of the crest of the Cascade mountain range.
[
2024 c 328 s 205
.]
NOTES:
Findings
—
Intent
—
2024 c 328:
See note following RCW 13.34.050
.
RCW 43.70.617
Prenatal nutrition best practices
—
Educational resources for pregnant women.
The department shall develop and make available educational resources for pregnant women regarding prenatal nutrition best practices to promote infant health. The educational resources may include, but are not limited to, courses delivered in-person or electronically and pamphlets printed on paper or made available on the department's website. The educational resources are intended to provide pregnant women knowledge of healthy foods and essential daily nutrients needed to promote infant growth and development.
[
2014 c 38 s 1
.]
RCW 43.70.618
In utero exposure to cytomegalovirus
—
Educational resources.
Subject to amounts appropriated specifically for this purpose, the department shall develop and make available educational resources for pregnant individuals about the nature and consequences of in utero exposure to cytomegalovirus and strategies to reduce the transmission of cytomegalovirus. The educational resources may include, but are not limited to, courses delivered in-person or electronically, pamphlets printed on paper and distributed through the watch me grow program, social media content, or made available on the department's website. The department shall also provide educational materials and outreach for providers regarding the strategies to reduce transmission of cytomegalovirus. The educational materials are intended to lower cytomegalovirus infection rates among pregnant individuals to save lives and prevent disability in their unborn children.
[
2024 c 96 s 2
.]
RCW 43.70.619
Pregnancy complications
—
Informational resources.
By December 31, 2021, the department shall design, prepare, and make available online, written materials to clearly inform health care providers and staff of the provisions of, and authority to act under, chapter
70.400
RCW.
[
2021 c 235 s 5
.]
NOTES:
Conflict with federal requirements
—
2021 c 235:
See RCW 70.400.900
.
RCW 43.70.620
List of contacts
—
Health care professions.
The secretary shall create and maintain a list of contacts with each of the health care professions regulated under the following chapters for the purpose of policy advice and information dissemination: RCW 18.06.080, 18.89.050, and
18.138.070
and chapters *18.135, 18.55, and
18.88A
RCW.
[
1999 c 151 s 402
.]
NOTES:
*Reviser's note:
Chapter
18.135
RCW was repealed by
2012 c 153 s 20
.
Part headings not law
—
Effective date
—
1999 c 151:
See notes following RCW 18.28.010
.
RCW 43.70.630
Cost-reimbursement agreements.
(1) The department may enter into a written cost-reimbursement agreement with a permit applicant or project proponent to recover from the applicant or proponent the reasonable costs incurred by the department in carrying out the requirements of this chapter, as well as the requirements of other relevant laws, as they relate to permit coordination, environmental review, application review, technical studies, and permit processing.
(2) The cost-reimbursement agreement shall identify the tasks and costs for work to be conducted under the agreement. The agreement must include a schedule that states:
(a) The estimated number of weeks for initial review of the permit application;
(b) The estimated number of revision cycles;
(c) The estimated number of weeks for review of subsequent revision submittals;
(d) The estimated number of billable hours of employee time;
(e) The rate per hour; and
(f) A date for revision of the agreement if necessary.
(3) The written cost-reimbursement agreement shall be negotiated with the permit applicant or project proponent. Under the provisions of a cost-reimbursement agreement, funds from the applicant or proponent shall be used by the department to contract with an independent consultant to carry out the work covered by the cost-reimbursement agreement. The department may also use funds provided under a cost-reimbursement agreement to hire temporary employees, to assign current staff to review the work of the consultant, to provide necessary technical assistance when an independent consultant with comparable technical skills is unavailable, and to recover reasonable and necessary direct and indirect costs that arise from processing the permit. The department shall, in developing the agreement, ensure that final decisions that involve policy matters are made by the agency and not by the consultant. The department shall make an estimate of the number of permanent staff hours to process the permits, and shall contract with consultants or hire temporary employees to replace the time and functions committed by these permanent staff to the project. The billing process shall provide for accurate time and cost accounting and may include a billing cycle that provides for progress payments.
(4) The cost-reimbursement agreement must not negatively impact the processing of other permit applications. In order to maintain permit processing capacity, the agency may hire outside consultants, temporary employees, or make internal administrative changes. Consultants or temporary employees hired as part of a cost-reimbursement agreement or to maintain agency capacity are hired as agents of the state not of the permit applicant. The restrictions of chapter
42.52
RCW apply to any cost-reimbursement agreement, and to any person hired as a result of a cost-reimbursement agreement.
[
2009 c 97 s 10
;
2007 c 94 s 12
;
2003 c 70 s 3
;
2000 c 251 s 4
.]
NOTES:
Intent
—
Captions not law
—
Effective date
—
2000 c 251:
See notes following RCW 43.21A.690
.
RCW 43.70.640
Workplace breastfeeding policies
—
Infant-friendly designation.
(1) An employer may use the designation "infant-friendly" on its promotional materials if the employer has an approved workplace breastfeeding policy addressing at least the following:
(a) Flexible work scheduling, including scheduling breaks and permitting work patterns that provide time for expression of breast milk;
(b) A convenient, sanitary, safe, and private location, other than a restroom, allowing privacy for breastfeeding or expressing breast milk;
(c) A convenient clean and safe water source with facilities for washing hands and rinsing breast-pumping equipment located in the private location specified in (b) of this subsection; and
(d) A convenient hygienic refrigerator in the workplace for the mother's breast milk.
(2) Employers seeking approval of a workplace breastfeeding policy must submit the policy to the department of health. The department of health shall review and approve those policies that meet the requirements of this section. The department may directly develop and implement the criteria for "infant-friendly" employers, or contract with a vendor for this purpose.
(3) For the purposes of this section, "employer" includes those employers defined in RCW 49.12.005
and also includes the state, state institutions, state agencies, political subdivisions of the state, and municipal corporations or quasi-municipal corporations.
[
2001 c 88 s 3
.]
NOTES:
Acknowledgment
—
Declaration
—
Findings
—
2001 c 88:
"(1) The legislature acknowledges the surgeon general's summons to all sectors of society and government to help redress the low breastfeeding rates and duration in the United States, including the social and workplace factors that can make it difficult for women to breastfeed. The legislature also acknowledges the surgeon general's report on the health and economic importance of breastfeeding which concludes that:
(a) Breastfeeding is one of the most important contributors to infant health;
(b) Breastfeeding provides a range of benefits for the infant's growth, immunity, and development; and
(c) Breastfeeding improves maternal health and contributes economic benefits to the family, health care system, and workplace.
(2) The legislature declares that the achievement of optimal infant and child health, growth, and development requires protection and support for the practice of breastfeeding. The legislature finds that:
(a) The American academy of pediatrics recommends exclusive breastfeeding for the first six months of a child's life and breastfeeding with the addition of solid foods to continue for at least twelve months, and that arrangements be made to provide expressed breast milk if the mother and child must separate during the first year. Children should be breastfed or fed expressed breast milk when they show signs of need, rather than according to a set schedule or the location;
(b) Breast milk contains all the nutrients a child needs for optimal health, growth, and development, many of which can only be found in breast milk;
(c) Research in developed countries provides strong evidence that breastfeeding decreases the incidence and/or severity of diarrhea, lower respiratory tract infection, otitis media, bacteremia, bacterial meningitis, urinary tract infection, and necrotizing enterocolitis. In addition, a number of studies show a possible protective effect of breastfeeding against SIDS, Type 1 diabetes mellitus, Crohn's disease, lymphoma, ulcerative colitis, and allergic diseases;
(d) Studies also indicate health benefits in mothers who breastfeed. Breastfeeding is one of the few ways that mothers may be able to lower their risk of developing breast and ovarian cancer, with benefits proportional to the duration that they are able to breastfeed. In addition, the maternal hormonal changes stimulated by breastfeeding also help the uterus recover faster and minimize the amount of blood mothers lose after birth. Breastfeeding inhibits ovulation and menstrual bleeding, thereby decreasing the risk of anemia and a precipitous subsequent pregnancy. Breastfeeding women also have an earlier return to prepregnancy weight;
(e) Approximately two-thirds of women who are employed when they become pregnant return to the workforce by the time their children are six months old;
(f) Employers benefit when their employees breastfeed. Breastfed infants are sick less often; therefore, maternal absenteeism from work is lower in companies with established lactation programs. In addition, employee medical costs are lower and employee productivity is higher;
(g) According to a survey of mothers in Washington, most want to breastfeed but discontinue sooner than they hope, citing lack of societal and workplace support as key factors limiting their ability to breastfeed;
(h) Many mothers fear that they are not making enough breast milk and therefore decrease or discontinue breastfeeding. Frequency of breastfeeding or expressing breast milk is the main regulator of milk supply, such that forcing mothers to go prolonged periods without breastfeeding or expressing breast milk can undermine their ability to maintain breastfeeding; and
(i) Maternal stress can physiologically inhibit a mother's ability to produce and let down milk. Mothers report modifiable sources of stress related to breastfeeding, including lack of protection from harassment and difficulty finding time and an appropriate location to express milk while away from their babies.
(3) The legislature encourages state and local governmental agencies, and private and public sector businesses to consider the benefits of providing convenient, sanitary, safe, and private rooms for mothers to express breast milk." [
2001 c 88 s 1
.]
RCW 43.70.645
Donor human milk
—
Milk bank safety standards.
The department shall adopt standards for ensuring milk bank safety. The standards adopted by the department must, at a minimum, consider the clinical, evidence-based guidelines established by a national accrediting organization. The standards must address donor screening, milk handling and processing, and recordkeeping. The department shall also review and consider requiring additional testing standards, including but not limited to testing for the presence of viruses, bacteria, and prescription and nonprescription drugs in donated milk.
[
2022 c 236 s 5
.]
RCW 43.70.650
School sealant endorsement program
—
Rules
—
Fee
—
Report to the legislature.
The secretary is authorized to create a school sealant endorsement program for dental hygienists and dental assistants. The secretary of health, in consultation with the dental quality assurance commission and the dental hygiene examining committee, shall adopt rules to implement this section.
(1) A dental hygienist licensed in this state after April 19, 2001, is eligible to apply for endorsement by the department of health as a school sealant dental hygienist upon completion of the Washington state school sealant endorsement program. While otherwise authorized to act, currently licensed hygienists may still elect to apply for the endorsement.
(2) A dental assistant employed after April 19, 2001, by a dentist licensed in this state, who has worked under dental supervision for at least two hundred hours, is eligible to apply for endorsement by the department of health as a school sealant dental assistant upon completion of the Washington state school sealant endorsement program. While otherwise authorized to act, currently employed dental assistants may still elect to apply for the endorsement.
(3) The department may impose a fee for implementation of this section.
(4) The secretary shall provide a report to the legislature by December 1, 2005, evaluating the outcome of chapter 93, Laws of 2001.
[
2001 c 93 s 2
.]
NOTES:
Findings
—
Intent
—
2001 c 93:
"The legislature finds that access to preventive and restorative oral health services by low-income children is currently restricted by complex regulatory, financial, cultural, and geographic barriers that have resulted in a large number of children suffering unnecessarily from dental disease. The legislature also finds that very early exposure to oral health care can reverse this disease in many cases, thereby significantly reducing costs of providing dental services to low-income populations.
It is the intent of the legislature to address the problem of poor access to oral health care by providing for school-based sealant programs through the endorsement of dental hygienists." [
2001 c 93 s 1
.]
Effective date
—
2001 c 93:
"This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [April 19, 2001]." [
2001 c 93 s 5
.]
RCW 43.70.660
Product safety education.
(1) The legislature authorizes the secretary to establish and maintain a product safety education campaign to promote greater awareness of products designed to be used by infants and children that:
(a) Are recalled by the United States consumer products safety commission;
(b) Do not meet federal safety regulations and voluntary safety standards;
(c) Are unsafe or illegal to place into the stream of commerce under the infant crib safety act, chapter
70.111
RCW; or
(d) Contain chemicals of high concern for children as identified under RCW 70A.430.040
.
(2) The department shall make reasonable efforts to ensure that this infant and children product safety education campaign reaches the target population. The target population for this campaign includes, but is not limited to, parents, foster parents and other caregivers, child care providers, consignment and resale stores selling infant and child products, and charitable and governmental entities serving infants, children, and families.
(3) The secretary may utilize a combination of methods to achieve this outreach and education goal, including but not limited to print and electronic media. The secretary may operate the campaign or may contract with a vendor.
(4) The department shall coordinate this infant and children product safety education campaign with child-serving entities including, but not limited to, hospitals, birthing centers, midwives, pediatricians, obstetricians, family practice physicians, governmental and private entities serving infants, children, and families, and relevant manufacturers.
(5) The department shall coordinate with other agencies and entities to eliminate duplication of effort in disseminating infant and children consumer product safety information.
(6) The department may receive funding for this infant and children product safety education effort from federal, state, and local governmental entities, child-serving foundations, or other private sources.
[
2021 c 65 s 45
;
2008 c 288 s 6
;
2001 c 257 s 2
.]
NOTES:
Explanatory statement
—
2021 c 65:
See note following RCW 53.54.030
.
Findings
—
Intent
—
2001 c 257:
"(1) The legislature finds that infants and children in Washington are injured, sometimes fatally, by unsafe consumer products designed for use by infants and children.
(2) The legislature finds that parents and other persons responsible for the care of infants and children are often unaware that some of these consumer products have been recalled or are unsafe.
(3) The legislature intends to address this lack of awareness by establishing a statewide infant and children product safety campaign across Washington state." [
2001 c 257 s 1
.]
RCW 43.70.665
Early detection breast and cervical cancer screening program
—
Medical advisory committee.
(1) The legislature finds that Washington state has the highest incidence of breast cancer in the nation. Despite this, mortality rates from breast cancer have declined due largely to early screening and detection. Invasive cervical cancer is the most preventable type of cancer. The Pap test, used to detect early signs of this disease, has been called "medicine's most successful screening test." Applied consistently, invasive cervical cancer could nearly be eliminated. The legislature further finds that increasing access to breast and cervical cancer screening is critical to reducing incidence and mortality rates, and eliminating the disparities of this disease in women in Washington state. Furthermore, the legislature finds there is a need for a permanent program providing early detection and screening to the women and families of Washington state.
It is the intent of the legislature to establish an early detection breast and cervical cancer screening program as a voluntary screening program directed at reducing mortalities through early detection to be offered to eligible women only as funds are available.
(2) As used in this section:
(a) "Eligible woman" means a woman who is age forty to sixty-four, and whose income is at or below two hundred fifty percent of the federal poverty level, as published annually by the federal department of health and human services. Priority enrollment shall be given to women as defined by the federal national breast and cervical cancer early detection program, under P.L. 101-354.
(b) "Approved providers" means those state-supported health providers, radiology facilities, and cytological laboratories that are recognized by the department as meeting the minimum program policies and procedures adopted by the department to qualify under the federal national breast and cervical cancer early detection program, and are designated as eligible for funding by the department.
(c) "Comprehensive" means a screening program that focuses on breast and cervical cancer screening as a preventive health measure, and includes diagnostic and case management services.
(3) The department of health is authorized to administer a state-supported early detection breast and cervical cancer screening program to assist eligible women with preventive health services. To the extent of available funding, eligible women may be enrolled in the early detection breast and cervical cancer screening program and additional eligible women may be enrolled to the extent that grants and contributions from community sources provide sufficient funds for expanding the program.
(4) Funds appropriated for the state program shall be used only to operate early detection breast and cervical cancer screening programs that have been approved by the department, or to increase access to existing state-approved programs, and shall not supplant federally supported breast and cervical cancer early detection programs.
(5) Enrollment in the early detection breast and cervical cancer screening program shall not result in expenditures that exceed the amount that has been appropriated for the program in the operating budget. If it appears that continued enrollment will result in expenditures exceeding the appropriated level for a particular fiscal year, the department may freeze new enrollment in the program. Nothing in this section prevents the department from continuing enrollment in the program if there are adequate private or public funds in addition to those appropriated in the biennial budget to support the cost of such enrollment.
(6) The department shall establish a medical advisory committee composed of interested medical professionals and consumer liaisons with expertise in a variety of areas relevant to breast and cervical health to provide expert medical advice and guidance. The medical advisory committee shall address national, state, and local concerns regarding best practices in the field of early prevention and detection for breast and cervical cancer and assist the early detection breast and cervical cancer screening program in implementing program policy that follows the best practices of high quality health care for clinical, diagnostic, pathologic, radiological, and oncology services.
[
2006 c 55 s 1
.]
RCW 43.70.670
Human immunodeficiency virus insurance program.
(1) "Human immunodeficiency virus insurance program," as used in this section, means a program that provides health insurance coverage for individuals with human immunodeficiency virus, as defined in RCW 70.24.017
(7), who are not eligible for medical assistance programs from the health care authority as defined in RCW 74.09.010
and meet eligibility requirements established by the department of health.
(2) The department of health may pay for health insurance coverage on behalf of persons with human immunodeficiency virus, who meet department eligibility requirements, and who are eligible for "continuation coverage" as provided by the federal consolidated omnibus budget reconciliation act of 1985, group health insurance policies, or individual policies.
[
2025 c 58 s 2024
;
2011 1st sp.s. c 15 s 72
;
2007 c 259 s 38
;
2003 c 274 s 2
.]
NOTES:
Explanatory note
—
2025 c 58:
See note following RCW 1.16.050
.
Effective date
—
Findings
—
Intent
—
Report
—
Agency transfer
—
References to head of health care authority
—
Draft legislation
—
2011 1st sp.s. c 15:
See notes following RCW 74.09.010
.
Subheadings not law
—
2007 c 259:
See note following RCW 7.70.060
.
Rules
—
2003 c 274:
"The department of health shall adopt rules to implement this act." [
2003 c 274 s 3
.]
Effective date
—
2003 c 274:
"This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 1, 2003." [
2003 c 274 s 4
.]
RCW 43.70.675
Public health advisory board.
(1) The public health advisory board is established within the department. The advisory board shall:
(a) Advise and provide feedback to the governmental public health system and provide formal public recommendations on public health;
(b) Monitor the performance of the governmental public health system;
(c) Develop goals and a direction for public health in Washington and provide recommendations to improve public health performance and to achieve the identified goals and direction;
(d) Advise and report to the secretary;
(e) Coordinate with the governor's office, department, state board of health, local health jurisdictions, and the secretary;
(f) Evaluate public health emergency response and provide recommendations for future response, including coordinating with relevant committees, task forces, and stakeholders to analyze the COVID-19 public health response; and
(g) Evaluate the use of foundational public health services funding by the governmental public health system.
(2) The public health advisory board shall consist of representatives from each of the following appointed by the governor:
(a) The governor's office;
(b) The director of the state board of health or the director's designee;
(c) The secretary of the department or the secretary's designee;
(d) The chair of the governor's interagency council on health disparities;
(e) Two representatives from the tribal government public health sector selected by the American Indian health commission;
(f) One member of the county legislative authority from a eastern Washington county selected by a statewide association representing counties;
(g) One member of the county legislative authority from a western Washington county selected by a statewide association representing counties;
(h) An organization representing businesses in a region of the state;
(i) A statewide association representing community and migrant health centers;
(j) A statewide association representing Washington cities;
(k) Four representatives from local health jurisdictions selected by a statewide association representing local public health officials, including one from a jurisdiction east of the Cascade mountains with a population between 200,000 and 600,000, one from a jurisdiction east of the Cascade mountains with a population under 200,000, one from a jurisdiction west of the Cascade mountains with a population between 200,000 and 600,000, and one from a jurisdiction west of the Cascade mountains with a population less than 200,000;
(l) A statewide association representing Washington hospitals;
(m) A statewide association representing Washington physicians;
(n) A statewide association representing Washington nurses;
(o) A statewide association representing Washington public health or public health professionals; and
(p) A consumer nonprofit organization representing marginalized populations.
(3) In addition to the members of the public health advisory board listed in subsection (2) of this section, there must be four nonvoting ex officio members from the legislature consisting of one legislator from each of the two largest caucuses in both the house of representatives and the senate.
(4) Staff support for the public health advisory board, including arranging meetings, must be provided by the department.
(5) Legislative members of the public health advisory board may be reimbursed for travel expenses in accordance with RCW 44.04.120
. Nonlegislative members are not entitled to be reimbursed for travel expenses if they are elected officials or are participating on behalf of an employer, governmental entity, or other organization. Any reimbursement for other nonlegislative members is subject to chapter
43.03
RCW.
(6) The public health advisory board is a class one group under chapter
43.03
RCW.
[
2021 c 205 s 2
.]
NOTES:
Finding
—
2021 c 205:
"The legislature finds that everyone in Washington state, no matter what community they live in, should be able to rely on a public health system that is able to support a standard level of public health service. Like public safety, there is a foundational level of public health delivery that must exist everywhere for services to work. A strong public health system is only possible with intentional investments into our state's public health system. Services should be delivered efficiently, equitably, and effectively, in ways that make the best use of technology, science, expertise, and leveraged resources and in a manner that is responsive to local communities." [
2021 c 205 s 1
.]
RCW 43.70.680
Volunteers for emergency or disaster assistance.
(1) The department is authorized to contact persons issued credentials under this title for the purpose of requesting permission to collect his or her name, profession, and contact information as a possible volunteer in the event of a bioterrorism incident, natural disaster, public health emergency, or other emergency or disaster, as defined in RCW 38.52.010, that requires the services of health care providers.
(2) The department shall maintain a record of all volunteers who provide information under subsection (1) of this section. Upon request, the department shall provide the record of volunteers to:
(a) Local health departments;
(b) State agencies engaged in public health emergency planning and response, including the state military department;
(c) Agencies of other states responsible for public health emergency planning and response; and
(d) The centers for disease control and prevention.
[
2003 c 384 s 1
.]
RCW 43.70.690
State asthma plan.
(1) The department, in collaboration with its public and private partners, shall design a state asthma plan, based on clinically sound criteria including nationally recognized guidelines such as those established by the national asthma education prevention partnership expert panel report guidelines for the diagnosis and management of asthma.
(2) The plan shall include recommendations in the following areas:
(a) Evidence-based processes for the prevention and management of asthma;
(b) Data systems that support asthma prevalence reporting, including population disparities and practice variation in the treatment of asthma;
(c) Quality improvement strategies addressing the successful diagnosis and management of the disease; and
(d) Cost estimates and sources of funding for plan implementation.
(3) The department shall submit the completed state plan to the governor and the legislature by December 1, 2005.
(4) The department shall implement the state plan recommendations made under subsection (2) of this section only to the extent that federal, state, or private funds, including grants, are available for that purpose.
[
2009 c 518 s 8
;
2005 c 462 s 4
.]
NOTES:
Findings
—
2005 c 462:
See note following RCW 28A.210.370
.
RCW 43.70.700
Locally grown foods
—
Women, infant, and children farmers market nutrition program
—
Fruit and vegetable benefit
—
Rules.
(1) The department shall adopt rules authorizing retail operation farms stores, owned and operated by a farmer and colocated with a site of agricultural production, to participate in the women, infant, and children farmers market nutrition program to provide locally grown, nutritious, unprepared fruits and vegetables to eligible program participants.
(2) Such rules must meet the provisions of 7 C.F.R. part 3016, uniform administrative requirements for grants and cooperative agreements to state and local governments, as it existed on June 12, 2008, or such subsequent date as may be provided by the department by rule, consistent with the purposes of this section.
(3) Subject to the availability of amounts appropriated for this specific purpose, the department shall distribute a fruit and vegetable benefit of no less than twenty-eight dollars per summer farmers market season to each eligible participant in the women, infant, and children farmers market nutrition program. To the extent that federal funds are available, the department shall use federal funds up to the maximum benefit allowable under federal law.
[
2020 c 68 s 2
;
2008 c 215 s 8
.]
NOTES:
Findings
—
Intent
—
2020 c 68:
"The legislature finds that our state has a robust agricultural system, with Washington farmers producing diverse foods available at regional markets throughout the state. The legislature further finds that one in six Washington children do not know where their next meal will come from and that promoting access to fresh foods supports Washington farmers as well as food-insecure families. Hunger for families with children continues to be a significant issue across our state and a growing concern. Hunger and unhealthy diets also impact the health and development of children and a child's ability to learn. Therefore, the legislature intends to expand access to nutritious foods by increasing the fruit and vegetable benefit for participants in the women, infant, and children farmers market nutrition program." [
2020 c 68 s 1
.]
Findings
—
Intent
—
Short title
—
Captions not law
—
Conflict with federal requirements
—
2008 c 215:
See notes following RCW 15.64.060
.
RCW 43.70.703
Mobile market program.
(Effective March 1, 2026.)
(1) The mobile market program is established in the department with the goals of providing increased nutrition access to participants of the women, infant, and children and senior farmers market nutrition program[s], while also supporting local farmers.
(2) The mobile market program is available to participants of the women, infant, and children and senior farmers market nutrition programs so long as funding is made available to the department through the United States department of agriculture.
(3) The department shall define the mobile market program through rule making. At a minimum, the definition must require mobile market programs to be operated by a nonprofit organization and prevent competition between a mobile market and a farmers market that is participating in the farmers market nutrition program.
(4) The department shall conduct rule making consistent with this section to establish the mobile market program.
(5) If the department deems it necessary to file a waiver, the department shall file a waiver with the United States department of agriculture to allow mobile market programs to accept both women, infants, and children and senior farmers market nutrition program benefits.
[
2025 c 127 s 2
.]
NOTES:
Findings
—
Intent
—
2025 c 127:
"The legislature finds that small local farmers play a crucial role in providing communities with access to fresh, healthy foods. Farmers markets provide a place for local farmers to sell their products, encouraging consumption of fresh products in the communities in which they were grown.
The legislature recognizes that some households may live in rural areas or food deserts where access to farmers markets and fresh food is limited. There are a number of programs to help increase access to fresh, healthy foods for low-income communities. The farmers market nutrition program was established by congress in 1992 to provide fresh, locally grown fruits and vegetables to women, infants, and children program participants and to expand the awareness, use of, and sales at farmers markets which benefits both program participants and local farmers. Similarly, the senior farmers market nutrition program provides low-income seniors with access to locally grown fruits and vegetables. Participants in both programs commonly use their food benefit at farmers markets, farms, and farm stands.
The legislature further recognizes that other states including Pennsylvania and Virginia also allow mobile market providers to accept both women, infants, and children and senior farmers market nutrition program benefits. This provides greater nutritional support to households that may live in a rural area, an area without access to a farmers market, or in a food desert. In these states, eligible low-income households are still able to access fresh, healthy foods which not only benefits that household, but benefits the local farmers as well.
It is hereby the intent of the legislature to provide participants of both the women, infants, and children and senior farmers market nutrition programs access to fresh, healthy food through nonprofit mobile markets to promote access to fresh, healthy food regardless of a household's proximity to a farmers market." [
2025 c 127 s 1
.]
Effective date
—
2025 c 127:
"This act takes effect March 1, 2026." [
2025 c 127 s 3
.]
RCW 43.70.705
Fall prevention program.
Within funds appropriated for this purpose, the department shall develop a statewide fall prevention program. The program shall include networking community services, identifying service gaps, making affordable senior-based, evaluated exercise programs more available, providing consumer education to older adults, their adult children, and the community at large, and conducting professional education on fall risk identification and reduction.
[
2008 c 146 s 7
.]
NOTES:
Findings
—
Intent
—
Severability
—
2008 c 146:
See notes following RCW 74.41.040
.
RCW 43.70.710
Annual review of medication practices of five jails that use nonpractitioner jail personnel
—
Noncompliance.
The department of health shall annually review the medication practices of five jails that provide for the delivery and administration of medications to inmates in their custody by nonpractitioner jail personnel. The review shall assess whether the jails are in compliance with sections 3 and 4, chapter 411, Laws of 2009. To the extent that a jail is found not in compliance, the department shall provide technical assistance to assist the jail in resolving any areas of noncompliance.
[
2009 c 411 s 5
.]
RCW 43.70.715
COVID-19 public health response account.
(1) The COVID-19 public health response account is created in the custody of the state treasurer. The account shall consist of funds appropriated by the legislature and grants received by the department of health for activities in response to the coronavirus pandemic (COVID-19). Only the secretary, or the secretary's designee, may authorize expenditures from the account for costs related to the public health response to COVID-19, subject to any limitations imposed by grant funding deposited into the account. The COVID-19 public health response account is subject to allotment procedures under chapter
43.88
RCW, but an appropriation is not required for expenditures.
(2)(a) The legislature finds that a safe, efficient, and effective delivery of vaccinations is of the utmost importance for restoring societal and economic functions. As we learn more about the virus, the vaccine, and challenges to vaccine allocation and distribution, it is anticipated that the state's COVID-19 vaccination distribution plan will evolve. To that end, the legislature has provided flexibility by funding expenditures for testing, contact tracing, mitigation activities, vaccine administration and distribution, and other allowable uses for the state, local health jurisdictions, and tribes at the discretion of the secretary and without an appropriation. However, to maintain fiscal control and to ensure spending priorities align, the department is required to collaborate and communicate with the chairs and ranking members of the health care and fiscal committees of the legislature and local health jurisdictions in advance of any significant revision of the state's COVID-19 vaccination plan and to provide regular updates on its implementation and spending.
(b) As part of the public health response to COVID-19, the expenditures from the account must be used to effectively administer the vaccine for COVID-19 and conduct testing and contact tracing. The department must ensure that COVID-19 outreach is accessible, culturally and linguistically appropriate, and that it includes community-driven partnerships and strategies.
(c) When making expenditures for administering the vaccine for COVID-19, the department must focus on identifying persons for vaccination, prioritizing underserved, underrepresented, and hard-to-reach communities, making the vaccine accessible, and providing support to schools for safe reopening. Strategies for vaccine distribution shall include the establishment and expansion of community vaccination centers, mobile vaccination units, reporting enhancements, in-home visits for vaccinations for the elderly, and transportation of individuals to vaccination sites.
(d) When making expenditures regarding testing and contact tracing, the department must provide equitable access, prioritize underserved, underrepresented, and hard-to-reach communities, and provide support and resources to facilitate the safe reopening of schools while minimizing community spread of the virus.
(e) The department may also make expenditures from the account related to developing the public health workforce using funds granted by the federal government for that purpose in section 2501, the American rescue plan act of 2021, P.L. 117-2.
(3) When making expenditures from the account, the department must include an emphasis on public communication regarding the availability and accessibility of the vaccine and testing, and the importance of vaccine and testing availability to the safe reopening of the state.
(4)(a) The department must report to the fiscal and health care committees of the legislature on a monthly basis regarding its COVID-19 response.
To the extent that it is available, the report must include data regarding vaccine distribution, testing, and contact tracing, as follows:
(i) The number of vaccines administered per day, including regional data regarding the location and age groups of persons receiving the vaccine, specifically identifying hard-to-reach communities in which vaccines were administered; and
(ii) The number of tests conducted per week, including data specifically addressing testing conducted in hard-to-reach communities.
(b)(i) Beginning with the quarter ending March 31, 2022, the department must report to the fiscal and health care committees of the legislature on a quarterly basis regarding revenues and expenditures related to the COVID-19 response. The reports must include:
(A) Quarterly expenditures of funds, by fund source, including the appropriated amounts pursuant to section 222 (76) and (77), chapter 297, Laws of 2022 for:
(I) Diagnostic testing;
(II) Case investigation and contact tracing;
(III) Outbreak response;
(IV) Care coordination;
(V) Community outreach;
(VI) Information and technology operations;
(VII) Surveillance;
(VIII) Vaccines;
(IX) Client services;
(X) Local health jurisdictions; and
(XI) Tribes; and
(B) Grant amounts received during the reporting quarter that may be used in the COVID-19 response.
(ii) The quarterly reports must reflect the previous quarter, a projection of expected expenditures and revenue for the next quarter, and an accounting of the expenditures and revenue for the 2021-2023 fiscal biennium to date. The quarterly reports are due no later than 30 days after the end of the applicable quarter.
(c) The first monthly report pursuant to (a) of this subsection is due no later than one month from February 19, 2021. Monthly reports are no longer required upon the department's determination that the remaining balance of the COVID-19 public health response account is less than $100,000.
[
2022 c 297 s 955
;
2022 c 157 s 7
. Prior:
2021 c 334 s 1004
;
2021 c 3 s 19
.]
NOTES:
Reviser's note:
This section was amended by 2022 c 157 s 7 and by 2022 c 297 s 955, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025
(2). For rule of construction, see RCW 1.12.025
(1).
Effective date
—
2022 c 297:
See note following RCW 43.79.565
.
Conflict with federal requirements
—
Effective date
—
2021 c 334:
See notes following RCW 43.79.555
.
Conflict with federal requirements
—
2021 c 3:
"If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not affect the operation of the remainder of this act in its application to the agencies concerned. Rules adopted under this act must meet federal requirements that are a necessary condition to the receipt of federal funds by the state." [
2021 c 3 s 21
.]
Effective date
—
2021 c 3:
"This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [February 19, 2021]." [
2021 c 3 s 22
.]
RCW 43.70.720
Universal vaccine purchase account.
The universal vaccine purchase account is created in the custody of the state treasurer. Receipts from public and private sources for the purpose of increasing access to vaccines for children may be deposited into the account. Expenditures from the account must be used exclusively for the purchase of vaccines, at no cost to health care providers in Washington, to administer to children under nineteen years old who are not eligible to receive vaccines at no cost through federal programs. Only the secretary or the secretary's designee may authorize expenditures from the account. The account is subject to allotment procedures under chapter
43.88
RCW, but an appropriation is not required for expenditures.
[
2010 c 174 s 10
;
2009 c 564 s 934
.]
NOTES:
Effective date
—
2010 c 174:
See RCW 70.290.900
.
Effective date
—
2009 c 564:
See note following RCW 2.68.020
.
RCW 43.70.723
Medication for people living with HIV rebate revenue account.
The medication for people living with HIV rebate revenue account is created in the custody of the state treasury. The early intervention program shall deposit any receipts from pharmaceutical rebates generated by the purchase of medications with federal grant funds and revenue generated from federal grant funds for any person enrolled in the early intervention program into the account. The expenditures may only be used for services defined in the grant award from the Ryan White HIV/AIDS program. Only the secretary or the secretary's designee may authorize expenditures from the account. An appropriation is not required for expenditures. The account is subject to allotment procedures under chapter
43.88
RCW.
[
2023 c 12 s 1
.]
NOTES:
Effective date
—
2023 c 12:
"This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 1, 2023." [
2023 c 12 s 3
.]
RCW 43.70.725
Health extension program
—
Dissemination of evidence-based tools and resources
—
Rules.
(1) Subject to the availability of amounts appropriated for this specific purpose, the department shall establish a health extension program to provide training, tools, and technical assistance to primary care, behavioral health, and other providers. The program must emphasize high quality preventive, chronic disease, and behavioral health care that is comprehensive and evidence-based.
(2) The health extension program must coordinate dissemination of evidence-based tools and resources that promote:
(a) Integration of physical and behavioral health;
(b) Clinical decision support to promote evidence-based care;
(c) Reports of the Robert Bree collaborative created by RCW 70.250.050
and findings of health technology assessments under RCW 70.14.080
through
70.14.130
;
(d) Methods of formal assessment;
(e) Support for patients managing their own conditions;
(f) Identification and use of resources that are available in the community for patients and their families, including community health workers; and
(g) Identification of evidence-based models to effectively treat depression and other conditions in primary care settings, such as the program advancing integrated mental health solutions, and others.
(3) The department may adopt rules necessary to implement this section, but may not adopt rules, policies, or procedures beyond the scope of authority granted in this section.
[
2014 c 223 s 5
.]
NOTES:
Finding
—
2014 c 223:
See note following RCW 41.05.690
.
RCW 43.70.738
Down syndrome resources
—
Development.
(1)(a) The department shall develop the following resources regarding Down syndrome:
(i) Up-to-date, evidence-based, written information about Down syndrome and people born with Down syndrome that has been reviewed by medical experts and national Down syndrome organizations; and
(ii) Contact information regarding support services, including information hotlines specific to Down syndrome, resource centers or clearinghouses, national and local Down syndrome organizations, and other education and support programs.
(b) The resources prepared by the department must:
(i) Be culturally and linguistically appropriate for expectant parents receiving a positive prenatal diagnosis or for the parents of a child receiving a postnatal diagnosis of Down syndrome; and
(ii) Include: Physical, developmental, educational, and psychosocial outcomes; life expectancy; clinical course; and intellectual and functional development and therapy options.
(2) The department shall make the information described in this section available to any person who renders prenatal care, postnatal care, or genetic counseling to expectant parents receiving a positive prenatal diagnosis or to the parents of a child receiving a postnatal diagnosis of Down syndrome.
(3) For the purposes of this section, "Down syndrome" means a chromosomal condition that results in the presence of an extra whole or partial copy of chromosome 21.
[
2016 c 70 s 1
.]
RCW 43.70.740
Adjudicative proceedings.
In all adjudicative proceedings before the secretary or the department, the secretary may delegate initial decision-making authority to a presiding officer. The presiding officer shall enter an initial order pursuant to RCW 34.05.461
subject to the review of the secretary or his or her designee. Pursuant to RCW 34.05.464, the secretary may, by rule, provide that initial orders in specified classes of cases may become final without further agency action unless, within a specified time period:
(1) The secretary upon his or her own motion determines that the initial order should be reviewed; or
(2) A party to the proceedings files a petition for administrative review of the initial order.
[
2013 c 109 s 3
.]
RCW 43.70.750
Community assistance referral and education program
—
Review of certification and training
—
Recommendations to the legislature.
The department of health must review the professional certification and training of health professionals participating in a community assistance referral and education program, review the certification and training requirements in other states with similar programs, and coordinate with the health care authority to link the certification requirements with the covered health care services recommended for payment in RCW 74.09.335
. The department shall submit recommendations to the appropriate committees of the legislature for any changes and suggestions for implementation within six months of the development of the payment standards.
[
2017 c 273 s 3
.]
RCW 43.70.765
Opioid drugs
—
Warning
—
Patient education materials.
(1) The department must create a statement warning individuals about the risks of opioid use and abuse and provide information about safe disposal of opioids. The department must provide the warning on its website.
(2) The department must review the science, data, and best practices around the use of opioids and their associated risks. As evidence and best practices evolve, the department must update its warning to reflect these changes.
(3) The department must update its patient education materials to reflect the patient's right to refuse an opioid prescription or order.
[
2019 c 314 s 11
.]
NOTES:
Declaration
—
2019 c 314:
See note following RCW 18.22.810
.
RCW 43.70.768
Statewide drug overdose prevention and awareness campaign.
(1) The department shall develop, implement, and maintain a statewide drug overdose prevention and awareness campaign to address the drug overdose epidemic.
(2)(a) The campaign must educate the public about the dangers of methamphetamines and opioids, including fentanyl, and the harms caused by drug use. The campaign must include outreach to both youth and adults aimed at preventing substance use and overdose deaths.
(b) The department, in consultation with the health care authority, may also include messaging focused on substance use disorder and overdose death prevention, resources for addiction treatment and services, and information on immunity for people who seek medical assistance in a drug overdose situation pursuant to RCW 69.50.315
.
(3) The 2024 and 2025 campaigns must focus on increasing the awareness of the dangers of fentanyl and other synthetic opioids, including the high possibility that other drugs are contaminated with synthetic opioids and that even trace amounts of synthetic opioids can be lethal.
(4) Beginning June 30, 2025, and each year thereafter, the department must submit a report to the appropriate committees of the legislature on the content and distribution of the statewide drug overdose prevention and awareness campaign. The report must include a summary of the messages distributed during the campaign, the mediums through which the campaign was operated, and data on how many individuals received information through the campaign. The department must identify measurable benchmarks to determine the effectiveness of the campaign and recommend whether the campaign should continue and if any changes should be made to the campaign. The report must be submitted in compliance with RCW 43.01.036
.
[
2024 c 216 s 1
.]
RCW 43.70.769
Opioid public outreach campaigns
—
Design.
(1) Insofar as is appropriate and practicable, when conducting any public outreach campaign on the dangers of fentanyl and other synthetic opioids, the department shall ensure that campaign materials are:
(a) Culturally appropriate;
(b) Accessible in other languages, as appropriate; and
(c) Accessible to the deaf and blind communities.
(2) When designing public outreach campaigns on the dangers of fentanyl and other synthetic opioids, the department shall consider using the phrase, "Not Even Once" where appropriate.
[
2024 c 309 s 2
.]
NOTES:
Findings
—
Intent
—
Short title
—
2024 c 309:
"(1) The legislature finds that:
(a) Fentanyl is a synthetic opioid that is up to 50 times stronger than morphine and is a major contributor to fatal and nonfatal overdoses in the United States;
(b) There are two types of fentanyl: Pharmaceutical fentanyl and illegally made fentanyl;
(c) Fentanyl and other synthetic opioids are causing a public health crisis in Washington;
(d) Addiction, overdoses, and deaths caused by fentanyl and other synthetic opioids are on the rise, and health care and treatment systems are becoming overextended;
(e) Effective outreach programs about the negative health effects of fentanyl misuse and abuse are necessary to help curb the public health crisis;
(f) Individuals who purchase or recover motor vehicles in which fentanyl or other synthetic opioids have been used face unique challenges in understanding how to decontaminate the vehicles; and
(g) More should be done to connect individuals who are arrested while intoxicated on fentanyl or other synthetic opioids with needed health care and treatment services.
(2) The legislature therefore intends to address this public health issue by:
(a) Providing guidance on public outreach campaigns on the dangers of misusing or abusing fentanyl and other synthetic opioids;
(b) Compiling information for individuals who wish to decontaminate a vehicle in which fentanyl or other synthetic opioids were used; and
(c) Increasing the likelihood that individuals will seek necessary substance abuse disorder treatment by offering to connect them with treatment upon release from custody in jail.
(3) This act may be known and cited as Ivan's law." [
2024 c 309 s 1
.]
RCW 43.70.770
State opioid response plan.
The secretary shall be responsible for coordinating the statewide response to the opioid epidemic and executing the state opioid response plan, in partnership with the health care authority. The department and the health care authority must collaborate with each of the agencies and organizations identified in the state opioid response plan.
[
2019 c 314 s 12
.]
NOTES:
Declaration
—
2019 c 314:
See note following RCW 18.22.810
.
RCW 43.70.775
Drug overdose prevention and awareness campaign
—
Annual report.
(1) The department shall develop, implement, and maintain a statewide drug overdose prevention and awareness campaign to address the drug overdose epidemic.
(2)(a) The campaign must educate the public about the dangers of methamphetamines and opioids, including fentanyl, and the harms caused by drug use. The campaign must include outreach to both youth and adults aimed at preventing substance use and overdose deaths.
(b) The department, in consultation with the health care authority, may also include messaging focused on substance use disorder and overdose death prevention, resources for addiction treatment and services, and information on immunity for people who seek medical assistance in a drug overdose situation pursuant to RCW 69.50.315
.
(3) The 2024 and 2025 campaigns must focus on increasing the awareness of the dangers of fentanyl and other synthetic opioids, including the high possibility that other drugs are contaminated with synthetic opioids and that even trace amounts of synthetic opioids can be lethal.
(4) Beginning June 30, 2025, and each year thereafter, the department must submit a report to the appropriate committees of the legislature on the content and distribution of the statewide drug overdose prevention and awareness campaign. The report must include a summary of the messages distributed during the campaign, the mediums through which the campaign was operated, and data on how many individuals received information through the campaign. The department must identify measurable benchmarks to determine the effectiveness of the campaign and recommend whether the campaign should continue and if any changes should be made to the campaign. The report must be submitted in compliance with RCW 43.01.036
.
[
2024 c 201 s 2
.]
NOTES:
Finding
—
Intent
—
2024 c 201:
"(1) The legislature finds that overdoses and overdose deaths, particularly from synthetic opioids, have increased in recent years. According to the federal centers for disease control and prevention, among persons aged 14 through 18, overdose deaths increased 94 percent from 2019 to 2020 and 20 percent from 2020 to 2021. In 2021, over 75 percent of all drug overdose deaths involved opioids, with synthetic opioids, including fentanyl, accounting for nearly 88 percent of those deaths. Between 2022 and 2023, Washington saw the largest increase in overdose deaths of any state at 40 percent.
(2) The legislature recognizes that fatal overdose risk among adolescents is increasing due to widespread availability of illicitly manufactured fentanyl, proliferation of counterfeit pills resembling prescription drugs but containing illicit drugs, and ease of purchasing pills through social media. The United States drug enforcement administration states that there is significant risk that illegal drugs have been intentionally contaminated with fentanyl. As a result, many young people may ingest a lethal dose without knowing that they are consuming fentanyl.
(3) The legislature acknowledges that the level of public health crisis created by use of fentanyl and other synthetic opioids requires an immediate, substantial, and coordinated effort by national, state, and local public health, social service, and educational agencies working together.
(4) The legislature also acknowledges that the popularity of drugs grows and wanes forming distinct drug epidemics, similar to disease epidemics. As the popularity and availability of synthetic opioids wanes, it is likely that some other substance will pose the next acute public health crisis.
(5) Therefore, in order to combat the current public health crisis of abuse of fentanyl and other synthetic opioids, and to be prepared to address the next drug epidemic before it reaches crisis level, the legislature intends to direct the state department of health to deploy a statewide substance use prevention and awareness campaign that evolves to address the substance or substances with the greatest impact on the health of Washington youth and their families, diverse regions and communities, and the broader public. The legislature also intends for the public education system to actively incorporate campaign messages and materials in classrooms, as well as in family and community communications." [
2024 c 201 s 1
.]
Effective date
—
2024 c 201:
"This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [March 19, 2024]." [
2024 c 201 s 5
.]
Short title
—
2024 c 201:
"This act may be known and cited as the Lucas Petty act." [
2024 c 201 s 7
.]
RCW 43.70.780
Fruit and vegetable incentives program.
(1) The fruit and vegetable incentives program is established to increase fruit and vegetable consumption among food insecure individuals with limited incomes. The fruit and vegetable incentives program includes:
(a) Farmers market basic food incentives to provide eligible participants with extra benefits to purchase fruits and vegetables at authorized farmers markets when the participant uses basic food benefits;
(b) Grocery store basic food incentives to provide eligible participants with extra benefits to purchase fruits and vegetables at authorized grocery stores when the participant uses basic food benefits; and
(c) Fruit and vegetable vouchers provided by a health care provider, health educator, community health worker, or other health professional to an eligible participant for use at an authorized farmers market or grocery store.
(2) Subject to the availability of amounts appropriated for this specific purpose, the department shall administer the fruit and vegetable incentives program. As part of its duties, the department shall:
(a) Collaborate with other state agencies whose missions and programs closely align with the fruit and vegetable incentives program, including the department of social and health services and the department of agriculture, in the development and implementation of the program;
(b) Provide resources, coordination, and technical assistance to program partners for targeted outreach to food insecure populations and for administration of the program. Program partners may include farmers markets, grocery stores, government agencies, health care systems, and nonprofit organizations; and
(c) Adopt rules to implement this section.
(3) Farmers market basic food incentives may be provided to eligible participants for use at farmers markets authorized by the department. The incentives are additional funds that may be used to purchase eligible fruits and vegetables as defined by the department. When authorizing a participating farmers market, the department may give preference to a farmers market that accepts or has previously accepted supplemental nutrition assistance program benefits, has the capacity to accept supplemental nutrition assistance program benefits, or is located in a county with a high level of food insecurity, as defined by the department.
(4) Grocery store basic food incentives may be provided to eligible participants for use at a grocery store that is an authorized supplemental nutrition assistance program retailer and approved by the department. The incentives are additional funds that may be used to purchase eligible fruits and vegetables as defined by the department. When approving a participating grocery store, the department may give preference to a store that is located in a county with a high level of food insecurity.
(5) Fruit and vegetable vouchers are cash-value vouchers that may be distributed by a participating health care provider, health educator, community health worker, or other health professional to a patient who is eligible for basic food and has a qualifying health condition, as defined by the department, or is food insecure. The voucher may be redeemed at a participating retailer, including an authorized farmers market or grocery store. The department shall approve participating health care systems and may give preference to systems that have operated fruit and vegetable prescription programs, routinely screen patients for food insecurity, have a high percentage of patients who are medicaid clients, or are located in a county with a high level of food insecurity.
(6) Subject to the availability of funds, the department must evaluate the fruit and vegetable incentives program effectiveness. When conducting the evaluation, the department must collect information related to fruit and vegetable consumption by eligible participants, levels of food security, and likely impacts on public health outcomes as a result of the program. By July 1, 2021, and in compliance with RCW 43.01.036, the department must submit a progress report to the governor and the legislature describing the results of the program and recommending any legislative or programmatic changes to improve the effectiveness of program delivery. By December 1, 2023, the department must submit a complete program evaluation describing the program's effectiveness and including any additional recommendations for program improvements.
(7) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.
(a) "Eligible participant" means:
(i) For the purposes of subsection (1)(a) and (b) of this section, a recipient of basic food benefits, including the supplemental nutrition assistance program and the food assistance program, as authorized under Title
74
RCW; or
(ii) For the purposes of subsection (1)(c) of this section, a person who is determined to be food insecure by a participating health care provider.
(b) "Food insecure" means a state in which consistent access to adequate food is limited by a lack of money and other resources at times during the year.
[
2019 c 168 s 2
.]
NOTES:
Findings
—
Intent
—
2019 c 168:
"(1) The legislature finds that nearly eleven percent of Washington households, including more than two hundred eighty thousand children, are food insecure with limited or uncertain availability of nutritionally adequate and safe foods. The legislature further finds that food insecurity contributes to poor quality diets; chronic medical conditions such as diabetes, heart disease, and hypertension; and negative outcomes for children and families, including harmful effects on behavioral health. Further, food insecurity disproportionately affects people with low incomes, people of color, and rural residents.
(2) The legislature finds that food assistance programs such as the special supplemental nutrition program for women, infants, and children and the supplemental nutrition assistance program are effective in significantly reducing food insecurity; that participants report difficulty affording and accessing healthy foods; and that fruit and vegetable consumption among such food assistance program participants is far below national dietary guidelines.
(3) The legislature finds that the state department of health has successfully managed a food insecurity nutrition incentives grant from the United States department of agriculture that provides a framework for providing fruit and vegetable incentives for low-income shoppers and that those federal funds are set to expire in March 2020. Further, the legislature finds that more than two million dollars in fruit and vegetable incentives have been redeemed by food insecure Washingtonians through this grant, helping to alleviate food insecurity and increase fruit and vegetable consumption.
(4) Therefore, the legislature intends to create a state fruit and vegetable incentives program to benefit people who are food insecure, our agricultural industry, and retailers across the state." [
2019 c 168 s 1
.]
RCW 43.70.790
Health care facility inspection and investigation availability.
As resources allow, the department shall make health care facility inspection and investigation statements of deficiencies, plans of correction, notice[s] of acceptance of plans of correction, enforcement actions, and notices of resolution available to the public on the internet, starting with psychiatric hospitals and residential treatment facilities.
[
2020 c 115 s 4
.]
NOTES:
Findings
—
Intent
—
Effective date
—
2020 c 115:
See notes following RCW 71.12.700
.
RCW 43.70.800
Oversight, consolidation, and standardization
—
Review.
The department must conduct a review of statutes for all health care facility types licensed by the department under chapters
18.46, 18.64, 70.41, 70.42, 70.127, 70.230, 71.12, and
71.24
RCW to evaluate appropriate levels of oversight and identify opportunities to consolidate and standardize licensing and enforcement requirements across facility types. The department must work with stakeholders including, but not limited to, the statewide associations of the facilities under review to create recommendations that will be shared with stakeholders and the legislature for a uniform health care facility enforcement act for consideration in the 2021 legislative session.
[
2020 c 115 s 5
.]
NOTES:
Findings
—
Intent
—
Effective date
—
2020 c 115:
See notes following RCW 71.12.700
.
RCW 43.70.810
Provision of medical information
—
Dissemination of requirements and authority.
(1) The department must design, prepare, and make available online, written materials to clearly inform health care providers and staff of the provisions of, and authority to act under, chapter
70.03
RCW.
(2) The department must design, prepare, and make available online, written materials to provide information to providers and patients regarding Washington's death with dignity act, chapter
70.245
RCW.
[
2020 c 102 s 4
.]
RCW 43.70.815
Environmental health disparities map.
(1) In consultation with the environmental justice council established in RCW 70A.02.110, the department must continue to develop and maintain an environmental health disparities map with the most current available information necessary to identify cumulative environmental health impacts and overburdened communities. The department may also consult with other interested partners, such as the University of Washington department of environmental and occupational health sciences, other academic partners, members of overburdened communities and vulnerable populations, and other agencies. The environmental health disparities map must include tools to:
(a) Track changes in environmental health disparities over time in an interactive, regularly updated display; and
(b) Measure the link between overall environmental health disparity map ranks, environmental data, vulnerable populations characteristics, such as race and income, and human health data.
(2) In further developing and maintaining the environmental health disparities map, the department must:
(a) Solicit feedback from representatives from overburdened communities and vulnerable populations through community engagement and listening sessions in all regions of the state and provide opportunities for public comment; and
(b) Request assistance from:
(i) State universities;
(ii) Other academic researchers, such as the Washington state institute for public policy, to perform modeling and create evidence-based indicators and to conduct sensitivity analyses to assess the impact of new indicators on communities and determinations of overburdened communities; and
(iii) Other state agencies to provide applicable statewide environmental and sampling data for air, water, soil, polluted sites, toxic waste, pesticides, toxic chemicals, and other applicable media.
(3) The department must:
(a) Document and publish a summary of the regular updates and revisions to the environmental health disparities map that happen over time as the new data becomes available, in order to help the public understand different versions of the map as they are published;
(b) At least every three years, perform a comprehensive evaluation of the map to ensure that the most current modeling and methods available to evaluate cumulative environmental health impacts are being used to develop and update the environmental health disparities map's indicators;
(c) Develop technical guidance for agencies that includes an online training video detailing a description of how to use the environmental health disparities map's features, access source data, and explanation of map and indicator limitations; and
(d) Provide support and consultation to agencies on the use of the environmental health disparities map by Washington tracking network staff.
(4)(a) By November 1, 2022, the Washington state institute for public policy must conduct a technical review of the measures and methods used in the environmental health disparities map. The review must, to the extent possible, address the following:
(i) Identify how the measures used in the map compare to measures used in other similar tools that aim to identify communities that are disproportionately impacted as a result of environmental justice issues;
(ii) Compare characteristics such as the reliability, validity, and clinical importance of individual and composite measures included in the map and other similar tools; and
(iii) Compare methodologies used in the map to statistical methodologies used in other similar tools.
(b) The department of health and the University of Washington must provide technical documentation regarding current methods to the Washington state institute for public policy and must consult with the institute as needed to ensure that the institute has adequate information to complete the technical review.
(c) By November 1, 2022, the Washington state institute for public policy must submit a report on their findings to the office of the governor, the appropriate committees of the legislature, and the environmental justice council.
[
2021 c 314 s 19
.]
NOTES:
Conflict with federal requirements
—
2021 c 314:
See note following RCW 70A.02.005
.
RCW 43.70.820
Environmental justice obligations of the department of health.
The department must apply and comply with the substantive and procedural requirements of chapter
70A.02
RCW.
[
2021 c 314 s 4
.]
NOTES:
Conflict with federal requirements
—
2021 c 314:
See note following RCW 70A.02.005
.
RCW 43.70.825
School-based health center program office.
(1) The school-based health center program office is established within the department, with the objective to expand and sustain the availability of school-based health center services to K-12 students in public schools, with a focus on historically underserved populations.
(2) Subject to the availability of amounts appropriated for this specific purpose, the school-based health center program office shall:
(a) Develop funding criteria and metrics for monitoring and evaluation in partnership with a statewide nonprofit organization providing training and technical assistance to school-based health centers;
(b) Award grant funding for school-based health centers. The department may grant funding for the following purposes:
(i) Planning a school-based health center;
(ii) Start-up costs associated with setting up a school-based health center; and
(iii) Ongoing costs of operating a school-based health center;
(c) Monitor and evaluate school-based health centers that receive grant funding from the program office;
(d) Partner with a statewide nonprofit organization to provide training and technical assistance to school-based health centers; and
(e) Coordinate with the statewide nonprofit organization providing training and technical assistance, educational service districts, the health care authority, hosting school districts, and the office of the insurance commissioner, to provide support to school-based health centers.
(3) For purposes of this section, a "school-based health center" means a collaboration between the community, the school, and a sponsoring agency that operates the school-based health center, which is a student-focused health center located in or adjacent to a school that provides integrated medical, behavioral health, and other health care services such as dental care.
[
2021 c 68 s 2
.]
NOTES:
Findings
—
Intent
—
2021 c 68:
"(1) The legislature finds that:
(a) Research shows that school-based health centers provide a crucial link between health and education, improving outcomes for students in both areas;
(b) Health and academic disparities are increasing during the COVID-19 pandemic, particularly for students of color;
(c) School-based health centers advance equity by providing health care access and support at schools;
(d) School-based health centers have been operating across the state for more than 30 years;
(e) Local control and decision making for school-based health centers is important; and
(f) In 2016, the legislature created the Washington integrated student supports protocol as a strategy to close educational opportunity gaps through school-based coordination of academic and nonacademic supports for students.
(2) Therefore, the legislature intends to create a school-based health center program office within the department of health to award grants and coordinate with other agencies and entities to provide support, training, and technical assistance to school-based health centers." [
2021 c 68 s 1
.]
RCW 43.70.827
Anaphylaxis occurring in educational settings
—
Standing order for epinephrine.
The secretary or the secretary's designee, if a licensed health professional with the authority to prescribe epinephrine, shall, as is consistent with the exercise of sound professional judgment, issue a statewide standing order prescribing epinephrine and epinephrine autoinjectors to any school district or school for use by a school nurse or other designated trained school personnel, as authorized under RCW 28A.210.383, for any student or individual experiencing anaphylaxis on school property, a school bus, a field trip, or designated school activity.
[
2024 c 81 s 1
.]
RCW 43.70.830
Lead contamination in drinking water in school buildings
—
Sampling and testing
—
Data-sharing agreement.
(1) The department shall conduct sampling and testing for lead contamination at drinking water outlets in school buildings built, or with all plumbing replaced, before 2016 as specified in this section. The department meets the requirements of this section when a school contracts for sampling and testing that meets the requirements of this section and submits the test results to the department according to a procedure and deadlines determined by the department.
(2) Sampling and testing for the presence and level of lead in drinking water must meet the technical requirements described in the technical guidance.
(3)(a) Initial testing for lead contamination in drinking water must be conducted between July 1, 2014, and June 30, 2026.
(b) Retesting for lead contamination in drinking water must be conducted no less than every five years beginning July 1, 2026.
(4)(a) The department shall develop and publish a two-year plan for sampling and testing. The plan must be updated at least annually. Prior to adding a school to the plan, the department must contact the school to determine whether the school has contracted, or is planning to contract, for sampling and testing.
(b) Beginning July 1, 2026, in developing the two-year plan for sampling and testing, the department must group school buildings by governing body and then prioritize the groups based on the combined length of time since each school building built, or with all plumbing replaced, before 2016 was sampled and tested.
(5) The department shall enter a data-sharing agreement with the office of the superintendent of public instruction for the purpose of compiling a list of school buildings built, or with all plumbing replaced, before 2016.
(6) The definitions in RCW 28A.210.410
apply throughout this section unless the context clearly requires otherwise.
[
2021 c 154 s 3
.]
NOTES:
Findings
—
Intent
—
2021 c 154:
"(1) The legislature recognizes that the United States environmental protection agency and centers for disease control and prevention acknowledge that there is no known safe level of lead in a child's blood. Even low levels of lead exposure can cause permanent cognitive, academic, and behavioral difficulties in children. The American academy of pediatrics recommends government action to ensure that the lead concentration in drinking water at schools does not exceed one part per billion.
(2) The legislature finds that the department of health sampled and tested drinking water outlets in 551 elementary schools between 2017 and 2020. 82 percent of these schools had lead contamination of five or more parts per billion in one or more drinking water outlets and 49 percent of these schools had lead contamination of 15 or more parts per billion in one or more drinking water outlets.
(3) The legislature acknowledges that the department of health was appropriated $1,000,000 in the 2019-2021 fiscal biennium to continue the testing for lead contamination in school drinking water. The legislature also finds that the office of the superintendent of public instruction was appropriated funds in the 2019-2021 fiscal biennium for the healthy kids/healthy schools initiative. Part of these funds are for the purpose of distributing grants to school districts for remediation of elevated lead levels in drinking water. The legislature encourages districts to apply for these grants when lead test results reveal elevated lead levels, which are lead levels above five parts per billion.
(4) The legislature acknowledges the historically inequitable distribution of lead exposure for communities of color and of low socioeconomic status and plans to make a priority the protection of children from the dangers of lead exposure through school drinking water. The legislature, therefore, intends to require that drinking water outlets in elementary and secondary school buildings built, or with all plumbing replaced, before 2016 be tested for the presence and level of lead contamination by June 30, 2026, and every five years thereafter. The legislature also intends to require that schools notify the school community of lead test results and develop action plans for remediation if test results exceed the health-based standard of five parts per billion.
(5) The legislature recognizes that the youngest children are the most vulnerable to lead exposure and that many of these children spend significant amounts of time at child care facilities.
(6) This act is named for the director of the Washington public interest research group who developed and advocated for this legislation before dying of cancer in 2019 and may be known as the Bruce Speight protect children from being exposed to lead in school drinking water act." [
2021 c 154 s 1
.]
Short title
—
2021 c 154:
"This act may be known and cited as the Bruce Speight protect children from being exposed to lead in school drinking water act." [
2021 c 154 s 8
.]
RCW 43.70.835
Lead contamination in drinking water in school buildings
—
State-tribal compact schools.
The department shall allow state-tribal compact schools established under chapter
28A.715
RCW to opt into sampling and testing for lead contamination at drinking water outlets in school buildings built, or with all plumbing replaced, before 2016 pursuant to RCW 43.70.830
.
[
2021 c 154 s 4
.]
NOTES:
Findings
—
Intent
—
Short title
—
2021 c 154:
See notes following RCW 43.70.830
.
RCW 43.70.840
Lead contamination in drinking water in school buildings
—
Technical guidance.
The department shall develop and make available technical guidance for reducing lead contamination in drinking water at schools that is at least as protective of student health as any technical guidance on this topic issued by the United States environmental protection agency. The technical guidance must include the technical requirements for sampling, processing, and analysis, including that analysis must be conducted by a laboratory accredited by the department of ecology. The technical guidance must describe best practices for remediating elevated lead levels at drinking water outlets in schools. Best practices must include installing and maintaining filters certified by a body accredited by the American national standards institute. Provisions of the technical guidance related to testing for the presence and level of lead in drinking water, as opposed to testing to identify sources of lead for remediation, must be designed to maximize detection of lead in water, and therefore must prohibit sampling or analytical methods that tend to mask lead contamination, including prestagnation flushing and removal of aerators prior to sampling.
[
2021 c 154 s 5
.]
NOTES:
Findings
—
Intent
—
Short title
—
2021 c 154:
See notes following RCW 43.70.830
.
RCW 43.70.845
Lead contamination in drinking water in school buildings
—
Department of health as lead agency
—
Waiver.
(1) To the fullest extent permitted by federal law, the department, rather than community water systems, is designated as the lead or principal agency in regard to lead in drinking water sampling, testing, notification, remediation, public education, and other actions at public and private elementary and secondary schools as required by the federal lead and copper rule, 40 C.F.R. Part 141.
(2) The department must issue a written waiver that exempts community water systems that serve schools from the sampling and testing requirements of 40 C.F.R. Part 141.92 related to schools if the department determines that the mandatory requirements for sampling and testing for, and remediation of, lead contamination in drinking water outlets at elementary and secondary schools under chapter 154, Laws of 2021 are consistent with the requirements in 40 C.F.R. Part 141.92 of the federal lead and copper rule.
[
2021 c 154 s 7
.]
NOTES:
Findings
—
Intent
—
Short title
—
2021 c 154:
See notes following RCW 43.70.830
.
RCW 43.70.855
Hospital staffing advisory committee
—
Appointments
—
Membership
—
Reporting.
(Expires July 1, 2030.)
(1) The department, in consultation with the department of labor and industries, must establish an advisory committee on hospital staffing by September 1, 2023.
(2) Appointments to the advisory committee on hospital staffing shall be jointly made by the secretary and the director of labor and industries. Members of the committee must have expertise in hospital staffing and working conditions and should reflect a diversity of hospital settings.
(3) The advisory committee membership includes:
(a) Six members representing hospitals and hospital systems and their alternates, selected from a list of nominees submitted by the Washington state hospital association; and
(b) Six members representing frontline hospital patient care staff and their alternates, selected from a list of nominees submitted by collective bargaining representatives of frontline hospital nursing staff.
(4) Any list submitted to the departments for the initial appointment under this section must be provided by August 4, 2023.
(5) If any member of the advisory committee is unable to continue to serve on the committee the secretary and the director of labor and industries shall select a new member based on the recommendations of either the hospital association for members appointed under subsection (3)(a) of this section or the collective bargaining representative for members appointed under subsection (3)(b) of this section.
(6) The advisory committee on hospital staffing shall meet at least once per month until the hospital staffing plan uniform form is developed.
(7) The advisory committee on hospital staffing shall advise the department on its development of the uniform hospital staffing plan form.
(8) The department and the department of labor and industries shall provide any necessary documentation to the advisory committee on hospital staffing in advance of the meetings to discuss technical assistance so that the advisory committee may consider areas of needed information.
(9) The advisory committee on hospital staffing must consider innovative hospital staffing and care delivery models, such as those that integrate on-site team-based care delivery, use of patient monitoring equipment and technology, and virtual or remote care delivery. This includes identifying and analyzing innovative hospital staffing and care delivery models including those explored by national organizations and evaluating feasibility of broad-based implementation of identified models. The advisory committee may consider disseminating this information and analysis.
(10) The department and the department of labor and industries must provide the advisory committee on hospital staffing with data on a quarterly basis related to compliance with this chapter, complaint filing and disposition trends, and notification of corrective plans of action plans and adherence to those plans.
(11) By December 1, 2023, the Washington state hospital association shall survey hospitals in Washington state and report to the advisory committee on hospital staffing on Washington hospitals' existing use of innovative hospital staffing and care delivery models including, but not limited to, integration of patient monitoring equipment, remote patient monitoring, team-based care models, apprenticeship and career ladder programs, and virtual or remote care delivery models, and any challenges with implementing the models.
(12) By December 1, 2024, the advisory committee on hospital staffing must review the report prepared by the Washington state institute for public policy as required by section 15, chapter 114, Laws of 2023.
(13) After January 1, 2027, when the forms are developed and effective, the advisory committee on hospital staffing may meet if it is determined by the department of health and committee members that such meetings are necessary.
(14) No earlier than July 1, 2029, the advisory committee on hospital staffing must discuss the issues related to applicability of RCW 70.41.420
(7)(b) (i) and (ii) for hospitals listed under RCW 70.41.420
(7)(b)(iv). This must include possible data collection options, potential costs, sources of funding, and implementation timeline.
(15) The advisory committee on hospital staffing must advise the department of labor and industries on the department's development by March 1, 2024, of a uniform form for reporting under RCW 49.12.480
(2).
(16) This section expires July 1, 2030.
[
2023 c 114 s 1
.]
RCW 43.70.860
Pregnancy loss in correctional institutions and private detention facilities
—
Reporting.
(Effective July 1, 2027.)
(1) Correctional institutions and private detention facilities shall report annually to the department of health on the aggregate number of people who experience miscarriage, stillbirth, or perinatal loss while confined or incarcerated in such facilities.
(2) The department of health shall deliver an annual statewide report to the legislature that details the aggregate number of people who experience miscarriage, stillbirth, or perinatal loss while confined or incarcerated in correctional institutions and private detention facilities. The first report shall be delivered by June 30, 2029. The report may not include personal identifying information concerning the individuals who experience miscarriage, stillbirth, or perinatal loss.
(3) For purposes of this section:
(a) "Correctional institutions" has the same meaning as "correctional institution" as defined in RCW 9.94.049, including any juvenile correctional facility under alternative administration operated by a consortium of counties under RCW 13.04.035
.
(b) "Private detention facilities" has the same meaning as defined in RCW 70.395.020
.
[
2025 c 374 s 3
.]
NOTES:
Effective date
—
2025 c 374 s 3:
"Section 3 of this act takes effect July 1, 2027." [
2025 c 374 s 5
.]
Findings
—
2025 c 374:
See note following RCW 68.50.010
.
RCW 43.70.900
References to the secretary or department of social and health services
—
1989 1st ex.s. c 9.
All references to the secretary or department of social and health services in the Revised Code of Washington shall be construed to mean the secretary or department of health when referring to the functions transferred in RCW 43.70.080, 18.104.005, 70.08.005, 70.24.005, 70.40.005, 70.41.005, and
70.54.005
.
[
2017 3rd sp.s. c 25 s 24
;
2015 1st sp.s. c 4 s 31
;
2007 c 52 s 2
;
1990 c 33 s 580
;
1989 1st ex.s. c 9 s 801
.]
NOTES:
Purpose
—
Statutory references
—
Severability
—
1990 c 33:
See RCW 28A.900.100
through
28A.900.102
.
RCW 43.70.901
References to the director or department of licensing
—
1989 1st ex.s. c 9.
All references to the director of licensing or department of licensing in the Revised Code of Washington shall be construed to mean the secretary or department of health when referring to the functions transferred in RCW 43.70.220
.
[
1989 1st ex.s. c 9 s 802
.]
RCW 43.70.902
References to the hospital commission
—
1989 1st ex.s. c 9.
All references to the hospital commission in the Revised Code of Washington shall be construed to mean the secretary or the department of health.
[
1989 1st ex.s. c 9 s 803
.]
RCW 43.70.903
Licensure requirements review
—
Report and recommendations on removing barriers.
(1) The department, in consultation with the workforce training and education coordinating board and the examining board of psychology, shall examine licensure requirements for the following professions to identify changes to statutes and rules that would remove barriers to entering and remaining in the health care workforce and to streamline and shorten the credentialing process:
(a) Advanced social workers and independent clinical social workers licensed under chapter
18.225
RCW;
(b) Marriage and family therapists licensed under chapter
18.225
RCW;
(c) Mental health counselors licensed under chapter
18.225
RCW;
(d) Substance use disorder professionals certified under chapter
18.205
RCW; and
(e) Psychologists licensed under chapter
18.83
RCW.
(2) The licensure requirements to be examined by the department shall include examinations, continuing education requirements, administrative requirements for license application and renewal, English language proficiency requirements, and supervised experience requirements, including supervisor requirements and costs associated with completing supervised experience requirements.
(3) When conducting the review required in subsection (1) of this section, the department shall at a minimum consider the following:
(a) The availability of peer-reviewed research and other evidence, including requirements in other states, indicating the necessity of specific licensure requirements for ensuring that behavioral health professionals are prepared to practice with reasonable skill and safety;
(b) Changes that would facilitate licensure of qualified, out-of-state and international applicants to promote reciprocity, including the adoption of applicable interstate compacts;
(c) Changes that would promote greater consistency across licensure requirements for professions licensed under chapter
18.225
RCW and allow for applicants' prior professional experience within relevant fields to be counted towards supervised experience requirements established under chapter
18.225
RCW, including the extent to which an applicant may use prior professional experience gained before graduation from a master's or doctoral level educational program to satisfy the applicant's supervised experience requirement;
(d) Technical assistance programs, such as navigators or dedicated customer service lines, to facilitate the completion of licensing applications;
(e) In consultation with the examining board of psychology and a statewide organization representing licensed psychologists, the creation of an associate-level license for psychologists;
(f) Whether agency affiliated counselors should be allowed to practice in federally qualified health centers; and
(g) Any rules that pose excessive administrative requirements for application or renewal or that place a disproportionate burden on applicants from disadvantaged communities.
(4) By November 1, 2023, the department shall provide a progress report and initial findings to the appropriate committees of the legislature on actions and recommendations to remove licensing barriers and improve credentialing time frames.
(5) By November 1, 2024, the department shall provide a final report to the appropriate committees of the legislature on actions and recommendations to remove licensing barriers and improve credentialing time frames.
[
2023 c 425 s 5
.]
NOTES:
Effective date
—
2023 c 425 ss 1-7, 13-20, and 22-26:
See note following RCW 18.83.170
.
RCW 43.70.904
Health care entity registry
—
Report.
(1) The department, in consultation with the health care authority, the office of the insurance commissioner, the office of the governor, and the office of financial management, and with input from stakeholders[,] shall develop a plan and provide recommendations to the legislature as to how to create a complete and interactive registry of the health care landscape in Washington. The plan and recommendations must identify:
(a) The health care entities, including but not limited to licensed and unlicensed facilities, providers, provider groups, systems, carriers, and health care benefit managers, that must report;
(b) The information that each entity must report; and
(c) The fee to be charged to the registering entities, which may be tiered, to support the registration process and creation of the registry.
(2) In developing the plan and recommendations, the department must consider:
(a) Opportunities to streamline reporting and consider opportunities to allow for information sharing between state agencies for health care entities and health care providers licensed or certified by a state agency; and
(b) Strategies to fully understand and monitor the business structure, funding, and contractual relationships of health care entities in Washington, including the current status and future changes in the direct or indirect ownership, control, or affiliation of and between health care entities and other entities and organizations, including private equity investment, that serve Washingtonians.
(3) The department shall provide a progress update to the relevant health and fiscal committees of the legislature by December 31, 2027, and a final report by November 1, 2028. The final report must identify any remaining data gaps and recommend an implementation plan for the registry.
[
2025 c 142 s 2
.]
NOTES:
Findings
—
Intent
—
2025 c 142:
"(1) The legislature finds that:
(a) Washington's health care landscape is changing rapidly. A 2023 report by the office of the insurance commissioner identified that Washington has experienced substantial horizontal consolidation and vertical integration across health care providers, facilities, and insurers;
(b) Washington's health care market is also experiencing investment from new for-profit entities such as private equity firms. While there were only four private equity acquisitions in Washington in 2014, this number had grown to 97 by 2023;
(c) These changes to Washington's health care landscape have not resolved access and affordability challenges. A 2024 survey of over 1,000 Washingtonians found that over half skipped needed care due to cost. Department of health data indicates substantial health disparities based on geographic location. Many rural Washingtonians experience health care deserts for essential care; and
(d) Washington is currently unable to evaluate how changes in the health care landscape are impacting access and affordability because the state lacks a complete and transparent registry of health care systems and entities. While the state collects some information about health insurers through annual financial statement filing requirements, there is no similar information available for other kinds of health care systems and entities. The office of financial management identified this critical data infrastructure gap in 2010, but it has not yet been resolved. Recent reports in 2023 and 2024 by the office of financial management, the office of the insurance commissioner, and the health care cost transparency board have indicated this data gap continues to prevent effective stewardship of health care resources and state health planning.
(2) Therefore, the legislature intends to develop a plan and recommendations with the goal of establishing a complete and interactive registry that will allow for the monitoring and measuring of changes in the health care landscape to better understand trends in health care market consolidation, with the goal of improving access and affordability." [
2025 c 142 s 1
.]
RCW 43.70.910
Effective date
—
1989 1st ex.s. c 9.
This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect July 1, 1989.
[
1989 1st ex.s. c 9 s 825
.]
RCW 43.70.920
Severability
—
1989 1st ex.s. c 9.
If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.
[
1989 1st ex.s. c 9 s 826
.]