DEPARTMENT OF HEALTH

(Pharmacy Quality Assurance Commission)

[Filed November 18, 2025, 8:03 a.m.]

Preproposal statement of inquiry was filed as WSR 25-16-045.

Title of Rule and Other Identifying Information: Medication assistance services provided by nonpractitioners; expanding the types of actions allowed. The pharmacy quality assurance commission (commission) is proposing to amend WAC 246-945-714 related to the regulation of medication assistance provided by nonpractitioners. The proposed amendments bring WAC 246-945-714 in line with changes made to RCW 69.41.010(15) following the passage of SHB 1720 (chapter 26, Laws of 2025).

Hearing Location(s): On February 5, 2026, at 9:30 a.m., at the Department of Labor and Industries, 7273 Linderson Way S.W., Tumwater, WA 98501; or virtual. To access the meeting on February 5, 2026, at 9:00 a.m., go to https://zoom.us/join or https://us02web.zoom.us/j/86309299195 and use the Webinar ID 863 0929 9195. The access options include one-tap mobile: US: +12532158782,,86309299195# or +16699009128,,86309299195#; or Telephone: Dial (for higher quality, dial a number based on your current location): US: +1 253 215 8782 or +1 669 900 9128 or +1 346 248 7799 or +1 669 444 9171 or +1 386 347 5053 or +1 564 217 2000 or +1 646 558 8656 or +1 646 931 3860 or +1 301 715 8592 or +1 312 626 6799, Webinar ID 861 1495 8466. International numbers available at https://us02web.zoom.us/u/kdLNo6unOZ.

Date of Intended Adoption: February 5, 2025.

Submit Written Comments to: Joshua Munroe, P.O. Box 47852, Olympia, WA 98504-7852, email PharmacyRules@doh.wa.gov, fax 360-236-2901, https://fortress.wa.gov/doh/policyreview, beginning the date and time of filing, by January 22, 2026, 11:59 p.m.

Assistance for Persons with Disabilities: Contact Joshua Munroe, phone 360-502-5058, fax 360-236-2901, TTY 711, email PharmacyRules@doh.wa.gov, by January 22, 2026.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The 2025 Washington state legislature passed SHB 1720, which expands the types of medication assistance that may be provided to residents of community-based care settings. SHB 1720 amends RCW 69.41.010 and allows a nonpractitioner to set up diabetic devices for self-administration or hand injectable medications to an individual for self-administration. These services are now allowed under the scope of medication assistance as defined in RCW 69.41.010(15).

The commission adopted a rule on the topic of medication assistance in 2025, which was filed under WSR 25-08-072 and went into effect on May 2, 2025. The rule updated and reestablished medication assistance language under the commission's regulatory jurisdiction. WAC 246-945-714, one of the sections of rule created under the commission's medication assistance rule, mirrors language from RCW 69.41.010(15) to outline which actions are and are not allowed for nonpractitioners in the provision of medication assistance. With the passage of SHB 1720, the commission determined that it needed to amend WAC 246-945-714 to reflect the changes made in the statute.

The goal of the proposed rule is to provide clarity to regulated entities that the medication assistance rules under the commission's jurisdiction match changes made in SHB 1720 relating to duties allowed for nonpractitioners providing medication assistance services.

Reasons Supporting Proposal: The proposed amendments bring WAC 246-945-714 in line with changes made to RCW 69.41.010(15) following the passage of SHB 1720. The goal of the proposed rule is to provide clarity to regulated entities that the medication assistance rules under the commission's jurisdiction match changes made in SHB 1720 relating to duties allowed for nonpractitioners providing medication assistance services.

Statutory Authority for Adoption: RCW 18.64.005 and 69.41.010(15).

Statute Being Implemented: SHB 1720 (chapter 26, Laws of 2025), codified in RCW 69.41.010.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Pharmacy quality assurance commission, governmental.

Name of Agency Personnel Responsible for Drafting and Implementation: Joshua Munroe, 111 Israel Road S.E., Tumwater, WA 98501, 360-502-5058; and Enforcement: Marlee O'Neill, 111 Israel Road S.E., Tumwater, WA 98501, 360-480-9108.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is not required under RCW 34.05.328. The proposed amendments to WAC 246-945-714 incorporate without material change regulation outlined in RCW 69.41.010(15) made by SHB 1720.

This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:

Is exempt under RCW 19.85.025(3) as the rules are adopting or incorporating by reference without material change federal statutes or regulations, Washington state statutes, rules of other Washington state agencies, shoreline master programs other than those programs governing shorelines of statewide significance, or, as referenced by Washington state law, national consensus codes that generally establish industry standards, if the material adopted or incorporated regulates the same subject matter and conduct as the adopting or incorporating rule.

Explanation of exemptions: SHB 1720 expands the types of medication assistance that may be provided to residents of community-based care settings. It amends RCW 69.41.010 and allows a nonpractitioner to set up diabetic devices for self-administration or hand injectable medications to an individual for self-administration. The proposed rule incorporates without material change language from RCW 69.41.010 and aligns the rule with the statute.

Scope of exemption for rule proposal:

Hawkins DeFrance, PharmD, Chair

Pharmacy Quality Assurance Commission

AMENDATORY SECTION(Amending WSR 25-08-072, filed 4/1/25, effective 5/2/25)

WAC 246-945-714Medication assistance by nonpractitioners.

(1) An individual may receive medication assistance from nonpractitioners. Medication assistance only includes:

(a) Reminding or coaching the individual to take their medication;

(b) Handing the individual their medication container;

(d) Using an enabler, except if a nonpractitioner uses the individual's hand as an enabler, the nonpractitioner may only steady or guide an individual's hand while the individual administers a medication to themselves and may not engage in "hand-over-hand" administration;

(e) Placing the individual's medication in their hand;

(f) ((Handing an individual their prefilled insulin syringe))Setting up a diabetic device for self-administration;

(g) Handing injectable medication to an individual for self-administration;

(h) The transfer of an individual's medication from one container to another container for the purpose of preparing an individual dose; or

(((h)))(i) Medication alteration. An individual must be aware that their medication has been altered.

(2) A nonpractitioner shall only perform the medication assistance described in subsection (1)(((g) and (h)))(h) and (i) of this section, where a practitioner has determined and communicated orally or by written direction that such medication preparation assistance is necessary and appropriate.

(3) A nonpractitioner shall not provide medication assistance to individuals that involves intravenous medications or injectable medications, except ((handing an individual their prefilled insulin syringes))setting up diabetic devices for self-administration or handing injectable medications to an individual for self-administration.