DEPARTMENT OF HEALTH

[Filed May 22, 2026, 8:47 a.m.]

Preproposal statement of inquiry was filed as WSR 25-04-007.

Title of Rule and Other Identifying Information: Acupuncture and Eastern medicine practitioners; expanding the acceptance of English proficiency examinations. The department of health (department), in consultation with the acupuncture and Eastern medicine advisory committee is proposing amendments to WAC 246-803-130 Applications requirements for applicants from foreign schools, and 246-803-240 Examinations, to allow the acceptance of additional English proficiency examinations as approved by the secretary in accordance with RCW 18.06.090.

Hearing Location(s): On July 8, 2026, at 10:00 a.m. Register in advance for this webinar at https://us02web.zoom.us/webinar/register/WN_vhn0jxd-TOSJpCkynKMlKg. After registering, you will receive a confirmation email containing information about joining the webinar. The department will hold a virtual only hearing. You may also submit comment in writing.

Date of Intended Adoption: July 15, 2026.

Submit Written Comments to: Adriana Barcena, P.O. Box 47852, Olympia, WA 98504-7852, email Adriana.barcena@doh.wa.gov, web https://fortress.wa.gov/doh/policyreview, beginning the date and time of this filing, by July 8, 2026, at 11:59 p.m.

Assistance for Persons with Disabilities: Contact Adriana Barcena, phone 360-236-4865, TTY 711, email Adriana.barcena@doh.wa.gov, by June 24, 2026.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Individuals who are seeking an acupuncture and Eastern medicine license in Washington state are required to demonstrate competency in English and skills by meeting examination requirements. Candidates who have not passed the required examinations in English are required to demonstrate sufficient fluency in reading, speaking, and comprehension by successfully passing an English proficiency examination. Updating WAC 246-803-130 will expand the acceptance of additional examinations candidates can take to demonstrate proficiency in the English language, increasing access and opportunity. The proposed rule amendments implement the general goals and objectives of RCW 18.06.090, which requires acupuncture and Eastern medicine practitioners to demonstrate sufficient English fluency for communicating with other health care providers and patients.

The proposal also updates existing language in WAC 246-803-240 to remove outdated reference to the Council of Colleges of Acupuncture and Herbal Medicine. The proposed amendments will ensure rules for applicants for acupuncture and Eastern medicine are accurate and reduce confusion.

Reasons Supporting Proposal: The proposed amendments maintain public protection by requiring all applicants who tested in a non-English language to demonstrate English proficiency sufficient for safe and effective patient care, while expanding acceptable examination options. Washington state currently only accepts one English proficiency examination, the internet-based test of English as a foreign language (ibTOEFL). The proposed rule amendments are necessary to facilitate the inclusion of alternative examinations for English proficiency and increase access for prospective licensees.

The proposed changes, to include successful passing of an English proficiency examination approved by the secretary, will facilitate the inclusion of alternative assessments and permit candidates to select from various English proficiency testing organizations as approved by the secretary of health, thereby increasing access and opportunity.

The proposed changes will allow additional organizations other than ibTOEFL, such as occupational English testing (OET), to be an approved English proficiency exam by the secretary.

Organizations like OET would provide an opportunity for an applicant to demonstrate English proficiency with realistic scenarios that would be encountered in the health care work setting. OET provides profession-specific examinations for the subtests in writing and speaking. The rule will allow applicants to take an OET acupuncture subtest when it becomes available in the future. In the meantime, acupuncturists can complete OET medicine examinations. Taking the OET will assist providers seeking licensure by ensuring they have necessary communication skills to provide safe and effective care.

The proposed amendments also allow for potential additional English proficiency examinations to be approved by the secretary in the future without the need for further rule making, which would be a cost savings.

Statutory Authority for Adoption: RCW 18.06.080 and 18.06.160.

Statute Being Implemented: RCW 18.06.080, 18.06.090, and 18.06.160.

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

Name of Proponent: Department of health, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Adriana Barcena, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-4865.

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

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Adriana Barcena, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-236-4865, TTY 711, email Adriana.Barcena@doh.wa.gov.

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(4).

Explanation of exemptions: The proposed rule is exempt under RCW 19.85.025(4) as the proposed changes and the existing requirements regulate acupuncturist applicants and do not impose requirements on business operations, staffing, equipment, fees, or reporting. Accordingly, the proposed rules do not affect small businesses and are fully exempt under RCW 19.85.025(4).

Scope of exemption for rule proposal:

Kristin Peterson, JD

for Dennis E. Worsham

AMENDATORY SECTION(Amending WSR 21-09-008, filed 4/8/21, effective 5/9/21)

WAC 246-803-130Application requirements for applicants from foreign schools.

(1) An applicant for an acupuncturist or acupuncture and Eastern medicine practitioner license who has graduated from a foreign acupuncture or Eastern medicine practitioner program not accredited, or approved by the secretary must:

(a) Have at least a bachelor's or master's degree in Eastern medicine or acupuncture from an institution of higher learning which is approved by the foreign country's ministry of education/health, or other governmental entity;

(b) Have graduated from a program of Eastern medicine or acupuncture education with requirements substantially equal to those required of graduates of secretary-approved programs; and

(c) Demonstrate fluency in reading, speaking, and understanding the English language by taking the examinations required in WAC 246-803-240 (2)(a) through (c) in English or ((by passage of the test of English as a foreign language in WAC 246-803-240(3)))successfully pass an English proficiency examination approved by the secretary with an overall passing rate of 74 percent.

(2) An applicant for an acupuncturist or acupuncture and Eastern medicine practitioner license must submit to the department:

(a) A completed application.

(b) The application fee required under WAC 246-803-990.

(d) A credentialing evaluation report from the International Consultants of Delaware (ICD).

(e) Verification of clinical training as required in WAC 246-803-230.

(f) Verification of successful completion of the examinations as required in WAC 246-803-240.

(g) Verification of all acupuncturist, acupuncture and Eastern medicine practitioner or health care licenses held, submitted directly from the licensing agency. The verification shall include the license number, issue date, expiration date and whether the acupuncturist or acupuncture and Eastern medicine practitioner has been the subject of final or pending disciplinary action.

(h) Verification of current cardiopulmonary resuscitation (CPR) certification. The training in CPR shall consist of a minimum of one quarter credit or equivalent. Red Cross certification or documentation of equivalent training may be substituted for the one quarter credit.

(i) Any additional documents requested by the secretary.

(3) The department recognizes the ICD for credential evaluations. The applicant shall request that the ICD send their evaluation directly to the department. To obtain a credentialing evaluation report, the applicant shall submit to the ICD:

(a) Transcripts;

(b) Appropriate fees; and

AMENDATORY SECTION(Amending WSR 22-12-018, filed 5/23/22, effective 7/1/22)

WAC 246-803-240Examinations.

(1) The examinations administered by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) are the official examinations for licensure as an acupuncturist or acupuncture and Eastern medicine practitioner.

(2) An applicant for licensure as an acupuncturist or acupuncture and Eastern medicine practitioner must pass the following examinations:

(a) Foundations of Oriental medicine examination;

(b) Acupuncture with point location examination;

(d) Council of Colleges of Acupuncture and ((Oriental))Herbal Medicine (((CCAOM))CCAHM) clean needle technique course.

(3) If the applicant takes the examinations listed in subsection (2) of this section in a language other than English, they must also ((take and pass the internet-based test of English as a foreign language (ibTOEFL) examination with an overall score of not less than 89. This is done by obtaining scores on the ibTOEFL of at least:

(a) Twenty-four on the writing section;

(b) Twenty-six on the speaking section;

(d) Eighteen on the listening comprehension section))successfully pass an English proficiency examination approved by the secretary with an overall passing rate of 74 percent.