title: RCW 18.235.170

text:
A person who attempts to obtain, obtains, or attempts to maintain a license by willful misrepresentation or fraudulent representation is guilty of a gross misdemeanor.
[ 2002 c 86 s 118.]

catchline: Misrepresentation—Gross misdemeanor.


doc_type: statute

jurisdiction: wa

title: RCW 18.235.180

text:
If the disciplinary authority has reason to believe that a license holder has committed a crime, or violated the laws of another regulatory body, the disciplinary authority may notify the attorney general or the county prosecuting attorney in the county in which the act took place, or other responsible official of the facts known to the disciplinary authority.
[ 2002 c 86 s 119.]

license: public-domain-government-work

rule_set: Revised Code of Washington

catchline: Crime or violation by license holder—Disciplinary authority may give notification.

code: rcw

unit: section

court: Washington State Legislature


title: RCW 18.235.190

text:
The director, members of the boards or commissions, or individuals acting on their behalf are immune from suit in any action, civil or criminal, based on any disciplinary actions or other official acts performed in the course of their duties.
[ 2002 c 86 s 120.]

catchline: Immunity from suit.


title: RCW 18.235.200

text:
This chapter does not affect the use of records, obtained from the director or the disciplinary authorities, in any existing investigation or action by any public agency. Nor does this chapter limit any existing exchange of information between the director or the disciplinary authorities and other public agencies.
[ 2002 c 86 s 121.]

catchline: Use of records—Exchange of information—Chapter does not affect or limit.


title: RCW 18.235.210

text:
(1) This chapter applies to any conduct, acts, or conditions occurring on or after January 1, 2003.
(2) This chapter does not apply to or govern the construction of and disciplinary action for any conduct, acts, or conditions occurring prior to January 1, 2003. The conduct, acts, or conditions must be construed and disciplinary action taken according to the provisions of law existing at the time of the occurrence in the same manner as if this chapter had not been enacted.
(3) Notwithstanding subsection (2) of this section, this chapter applies to applications for licensure made on or after January 1, 2003.
[ 2007 c 256 s 21; 2002 c 86 s 122.]

catchline: Application of chapter—January 1, 2003.


title: RCW 18.235.900

text:
This chapter may be known and cited as the uniform regulation of business and professions act.
[ 2002 c 86 s 123.]

catchline: Short title.


title: RCW 18.235.901

text:
Sections 101 through 123 of this act take effect January 1, 2003.
[ 2002 c 86 s 124.]

catchline: Effective date—2002 c 86 ss 101-123.


title: RCW 18.235.902

text:
Part headings used in this act are not any part of the law.
[ 2002 c 86 s 402.]

catchline: Part headings not law—2002 c 86.


title: RCW 18.235.903

text:
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.
[ 2002 c 86 s 404.]

catchline: Severability—2002 c 86.


title: RCW 18.240.005

text:
The certification of animal massage therapists is in the interest of the public health, safety, and welfare. While veterinarians and certain massage therapists may perform animal massage techniques, the legislature finds that meeting all of the requirements of those professions can be unnecessarily cumbersome for those individuals who would like to limit their practice only to animal massage.
[ 2016 c 41 s 19; 2007 c 70 s 1.]
Notes:
Effective date—2016 c 41: See note following RCW 18.108.010.

catchline: Finding.


title: RCW 18.240.010

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Board" means the veterinary board of governors established in chapter 18.92 RCW.
(2) "Certified animal massage therapist" means an individual who provides external manipulation or pressure of soft tissues by use of the hands, body, or device designed and limited to providing massage. Animal massage may include techniques such as stroking, percussions, compressions, friction, Swedish gymnastics or movements, gliding, kneading, range of motion or stretching, and fascial or connective tissue stretching, with or without the aid of superficial heat, cold, water, lubricants, or salts. Animal massage does not include: Diagnosis, prognosis, or all treatment of diseases, deformities, defects, wounds, or injuries of animals; attempts to adjust or manipulate any articulations of the animal's body or spine or mobilization of these articulations by the use of a thrusting force; acupuncture involving the use of needles; or mechanical therapies that are restricted to the field of veterinary medicine. Animal massage may be performed solely for purposes of patient well-being.
(3) "Department" means the department of health.
(4) "Secretary" means the secretary of health or the secretary's designee.
[ 2016 c 41 s 20; 2007 c 70 s 2.]
Notes:
Effective date—2016 c 41: See note following RCW 18.108.010.

catchline: Definitions.


title: RCW 18.240.020

text:
No person may practice as a certified animal massage therapist in this state without having a certification issued by the secretary unless he or she is exempt under RCW 18.240.040.
[ 2016 c 41 s 21; 2007 c 70 s 3.]
Notes:
Effective date—2016 c 41: See note following RCW 18.108.010.

catchline: Certification required.


title: RCW 18.240.030

text:
The secretary shall issue a certificate to any applicant who demonstrates that the following requirements have been met:
(1) Successful completion of a training program approved by the secretary that includes three hundred hours of instruction in general animal massage techniques, kinesiology, anatomy, physiology, behavior, first aid care, and handling techniques as follows:
(a) For a certificate to practice animal massage on large animals, the three hundred hours of specialized instruction must be related to the performance of animal massage on large animals; and
(b) For a certificate to practice animal massage on small animals, the three hundred hours of specialized instruction must be related to the performance of animal massage on small animals; and
(2) Successful completion of a competency evaluation, approved by the secretary, in either large animal massage or small animal massage, or both.
[ 2007 c 70 s 4.]

catchline: Certification requirements.


title: RCW 18.240.040

text:
Nothing in this chapter may be construed to prohibit or restrict:
(1) The practice of veterinary medicine by those who are in compliance with chapter 18.92 RCW;
(2) The practice of animal massage by those who are in compliance with chapter 18.108 RCW;
(3) The practice of animal massage therapy by a person who is a regular student in an educational program whose performance of services is pursuant to a regular course of instruction or assignments from an instructor and under the general supervision of the instructor; or
(4) The use of animal massage techniques by the owner of the animal who is the recipient of the services or by an employee of the owner or another person providing gratuitous assistance.
[ 2007 c 70 s 5.]

catchline: Limitation of chapter.


title: RCW 18.240.050

text:
In addition to any other authority provided by law, the secretary has the authority to:
(1) Adopt rules under chapter 34.05 RCW as required to implement this chapter;
(2) Establish all certification and renewal fees in accordance with RCW 43.70.110 and 43.70.250;
(3) Establish forms and procedures necessary to administer this chapter;
(4) Certify an applicant or deny certification based upon unprofessional conduct or impairment governed by the uniform disciplinary act, chapter 18.130 RCW;
(5) Deny certification to applicants who do not meet the training, competency evaluation, and conduct requirements for certification;
(6) Hire clerical, administrative, investigative, and other staff as needed to implement this chapter;
(7) Maintain the official department record for all applicants and persons with certifications;
(8) Review coursework and training taken by an applicant in another state to determine whether it is substantially equivalent to that required under this chapter and determine whether additional coursework or training is needed before taking an examination for certification under RCW 18.240.060;
(9) Approve education and training programs; and
(10) Convene temporary work groups of individuals knowledgeable in the practice of animal massage to advise the secretary on appropriate standards of practice and credentialing, as necessary.
[ 2007 c 70 s 6.]

catchline: Secretary's authority.


title: RCW 18.240.060

text:
(1) The date and location of examinations must be established by the secretary. Applicants who have been found by the secretary to meet the other requirements for obtaining a certificate must be scheduled for the next examination following the filing of the application. The secretary shall establish by rule the examination application deadline.
(2) The secretary shall examine each applicant, by means determined most effective, on subjects appropriate to the scope of practice, as applicable. The examinations must be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.
(3) The examination papers, all grading of the papers, and the grading of any practical work must be preserved for a period of not less than one year after the secretary has made and published the decisions. All examinations must be conducted under fair and wholly impartial methods.
(4) Any applicant failing to make the required grade in the first examination may take up to three subsequent examinations as the applicant desires upon prepaying a fee determined by the secretary under RCW 43.70.250 for each subsequent examination. Upon failing four examinations, the secretary may invalidate the original application and require remedial education before the person may take future examinations.
(5) The secretary may approve an examination prepared or administered by a private testing agency or association of licensing agencies for use by an applicant in meeting the certification requirements.
[ 2007 c 70 s 7.]

catchline: Examinations.


title: RCW 18.240.070

text:
The secretary shall certify an applicant on forms provided by the secretary. Each applicant shall pay a fee determined by the secretary under RCW 43.70.250. The fee must accompany the application.
[ 2007 c 70 s 8.]

catchline: Applicant certification—Fees.


title: RCW 18.240.080

text:
The secretary shall establish by rule the procedural requirements and fees for renewal of certification. Failure to renew invalidates the certification and all privileges granted by the certification.
[ 2007 c 70 s 9.]

catchline: Renewal of certification.


title: RCW 18.240.090

text:
The uniform disciplinary act, chapter 18.130 RCW, governs the uncertified practice, the issuance and denial of certification, and the discipline of persons certified under this chapter. The secretary is the disciplining authority under this chapter.
[ 2007 c 70 s 10.]

catchline: Application of uniform disciplinary act.


title: RCW 18.25.002

text:
This chapter is enacted:
(1) In the exercise of the police power of the state and to provide an adequate public agency to act as a disciplinary body for the members of the chiropractic profession licensed to practice chiropractic in this state;
(2) Because the health and well-being of the people of this state are of paramount importance;
(3) Because the conduct of members of the chiropractic profession licensed to practice chiropractic in this state plays a vital role in preserving the health and well-being of the people of the state; and
(4) Because practicing other healing arts while licensed to practice chiropractic and while holding one's self out to the public as a chiropractor affects the health and welfare of the people of the state.
It is the purpose of the commission established under RCW 18.25.0151 to regulate the competency and quality of professional health care providers under its jurisdiction by establishing, monitoring, and enforcing qualifications for licensing, consistent standards of practice, continuing competency mechanisms, and discipline. Rules, policies, and procedures developed by the commission must promote the delivery of quality health care to the residents of the state.
[ 1994 sp.s. c 9 s 101.]

catchline: Purpose.


title: RCW 18.25.003

text: See chapter 18.120 RCW.

catchline: Regulation of health care professions—Criteria.


title: RCW 18.25.005

text:
(1) Chiropractic is the practice of health care that deals with the diagnosis or analysis and care or treatment of the vertebral subluxation complex and its effects, articular dysfunction, and musculoskeletal disorders, all for the restoration and maintenance of health and recognizing the recuperative powers of the body.
(2) Chiropractic treatment or care includes the use of procedures involving spinal adjustments and extremity manipulation. Chiropractic treatment also includes the use of heat, cold, water, exercise, massage, trigger point therapy, dietary advice and recommendation of nutritional supplementation, the normal regimen and rehabilitation of the patient, first aid, and counseling on hygiene, sanitation, and preventive measures. Chiropractic care also includes such physiological therapeutic procedures as traction and light, but does not include procedures involving the application of sound, diathermy, or electricity.
(3) As part of a chiropractic differential diagnosis, a chiropractor shall perform a physical examination, which may include diagnostic x-rays, to determine the appropriateness of chiropractic care or the need for referral to other health care providers. The chiropractic quality assurance commission shall provide by rule for the type and use of diagnostic and analytical devices and procedures consistent with this chapter.
(4) Chiropractic care shall not include the prescription or dispensing of any medicine or drug, the practice of obstetrics or surgery, the use of x-rays or any other form of radiation for therapeutic purposes, colonic irrigation, or any form of venipuncture.
(5) Nothing in this chapter prohibits or restricts any other practitioner of a "health profession" defined in RCW 18.120.020(4) from performing any functions or procedures the practitioner is licensed or permitted to perform, and the term "chiropractic" as defined in this chapter shall not prohibit a practitioner licensed under chapter 18.71 RCW from performing medical procedures, except such procedures shall not include the adjustment by hand of any articulation of the spine.
[ 2002 c 225 s 1; 1994 sp.s. c 9 s 102; 1992 c 241 s 2; 1974 ex.s. c 97 s 7.]
Notes:
Intent—1992 c 241: "This act is intended to expand the scope of practice of chiropractic only with regard to adjustment of extremities in connection with a spinal adjustment." [ 1992 c 241 s 1.]
Severability—1974 ex.s. c 97: See note following RCW 18.25.0192.

catchline: "Chiropractic" defined.


title: RCW 18.25.006

text:
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
(1) "Department" means the department of health.
(2) "Secretary" means the secretary of the department of health or the secretary's designee.
(3) "Chiropractor" means an individual licensed under this chapter.
(4) "Commission" means the Washington state chiropractic quality assurance commission.
(5) "Vertebral subluxation complex" means a functional defect or alteration of the biomechanical and physiological dynamics in a joint that may cause neuronal disturbances, with or without displacement detectable by X-ray. The effects of the vertebral subluxation complex may include, but are not limited to, any of the following: Fixation, hypomobility, hypermobility, periarticular muscle spasm, edema, or inflammation.
(6) "Articular dysfunction" means an alteration of the biomechanical and physiological dynamics of a joint of the axial or appendicular skeleton.
(7) "Musculoskeletal disorders" means abnormalities of the muscles, bones, and connective tissue.
(8) "Chiropractic differential diagnosis" means a diagnosis to determine the existence of a vertebral subluxation complex, articular dysfunction, or musculoskeletal disorder, and the appropriateness of chiropractic care or the need for referral to other health care providers.
(9) "Chiropractic adjustment" means chiropractic care of a vertebral subluxation complex, articular dysfunction, or musculoskeletal disorder. Such care includes manual or mechanical adjustment of any vertebral articulation and contiguous articulations beyond the normal passive physiological range of motion.
(10) "Extremity manipulation" means a corrective thrust or maneuver applied to a joint of the appendicular skeleton.
[ 2002 c 225 s 2; 1994 sp.s. c 9 s 103; 1992 c 241 s 3; 1991 c 3 s 36; 1989 c 258 s 12.]
Notes:
Intent—1992 c 241: See note following RCW 18.25.005.


title: RCW 18.25.011

text:
It is a violation of RCW 18.130.190 for any person to practice chiropractic in this state unless the person has obtained a license as provided in this chapter.
[ 1987 c 150 s 14.]
Notes:
Severability—1987 c 150: See RCW 18.122.901.

catchline: License required.


title: RCW 18.25.0151

text:
The Washington state chiropractic quality assurance commission is established, consisting of fourteen members appointed by the governor to four-year terms, and including eleven practicing chiropractors and three public members. No member may serve more than two consecutive full terms. In appointing the initial members of the commission, it is the intent of the legislature that, to the extent possible, the governor appoint members of the previous boards and committees regulating this profession to the commission. Members of the commission hold office until their successors are appointed. The governor may appoint the members of the initial commission to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms. The governor may consider persons who are recommended for appointment by chiropractic associations of this state.
[ 2000 c 171 s 5; 1994 sp.s. c 9 s 104.]

catchline: Commission established—Membership.


title: RCW 18.25.0161

text:
The governor may remove a member of the commission for neglect of duty, misconduct, or malfeasance or misfeasance in office. Whenever the governor is satisfied that a member of the commission has been guilty of neglect of duty, misconduct, or malfeasance or misfeasance in office, the governor shall file with the secretary of state a statement of the causes for and the order of removal from office, and the secretary shall forthwith send a certified copy of the order of removal and statement of causes by certified mail to the last known post office address of the member. If a vacancy occurs on the commission, the governor shall appoint a replacement to fill the remainder of the unexpired term.
[ 1994 sp.s. c 9 s 105.]

catchline: Commission—Removal of member—Order of removal—Vacancy.


title: RCW 18.25.0165

text:
Members must be residents of this state. Members must be licensed chiropractors for a period of five years before appointment. Public members of the commission may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the commission, or have a material or financial interest in the rendering of health services regulated by the commission.
[ 2022 c 240 s 31; 1994 sp.s. c 9 s 106.]

catchline: Commission—Qualifications of members.


title: RCW 18.25.0167

text:
(1) The secretary shall employ an executive director that is:
(a) Hired by and serves at the pleasure of the commission;
(b) Exempt from the provisions of the civil service law, chapter 41.06 RCW and whose salary is established by the commission in accordance with RCW 43.03.028; and
(c) Responsible for performing all administrative duties of the commission, including preparing an annual budget, and any other duties as delegated to the executive director by the commission.
(2) Consistent with the budgeting and accounting act, the commission is responsible for proposing its own biennial budget which the secretary must submit to the office of financial management.
(3) Prior to adopting credentialing fees under RCW 43.70.250, the secretary shall collaborate with the commission to determine the appropriate fees necessary to support the activities of the commission.
(4) Prior to the secretary exercising the secretary's authority to adopt uniform rules and guidelines, or any other actions that might impact the licensing or disciplinary authority of the commission, the secretary shall first meet with the commission to determine how those rules or guidelines, or changes to rules or guidelines, might impact the commission's ability to effectively carry out its statutory duties. If the commission, in consultation with the secretary, determines that the proposed rules or guidelines, or changes to existing rules or guidelines, will negatively impact the commission's ability to effectively carry out its statutory duties, then the individual commission shall collaborate with the secretary to develop alternative solutions to mitigate the impacts. If an alternative solution cannot be reached, the parties may resolve the dispute through a mediator as set forth in subsection (6) of this section.
(5) The commission shall negotiate with the secretary to develop performance-based expectations, including identification of key performance measures. The performance expectations should focus on consistent, timely regulation of health care professionals.
(6) In the event there is a disagreement between the commission and the secretary, that is unable to be resolved through negotiation, a representative of both parties shall agree on the designation of a third party to mediate the dispute.
(7) The secretary shall employ staff that are hired and managed by the executive director provided that nothing contained in this section may be construed to alter any existing collective bargaining unit or the provisions of any existing collective bargaining agreement.
[ 2018 c 215 s 1; 2013 c 81 s 1; 2011 c 60 s 5; 2008 c 134 s 31. Formerly RCW 18.25.210.]
Notes:
Effective date—2013 c 81: "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, 2013." [ 2013 c 81 s 9.]
Effective date—2011 c 60: See note following RCW 29B.20.030.
Finding—Intent—Severability—2008 c 134: See notes following RCW 18.130.020.


title: RCW 18.25.0171

text:
The commission shall elect officers each year. Meetings of the commission are open to the public, except that the commission may hold executive sessions to the extent permitted by chapter 42.30 RCW. The secretary of health shall furnish such secretarial, clerical, and other assistance as the commission may require.
Each member of the commission shall be compensated in accordance with RCW 43.03.265. Members shall be reimbursed for travel expenses incurred in the actual performance of their duties, as provided in RCW 43.03.050 and 43.03.060.
A majority of the commission members appointed and serving constitutes a quorum for the transaction of commission business. The affirmative vote of a majority of a quorum of the commission is required to carry a motion or resolution, to adopt a rule, or to pass a measure.
The commission may appoint members of panels of at least three members. A quorum for transaction of any business by a panel is a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the commission.
The members of the commission are immune from suit in an action, civil or criminal, based upon its disciplinary proceedings or other official acts performed in good faith as members of the commission.
The commission may, whenever the workload of the commission requires, request that the secretary appoint pro tempore members. While serving as members pro tempore persons have all the powers, duties, and immunities, and are entitled to the emoluments, including travel expenses, of the commission.
The commission shall prepare or determine the nature of the examinations for applicants to practice chiropractic.
The commission may adopt such rules as are consistent with this chapter as may be deemed necessary and proper to carry out the purposes of this chapter.
[ 1999 c 366 s 2; 1994 sp.s. c 9 s 107.]


title: RCW 18.25.0172

text:
The commission is the successor in interest of the board of chiropractic examiners, the chiropractic disciplinary board, and the chiropractic peer review committee. All contracts, undertakings, agreements, rules, regulations, and policies of those bodies continue in full force and effect on July 1, 1994, unless otherwise repealed or rejected by chapter 9, Laws of 1994 sp. sess. or by the commission.
[ 1994 sp.s. c 9 s 119.]

catchline: Commission successor to other boards, committee.


title: RCW 18.25.0181

text:
In addition to the authority provided in RCW 42.52.804, the commission, its members, or staff as directed by the commission, may communicate, present information requested, volunteer information, testify before legislative committees, and educate the legislature, as the commission may from time to time see fit.
[ 2013 c 81 s 2.]
Notes:
Effective date—2013 c 81: See note following RCW 18.25.0167.

catchline: Commission—Information to legislature.


title: RCW 18.25.019

text:
The Uniform Disciplinary Act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses, and the discipline of licensees under this chapter.
[ 1994 sp.s. c 9 s 108; 1987 c 150 s 12; 1986 c 259 s 21.]
Notes:
Severability—1987 c 150: See RCW 18.122.901.
Severability—1986 c 259: See note following RCW 18.130.010.

catchline: Application of Uniform Disciplinary Act.


title: RCW 18.25.0192

text:
The legislature finds and declares that the costs of health care to the people are rising disproportionately to other costs and that there is a paramount concern that the right of the people to obtain access to health care in all its facets is being impaired thereby. For this reason, the reliance on the mechanism of health care service contractors, whether profit or nonprofit, is the only effective manner in which the large majority of the people can attain access to quality health care, and it is therefore declared to be in the public interest that health care service contractors be regulated to assure that all the people have access to health care to the greatest extent possible. Chapter 97, Laws of 1974 ex. sess., prohibiting discrimination against the legally recognized and licensed profession of chiropractic, is necessary in the interest of the public health, welfare, and safety.
[ 1974 ex.s. c 97 s 1. Formerly RCW 18.25.120.]
Notes:
Severability—1974 ex.s. c 97: "If any provision of this 1974 amendatory 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." [ 1974 ex.s. c 97 s 16.]

catchline: Discrimination—Legislative finding and declaration.


title: RCW 18.25.0193

text:
Notwithstanding any other provision of law, the state and its political subdivisions shall accept the services of licensed chiropractors for any service covered by their licenses with relation to any person receiving benefits, salaries, wages, or any other type of compensation from the state, its agencies or subdivisions.
[ 1974 ex.s. c 97 s 2. Formerly RCW 18.25.130.]
Notes:
Severability—1974 ex.s. c 97: See note following RCW 18.25.0192.

catchline: Discrimination—Acceptance of services required.


title: RCW 18.25.0194

text:
The state and its political subdivisions, and all officials, agents, employees, or representatives thereof, are prohibited from in any way discriminating against licensed chiropractors in performing and receiving compensation for services covered by their licenses.
[ 1974 ex.s. c 97 s 3. Formerly RCW 18.25.140.]
Notes:
Severability—1974 ex.s. c 97: See note following RCW 18.25.0192.

catchline: Discrimination by governments prohibited.


title: RCW 18.25.0195

text:
Notwithstanding any other provision of law, the state and its political subdivisions, and all officials, agents, employees, or representatives thereof, are prohibited from entering into any agreement or contract with any individual, group, association, or corporation which in any way, directly or indirectly, discriminates against licensed chiropractors in performing and receiving compensation for services covered by their licenses.
[ 1974 ex.s. c 97 s 4. Formerly RCW 18.25.150.]
Notes:
Severability—1974 ex.s. c 97: See note following RCW 18.25.0192.

catchline: Discriminatory government contracts prohibited.


title: RCW 18.25.0196

text:
Notwithstanding any other provision of law, for the purpose of RCW 18.25.0192 through 18.25.0195 and 18.25.0197 it is immaterial whether the cost of any policy, plan, agreement, or contract be deemed additional compensation for services, or otherwise.
[ 2000 c 171 s 6; 1974 ex.s. c 97 s 5. Formerly RCW 18.25.160.]
Notes:
Severability—1974 ex.s. c 97: See note following RCW 18.25.0192.

catchline: Discrimination—Policy costs as additional compensation.


title: RCW 18.25.0197

text:
RCW 18.25.0192 through 18.25.0196 shall apply to all agreements, renewals, or contracts issued on or after July 24, 1974.
[ 2000 c 171 s 7; 1974 ex.s. c 97 s 6. Formerly RCW 18.25.170.]
Notes:
Severability—1974 ex.s. c 97: See note following RCW 18.25.0192.

catchline: Discrimination—Application of RCW 18.25.0192 through 18.25.0196.


title: RCW 18.25.020

text:
(1) Any person not now licensed to practice chiropractic in this state and who desires to practice chiropractic in this state, before it shall be lawful for him or her to do so, shall make application therefor to the secretary, upon such form and in such manner as may be adopted and directed by the secretary. Each applicant who matriculates to a chiropractic college, shall have completed not less than one-half of the requirements for a baccalaureate degree at an accredited and approved college or university and shall be a graduate of a chiropractic school or college accredited and approved by the commission and shall show satisfactory evidence of completion by each applicant of a resident course of study of not less than four thousand classroom hours of instruction in such school or college. Applications shall be in writing and shall be signed by the applicant, and shall recite the history of the applicant as to his or her educational advantages, his or her experience in matters pertaining to a knowledge of the care of the sick, how long he or she has studied chiropractic, under what teachers, what collateral branches, if any, he or she has studied, the length of time he or she has engaged in clinical practice; accompanying the same by reference therein, with any proof thereof in the shape of diplomas, certificates, and shall accompany said application with satisfactory evidence of good character and reputation.
(2) Applicants shall follow administrative procedures and administrative requirements and pay fees as provided in RCW 43.70.250 and 43.70.280.
[ 2015 c 72 s 7; 1996 c 191 s 8; 1994 sp.s. c 9 s 109; 1991 c 3 s 38; 1989 c 258 s 3; 1985 c 7 s 14; 1975 1st ex.s. c 30 s 19; 1974 ex.s. c 97 s 9; 1959 c 53 s 3; 1919 c 5 s 5; RRS s 10100.]
Notes:
Severability—1974 ex.s. c 97: See note following RCW 18.25.0192.

catchline: Applications—Qualifications—Fees.


title: RCW 18.25.025

text:
The commission shall have authority to grant accreditation to chiropractic schools and colleges.
The commission shall have authority to adopt educational standards which may include standards of any accreditation agency recognized by the office of education of the department of health and human services or its successor agency, or any portion of such standards, as the commission's standards: PROVIDED, That such standards, so adopted, shall contain, as a minimum of on-campus instruction in chiropractic, the following: Principles of chiropractic, two hundred hours; adjustive technique, four hundred hours; spinal roentgenology, one hundred seventy-five hours; symptomatology and diagnosis, four hundred twenty-five hours; clinic, six hundred twenty-five hours: PROVIDED FURTHER, That such standards shall not mandate, as a requirement for either graduation or accreditation, or include in the computation of hours of chiropractic instruction required by this section, instruction in the following: Mechanotherapy, physiotherapy, acupuncture, acupressure, or any other therapy.
The commission shall approve and accredit chiropractic colleges and schools which apply for commission accreditation and approval and which meet to the commission's satisfaction the educational standards adopted by the commission. It shall be the responsibility of the college to apply for accreditation and approval, and of a student to ascertain whether a college or school has been accredited or approved by the commission.
The commission shall have authority to engage assistants in the giving of examinations called for under this chapter.
[ 1994 sp.s. c 9 s 110; 1980 c 51 s 3.]
Notes:
Severability—1980 c 51: "If any provision of this 1980 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." [ 1980 c 51 s 6.]

catchline: Accreditation of schools and colleges—Standards—Assistants for examinations authorized.


title: RCW 18.25.030

text:
Examinations for license to practice chiropractic shall be developed and administered, or approved, or both, by the commission according to the method deemed by it to be the most practicable and expeditious to test the applicant's qualifications. The commission may approve an examination prepared or administered by a private testing agency or association of licensing authorities. The applicant shall be designated by a number instead of his or her name, so that the identity shall not be discovered or disclosed to the members of the commission until after the examination papers are graded.
Examination subjects may include the following: Anatomy, physiology, spinal anatomy, microbiology-public health, general diagnosis, neuromuscularskeletal diagnosis, X-ray, principles of chiropractic and adjusting, as taught by chiropractic schools and colleges, and any other subject areas consistent with chapter 18.25 RCW. The commission shall set the standards for passing the examination. The commission may enact additional requirements for testing administered by the national board of chiropractic examiners.
[ 1995 c 198 s 1; 1994 sp.s. c 9 s 111; 1989 c 258 s 4; 1974 ex.s. c 97 s 10; 1959 c 53 s 4; 1919 c 5 s 6; RRS s 10101.]
Notes:
Severability—1974 ex.s. c 97: See note following RCW 18.25.0192.
Hiring assistants for examinations: RCW 18.25.025.

catchline: Examinations—Subjects—Grades.


title: RCW 18.25.035

text:
The commission may, in its discretion, waive any examination required by this chapter of persons applying for a license to practice chiropractic if, in its opinion, the applicant has successfully passed an examination conducted by the national board of chiropractic examiners of the United States that is of equal or greater difficulty than the examination being waived by the commission.
[ 1994 sp.s. c 9 s 112; 1971 ex.s. c 227 s 5.]

catchline: Waiver of examination.


title: RCW 18.25.040

text:
Persons licensed to practice chiropractic under the laws of any other state, territory of the United States, the District of Columbia, Puerto Rico, or province of Canada, having qualifications substantially equivalent to those required by this chapter, may, in the discretion of the commission, and after such examination as may be required by rule of the commission, be issued a license to practice in this state without further examination, upon payment of a fee determined by the secretary as provided in RCW 43.70.250.
[ 1994 sp.s. c 9 s 113; 1991 c 320 s 8; 1991 c 3 s 39; 1985 c 7 s 15; 1975 1st ex.s. c 30 s 20; 1971 ex.s. c 227 s 6; 1919 c 5 s 14; RRS s 10108.]

catchline: Licensure by endorsement.


title: RCW 18.25.070

text:
Every person practicing chiropractic shall, as a prerequisite to renewal of license, submit to the secretary at the time of application therefor, satisfactory proof showing attendance of at least twenty-five hours per year during the preceding credential period, at one or more chiropractic symposiums which are recognized and approved by the commission. The commission may, for good cause shown, waive said attendance. The following guidelines for such symposiums shall apply:
(1) The commission shall set criteria for the course content of educational symposia concerning matters which are recognized by the state of Washington chiropractic licensing laws; it shall be the licensee's responsibility to determine whether the course content meets these criteria;
(2) The commission shall adopt standards for distribution of annual continuing education credit requirements;
(3) Rules shall be adopted by the commission for licensees practicing and residing outside the state who shall meet all requirements established by rule of the commission.
[ 1996 c 191 s 9; 1994 sp.s. c 9 s 114; 1991 c 3 s 40; 1989 c 258 s 5; 1985 c 7 s 17; 1980 c 51 s 2; 1975 1st ex.s. c 30 s 22; 1974 ex.s. c 97 s 11; 1971 ex.s. c 266 s 5; 1959 c 53 s 5; 1919 c 5 s 10; RRS s 10105.]
Notes:
Severability—1980 c 51: See note following RCW 18.25.025.
Severability—1974 ex.s. c 97: See note following RCW 18.25.0192.


title: RCW 18.25.075

text:
(1) An individual may place his or her license on inactive status. The holder of an inactive license shall not practice chiropractic in this state without first activating the license.
(2) The inactive renewal fee shall be established by the secretary pursuant to RCW 43.70.250. Failure to renew an inactive license shall result in cancellation in the same manner as an active license.
(3) An inactive license may be placed in an active status upon compliance with the rules established by the commission.
(4) The provisions relating to the denial, suspension, and revocation of a license shall be applicable to an inactive license, except that when proceedings to suspend or revoke an inactive license have been initiated, the license shall remain inactive until the proceedings have been completed.
[ 1994 sp.s. c 9 s 115; 1991 c 3 s 41; 1989 c 258 s 14.]

catchline: Inactive status.


title: RCW 18.25.080

text:
Chiropractic practitioners shall observe and be subject to all state and municipal regulations relating to the control of contagious and infectious diseases, sign death certificates and any and all matters pertaining to public health, reporting to the proper health officers the same as other practitioners.
[ 1919 c 5 s 12; RRS s 10107.]

catchline: Health regulations.


title: RCW 18.25.090

text:
On all cards, books, papers, signs or other written or printed means of giving information to the public, used by those licensed by this chapter to practice chiropractic, the practitioner shall use after or below his or her name the term chiropractor, chiropractic physician, D.C., or D.C.Ph.C., designating his or her line of drugless practice, and shall not use the letters M.D. or D.O.: PROVIDED, That the word doctor or "Dr." or physician may be used only in conjunction with the word "chiropractic" or "chiropractor". Nothing in this chapter shall be held to apply to or to regulate any kind of treatment by prayer.
[ 1991 c 320 s 9; 1989 c 258 s 6; 1986 c 259 s 24; 1981 c 277 s 3; 1971 ex.s. c 227 s 7; 1919 c 5 s 15; RRS s 10109.]
Notes:
Severability—1986 c 259: See note following RCW 18.130.010.

catchline: Use of credentials in written materials—Treatment by prayer not regulated.


title: RCW 18.25.100

text:
It shall be the duty of the several prosecuting attorneys of this state to prosecute all persons charged with the violation of any of the provisions of this chapter. It shall be the duty of the secretary to aid said attorneys of this state in the enforcement of this chapter.
[ 1991 c 3 s 42; 1919 c 5 s 16; RRS s 10110.]

catchline: Prosecutions for violations.


title: RCW 18.25.112

text:
(1) In addition to those acts defined in chapter 18.130 RCW, the term "unprofessional conduct" as used in this chapter includes failing to differentiate chiropractic care from any and all other methods of healing at all times.
(2) Proceedings involving alleged unprofessional conduct shall be prosecuted by the attorney general upon the direction of the commission.
[ 1994 sp.s. c 9 s 116.]


title: RCW 18.25.180

text:
(1) A chiropractor may employ a technician to operate X-ray equipment after the technician has registered with the commission.
(2) The commission may adopt rules necessary and appropriate to carry out the purposes of this section.
[ 1994 sp.s. c 9 s 117; 1991 c 222 s 9.]
Notes:
Effective date—1991 c 222: See RCW 18.84.903.

catchline: Employment of X-ray technicians—Rules.


title: RCW 18.25.190

text:
Nothing in this chapter shall be construed to prohibit:
(1) The temporary practice in this state of chiropractic by any chiropractor licensed by another state, territory, or country in which he or she resides. However, the chiropractor shall not establish a practice open to the general public and shall not engage in temporary practice under this section for a period longer than thirty days. The chiropractor shall register his or her intention to engage in the temporary practice of chiropractic in this state with the commission before engaging in the practice of chiropractic, and shall agree to be bound by such conditions as may be prescribed by rule by the commission.
(2) The practice of chiropractic by a person who is a regular senior student in an accredited school of chiropractic approved by the commission if the practice is part of a regular course of instruction offered by the school and the student is under the direct supervision and control of a chiropractor duly licensed pursuant to this chapter and approved by the commission. A senior student practicing chiropractic under this subsection must pass an open book written jurisprudence examination approved by the commission prior to administering a chiropractic adjustment. The commission may adopt rules requiring the student and his or her supervising licensed chiropractor to file information with the commission regarding the practice of chiropractic under this subsection, including the name and contact information of the student, the name and contact information of the supervising licensed chiropractor, and the location where the student will be practicing.
(3) The practice of chiropractic by a person serving a period of postgraduate chiropractic training in a program of clinical chiropractic training sponsored by a school of chiropractic accredited in this state if the practice is part of his or her duties as a clinical postgraduate trainee and the trainee is under the direct supervision and control of a chiropractor duly licensed pursuant to this chapter and approved by the commission.
(4) The practice of chiropractic by a person who is eligible and has applied to take the next available examination for licensing offered by the commission, except that the unlicensed chiropractor must provide all services under the direct control and supervision of a licensed chiropractor approved by the commission. The unlicensed chiropractor may continue to practice as provided by this subsection until the results of the next available examination are published, but in no case for a period longer than six months. The commission shall adopt rules necessary to effectuate the intent of this subsection.
Any provision of chiropractic services by any individual under subsection (1), (2), (3), or (4) of this section shall be subject to the jurisdiction of the commission as provided in chapter 18.130 RCW.
[ 2019 c 405 s 1; 2000 c 171 s 8; 1994 sp.s. c 9 s 118; 1991 c 320 s 10.]

catchline: Exemptions—Jurisdiction of commission.


title: RCW 18.25.200

text:
All state health care purchasers shall have the authority to set service and fee limitations on chiropractic costs. The health care authority shall establish pilot projects in defined geographic regions of the state to contract with organizations of chiropractors for a prepaid capitated amount.
[ 1992 c 241 s 4.]
Notes:
Intent—1992 c 241: See note following RCW 18.25.005.

catchline: Service and fee limitations by health care purchasers—Pilot projects.


title: RCW 18.250.005

text:
It is the purpose of this chapter to provide for the licensure of persons offering athletic training services to the public and to ensure standards of competence and professional conduct on the part of athletic trainers.
[ 2007 c 253 s 1.]

catchline: Purpose.


title: RCW 18.250.010

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Athlete" means a person who participates in exercise, recreation, activities, sport, or games requiring physical strength, range-of-motion, flexibility, body awareness and control, speed, stamina, or agility, and the exercise, recreation, activities, sports, or games are of a type conducted for the benefits of health and wellness in association with an educational institution or professional, amateur, recreational sports club or organization, hospital, or industrial-based organization.
(2) "Athletic injury" means an injury or condition sustained by an athlete that affects the person's participation or performance in exercise, recreation, activities, sport, or games and the injury or condition is within the professional preparation and education of an athletic trainer.
(3) "Athletic trainer" means a health care provider who is licensed under this chapter. An athletic trainer can practice athletic training through the consultation, referral, or guidelines of a licensed health care provider as defined in subsection (7) of this section working within their scope of practice.
(4)(a) "Athletic training" means the application of the following principles and methods as provided by a licensed athletic trainer:
(i) Risk management and prevention of athletic injuries through preactivity screening and evaluation, educational programs, physical conditioning and reconditioning programs, application of commercial products, use of protective equipment, promotion of healthy behaviors, and reduction of environmental risks;
(ii) Recognition, evaluation, and assessment of athletic injuries by obtaining a history of the athletic injury, inspection and palpation of the injured part and associated structures, and performance of specific testing techniques related to stability and function to determine the extent of an injury;
(iii) Immediate care of athletic injuries, including emergency medical situations through the application of first-aid and emergency procedures and techniques for nonlife-threatening or life-threatening athletic injuries;
(iv) Treatment, rehabilitation, and reconditioning of athletic injuries through the application of physical agents and modalities, therapeutic activities and exercise, standard reassessment techniques and procedures, commercial products, and educational programs, in accordance with guidelines established with a licensed health care provider as provided in RCW 18.250.070;
(v) Treatment, rehabilitation, and reconditioning of work-related injuries through the application of physical agents and modalities, therapeutic activities and exercise, standard reassessment techniques and procedures, commercial products, and educational programs, under the direct supervision of and in accordance with a plan of care for an individual worker established by a provider authorized to provide physical medicine and rehabilitation services for injured workers; and
(vi) Referral of an athlete to an appropriately licensed health care provider if the athletic injury requires further definitive care or the injury or condition is outside an athletic trainer's scope of practice, in accordance with RCW 18.250.070.
(b) "Athletic training" does not include:
(i) The use of spinal adjustment or manipulative mobilization of the spine and its immediate articulations;
(ii) Orthotic or prosthetic services with the exception of evaluation, measurement, fitting, and adjustment of temporary, prefabricated or direct-formed orthosis as defined in chapter 18.200 RCW;
(iii) The practice of occupational therapy as defined in chapter 18.59 RCW;
(iv) The practice of acupuncture and Eastern medicine as defined in chapter 18.06 RCW;
(v) Any medical diagnosis; and
(vi) Prescribing legend drugs or controlled substances, or surgery.
(5) "Committee" means the athletic training advisory committee.
(6) "Department" means the department of health.
(7) "Licensed health care provider" means a physician, physician assistant, osteopathic physician, *advanced registered nurse practitioner, naturopath, physical therapist, chiropractor, dentist, massage therapist, acupuncturist, occupational therapist, or podiatric physician and surgeon.
(8) "Secretary" means the secretary of health or the secretary's designee.
[ 2023 c 143 s 1; 2020 c 80 s 25; 2019 c 308 s 19; 2016 c 41 s 22; 2014 c 194 s 1; 2007 c 253 s 2.]
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.
Findings—2019 c 308: See note following RCW 18.06.010.
Effective date—2016 c 41: See note following RCW 18.108.010.
PDF
RCW 18.250.010
Definitions. (Effective June 30, 2027.)
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Athlete" means a person who participates in exercise, recreation, activities, sport, or games requiring physical strength, range-of-motion, flexibility, body awareness and control, speed, stamina, or agility, and the exercise, recreation, activities, sports, or games are of a type conducted for the benefits of health and wellness in association with an educational institution or professional, amateur, recreational sports club or organization, hospital, or industrial-based organization.
(2) "Athletic injury" means an injury or condition sustained by an athlete that affects the person's participation or performance in exercise, recreation, activities, sport, or games and the injury or condition is within the professional preparation and education of an athletic trainer.
(3) "Athletic trainer" means a health care provider who is licensed under this chapter. An athletic trainer can practice athletic training through the consultation, referral, or guidelines of a licensed health care provider as defined in subsection (7) of this section working within their scope of practice.
(4)(a) "Athletic training" means the application of the following principles and methods as provided by a licensed athletic trainer:
(i) Risk management and prevention of athletic injuries through preactivity screening and evaluation, educational programs, physical conditioning and reconditioning programs, application of commercial products, use of protective equipment, promotion of healthy behaviors, and reduction of environmental risks;
(ii) Recognition, evaluation, and assessment of athletic injuries by obtaining a history of the athletic injury, inspection and palpation of the injured part and associated structures, and performance of specific testing techniques related to stability and function to determine the extent of an injury;
(iii) Immediate care of athletic injuries, including emergency medical situations through the application of first-aid and emergency procedures and techniques for nonlife-threatening or life-threatening athletic injuries;
(iv) Treatment, rehabilitation, and reconditioning of athletic injuries through the application of physical agents and modalities, therapeutic activities and exercise, standard reassessment techniques and procedures, commercial products, and educational programs, in accordance with guidelines established with a licensed health care provider as provided in RCW 18.250.070;
(v) Treatment, rehabilitation, and reconditioning of work-related injuries through the application of physical agents and modalities, therapeutic activities and exercise, standard reassessment techniques and procedures, commercial products, and educational programs, under the direct supervision of and in accordance with a plan of care for an individual worker established by a provider authorized to provide physical medicine and rehabilitation services for injured workers; and
(vi) Referral of an athlete to an appropriately licensed health care provider if the athletic injury requires further definitive care or the injury or condition is outside an athletic trainer's scope of practice, in accordance with RCW 18.250.070.
(b) "Athletic training" does not include:
(i) The use of spinal adjustment or manipulative mobilization of the spine and its immediate articulations;
(ii) Orthotic or prosthetic services with the exception of evaluation, measurement, fitting, and adjustment of temporary, prefabricated or direct-formed orthosis as defined in chapter 18.200 RCW;
(iii) The practice of occupational therapy as defined in chapter 18.59 RCW;
(iv) The practice of acupuncture and Eastern medicine as defined in chapter 18.06 RCW;
(v) Any medical diagnosis; and
(vi) Prescribing legend drugs or controlled substances, or surgery.
(5) "Committee" means the athletic training advisory committee.
(6) "Department" means the department of health.
(7) "Licensed health care provider" means a physician, physician assistant, osteopathic physician, advanced practice registered nurse, naturopath, physical therapist, chiropractor, dentist, massage therapist, acupuncturist, occupational therapist, or podiatric physician and surgeon.
(8) "Secretary" means the secretary of health or the secretary's designee.
[ 2025 c 58 s 5083; 2023 c 143 s 1; 2020 c 80 s 25; 2019 c 308 s 19; 2016 c 41 s 22; 2014 c 194 s 1; 2007 c 253 s 2.]
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.
Findings—2019 c 308: See note following RCW 18.06.010.
Effective date—2016 c 41: See note following RCW 18.108.010.

catchline: Definitions. (Effective until June 30, 2027.)


title: RCW 18.250.020

text:
(1) In addition to any other authority provided by law, the secretary may:
(a) Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;
(b) Establish all license, examination, and renewal fees in accordance with RCW 43.70.250;
(c) Establish forms and procedures necessary to administer this chapter;
(d) Establish administrative procedures, administrative requirements, and fees in accordance with RCW 43.70.250 and 43.70.280. All fees collected under this section must be credited to the health professions account as required under RCW 43.70.320;
(e) Develop and administer, or approve, or both, examinations to applicants for a license under this chapter;
(f) Establish continuing education requirements by rule;
(g) Issue a license to any applicant who has met the education, training, and examination requirements for licensure and deny a license to applicants who do not meet the minimum qualifications for licensure. However, denial of licenses based on unprofessional conduct or impaired practice is governed by the uniform disciplinary act, chapter 18.130 RCW;
(h) In consultation with the committee, approve examinations prepared or administered by private testing agencies or organizations for use by an applicant in meeting the licensing requirements under RCW 18.250.060;
(i) Determine which states have credentialing requirements substantially equivalent to those of this state, and issue licenses to individuals credentialed in those states that have successfully fulfilled the requirements of RCW 18.250.080;
(j) Hire clerical, administrative, and investigative staff as needed to implement and administer this chapter;
(k) Maintain the official department record of all applicants and licensees; and
(l) Establish requirements and procedures for an inactive license.
(2) The uniform disciplinary act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses, and the discipline of licensees under this chapter.
[ 2014 c 194 s 2; 2007 c 253 s 3.]

catchline: Secretary's authority—Application of uniform disciplinary act.


title: RCW 18.250.030

text:
(1) The athletic training advisory committee is formed to further the purposes of this chapter.
(2) The committee consists of five members. Four members of the committee must be athletic trainers licensed under this chapter and residing in this state, must have not less than five years' experience in the practice of athletic training, and must be actively engaged in practice within two years of appointment. The fifth member must be appointed from the public at large, and have an interest in the rights of consumers of health services.
(3) The committee may provide advice on matters specifically identified and requested by the secretary, such as applications for licenses.
(4) The committee may be requested by the secretary to approve an examination required for licensure under this chapter.
(5) The committee, at the request of the secretary, may recommend rules in accordance with the administrative procedure act, chapter 34.05 RCW, relating to standards for appropriateness of athletic training care.
(6) The committee must meet during the year as necessary to provide advice to the secretary. The committee may elect a chair and a vice chair. A majority of the members currently serving constitute a quorum.
(7) Each member of the committee must be reimbursed for travel expenses as authorized in RCW 43.03.050 and 43.03.060. In addition, members of the committee must be compensated in accordance with RCW 43.03.240 when engaged in the authorized business of the committee.
(8) The secretary, members of the committee, or individuals acting on their behalf are immune from suit in any action, civil or criminal, based on any credentialing or disciplinary proceedings or other official acts performed in the course of their duties.
[ 2007 c 253 s 4.]

catchline: Athletic training advisory committee.


title: RCW 18.250.040

text:
(1) It is unlawful for any person to practice or offer to practice as an athletic trainer, or to represent themselves or other persons to be legally able to provide services as an athletic trainer, unless the person is licensed under the provisions of this chapter.
(2) No person may use the title "athletic trainer," the letters "ATC" or "LAT," the terms "sports trainer," "team trainer," "trainer," or any other words, abbreviations, or insignia in connection with his or her name to indicate or imply, directly or indirectly, that he or she is an athletic trainer without being licensed in accordance with this chapter as an athletic trainer.
[ 2019 c 358 s 1; 2007 c 253 s 5.]

catchline: License required.


title: RCW 18.250.050

text:
Nothing in this chapter may prohibit, restrict, or require licensure of:
(1) Any person licensed, certified, or registered in this state and performing services within the authorized scope of practice;
(2) The practice by an individual employed by the government of the United States as an athletic trainer while engaged in the performance of duties prescribed by the laws of the United States;
(3) Any person pursuing a supervised course of study in an accredited athletic training educational program, if the person is designated by a title that clearly indicates a student or trainee status;
(4) An athletic trainer from another state for purposes of continuing education, consulting, or performing athletic training services while accompanying his or her group, individual, or representatives into Washington state on a temporary basis for no more than ninety days in a calendar year;
(5) Any elementary, secondary, or postsecondary school teacher, educator, or coach who does not represent themselves to the public as an athletic trainer; or
(6) A personal or fitness trainer employed by an athletic club or fitness center and not representing themselves as an athletic trainer or performing the duties of an athletic trainer provided under RCW 18.250.010(4)(a) (ii) through (vi).
[ 2019 c 358 s 2; 2007 c 253 s 6.]

catchline: Limitations of chapter.


title: RCW 18.250.060

text:
An applicant for an athletic trainer license must:
(1) Have received a bachelor's or advanced degree from an accredited four-year college or university that meets the academic standards of athletic training, accepted by the secretary, as advised by the committee;
(2) Have successfully completed an examination administered or approved by the secretary, in consultation with the committee; and
(3) Submit an application on forms prescribed by the secretary and pay the licensure fee required under this chapter.
[ 2007 c 253 s 7.]

catchline: Applicant requirements.


title: RCW 18.250.070

text:
(1) Except as necessary to provide emergency care of athletic injuries, an athletic trainer shall not provide treatment, rehabilitation, or reconditioning services to any person except as specified in guidelines established with a licensed health care provider who is licensed to perform the services provided in the guidelines.
(2) If there is no improvement in an athlete who has sustained an athletic injury within fifteen days of initiation of treatment, rehabilitation, or reconditioning, the athletic trainer must refer the athlete to a licensed health care provider that is appropriately licensed to assist the athlete.
(3) If an athletic injury requires treatment, rehabilitation, or reconditioning for more than forty-five days, the athletic trainer must consult with, or refer the athlete to a licensed health care provider. The athletic trainer shall document the action taken.
[ 2007 c 253 s 8.]

catchline: Treatment, rehabilitation, and reconditioning—Referral to licensed health care provider.


title: RCW 18.250.080

text:
Each applicant and license holder must comply with administrative procedures, administrative requirements, and fees under RCW 43.70.250 and 43.70.280. The secretary shall furnish a license to any person who applies and who has qualified under the provisions of this chapter.
[ 2007 c 253 s 9.]

catchline: Application procedures, requirements, and fees.


title: RCW 18.250.090

text:
Nothing in this chapter restricts the ability of athletic trainers to work in the practice setting of his or her choice.
[ 2007 c 253 s 10.]

catchline: Practice setting not restricted.


title: RCW 18.250.100

text:
Nothing in this chapter may be construed to require that a health carrier defined in RCW 48.43.005 contract with a person licensed as an athletic trainer under this chapter.
[ 2007 c 253 s 11.]

catchline: Health carrier contract with athletic trainer not required.


title: RCW 18.250.110

text:
(1) An athletic trainer licensed under this chapter:
(a) May purchase, store, and administer over-the-counter medications, as prescribed by an authorized health care practitioner for the practice of athletic training;
(b) Who has completed accredited training programs on pharmacology and medication administration may purchase, store, and administer medications in accordance with the programs, as prescribed by an authorized health care practitioner for the practice of athletic training.
(2) An athletic trainer may not administer any medications to a student in a public school as defined in RCW 28A.150.010 or private schools governed by chapter 28A.195 RCW.
(3) An athletic trainer may administer medications consistent with this section to a minor in a setting other than a school, if the minor's parent or guardian provides written consent.
(4) An athletic trainer licensed under this chapter who has completed an anaphylaxis training program in accordance with RCW 70.54.440 may administer an epinephrine autoinjector to any individual who the athletic trainer believes in good faith is experiencing anaphylaxis as authorized by RCW 70.54.440.
[ 2023 c 143 s 2; 2019 c 358 s 3.]

catchline: Medications.


title: RCW 18.250.901

text:
This act takes effect July 1, 2008.
[ 2007 c 253 s 16.]

catchline: Effective date—2007 c 253.


title: RCW 18.250.902

text:
The secretary of health may take the necessary steps to ensure that this act is implemented on its effective date.
[ 2007 c 253 s 17.]

catchline: Implementation—2007 c 253.


title: RCW 18.260.010

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Close supervision" means that a supervising dentist or supervising dental therapist whose patient is being treated has personally diagnosed the condition to be treated and has personally authorized the procedures to be performed. The supervising dentist or supervising dental therapist is continuously on-site and physically present in the treatment facility while the procedures are performed by the assistive personnel and capable of responding immediately in the event of an emergency. The term does not require a supervising dentist or supervising dental therapist to be physically present in the operatory.
(2) "Commission" means the Washington state dental quality assurance commission created in chapter 18.32 RCW.
(3) "Dental assistant" means a person who is registered by the commission to provide supportive services to a licensed dentist or a licensed dental therapist to the extent provided in this chapter and under the close supervision of a dentist or close supervision of a dental therapist.
(4) "Dental therapist" means an individual who holds a license to practice as a dental therapist under chapter 18.265 RCW.
(5) "Dentist" means an individual who holds a license to practice dentistry under chapter 18.32 RCW.
(6) "Department" means the department of health.
(7) "Expanded function dental auxiliary" means a person who is licensed by the commission to provide supportive services to a licensed dentist or dental therapist to the extent provided in this chapter and under the specified level of supervision of a dentist or dental therapist.
(8) "General supervision" means that a supervising dentist or dental therapist has examined and diagnosed the patient and provided subsequent instructions to be performed by the assistive personnel, but does not require that the dentist or dental therapist be physically present in the treatment facility.
(9) "Secretary" means the secretary of health.
(10) "Supervising dental therapist" means a dental therapist licensed under chapter 18.265 RCW who is responsible for providing the appropriate level of supervision for dental assistants and expanded function dental auxiliaries.
(11) "Supervising dentist" means a dentist licensed under chapter 18.32 RCW that is responsible for providing the appropriate level of supervision for dental assistants and expanded function dental auxiliaries.
[ 2023 c 460 s 16; 2007 c 269 s 1.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Definitions.


title: RCW 18.260.020

text:
(1) No person may practice or represent himself or herself as a registered dental assistant by use of any title or description without being registered by the commission as having met the standards established for registration under this chapter unless he or she is exempt under RCW 18.260.110.
(2) No person may practice or represent himself or herself as a licensed expanded function dental auxiliary by use of any title or description without being licensed by the commission under this chapter unless he or she is exempt under RCW 18.260.110.
[ 2007 c 269 s 2.]

catchline: Registration or license required.


title: RCW 18.260.030

text:
The commission shall issue a registration to practice as a dental assistant to any applicant who pays any applicable fees, as established by the secretary in accordance with RCW 43.70.110 and 43.70.250, and submits, on forms provided by the secretary, the applicant's name, address, and other information as determined by the secretary.
[ 2007 c 269 s 3.]

catchline: Dental assistants—Registration.


title: RCW 18.260.040

text:
(1)(a) The commission shall adopt rules relating to the scope of dental assisting services related to patient care and laboratory duties that may be performed by dental assistants.
(b) In addition to the services and duties authorized by the rules adopted under (a) of this subsection, a dental assistant may apply topical anesthetic agents.
(c) All dental services performed by dental assistants under (a) or (b) of this subsection must be performed under the close supervision of a supervising dentist or supervising dental therapist as the dentist or dental therapist may allow.
(2) In addition to any other limitations established by the commission, dental assistants may not perform the following procedures:
(a) Any scaling procedure;
(b) Any oral prophylaxis, except coronal polishing;
(c) Administration of any general or local anesthetic, including intravenous sedation;
(d) Any removal of or addition to the hard or soft tissue of the oral cavity;
(e) Any diagnosis of or prescription for treatment of disease, pain, deformity, deficiency, injury, or physical condition of the human teeth, jaw, or adjacent structures; and
(f) The taking of any impressions of the teeth or jaw or the relationships of the teeth or jaws, for the purpose of fabricating any intra-oral restoration, appliance, or prosthesis, other than impressions allowed as a delegated duty for dental assistants pursuant to rules adopted by the commission.
(3) A dentist or dental therapist may not assign a dental assistant to perform duties until the dental assistant has demonstrated skills necessary to perform competently all assigned duties and responsibilities.
[ 2023 c 460 s 17; 2015 c 120 s 3; 2013 c 87 s 4; 2007 c 269 s 5.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Dental assistants—Scope of practice.


title: RCW 18.260.050

text:
(1) The commission shall issue a license to practice as an expanded function dental auxiliary to any applicant who:
(a) Pays any applicable fees as established by the secretary in accordance with RCW 43.70.110 and 43.70.250;
(b) Submits, on forms provided by the secretary, the applicant's name, address, and other applicable information as determined by the secretary; and
(c) Demonstrates that the following requirements have been met:
(i) Successful completion of a dental assisting education program approved by the commission. The program may be an approved online education program;
(ii) Successful completion of an expanded function dental auxiliary education program approved by the commission; and
(iii) Successful passage of both a written examination and a clinical examination in restorations approved by the commission.
(2)(a) An applicant that holds a limited license to practice dental hygiene under chapter 18.29 RCW is considered to have met the dental assisting education program requirements of subsection (1)(c)(i) of this section.
(b) An applicant that holds a full license to practice dental hygiene under chapter 18.29 RCW is considered to have met the requirements of subsection (1)(c) of this section upon demonstrating the successful completion of training in taking final impressions as approved by the commission.
[ 2007 c 269 s 4.]

catchline: Expanded function dental auxiliary—License.


title: RCW 18.260.060

text:
An applicant holding a license in another state may be licensed as an expanded function dental auxiliary in this state without examination if the commission determines that the other state's licensing standards are substantially equivalent to the standards in this state.
[ 2007 c 269 s 9.]

catchline: Expanded function dental auxiliary—License—Reciprocity.


title: RCW 18.260.065

text:
An applicant with military training or experience satisfies the training or experience requirements of this chapter unless the commission determines that the military training or experience is not substantially equivalent to the standards of this state.
[ 2011 c 32 s 14.]

catchline: Registration or licensing requirements—Military training or experience.


title: RCW 18.260.070

text:
(1) The commission shall adopt rules relating to the scope of expanded function dental auxiliary services related to patient care and laboratory duties that may be performed by expanded function dental auxiliaries.
(2) The scope of expanded function dental auxiliary services that the commission identifies in subsection (1) of this section includes:
(a) In addition to the dental assisting services that a dental assistant may perform under the close supervision of a supervising dentist or supervising dental therapist, the performance of the following services under the general supervision of a supervising dentist or supervising dental therapist as the dentist or dental therapist may allow:
(i) Performing coronal polishing;
(ii) Giving fluoride treatments;
(iii) Applying sealants;
(iv) Placing dental x-ray film and exposing and developing the films;
(v) Giving patient oral health instruction; and
(b) Notwithstanding any prohibitions in RCW 18.260.040, the performance of the following services under the close supervision of a supervising dentist or supervising dental therapist as the dentist or dental therapist may allow:
(i) Placing and carving direct restorations; and
(ii) Taking final impressions.
(3) A dentist or dental therapist may not assign an expanded function dental auxiliary to perform services until the expanded function dental auxiliary has demonstrated skills necessary to perform competently all assigned duties and responsibilities.
[ 2023 c 460 s 18; 2007 c 269 s 6.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Expanded function dental auxiliary—Scope of practice.


title: RCW 18.260.080

text:
A supervising dentist or supervising dental therapist is responsible for:
(1) Maintaining the appropriate level of supervision for dental assistants and expanded function dental auxiliaries; and
(2) Ensuring that the dental assistants and expanded function dental auxiliaries that the dentist or dental therapist supervises are able to competently perform the tasks that they are assigned.
[ 2023 c 460 s 19; 2007 c 269 s 7.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Supervising dentist and supervising dental therapists—Responsibilities.


title: RCW 18.260.090

text:
The commission shall issue an initial credential or renewal credential to an applicant who has met the requirements for a credential or deny an initial credential or renewal credential based upon failure to meet the requirements for a credential or unprofessional conduct or impairment governed by chapter 18.130 RCW.
[ 2007 c 269 s 8.]

catchline: Initial or renewal credentials—Issuance and denial.


title: RCW 18.260.100

text:
(1) The commission may approve a written examination prepared or administered by a private testing agency or association of licensing agencies for use by an applicant in meeting the licensing requirements under RCW 18.260.050. The requirement that the examination be written does not exclude the use of computerized test administration.
(2) The commission, upon consultation with the dental hygiene examining committee, may approve a clinical examination prepared or administered by a private testing agency or association of licensing agencies for use by an applicant in meeting the licensing requirements under RCW 18.260.050.
[ 2007 c 269 s 10.]

catchline: Examinations.


title: RCW 18.260.110

text:
Nothing in this chapter may be construed to prohibit or restrict:
(1) The practice of a dental assistant in the discharge of official duties by dental assistants in the United States federal services on federal reservations, including but not limited to the armed services, coast guard, public health service, veterans' bureau, or bureau of Indian affairs;
(2) Expanded function dental auxiliary education and training programs approved by the commission and the practice as an expanded function dental auxiliary by students in expanded function dental auxiliary education and training programs approved by the commission, when acting under the direction and supervision of persons licensed under chapter 18.29 or 18.32 RCW;
(3) Dental assistant education and training programs, and the practice of dental assisting by students in dental assistant education and training programs approved by the commission or offered at a school approved or licensed by the workforce training and education coordinating board, student achievement council, state board for community and technical colleges, or Washington state skill centers certified by the office of the superintendent of public instruction, when acting under the direction and supervision of persons registered or licensed under this chapter or chapter 18.29 or 18.32 RCW;
(4) The practice of a volunteer dental assistant providing services under the supervision of a licensed dentist in a charitable dental clinic, as approved by the commission in rule; or
(5) The performance of dental health aide therapist services to the extent authorized under chapter 70.350 RCW.
[ 2017 c 5 s 6; 2012 c 229 s 502; 2008 c 150 s 1; 2007 c 269 s 11.]
Notes:
Effective date—2012 c 229 ss 101, 117, 401, 402, 501 through 594, 601 through 609, 701 through 708, 801 through 821, 902, and 904: See note following RCW 28B.77.005.

catchline: Limitation of chapter.


title: RCW 18.260.120

text:
The commission may adopt rules under chapter 34.05 RCW as required to implement this chapter.
[ 2007 c 269 s 12.]

catchline: Rules.


title: RCW 18.260.130

text:
Chapter 18.130 RCW governs unregistered or unlicensed practice, the issuance and denial of credentials, and the discipline of those credentialed under this chapter. The commission is the disciplining authority under this chapter.
[ 2007 c 269 s 13.]

catchline: Application of uniform disciplinary act.


title: RCW 18.260.140

text:
By November 15, 2012, the department, in consultation with the commission and the dental hygiene examining committee, shall conduct a review of the effectiveness of the creation of the dental assistant and expanded function dental auxiliary professions as related to:
(1) Increasing professional standards in dental practices;
(2) Increasing efficiency in dental practices and community health clinics;
(3) Promoting career ladders in the dental professions; and
(4) Recommendations for expanding or contracting the practice of dental assistants and expanded function dental auxiliaries.
[ 2007 c 269 s 18.]

catchline: Department review.


title: RCW 18.260.900

text:
(1) The provisions of this act apply to registered dental assistants effective July 1, 2008.
(2) The provisions of this act apply to expanded function dental auxiliaries effective December 1, 2008.
[ 2007 c 269 s 21.]

catchline: Application—2007 c 269.


title: RCW 18.260.901

text:
The secretary of health and the Washington state dental quality assurance commission may take the necessary steps to ensure that this act is implemented on its effective date.
[ 2007 c 269 s 22.]

catchline: Implementation—2007 c 269.


title: RCW 18.265.005

text:
The legislature finds that good oral health is an integral piece of overall health and well-being. Without treatment, dental disease compromises overall health and requires increasingly costly interventions. However, most dental disease can be prevented at little cost through routine dental care and disease prevention.
Dental-related issues are a leading reason that Washingtonians seek care in hospital emergency departments, which has become the source of care for many, especially uninsured and low-income populations.
It is the intent of the legislature to expand access to oral health care for all Washingtonians through an evidence-based mid-level dental provider called a dental therapist. Dental therapy is a strategy to address racial and ethnic disparities in health and rural health care access gaps. Dental therapists are also a strategy to increase workforce diversity in health care and expand career opportunities for existing members of the dental care workforce such as dental hygienists.
It is the legislature's intent that dental therapists will meet the needs of local communities as they work under the direction of a dentist licensed in accordance with state or federal law. The legislature intends for dental therapists to be incorporated into the dental care workforce and used to effectively treat more patients.
It is the intent of the legislature to follow the national commission on dental accreditation's standards for dental therapy education. This will ensure that dental therapists are trained to the highest quality standards and provide state-to-state consistency. It is the intent of the legislature that incorporating the commission on dental accreditation's standards for dental therapy education will pave the way for Washington education institutions to become accredited programs and for students to qualify for financial aid.
It is also the intent of the legislature to provide an efficient and reasonable pathway, through a limited license, for federally certified dental health aide therapists or tribally licensed dental therapists to become a Washington state licensed dental therapist.
[ 2023 c 460 s 1.]
Notes:
Effective date—2023 c 460 ss 1-22: "Sections 1 through 22 of this act take effect January 1, 2024." [ 2023 c 460 s 25.]

catchline: Finding—Intent.


title: RCW 18.265.010

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Close supervision of a dentist" means that a supervising dentist:
(a) Has personally examined and diagnosed the patient and has personally authorized the procedures to be performed;
(b) Is continuously on-site while the procedure in question is being performed; and
(c) Is capable of responding immediately in the event of an emergency.
(2) "Commission" means the dental quality assurance commission established in chapter 18.32 RCW.
(3) "Dental therapist" means a person licensed to practice dental therapy under this chapter.
(4) "Dental therapy" means the services and procedures specified in RCW 18.265.050.
(5) "Dentist" means a person licensed to practice dentistry under chapter 18.32 RCW or exempt from such licensure pursuant to Title 25 U.S.C. Sec. 1621t of the Indian health care improvement act.
(6) "Denturist" means a person licensed to engage in the practice of denturism under chapter 18.30 RCW.
(7) "Department" means the department of health.
(8) "Off-site supervision" means supervision that does not require the dentist to be personally on-site when services are provided or to previously examine or diagnose the patient.
(9) "Practice plan contract" means a document that is signed by a dentist and a dental therapist and outlines the functions the dentist authorizes the dental therapist to perform and the level and type of dentist supervision that is required.
(10) "Secretary" means the secretary of health.
[ 2023 c 460 s 2.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Definitions.


title: RCW 18.265.020

text:
No person may practice dental therapy or represent himself or herself as a dental therapist without being licensed by the department under this chapter. Every person licensed to practice dental therapy in this state shall renew their license and comply with administrative procedures, administrative requirements, continuing education requirements, and fees provided in RCW 43.70.250 and 43.70.280. The licensing fees for dental therapists may not be subsidized by other health professions. The department shall establish by rule mandatory continuing education requirements to be met by dental therapists applying for license renewal. A dental therapist must obtain liability insurance with coverage equivalent to that of the supervising dentist's liability insurance coverage.
[ 2023 c 460 s 3.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: License required—Liability insurance.


title: RCW 18.265.030

text:
(1) The department shall issue a license to practice as a dental therapist to any applicant who:
(a) Pays any applicable fees established by the secretary under RCW 43.70.110 and 43.70.250;
(b) Except as provided in subsection (2) of this section, successfully completes a dental therapist program that is accredited or has received initial accreditation by the American dental association's commission on dental accreditation;
(c) Passes an examination approved by the commission; and
(d) Submits, on forms provided by the secretary, the applicant's name, address, and other applicable information as determined by the secretary.
(2) Applicants who successfully completed a dental therapist program before September 30, 2022, that was not accredited by the American dental association's commission on dental accreditation but that the commission determines is substantially equivalent to an accredited education program meet the criteria described in subsection (1)(b) of this section if the applicant also , has proof of at least 400 preceptorship hours under the close supervision of a dentist.
(3) When considering and approving the exam under subsection (1)(c) of this section, the committee must consult with tribes that license dental health aide therapists and with dental therapy education programs located in this state.
(4) The secretary in consultation with the commission must establish by rule the procedures to implement this section.
[ 2023 c 460 s 4.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Licensing requirements.


title: RCW 18.265.040

text:
An applicant holding a valid license and currently engaged in practice in another state may be granted a license without examination required by this chapter, on the payment of any required fees, if the secretary determines that the other state's licensing standards are substantively equivalent to the standards in this state: PROVIDED, That the secretary may require the applicant to: (1) File with the secretary documentation certifying the applicant is licensed to practice in another state; and (2) provide information as the secretary deems necessary pertaining to the conditions and criteria of the uniform disciplinary act, chapter 18.130 RCW, and to demonstrate to the secretary a knowledge of Washington law pertaining to the practice of dental therapy.
[ 2023 c 460 s 5.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Licensure without examination—Licensed in another state.


title: RCW 18.265.050

text:
(1) Subject to the limitations in this section, a licensed dental therapist may provide the following services and procedures under the supervision of a licensed dentist as provided under RCW 18.265.060 and to the extent the supervising dentist authorizes the service or procedure to be provided by the dental therapist:
(a) Oral health instruction and disease prevention education, including nutritional counseling and dietary analysis;
(b) Comprehensive charting of the oral cavity;
(c) Making radiographs;
(d) Mechanical polishing;
(e) Prophylaxis;
(f) Periodontal scaling and root planing;
(g) Application of topical preventative or prophylactic agents, including fluoride and pit and fissure sealants;
(h) Pulp vitality testing;
(i) Application of desensitizing medication or resin;
(j) Fabrication of athletic mouth guards;
(k) Placement of temporary restorations;
(l) Fabrication of soft occlusal guards;
(m) Tissue conditioning and soft reline;
(n) Atraumatic restorative therapy and interim restorative therapy;
(o) Dressing changes;
(p) Administration of local anesthetic;
(q) Administration of nitrous oxide;
(r) Emergency palliative treatment of dental pain limited to the procedures in this section;
(s) The placement and removal of space maintainers;
(t) Cavity preparation;
(u) Restoration of primary and permanent teeth;
(v) Placement of temporary crowns;
(w) Preparation and placement of preformed crowns for patients 18 years of age or older;
(x) Indirect and direct pulp capping on primary and permanent teeth;
(y) Stabilization of reimplanted teeth;
(z) Extractions of primary teeth;
(aa) Suture removal;
(bb) Brush biopsies;
(cc) Minor adjustments and repairs on removable prostheses;
(dd) Recementing of permanent crowns;
(ee) Oral evaluation and assessment of dental disease and the formulation of an individualized treatment plan. When possible, a dental therapist must collaborate with the supervising dentist to formulate a patient's individualized treatment plan;
(ff) Identification of oral and systemic conditions requiring evaluation and treatment by a dentist, physician, or other health care provider, and management of referrals;
(gg) The supervision of expanded function dental auxiliaries, dental assistants, and dental hygienists. However, a dental therapist may supervise no more than a total of three expanded function dental auxiliaries, dental assistants, and dental hygienists at any one time in any one practice setting. A dental therapist may not supervise an expanded function dental auxiliary, dental assistant, or dental hygienist with respect to tasks that the dental therapist is not authorized to perform;
(hh) Nonsurgical extractions of erupted permanent teeth under limited conditions; and
(ii) The dispensation and oral administration of drugs pursuant to subsection (2) of this section.
(2)(a) A dental therapist may dispense and orally administer the following drugs within the parameters of the practice plan contract established in RCW 18.265.060: Nonnarcotic analgesics, anti-inflammatories, preventive agents, and antibiotics.
(b) The authority to dispense and orally administer drugs extends only to the drugs identified in this subsection and may be further limited by the practice plan contract.
(c) The authority to dispense includes the authority to dispense sample drugs within the categories established in this subsection if the dispensing is permitted under the practice plan contract.
(d) A dental therapist may not dispense or administer narcotic drugs as defined in chapter 69.50 RCW.
(e) A dental therapist does not have the authority to prescribe drugs.
(3) A dental therapist may only provide services and procedures in which they have been educated.
(4) A dental therapist may not provide any service or procedure that is not both authorized by this section and been authorized by the supervising dentist via inclusion in the dental therapist's practice plan contract.
[ 2023 c 460 s 6.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Scope of practice.


title: RCW 18.265.060

text:
(1) A dental therapist may only practice dental therapy under the supervision of a dentist and pursuant to a written practice plan contract with the supervising dentist. A dental therapist may not practice independently. In circumstances authorized by the supervising dentist in the written practice plan contract, a dental therapist may provide services under off-site supervision. The contract must, at a minimum, contain the following elements:
(a) The level of supervision required and circumstances when the prior knowledge and consent of the supervising dentist is required;
(b) Practice settings where services and procedures may be provided;
(c) Any limitations on the services or procedures the dental therapist may provide;
(d) Age and procedure-specific practice protocols, including case selection criteria, assessment guidelines, and imaging frequency;
(e) Procedures for creating and maintaining dental records for patients treated by the dental therapist;
(f) A plan to manage medical emergencies in each practice setting where the dental therapist provides care;
(g) A quality assurance plan for monitoring care provided by the dental therapist or, including patient care review, referral follow-up, and a quality assurance chart review;
(h) Protocols for administering and dispensing medications, including the specific circumstances under which the medications may be dispensed and administered;
(i) Criteria relating to the provision of care to patients with specific medical conditions or complex medical histories, including requirements for consultation prior to the initiation of care; and
(j) Specific written protocols governing situations where the dental therapist encounters a patient requiring treatment that exceeds the dental therapist's scope of practice or capabilities and protocols for referral of patients requiring evaluation and treatment by dentists, denturists, physicians, *advanced registered nurse practitioners, or other health care providers.
(2) The dental therapist shall accept responsibility for all services and procedures provided by the dental therapist or any auxiliary dental providers the dental therapist is supervising pursuant to the practice plan contract.
(3) A supervising dentist licensed under chapter 18.32 RCW who knowingly permits a dental therapist to provide a service or procedure that is not authorized in the practice plan contract, or any dental therapist who provides a service or procedure that is not authorized in the practice plan contract, commits unprofessional conduct for purposes of chapter 18.130 RCW.
(4) A dentist who enters into a written practice plan contract with a dental therapist shall:
(a) Directly provide or arrange for another dentist, denturist, or specialist to provide any necessary advanced procedures or services needed by the patient or any treatment that exceeds the dental therapist's scope of practice or capabilities;
(b) Ensure that he or she or another dentist is available to the dental therapist for timely communication during treatment if needed.
(5) A dental therapist shall perform only those services authorized by the supervising dentist and written practice plan contract and shall maintain an appropriate level of contact with the supervising dentist.
(6) A supervising dentist may supervise no more than a total of five dental therapists at any one time.
(7) Practice plan contracts must be signed and maintained by both the supervising dentist and the dental therapist.
(8) A dental therapist must submit a signed copy of the practice plan contract to the secretary at the time of licensure renewal. If the practice plan contract is revised in between license renewal, a signed copy of the revised practice plan contract must be submitted as soon as practicable after the revision is made.
[ 2023 c 460 s 7.]
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—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Supervising dentist—Practice plan contract—Requirements.


title: RCW 18.265.070

text:
Nothing in this chapter prohibits or affects:
(1) The practice of dental therapy by an individual otherwise licensed under this title and performing services within his or her scope of practice;
(2) The practice of dental therapy in the discharge of official duties on behalf of the United States government including, but not limited to, the armed forces, coast guard, public health service, veterans' bureau, or bureau of Indian affairs;
(3) The practice of dental therapy pursuant to an education program described in RCW 18.265.030;
(4) The practice of dental therapy under the supervision of a dentist necessary to meet the clinical experience or preceptorship requirements of RCW 18.265.030; or
(5) The practice of federally certified dental health aide therapists or tribally licensed dental health aide therapists as authorized under chapter 70.350 RCW.
[ 2023 c 460 s 8.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Exclusions from chapter.


title: RCW 18.265.080

text:
(1) A dental therapist may practice only in federally qualified health centers, tribal federally qualified health centers, and federally qualified health center look-alikes.
(2) A dentist providing dental services at a federally qualified health center is not required to enter a practice plan contract and may not face retaliation or default on a loan repayment contract if the dentist refuses to enter into a practice plan contract or supervise a dental therapist.
(3) For purposes of this section, a "tribal federally qualified health center" means a tribal facility operating in accordance with Title XIX Sec. 1905(l)(2)(B) of the social security act and the Indian self-determination and education assistance act (P.L. 93-638) and that enrolls in Washington medicaid as a tribal federally qualified health center.
[ 2023 c 460 s 9.]
Notes:
Effective date—2023 c 460 ss 1-22: See note following RCW 18.265.005.

catchline: Practice limited to federally qualified health centers and look-alikes.