title: RCW 43.70.527

text:
The department may issue immunization recommendations and related guidance. In developing its recommendations, the department must consider the recommendations of the advisory committee on immunization practices of the United States centers for disease control and prevention and experts and expert organizations that the department in its discretion deems relevant and based on reasonable scientific evidence and judgment. Any recommendations or guidance issued by the department under this section shall be posted on the department's website. Any recommendations or guidance issued by the department under this section are not subject to the rule-making requirements of chapter 34.05 RCW.
[ 2026 c 13 s 2.]
Notes:
Intent—2026 c 13: "(1) It is the intent of the legislature to preserve access to evidence-based preventive health services for people residing in Washington state who choose to use such services.
(2) The legislature does not intend to establish new requirements that any individual receive any immunization, including children under childhood vaccination requirements, or other preventive health service, nor does the legislature intend to modify, limit, or expand existing laws related to informed consent for health care decisions for minors or adults." [ 2026 c 13 s 1.]
Effective date—2026 c 13: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [March 9, 2026]." [ 2026 c 13 s 8.]

catchline: Immunization recommendations and guidance.


doc_type: statute

jurisdiction: wa

title: RCW 43.70.533

text:
(1) The department shall conduct a program of training and technical assistance regarding care of people with chronic conditions for providers of primary care. The program shall emphasize evidence-based high quality preventive and chronic disease care and shall collaborate with the health care authority to promote the adoption of primary care health homes established under chapter 316, Laws of 2011. The department may designate one or more chronic conditions to be the subject of the program.
(2) The training and technical assistance program shall include the following elements:
(a) Clinical information systems and sharing and organization of patient data;
(b) Decision support to promote evidence-based care;
(c) Clinical delivery system design;
(d) Support for patients managing their own conditions; and
(e) Identification and use of community resources that are available in the community for patients and their families.
(3) In selecting primary care providers to participate in the program, the department shall consider the number and type of patients with chronic conditions the provider serves, and the provider's participation in the medicaid program, the basic health plan, and health plans offered through the public employees' benefits board.
(4) For the purposes of this section, "health home" and "primary care provider" have the same meaning as in RCW 74.09.010.
[ 2011 c 316 s 3; 2007 c 259 s 5.]
Notes:
Subheadings not law—2007 c 259: See note following RCW 7.70.060.

license: public-domain-government-work

rule_set: Revised Code of Washington

catchline: Chronic conditions—Training and technical assistance for primary care providers.

code: rcw

unit: section

court: Washington State Legislature


title: RCW 43.70.540

text:
The legislature recognizes that the state patrol, the administrative office of the courts, the sheriffs' and police chiefs' association, the department of social and health services, the department of commerce, the sentencing guidelines commission, the department of corrections, and the superintendent of public instruction each have comprehensive data and analysis capabilities that have contributed greatly to our current understanding of crime and violence, and their causes.
The legislature finds, however, that a single health-oriented agency must be designated to provide consistent guidelines to all these groups regarding the way in which their data systems collect this important data. It is not the intent of the legislature by RCW 43.70.545 to transfer data collection requirements from existing agencies or to require the addition of major new data systems. It is rather the intent to make only the minimum required changes in existing data systems to increase compatibility and comparability, reduce duplication, and to increase the usefulness of data collected by these agencies in developing more accurate descriptions of violence.
[ 2023 c 470 s 2057; 2005 c 282 s 45; 1995 c 399 s 76; 1994 sp.s. c 7 s 201.]
Notes:
Explanatory statement—2023 c 470: See note following RCW 10.99.030.
Legislative finding and intent—1994 sp.s. c 7: "The legislature finds that the increasing violence in our society causes great concern for the immediate health and safety of our citizens and our social institutions. Youth violence is increasing at an alarming rate and young people between the ages of fifteen and twenty-four are at the highest risk of being perpetrators and victims of violence. Additionally, random violence, including homicide and the use of firearms, has dramatically increased over the last decade.
The legislature finds that violence is abhorrent to the aims of a free society and that it cannot be tolerated. State efforts at reducing violence must include changes in criminal penalties, reducing the unlawful use of and access to firearms, increasing educational efforts to encourage nonviolent means for resolving conflicts, and allowing communities to design their prevention efforts.
The legislature finds that the problem of violence can be addressed with many of the same approaches that public health programs have used to control other problems such as infectious disease, tobacco use, and traffic fatalities.
Addressing the problem of violence requires the concerted effort of all communities and all parts of state and local governments. It is the immediate purpose of chapter 7, Laws of 1994 sp. sess. to: (1) Prevent acts of violence by encouraging change in social norms and individual behaviors that have been shown to increase the risk of violence; (2) reduce the rate of at-risk children and youth, as defined in *RCW 70.190.010; (3) increase the severity and certainty of punishment for youth and adults who commit violent acts; (4) reduce the severity of harm to individuals when violence occurs; (5) empower communities to focus their concerns and allow them to control the funds dedicated to empirically supported preventive efforts in their region; and (6) reduce the fiscal and social impact of violence on our society." [ 1994 sp.s. c 7 s 101.]
*Reviser's note: The governor vetoed 1994 sp.s. c 7 s 302, which amended RCW 70.190.010 to define "at-risk children and youth." RCW 70.190.010 was subsequently amended by 1996 c 132 s 2, which now includes a definition for "at-risk children." RCW 70.190.010 was subsequently repealed by 2011 1st sp.s. c 32 s 13, effective June 30, 2012.
Severability—1994 sp.s. c 7: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 1994 sp.s. c 7 s 913.]
Effective dates—Contingent expiration date—1994 sp.s. c 7: "(1) Sections 201 through 204, 302, 323, 411, 412, 417, and 418 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect immediately [April 6, 1994].
(2) Sections 904 through 908 of this act shall take effect July 1, 1995.
*(3) Notwithstanding other provisions of this section, if sections 901 through 909 of this act are referred to the voters at the next succeeding general election and sections 901 through 909 of this act are rejected by the voters, then the amendments by sections 510 through 512, 519, 521, 525, and 527 of this act shall expire on July 1, 1995." [ 1994 sp.s. c 7 s 915 (Referendum Bill No. 43, subsection (3) approved November 8, 1994).]
*Reviser's note: Sections 901 through 909, chapter 7, Laws of 1994 sp. sess. were approved and ratified by the voters on November 8, 1994, in Referendum Bill No. 43. Therefore, the amendments to sections 510 through 512, 519, 521, 525, and 527, chapter 7, Laws of 1994 sp. sess. do not expire on July 1, 1995.

catchline: Data collection—Finding—Intent.


title: RCW 43.70.545

text:
(1) The department of health shall develop, based on recommendations in the public health services improvement plan and in consultation with affected groups or agencies, comprehensive rules for the collection and reporting of data relating to acts of violence, at-risk behaviors, and risk and protective factors. The data collection and reporting rules shall be used by any public or private entity that is required to report data relating to these behaviors and conditions. The department may require any agency or program that is state-funded or that accepts state funds and any licensed or regulated person or professional to report these behaviors and conditions. To the extent possible the department shall require the reports to be filed through existing data systems. The department may also require reporting of attempted acts of violence and of nonphysical injuries. For the purposes of this section "acts of violence" means self-directed and interpersonal behaviors that can result in suicide, homicide, and nonfatal intentional injuries. "At-risk behaviors," "protective factors," and "risk factors" have the same meanings as provided in *RCW 70.190.010. A copy of the data used by a school district to prepare and submit a report to the department shall be retained by the district and, in the copy retained by the district, identify the reported acts or behaviors by school site.
(2) The department is designated as the statewide agency for the coordination of all information relating to violence and other intentional injuries, at-risk behaviors, and risk and protective factors.
(3) The department shall provide necessary data to the local health departments for use in planning by or evaluation of any community network authorized under RCW 70.190.060.
(4) The department shall by rule establish requirements for local health departments to perform assessment related to at-risk behaviors and risk and protective factors and to assist community networks in policy development and in planning and other duties under chapter 7, Laws of 1994 sp. sess.
(5) The department may, consistent with its general authority and directives under RCW 43.70.540 through 43.70.560, contract with a college or university that has experience in data collection relating to the health and overall welfare of children to provide assistance to:
(a) State and local health departments in developing new sources of data to track acts of violence, at-risk behaviors, and risk and protective factors; and
(b) Local health departments to compile and effectively communicate data in their communities.
[ 1998 c 245 s 76; 1994 sp.s. c 7 s 202.]
Notes:
*Reviser's note: RCW 70.190.010 was repealed by 2011 1st sp.s. c 32 s 13, effective June 30, 2012.
Finding—Intent—Severability—Effective dates—Contingent expiration date—1994 sp.s. c 7: See notes following RCW 43.70.540.

catchline: Data collection and reporting rules.


title: RCW 43.70.550

text:
The public health services improvement plan developed under *RCW 43.70.520 shall include:
(1) Minimum standards for state and local public health assessment, performance measurement, policy development, and assurance regarding social development to reduce at-risk behaviors and risk and protective factors. The department in the development of data collection and reporting requirements for the superintendent of public instruction, schools, and school districts shall consult with the joint select committee on education restructuring and local school districts.
(2)(a) Measurable risk factors that are empirically linked to violent criminal acts by juveniles, teen substance abuse, teen pregnancy and male parentage, teen suicide attempts, dropping out of school, child abuse or neglect, and domestic violence; and
(b) An evaluation of other factors to determine whether they are empirically related risk factors, such as: Out-of-home placements, poverty, single-parent households, inadequate nutrition, hunger, unemployment, lack of job skills, gang affiliation, lack of recreational or cultural opportunities, school absenteeism, court-ordered parenting plans, physical, emotional, or behavioral problems requiring special needs assistance in K-12 schools, learning disabilities, and any other possible factors.
(3) Data collection and analysis standards on at-risk behaviors and risk and protective factors for use by the local public health departments and the **state council and the local community networks to ensure consistent and interchangeable data.
(4) Recommendations regarding any state or federal statutory barriers affecting data collection or reporting.
The department shall provide an annual report to the Washington state institute for public policy on the implementation of this section.
[ 1994 sp.s. c 7 s 203.]
Notes:
Reviser's note: *(1) RCW 43.70.520 was repealed by 2019 c 14 s 3.
**(2) RCW 70.170.030, which created the health care access and cost control council, was repealed by 1995 c 269 s 2204.
Finding—Intent—Severability—Effective dates—Contingent expiration date—1994 sp.s. c 7: See notes following RCW 43.70.540.

catchline: Public health services improvement plan—Contents.


title: RCW 43.70.555

text:
The department shall establish, by rule, standards for local health departments and networks to use in assessment, performance measurement, policy development, and assurance regarding social development to prevent health problems caused by risk factors empirically linked to: Violent criminal acts by juveniles, teen substance abuse, teen pregnancy and male parentage, teen suicide attempts, dropping out of school, child abuse or neglect, and domestic violence. The standards shall be based on the standards set forth in the public health services improvement plan as required by RCW 43.70.550.
[ 2011 1st sp.s. c 32 s 8; 1998 c 245 s 77; 1994 sp.s. c 7 s 204.]
Notes:
Transition plan—Report to the legislature—2011 1st sp.s. c 32: See note following RCW 70.305.005.
Finding—Intent—Severability—Effective dates—Contingent expiration date—1994 sp.s. c 7: See notes following RCW 43.70.540.

catchline: Assessment standards.


title: RCW 43.70.560

text:
The legislature encourages the use of a statewide voluntary, socially responsible policy to reduce the emphasis, amount, and type of violence in all public media. The department shall develop a suggested reporting format for use by the print, television, and radio media in reporting their voluntary violence reduction efforts. Each area of the public media may carry out the policy in whatever manner that area deems appropriate.
[ 1994 sp.s. c 7 s 205.]
Notes:
Finding—Intent—Severability—1994 sp.s. c 7: See notes following RCW 43.70.540.

catchline: Media violence—Reporting reduction efforts.


title: RCW 43.70.570

text:
The legislature declares its intent to implement the recommendations of the public health improvement plan by initiating a program to provide the public health system with the necessary capacity to improve the health outcomes of the population of Washington state and establishing the methodology by which improvement in the health outcomes and delivery of public health activities will be assessed.
[ 1995 c 43 s 1.]
Notes:
Severability—1995 c 43: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 1995 c 43 s 14.]
Effective dates—Contingent effective dates—1995 c 43: See note following RCW 70.05.030.

catchline: Intent—1995 c 43.


title: RCW 43.70.575

text:
Unless the context clearly requires otherwise, the definitions in this section apply throughout RCW 43.70.570 through * 43.70.580.
(1) "Capacity" means actions that public health jurisdictions must do as part of ongoing daily operations to adequately protect and promote health and prevent disease, injury, and premature death. The public health improvement plan identifies capacity necessary for assessment, policy development, administration, prevention, including promotion and protection, and access and quality.
(2) "Department" means the department of health.
(3) "Local health jurisdiction" means the local health agency, either county or multicounty, operated by local government, with oversight and direction from a local board of health, that provides public health services throughout a defined geographic area.
(4) "Health outcomes" means long-term objectives that define optimal, measurable, future levels of health status, maximum acceptable levels of disease, injury, or dysfunction, or prevalence of risk factors in areas such as improving the rate of immunizations for infants and children to ninety percent and controlling and reducing the spread of tuberculosis and that are stated in the public health improvement plan.
(5) "Public health improvement plan," also known as the public health services improvement plan, means the public health services improvement plan established under *RCW 43.70.520, developed by the department, in consultation with local health departments and districts, the state board of health, the health services commission, area Indian health services, and other state agencies, health services providers, and residents concerned about public health, to provide a detailed accounting of deficits in the core functions of assessment, policy development, and assurance of the current public health system, how additional public health funding would be used, and to describe the benefits expected from expanded expenditures.
(6) "Public health" means activities that society does collectively to assure the conditions in which people can be healthy. This includes organized community efforts to prevent, identify, preempt, and counter threats to the public's health.
(7) "Public health system" means the department, the state board of health, and local health jurisdictions.
[ 1995 c 43 s 2.]
Notes:
*Reviser's note: RCW 43.70.580 and 43.70.520 were repealed by 2019 c 14 s 3.
Effective dates—Contingent effective dates—1995 c 43: See note following RCW 70.05.030.
Severability—1995 c 43: See note following RCW 43.70.570.

catchline: Definitions.


title: RCW 43.70.590

text:
Consistent with funds appropriated specifically for this purpose, the department shall establish in conjunction with the area Indian health services system and providers an advisory group comprised of Indian and non-Indian health care facilities and providers to formulate an American Indian health care delivery plan. The plan shall include:
(1) Recommendations to providers and facilities methods for coordinating and joint venturing with the Indian health services for service delivery;
(2) Methods to improve American Indian-specific health programming; and
(3) Creation of co-funding recommendations and opportunities for the unmet health services programming needs of American Indians.
[ 1995 c 43 s 4; 1993 c 492 s 468. Formerly RCW 41.05.240.]
Notes:
Reviser's note: RCW 41.05.240 was amended and recodified as RCW 43.70.590 by 1995 c 43 without cognizance of the repeal by 1995 1st sp.s. c 6 s 9. For rule of construction concerning sections amended and repealed in the same legislative session, see RCW 1.12.025.
Effective dates—Contingent effective dates—1995 c 43: See note following RCW 70.05.030.
Severability—1995 c 43: See note following RCW 43.70.570.
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.


title: RCW 43.70.595

text:
(1) Subject to the availability of amounts appropriated for this specific purpose, the department, in coordination with the governor's interagency council on health disparities, local health jurisdictions, and accountable communities of health, must share and review population health data, which may be related to chronic and infectious diseases, maternal birth complications, preterm births and other newborn health complications, and any other relevant health data, including hospital community health needs assessments, to identify, or allow communities to self-identify, potential health equity zones in the state and develop projects to meet the unique needs of each zone. The department must provide technical support to communities in the use of data to facilitate self-identification of health equity zones.
(2) Communities' uses of data must align with projects and outcomes to be measured in self-identified zones.
(3) The department must use the first 12 months following July 25, 2021, to develop a plan and process to allow communities to implement health equity zone programs statewide. The department has authority to determine the number of health equity zones and projects based on available resources.
(4) Communities that self-identify zones or the department must notify relevant community organizations in the zones of the health equity zone designation and allow those organizations to identify projects to address the zone's most urgent needs related to health disparities. Community organizations may include, but are not limited to:
(a) Community health clinics;
(b) Local health providers;
(c) Federally qualified health centers;
(d) Health systems;
(e) Local government;
(f) Public school districts;
(g) Recognized American Indian organizations and Indian health organizations;
(h) Local health jurisdictions; and
(i) Any other nonprofit organization working to address health disparities in the zone.
(5) Local organizations working within zones may form coalitions to identify the needs of the zone, design projects to address those needs, and develop an action plan to implement the projects. Local organizations may partner with state or national organizations outside the specific zone designation. Projects may include, but are not limited to:
(a) Addressing health care provider access and health service delivery;
(b) Improving information sharing and community trust in providers and services;
(c) Conducting outreach and education efforts; and
(d) Recommending systems and policy changes that will improve population health.
(6) The department must provide:
(a) Support to the coalitions in identifying and applying for resources to support projects within the zones;
(b) Technical assistance related to project management and developing health outcome and other measures to evaluate project success; and
(c) Subject to availability, funding to implement projects.
(7) Subject to the availability of amounts appropriated for this specific purpose, by December 1, 2023, and every two years thereafter, the department must submit a report to the legislature detailing the projects implemented in each zone and the outcome measures, including year-over-year health data, to demonstrate project success.
(8) For the purposes of this section "health equity zone" or "zone" means a contiguous geographic area that demonstrates measurable and documented health disparities and poor health outcomes, which may include but are not limited to high rates of maternal complications, newborn health complications, and chronic and infectious disease, is populated by communities of color, Indian communities, communities experiencing poverty, or immigrant communities, and is small enough for targeted interventions to have a significant impact on health outcomes and health disparities. Documented health disparities must be documented or identified by the department or the centers for disease control and prevention.
[ 2021 c 262 s 2.]
Notes:
Findings—Intent—2021 c 262: "(1) The legislature finds that people of color, Indian, people experiencing poverty, and immigrant populations experience significant health disparities compared to the general population, including more limited access to health care and poorer health outcomes. The legislature finds that these circumstances result in higher rates of morbidity and mortality for persons of color and immigrant populations than observed in the general population.
(2) Therefore, the legislature intends to create health equity zones to address significant health disparities identified by health outcome data. The state intends to work with community leaders within the health equity zones to share information and coordinate efforts with the goal of addressing the most urgent needs. Health equity zone partners shall develop, expand, and maintain positive relationships with communities of color, Indian communities, communities experiencing poverty, and immigrant communities within the zone to develop effective and sustainable programs to address health inequity." [ 2021 c 262 s 1.]

catchline: Health equity zones.


title: RCW 43.70.600

text:
When funds are appropriated for this purpose, the department shall conduct a survey of scientific literature regarding the possible health effects of human exposure to the radio frequency part of the electromagnetic spectrum (300Hz to 300GHz). The department may submit the survey results to the legislature, prepare a summary of that survey, and make the summary available to the public. The department may update the survey and summary periodically.
[ 1998 c 245 s 78; 1996 c 323 s 6.]
Notes:
Findings—1996 c 323: "The legislature finds that concerns have been raised over possible health effects from exposure to some wireless telecommunications facilities, and that exposures from these facilities should be kept as low as reasonably achievable while still allowing the operation of these networks. The legislature further finds that the department of health should serve as the state agency that follows the issues and compiles information pertaining to potential health effects from wireless telecommunications facilities." [ 1996 c 323 s 1.]

catchline: Survey regarding exposure to radio frequencies—Results.


title: RCW 43.70.605

text:
Unless this section is preempted by applicable federal statutes, the department may require that in residential zones or areas, all providers of personal wireless services, as defined in *section 1 of this act, provide random test results on power density analysis for the provider's licensed frequencies showing radio frequency levels before and after development of the personal wireless service antenna facilities, following national standards or protocols of the federal communications commission or other federal agencies. This section shall not apply to microcells as defined in RCW 80.36.375. The department may adopt rules to implement this section.
[ 1996 c 323 s 7.]
Notes:
*Reviser's note: The reference to section 1 of this act is erroneous. Section 2 of the act, codified as RCW 43.21C.0384, was apparently intended.
Findings—1996 c 323: See note following RCW 43.70.600.

catchline: Personal wireless services—Random testing on power density analysis—Rules.


title: RCW 43.70.610

text:
The legislature finds that domestic violence is the leading cause of injury among women and is linked to numerous health problems, including depression, abuse of alcohol and other drugs, and suicide. Despite the frequency of medical attention, few people are diagnosed as victims of spousal abuse. The department, in consultation with the disciplinary authorities as defined in RCW 18.130.040, shall establish, within available department general funds, an ongoing domestic violence education program as an integral part of its health professions regulation. The purpose of the education program is to raise awareness and educate health care professionals regarding the identification, appropriate treatment, and appropriate referral of victims of domestic violence. The disciplinary authorities having the authority to offer continuing education may provide training in the dynamics of domestic violence. No funds from the health professions account may be utilized to fund activities under this section unless the disciplinary authority authorizes expenditures from its proportions of the account. A disciplinary authority may defray costs by authorizing a fee to be charged for participants or materials relating to any sponsored program.
[ 1996 c 191 s 89.]

catchline: Domestic violence education program—Established—Findings.


title: RCW 43.70.613

text:
(1) By January 1, 2024, the rule-making authority for each health profession licensed under Title 18 RCW subject to continuing education requirements must adopt rules requiring a licensee to complete health equity continuing education training at least once every four years.
(2) Health equity continuing education courses may be taken in addition to or, if a rule-making authority determines the course fulfills existing continuing education requirements, in place of other continuing education requirements imposed by the rule-making authority.
(3)(a) The secretary and the rule-making authorities must work collaboratively to provide information to licensees about available courses. The secretary and rule-making authorities shall consult with patients or communities with lived experiences of health inequities or racism in the health care system and relevant professional organizations when developing the information and must make this information available by July 1, 2023. The information should include a course option that is free of charge to licensees. It is not required that courses be included in the information in order to fulfill the health equity continuing education requirement.
(b) By January 1, 2023, the department, in consultation with the boards and commissions, shall adopt model rules establishing the minimum standards for continuing education programs meeting the requirements of this section. The department shall consult with patients or communities with lived experience of health inequities or racism in the health care system, relevant professional organizations, and the rule-making authorities in the development of these rules.
(c) The minimum standards must include instruction on skills to address the structural factors, such as bias, racism, and poverty, that manifest as health inequities. These skills include individual-level and system-level intervention, and self-reflection to assess how the licensee's social position can influence their relationship with patients and their communities. These skills enable a health care professional to care effectively for patients from diverse cultures, groups, and communities, varying in race, ethnicity, gender identity, sexuality, religion, age, ability, socioeconomic status, and other categories of identity. The courses must assess the licensee's ability to apply health equity concepts into practice. Course topics may include, but are not limited to:
(i) Strategies for recognizing patterns of health care disparities on an individual, institutional, and structural level and eliminating factors that influence them;
(ii) Intercultural communication skills training, including how to work effectively with an interpreter and how communication styles differ across cultures;
(iii) Implicit bias training to identify strategies to reduce bias during assessment and diagnosis;
(iv) Methods for addressing the emotional well-being of children and youth of diverse backgrounds;
(v) Ensuring equity and antiracism in care delivery pertaining to medical developments and emerging therapies;
(vi) Structural competency training addressing five core competencies:
(A) Recognizing the structures that shape clinical interactions;
(B) Developing an extraclinical language of structure;
(C) Rearticulating "cultural" formulations in structural terms;
(D) Observing and imagining structural interventions; and
(E) Developing structural humility; and
(vii) Cultural safety training.
(4) The rule-making authority may adopt rules to implement and administer this section, including rules to establish a process to determine if a continuing education course meets the health equity continuing education requirement established in this section.
(5) For purposes of this section the following definitions apply:
(a) "Rule-making authority" means the regulatory entities identified in RCW 18.130.040 and authorized to establish continuing education requirements for the health care professions governed by those regulatory entities.
(b) "Structural competency" means a shift in medical education away from pedagogic approaches to stigma and inequalities that emphasize cross-cultural understandings of individual patients, toward attention to forces that influence health outcomes at levels above individual interactions. Structural competency reviews existing structural approaches to stigma and health inequities developed outside of medicine and proposes changes to United States medical education that will infuse clinical training with a structural focus.
(c) "Cultural safety" means an examination by health care professionals of themselves and the potential impact of their own culture on clinical interactions and health care service delivery. This requires individual health care professionals and health care organizations to acknowledge and address their own biases, attitudes, assumptions, stereotypes, prejudices, structures, and characteristics that may affect the quality of care provided. In doing so, cultural safety encompasses a critical consciousness where health care professionals and health care organizations engage in ongoing self-reflection and self-awareness and hold themselves accountable for providing culturally safe care, as defined by the patient and their communities, and as measured through progress towards achieving health equity. Cultural safety requires health care professionals and their associated health care organizations to influence health care to reduce bias and achieve equity within the workforce and working environment.
[ 2021 c 276 s 2.]
Notes:
Findings—2021 c 276: "The legislature finds that:
(1) Healthy Washingtonians contribute to the economic and social welfare of their families and communities, and access to health services and improved health outcomes allows all Washington families to enjoy productive and satisfying lives;
(2) The COVID-19 pandemic has further exposed that health outcomes are experienced differently by different people based on discrimination and bias by the health care system. Research shows that health care resources are distributed unevenly by intersectional categories including, but not limited to, race, gender, ability status, religion, sexual orientation, socioeconomic status, and geography; and
(3) These inequities have permeated health care delivery, deepening adverse outcomes for marginalized communities. This bill aims to equip health care workers with the skills to recognize and reduce these inequities in their daily work. In addition to their individual impact, health care workers need the skills to address systemic racism and bias." [ 2021 c 276 s 1.]

catchline: Health care professionals—Health equity continuing education.


title: RCW 43.70.614

text:
(1) The department must establish an education program for the prevention of female genital mutilation. The program must be designed to provide information about the health risks and emotional trauma inflicted by the practice of female genital mutilation, as well as the civil and criminal penalties for committing female genital mutilation.
(2) The department must develop policies and procedures to promote partnerships with relevant stakeholders to prevent female genital mutilation and to protect and provide assistance to victims of female genital mutilation, including partnerships with:
(a) Relevant state agencies that provide services to persons at risk of female genital mutilation or persons who have been subjected to female genital mutilation;
(b) The department of children, youth, and families;
(c) The Washington state patrol;
(d) The attorney general; and
(e) Other government entities and nongovernmental organizations.
(3) The department must make recommendations and develop procedures regarding strategies and methodologies for training health care providers as defined in RCW 70.02.010 on recognizing the risk factors associated with female genital mutilation and the signs that a person may be a victim of female genital mutilation.
(4) Subject to the availability of amounts appropriated for this specific purpose, the department may contract with nongovernmental organizations, entities, or persons with experience working with victims of female genital mutilation to provide training and materials and other services as the department deems necessary.
(5) The department may adopt rules necessary to implement this section.
(6) For purposes of this section, "female genital mutilation" has the meaning provided in RCW 18.130.460.
[ 2023 c 122 s 6.]
Notes:
Finding—Intent—Effective date—2023 c 122: See notes following RCW 9A.36.170.

catchline: Female genital mutilation—Education program.


title: RCW 43.70.615

text:
(1) For the purposes of this section, "multicultural health" means the provision of health care services with the knowledge and awareness of the causes and effects of the determinants of health that lead to disparities in health status between different genders and racial and ethnic populations and the practice skills necessary to respond appropriately.
(2) The department, in consultation with the disciplining authorities as defined in RCW 18.130.040, shall establish, within available department general funds, an ongoing multicultural health awareness and education program as an integral part of its health professions regulation. The purpose of the education program is to raise awareness and educate health care professionals regarding the knowledge, attitudes, and practice skills necessary to care for diverse populations to achieve a greater understanding of the relationship between culture and health. Any such education shall be developed in collaboration with education programs that train students in that health profession. No funds from the health professions account may be utilized to fund activities under this section unless the disciplining authority authorizes expenditures from its proportions of the account.
(3) By July 1, 2008, each education program with a curriculum to train health professionals for employment in a profession credentialed by a disciplining authority under chapter 18.130 RCW shall integrate into the curriculum instruction in multicultural health as part of its basic education preparation curriculum. The department may not deny the application of any applicant for a credential to practice a health profession on the basis that the education or training program that the applicant successfully completed did not include integrated multicultural health curriculum as part of its basic instruction.
[ 2021 c 276 s 3; 2006 c 237 s 2.]
Notes:
Findings—2021 c 276: See note following RCW 43.70.613.
Findings—2006 c 237: "The legislature finds that women and people of color experience significant disparities from the general population in education, employment, healthy living conditions, access to health care, and other social determinants of health. The legislature finds that it shall be a priority for the state to develop the knowledge, attitudes, and practice skills of health professionals and those working with diverse populations to achieve a greater understanding of the relationship between culture and health and gender and health." [ 2006 c 237 s 1.]

catchline: Multicultural health awareness and education program—Integration into health professions basic education preparation curriculum.


title: RCW 43.70.616

text:
(1) Subject to the availability of funds for this specific purpose, the department of health shall provide funding to support promotoras in at least two communities. These promotoras shall provide culturally sensitive, lay health education for the Latinx community, and act as liaisons between their community, health professionals, and human and social service organizations.
(2) In determining which communities will be served by the promotoras under this section, the department of health shall provide funding to support one community west of the crest of the Cascade mountain range and one community east of the crest of the Cascade mountain range.
[ 2024 c 328 s 205.]
Notes:
Findings—Intent—2024 c 328: See note following RCW 13.34.050.

catchline: Health education—Funding to support promotoras.


title: RCW 43.70.617

text:
The department shall develop and make available educational resources for pregnant women regarding prenatal nutrition best practices to promote infant health. The educational resources may include, but are not limited to, courses delivered in-person or electronically and pamphlets printed on paper or made available on the department's website. The educational resources are intended to provide pregnant women knowledge of healthy foods and essential daily nutrients needed to promote infant growth and development.
[ 2014 c 38 s 1.]

catchline: Prenatal nutrition best practices—Educational resources for pregnant women.


title: RCW 43.70.618

text:
Subject to amounts appropriated specifically for this purpose, the department shall develop and make available educational resources for pregnant individuals about the nature and consequences of in utero exposure to cytomegalovirus and strategies to reduce the transmission of cytomegalovirus. The educational resources may include, but are not limited to, courses delivered in-person or electronically, pamphlets printed on paper and distributed through the watch me grow program, social media content, or made available on the department's website. The department shall also provide educational materials and outreach for providers regarding the strategies to reduce transmission of cytomegalovirus. The educational materials are intended to lower cytomegalovirus infection rates among pregnant individuals to save lives and prevent disability in their unborn children.
[ 2024 c 96 s 2.]

catchline: In utero exposure to cytomegalovirus—Educational resources.


title: RCW 43.70.619

text:
By December 31, 2021, the department shall design, prepare, and make available online, written materials to clearly inform health care providers and staff of the provisions of, and authority to act under, chapter 70.400 RCW.
[ 2021 c 235 s 5.]
Notes:
Conflict with federal requirements—2021 c 235: See RCW 70.400.900.


title: RCW 43.70.620

text:
The secretary shall create and maintain a list of contacts with each of the health care professions regulated under the following chapters for the purpose of policy advice and information dissemination: RCW 18.06.080, 18.89.050, and 18.138.070 and chapters *18.135, 18.55, and 18.88A RCW.
[ 1999 c 151 s 402.]
Notes:
*Reviser's note: Chapter 18.135 RCW was repealed by 2012 c 153 s 20.
Part headings not law—Effective date—1999 c 151: See notes following RCW 18.28.010.

catchline: List of contacts—Health care professions.


title: RCW 43.70.630

text:
(1) The department may enter into a written cost-reimbursement agreement with a permit applicant or project proponent to recover from the applicant or proponent the reasonable costs incurred by the department in carrying out the requirements of this chapter, as well as the requirements of other relevant laws, as they relate to permit coordination, environmental review, application review, technical studies, and permit processing.
(2) The cost-reimbursement agreement shall identify the tasks and costs for work to be conducted under the agreement. The agreement must include a schedule that states:
(a) The estimated number of weeks for initial review of the permit application;
(b) The estimated number of revision cycles;
(c) The estimated number of weeks for review of subsequent revision submittals;
(d) The estimated number of billable hours of employee time;
(e) The rate per hour; and
(f) A date for revision of the agreement if necessary.
(3) The written cost-reimbursement agreement shall be negotiated with the permit applicant or project proponent. Under the provisions of a cost-reimbursement agreement, funds from the applicant or proponent shall be used by the department to contract with an independent consultant to carry out the work covered by the cost-reimbursement agreement. The department may also use funds provided under a cost-reimbursement agreement to hire temporary employees, to assign current staff to review the work of the consultant, to provide necessary technical assistance when an independent consultant with comparable technical skills is unavailable, and to recover reasonable and necessary direct and indirect costs that arise from processing the permit. The department shall, in developing the agreement, ensure that final decisions that involve policy matters are made by the agency and not by the consultant. The department shall make an estimate of the number of permanent staff hours to process the permits, and shall contract with consultants or hire temporary employees to replace the time and functions committed by these permanent staff to the project. The billing process shall provide for accurate time and cost accounting and may include a billing cycle that provides for progress payments.
(4) The cost-reimbursement agreement must not negatively impact the processing of other permit applications. In order to maintain permit processing capacity, the agency may hire outside consultants, temporary employees, or make internal administrative changes. Consultants or temporary employees hired as part of a cost-reimbursement agreement or to maintain agency capacity are hired as agents of the state not of the permit applicant. The restrictions of chapter 42.52 RCW apply to any cost-reimbursement agreement, and to any person hired as a result of a cost-reimbursement agreement.
[ 2009 c 97 s 10; 2007 c 94 s 12; 2003 c 70 s 3; 2000 c 251 s 4.]
Notes:
Intent—Captions not law—Effective date—2000 c 251: See notes following RCW 43.21A.690.

catchline: Cost-reimbursement agreements.


title: RCW 43.70.640

text:
(1) An employer may use the designation "infant-friendly" on its promotional materials if the employer has an approved workplace breastfeeding policy addressing at least the following:
(a) Flexible work scheduling, including scheduling breaks and permitting work patterns that provide time for expression of breast milk;
(b) A convenient, sanitary, safe, and private location, other than a restroom, allowing privacy for breastfeeding or expressing breast milk;
(c) A convenient clean and safe water source with facilities for washing hands and rinsing breast-pumping equipment located in the private location specified in (b) of this subsection; and
(d) A convenient hygienic refrigerator in the workplace for the mother's breast milk.
(2) Employers seeking approval of a workplace breastfeeding policy must submit the policy to the department of health. The department of health shall review and approve those policies that meet the requirements of this section. The department may directly develop and implement the criteria for "infant-friendly" employers, or contract with a vendor for this purpose.
(3) For the purposes of this section, "employer" includes those employers defined in RCW 49.12.005 and also includes the state, state institutions, state agencies, political subdivisions of the state, and municipal corporations or quasi-municipal corporations.
[ 2001 c 88 s 3.]
Notes:
Acknowledgment—Declaration—Findings—2001 c 88: "(1) The legislature acknowledges the surgeon general's summons to all sectors of society and government to help redress the low breastfeeding rates and duration in the United States, including the social and workplace factors that can make it difficult for women to breastfeed. The legislature also acknowledges the surgeon general's report on the health and economic importance of breastfeeding which concludes that:
(a) Breastfeeding is one of the most important contributors to infant health;
(b) Breastfeeding provides a range of benefits for the infant's growth, immunity, and development; and
(c) Breastfeeding improves maternal health and contributes economic benefits to the family, health care system, and workplace.
(2) The legislature declares that the achievement of optimal infant and child health, growth, and development requires protection and support for the practice of breastfeeding. The legislature finds that:
(a) The American academy of pediatrics recommends exclusive breastfeeding for the first six months of a child's life and breastfeeding with the addition of solid foods to continue for at least twelve months, and that arrangements be made to provide expressed breast milk if the mother and child must separate during the first year. Children should be breastfed or fed expressed breast milk when they show signs of need, rather than according to a set schedule or the location;
(b) Breast milk contains all the nutrients a child needs for optimal health, growth, and development, many of which can only be found in breast milk;
(c) Research in developed countries provides strong evidence that breastfeeding decreases the incidence and/or severity of diarrhea, lower respiratory tract infection, otitis media, bacteremia, bacterial meningitis, urinary tract infection, and necrotizing enterocolitis. In addition, a number of studies show a possible protective effect of breastfeeding against SIDS, Type 1 diabetes mellitus, Crohn's disease, lymphoma, ulcerative colitis, and allergic diseases;
(d) Studies also indicate health benefits in mothers who breastfeed. Breastfeeding is one of the few ways that mothers may be able to lower their risk of developing breast and ovarian cancer, with benefits proportional to the duration that they are able to breastfeed. In addition, the maternal hormonal changes stimulated by breastfeeding also help the uterus recover faster and minimize the amount of blood mothers lose after birth. Breastfeeding inhibits ovulation and menstrual bleeding, thereby decreasing the risk of anemia and a precipitous subsequent pregnancy. Breastfeeding women also have an earlier return to prepregnancy weight;
(e) Approximately two-thirds of women who are employed when they become pregnant return to the workforce by the time their children are six months old;
(f) Employers benefit when their employees breastfeed. Breastfed infants are sick less often; therefore, maternal absenteeism from work is lower in companies with established lactation programs. In addition, employee medical costs are lower and employee productivity is higher;
(g) According to a survey of mothers in Washington, most want to breastfeed but discontinue sooner than they hope, citing lack of societal and workplace support as key factors limiting their ability to breastfeed;
(h) Many mothers fear that they are not making enough breast milk and therefore decrease or discontinue breastfeeding. Frequency of breastfeeding or expressing breast milk is the main regulator of milk supply, such that forcing mothers to go prolonged periods without breastfeeding or expressing breast milk can undermine their ability to maintain breastfeeding; and
(i) Maternal stress can physiologically inhibit a mother's ability to produce and let down milk. Mothers report modifiable sources of stress related to breastfeeding, including lack of protection from harassment and difficulty finding time and an appropriate location to express milk while away from their babies.
(3) The legislature encourages state and local governmental agencies, and private and public sector businesses to consider the benefits of providing convenient, sanitary, safe, and private rooms for mothers to express breast milk." [ 2001 c 88 s 1.]

catchline: Workplace breastfeeding policies—Infant-friendly designation.


title: RCW 43.70.645

text:
The department shall adopt standards for ensuring milk bank safety. The standards adopted by the department must, at a minimum, consider the clinical, evidence-based guidelines established by a national accrediting organization. The standards must address donor screening, milk handling and processing, and recordkeeping. The department shall also review and consider requiring additional testing standards, including but not limited to testing for the presence of viruses, bacteria, and prescription and nonprescription drugs in donated milk.
[ 2022 c 236 s 5.]

catchline: Donor human milk—Milk bank safety standards.


title: RCW 43.70.650

text:
The secretary is authorized to create a school sealant endorsement program for dental hygienists and dental assistants. The secretary of health, in consultation with the dental quality assurance commission and the dental hygiene examining committee, shall adopt rules to implement this section.
(1) A dental hygienist licensed in this state after April 19, 2001, is eligible to apply for endorsement by the department of health as a school sealant dental hygienist upon completion of the Washington state school sealant endorsement program. While otherwise authorized to act, currently licensed hygienists may still elect to apply for the endorsement.
(2) A dental assistant employed after April 19, 2001, by a dentist licensed in this state, who has worked under dental supervision for at least two hundred hours, is eligible to apply for endorsement by the department of health as a school sealant dental assistant upon completion of the Washington state school sealant endorsement program. While otherwise authorized to act, currently employed dental assistants may still elect to apply for the endorsement.
(3) The department may impose a fee for implementation of this section.
(4) The secretary shall provide a report to the legislature by December 1, 2005, evaluating the outcome of chapter 93, Laws of 2001.
[ 2001 c 93 s 2.]
Notes:
Findings—Intent—2001 c 93: "The legislature finds that access to preventive and restorative oral health services by low-income children is currently restricted by complex regulatory, financial, cultural, and geographic barriers that have resulted in a large number of children suffering unnecessarily from dental disease. The legislature also finds that very early exposure to oral health care can reverse this disease in many cases, thereby significantly reducing costs of providing dental services to low-income populations.
It is the intent of the legislature to address the problem of poor access to oral health care by providing for school-based sealant programs through the endorsement of dental hygienists." [ 2001 c 93 s 1.]
Effective date—2001 c 93: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [April 19, 2001]." [ 2001 c 93 s 5.]

catchline: School sealant endorsement program—Rules—Fee—Report to the legislature.


title: RCW 43.70.660

text:
(1) The legislature authorizes the secretary to establish and maintain a product safety education campaign to promote greater awareness of products designed to be used by infants and children that:
(a) Are recalled by the United States consumer products safety commission;
(b) Do not meet federal safety regulations and voluntary safety standards;
(c) Are unsafe or illegal to place into the stream of commerce under the infant crib safety act, chapter 70.111 RCW; or
(d) Contain chemicals of high concern for children as identified under RCW 70A.430.040.
(2) The department shall make reasonable efforts to ensure that this infant and children product safety education campaign reaches the target population. The target population for this campaign includes, but is not limited to, parents, foster parents and other caregivers, child care providers, consignment and resale stores selling infant and child products, and charitable and governmental entities serving infants, children, and families.
(3) The secretary may utilize a combination of methods to achieve this outreach and education goal, including but not limited to print and electronic media. The secretary may operate the campaign or may contract with a vendor.
(4) The department shall coordinate this infant and children product safety education campaign with child-serving entities including, but not limited to, hospitals, birthing centers, midwives, pediatricians, obstetricians, family practice physicians, governmental and private entities serving infants, children, and families, and relevant manufacturers.
(5) The department shall coordinate with other agencies and entities to eliminate duplication of effort in disseminating infant and children consumer product safety information.
(6) The department may receive funding for this infant and children product safety education effort from federal, state, and local governmental entities, child-serving foundations, or other private sources.
[ 2021 c 65 s 45; 2008 c 288 s 6; 2001 c 257 s 2.]
Notes:
Explanatory statement—2021 c 65: See note following RCW 53.54.030.
Findings—Intent—2001 c 257: "(1) The legislature finds that infants and children in Washington are injured, sometimes fatally, by unsafe consumer products designed for use by infants and children.
(2) The legislature finds that parents and other persons responsible for the care of infants and children are often unaware that some of these consumer products have been recalled or are unsafe.
(3) The legislature intends to address this lack of awareness by establishing a statewide infant and children product safety campaign across Washington state." [ 2001 c 257 s 1.]

catchline: Product safety education.


title: RCW 43.70.665

text:
(1) The legislature finds that Washington state has the highest incidence of breast cancer in the nation. Despite this, mortality rates from breast cancer have declined due largely to early screening and detection. Invasive cervical cancer is the most preventable type of cancer. The Pap test, used to detect early signs of this disease, has been called "medicine's most successful screening test." Applied consistently, invasive cervical cancer could nearly be eliminated. The legislature further finds that increasing access to breast and cervical cancer screening is critical to reducing incidence and mortality rates, and eliminating the disparities of this disease in women in Washington state. Furthermore, the legislature finds there is a need for a permanent program providing early detection and screening to the women and families of Washington state.
It is the intent of the legislature to establish an early detection breast and cervical cancer screening program as a voluntary screening program directed at reducing mortalities through early detection to be offered to eligible women only as funds are available.
(2) As used in this section:
(a) "Eligible woman" means a woman who is age forty to sixty-four, and whose income is at or below two hundred fifty percent of the federal poverty level, as published annually by the federal department of health and human services. Priority enrollment shall be given to women as defined by the federal national breast and cervical cancer early detection program, under P.L. 101-354.
(b) "Approved providers" means those state-supported health providers, radiology facilities, and cytological laboratories that are recognized by the department as meeting the minimum program policies and procedures adopted by the department to qualify under the federal national breast and cervical cancer early detection program, and are designated as eligible for funding by the department.
(c) "Comprehensive" means a screening program that focuses on breast and cervical cancer screening as a preventive health measure, and includes diagnostic and case management services.
(3) The department of health is authorized to administer a state-supported early detection breast and cervical cancer screening program to assist eligible women with preventive health services. To the extent of available funding, eligible women may be enrolled in the early detection breast and cervical cancer screening program and additional eligible women may be enrolled to the extent that grants and contributions from community sources provide sufficient funds for expanding the program.
(4) Funds appropriated for the state program shall be used only to operate early detection breast and cervical cancer screening programs that have been approved by the department, or to increase access to existing state-approved programs, and shall not supplant federally supported breast and cervical cancer early detection programs.
(5) Enrollment in the early detection breast and cervical cancer screening program shall not result in expenditures that exceed the amount that has been appropriated for the program in the operating budget. If it appears that continued enrollment will result in expenditures exceeding the appropriated level for a particular fiscal year, the department may freeze new enrollment in the program. Nothing in this section prevents the department from continuing enrollment in the program if there are adequate private or public funds in addition to those appropriated in the biennial budget to support the cost of such enrollment.
(6) The department shall establish a medical advisory committee composed of interested medical professionals and consumer liaisons with expertise in a variety of areas relevant to breast and cervical health to provide expert medical advice and guidance. The medical advisory committee shall address national, state, and local concerns regarding best practices in the field of early prevention and detection for breast and cervical cancer and assist the early detection breast and cervical cancer screening program in implementing program policy that follows the best practices of high quality health care for clinical, diagnostic, pathologic, radiological, and oncology services.
[ 2006 c 55 s 1.]

catchline: Early detection breast and cervical cancer screening program—Medical advisory committee.


title: RCW 43.70.670

text:
(1) "Human immunodeficiency virus insurance program," as used in this section, means a program that provides health insurance coverage for individuals with human immunodeficiency virus, as defined in RCW 70.24.017(7), who are not eligible for medical assistance programs from the health care authority as defined in RCW 74.09.010 and meet eligibility requirements established by the department of health.
(2) The department of health may pay for health insurance coverage on behalf of persons with human immunodeficiency virus, who meet department eligibility requirements, and who are eligible for "continuation coverage" as provided by the federal consolidated omnibus budget reconciliation act of 1985, group health insurance policies, or individual policies.
[ 2025 c 58 s 2024; 2011 1st sp.s. c 15 s 72; 2007 c 259 s 38; 2003 c 274 s 2.]
Notes:
Explanatory note—2025 c 58: See note following RCW 1.16.050.
Effective date—Findings—Intent—Report—Agency transfer—References to head of health care authority—Draft legislation—2011 1st sp.s. c 15: See notes following RCW 74.09.010.
Subheadings not law—2007 c 259: See note following RCW 7.70.060.
Rules—2003 c 274: "The department of health shall adopt rules to implement this act." [ 2003 c 274 s 3.]
Effective date—2003 c 274: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 1, 2003." [ 2003 c 274 s 4.]

catchline: Human immunodeficiency virus insurance program.


title: RCW 43.70.675

text:
(1) The public health advisory board is established within the department. The advisory board shall:
(a) Advise and provide feedback to the governmental public health system and provide formal public recommendations on public health;
(b) Monitor the performance of the governmental public health system;
(c) Develop goals and a direction for public health in Washington and provide recommendations to improve public health performance and to achieve the identified goals and direction;
(d) Advise and report to the secretary;
(e) Coordinate with the governor's office, department, state board of health, local health jurisdictions, and the secretary;
(f) Evaluate public health emergency response and provide recommendations for future response, including coordinating with relevant committees, task forces, and stakeholders to analyze the COVID-19 public health response; and
(g) Evaluate the use of foundational public health services funding by the governmental public health system.
(2) The public health advisory board shall consist of representatives from each of the following appointed by the governor:
(a) The governor's office;
(b) The director of the state board of health or the director's designee;
(c) The secretary of the department or the secretary's designee;
(d) The chair of the governor's interagency council on health disparities;
(e) Two representatives from the tribal government public health sector selected by the American Indian health commission;
(f) One member of the county legislative authority from a eastern Washington county selected by a statewide association representing counties;
(g) One member of the county legislative authority from a western Washington county selected by a statewide association representing counties;
(h) An organization representing businesses in a region of the state;
(i) A statewide association representing community and migrant health centers;
(j) A statewide association representing Washington cities;
(k) Four representatives from local health jurisdictions selected by a statewide association representing local public health officials, including one from a jurisdiction east of the Cascade mountains with a population between 200,000 and 600,000, one from a jurisdiction east of the Cascade mountains with a population under 200,000, one from a jurisdiction west of the Cascade mountains with a population between 200,000 and 600,000, and one from a jurisdiction west of the Cascade mountains with a population less than 200,000;
(l) A statewide association representing Washington hospitals;
(m) A statewide association representing Washington physicians;
(n) A statewide association representing Washington nurses;
(o) A statewide association representing Washington public health or public health professionals; and
(p) A consumer nonprofit organization representing marginalized populations.
(3) In addition to the members of the public health advisory board listed in subsection (2) of this section, there must be four nonvoting ex officio members from the legislature consisting of one legislator from each of the two largest caucuses in both the house of representatives and the senate.
(4) Staff support for the public health advisory board, including arranging meetings, must be provided by the department.
(5) Legislative members of the public health advisory board may be reimbursed for travel expenses in accordance with RCW 44.04.120. Nonlegislative members are not entitled to be reimbursed for travel expenses if they are elected officials or are participating on behalf of an employer, governmental entity, or other organization. Any reimbursement for other nonlegislative members is subject to chapter 43.03 RCW.
(6) The public health advisory board is a class one group under chapter 43.03 RCW.
[ 2021 c 205 s 2.]
Notes:
Finding—2021 c 205: "The legislature finds that everyone in Washington state, no matter what community they live in, should be able to rely on a public health system that is able to support a standard level of public health service. Like public safety, there is a foundational level of public health delivery that must exist everywhere for services to work. A strong public health system is only possible with intentional investments into our state's public health system. Services should be delivered efficiently, equitably, and effectively, in ways that make the best use of technology, science, expertise, and leveraged resources and in a manner that is responsive to local communities." [ 2021 c 205 s 1.]

catchline: Public health advisory board.


title: RCW 43.70.680

text:
(1) The department is authorized to contact persons issued credentials under this title for the purpose of requesting permission to collect his or her name, profession, and contact information as a possible volunteer in the event of a bioterrorism incident, natural disaster, public health emergency, or other emergency or disaster, as defined in RCW 38.52.010, that requires the services of health care providers.
(2) The department shall maintain a record of all volunteers who provide information under subsection (1) of this section. Upon request, the department shall provide the record of volunteers to:
(a) Local health departments;
(b) State agencies engaged in public health emergency planning and response, including the state military department;
(c) Agencies of other states responsible for public health emergency planning and response; and
(d) The centers for disease control and prevention.
[ 2003 c 384 s 1.]

catchline: Volunteers for emergency or disaster assistance.


title: RCW 43.70.690

text:
(1) The department, in collaboration with its public and private partners, shall design a state asthma plan, based on clinically sound criteria including nationally recognized guidelines such as those established by the national asthma education prevention partnership expert panel report guidelines for the diagnosis and management of asthma.
(2) The plan shall include recommendations in the following areas:
(a) Evidence-based processes for the prevention and management of asthma;
(b) Data systems that support asthma prevalence reporting, including population disparities and practice variation in the treatment of asthma;
(c) Quality improvement strategies addressing the successful diagnosis and management of the disease; and
(d) Cost estimates and sources of funding for plan implementation.
(3) The department shall submit the completed state plan to the governor and the legislature by December 1, 2005.
(4) The department shall implement the state plan recommendations made under subsection (2) of this section only to the extent that federal, state, or private funds, including grants, are available for that purpose.
[ 2009 c 518 s 8; 2005 c 462 s 4.]
Notes:
Findings—2005 c 462: See note following RCW 28A.210.370.

catchline: State asthma plan.


title: RCW 43.70.700

text:
(1) The department shall adopt rules authorizing retail operation farms stores, owned and operated by a farmer and colocated with a site of agricultural production, to participate in the women, infant, and children farmers market nutrition program to provide locally grown, nutritious, unprepared fruits and vegetables to eligible program participants.
(2) Such rules must meet the provisions of 7 C.F.R. part 3016, uniform administrative requirements for grants and cooperative agreements to state and local governments, as it existed on June 12, 2008, or such subsequent date as may be provided by the department by rule, consistent with the purposes of this section.
(3) Subject to the availability of amounts appropriated for this specific purpose, the department shall distribute a fruit and vegetable benefit of no less than twenty-eight dollars per summer farmers market season to each eligible participant in the women, infant, and children farmers market nutrition program. To the extent that federal funds are available, the department shall use federal funds up to the maximum benefit allowable under federal law.
[ 2020 c 68 s 2; 2008 c 215 s 8.]
Notes:
Findings—Intent—2020 c 68: "The legislature finds that our state has a robust agricultural system, with Washington farmers producing diverse foods available at regional markets throughout the state. The legislature further finds that one in six Washington children do not know where their next meal will come from and that promoting access to fresh foods supports Washington farmers as well as food-insecure families. Hunger for families with children continues to be a significant issue across our state and a growing concern. Hunger and unhealthy diets also impact the health and development of children and a child's ability to learn. Therefore, the legislature intends to expand access to nutritious foods by increasing the fruit and vegetable benefit for participants in the women, infant, and children farmers market nutrition program." [ 2020 c 68 s 1.]
Findings—Intent—Short title—Captions not law—Conflict with federal requirements—2008 c 215: See notes following RCW 15.64.060.

catchline: Locally grown foods—Women, infant, and children farmers market nutrition program—Fruit and vegetable benefit—Rules.


title: RCW 43.70.703

text:
(1) The mobile market program is established in the department with the goals of providing increased nutrition access to participants of the women, infant, and children and senior farmers market nutrition program[s], while also supporting local farmers.
(2) The mobile market program is available to participants of the women, infant, and children and senior farmers market nutrition programs so long as funding is made available to the department through the United States department of agriculture.
(3) The department shall define the mobile market program through rule making. At a minimum, the definition must require mobile market programs to be operated by a nonprofit organization and prevent competition between a mobile market and a farmers market that is participating in the farmers market nutrition program.
(4) The department shall conduct rule making consistent with this section to establish the mobile market program.
(5) If the department deems it necessary to file a waiver, the department shall file a waiver with the United States department of agriculture to allow mobile market programs to accept both women, infants, and children and senior farmers market nutrition program benefits.
[ 2025 c 127 s 2.]
Notes:
Findings—Intent—2025 c 127: "The legislature finds that small local farmers play a crucial role in providing communities with access to fresh, healthy foods. Farmers markets provide a place for local farmers to sell their products, encouraging consumption of fresh products in the communities in which they were grown.
The legislature recognizes that some households may live in rural areas or food deserts where access to farmers markets and fresh food is limited. There are a number of programs to help increase access to fresh, healthy foods for low-income communities. The farmers market nutrition program was established by congress in 1992 to provide fresh, locally grown fruits and vegetables to women, infants, and children program participants and to expand the awareness, use of, and sales at farmers markets which benefits both program participants and local farmers. Similarly, the senior farmers market nutrition program provides low-income seniors with access to locally grown fruits and vegetables. Participants in both programs commonly use their food benefit at farmers markets, farms, and farm stands.
The legislature further recognizes that other states including Pennsylvania and Virginia also allow mobile market providers to accept both women, infants, and children and senior farmers market nutrition program benefits. This provides greater nutritional support to households that may live in a rural area, an area without access to a farmers market, or in a food desert. In these states, eligible low-income households are still able to access fresh, healthy foods which not only benefits that household, but benefits the local farmers as well.
It is hereby the intent of the legislature to provide participants of both the women, infants, and children and senior farmers market nutrition programs access to fresh, healthy food through nonprofit mobile markets to promote access to fresh, healthy food regardless of a household's proximity to a farmers market." [ 2025 c 127 s 1.]
Effective date—2025 c 127: "This act takes effect March 1, 2026." [ 2025 c 127 s 3.]

catchline: Mobile market program.


title: RCW 43.70.705

text:
Within funds appropriated for this purpose, the department shall develop a statewide fall prevention program. The program shall include networking community services, identifying service gaps, making affordable senior-based, evaluated exercise programs more available, providing consumer education to older adults, their adult children, and the community at large, and conducting professional education on fall risk identification and reduction.
[ 2008 c 146 s 7.]
Notes:
Findings—Intent—Severability—2008 c 146: See notes following RCW 74.41.040.

catchline: Fall prevention program.


title: RCW 43.70.710

text:
The department of health shall annually review the medication practices of five jails that provide for the delivery and administration of medications to inmates in their custody by nonpractitioner jail personnel. The review shall assess whether the jails are in compliance with sections 3 and 4, chapter 411, Laws of 2009. To the extent that a jail is found not in compliance, the department shall provide technical assistance to assist the jail in resolving any areas of noncompliance.
[ 2009 c 411 s 5.]

catchline: Annual review of medication practices of five jails that use nonpractitioner jail personnel—Noncompliance.


title: RCW 43.70.715

text:
(1) The COVID-19 public health response account is created in the custody of the state treasurer. The account shall consist of funds appropriated by the legislature and grants received by the department of health for activities in response to the coronavirus pandemic (COVID-19). Only the secretary, or the secretary's designee, may authorize expenditures from the account for costs related to the public health response to COVID-19, subject to any limitations imposed by grant funding deposited into the account. The COVID-19 public health response account is subject to allotment procedures under chapter 43.88 RCW, but an appropriation is not required for expenditures.
(2)(a) The legislature finds that a safe, efficient, and effective delivery of vaccinations is of the utmost importance for restoring societal and economic functions. As we learn more about the virus, the vaccine, and challenges to vaccine allocation and distribution, it is anticipated that the state's COVID-19 vaccination distribution plan will evolve. To that end, the legislature has provided flexibility by funding expenditures for testing, contact tracing, mitigation activities, vaccine administration and distribution, and other allowable uses for the state, local health jurisdictions, and tribes at the discretion of the secretary and without an appropriation. However, to maintain fiscal control and to ensure spending priorities align, the department is required to collaborate and communicate with the chairs and ranking members of the health care and fiscal committees of the legislature and local health jurisdictions in advance of any significant revision of the state's COVID-19 vaccination plan and to provide regular updates on its implementation and spending.
(b) As part of the public health response to COVID-19, the expenditures from the account must be used to effectively administer the vaccine for COVID-19 and conduct testing and contact tracing. The department must ensure that COVID-19 outreach is accessible, culturally and linguistically appropriate, and that it includes community-driven partnerships and strategies.
(c) When making expenditures for administering the vaccine for COVID-19, the department must focus on identifying persons for vaccination, prioritizing underserved, underrepresented, and hard-to-reach communities, making the vaccine accessible, and providing support to schools for safe reopening. Strategies for vaccine distribution shall include the establishment and expansion of community vaccination centers, mobile vaccination units, reporting enhancements, in-home visits for vaccinations for the elderly, and transportation of individuals to vaccination sites.
(d) When making expenditures regarding testing and contact tracing, the department must provide equitable access, prioritize underserved, underrepresented, and hard-to-reach communities, and provide support and resources to facilitate the safe reopening of schools while minimizing community spread of the virus.
(e) The department may also make expenditures from the account related to developing the public health workforce using funds granted by the federal government for that purpose in section 2501, the American rescue plan act of 2021, P.L. 117-2.
(3) When making expenditures from the account, the department must include an emphasis on public communication regarding the availability and accessibility of the vaccine and testing, and the importance of vaccine and testing availability to the safe reopening of the state.
(4)(a) The department must report to the fiscal and health care committees of the legislature on a monthly basis regarding its COVID-19 response.
To the extent that it is available, the report must include data regarding vaccine distribution, testing, and contact tracing, as follows:
(i) The number of vaccines administered per day, including regional data regarding the location and age groups of persons receiving the vaccine, specifically identifying hard-to-reach communities in which vaccines were administered; and
(ii) The number of tests conducted per week, including data specifically addressing testing conducted in hard-to-reach communities.
(b)(i) Beginning with the quarter ending March 31, 2022, the department must report to the fiscal and health care committees of the legislature on a quarterly basis regarding revenues and expenditures related to the COVID-19 response. The reports must include:
(A) Quarterly expenditures of funds, by fund source, including the appropriated amounts pursuant to section 222 (76) and (77), chapter 297, Laws of 2022 for:
(I) Diagnostic testing;
(II) Case investigation and contact tracing;
(III) Outbreak response;
(IV) Care coordination;
(V) Community outreach;
(VI) Information and technology operations;
(VII) Surveillance;
(VIII) Vaccines;
(IX) Client services;
(X) Local health jurisdictions; and
(XI) Tribes; and
(B) Grant amounts received during the reporting quarter that may be used in the COVID-19 response.
(ii) The quarterly reports must reflect the previous quarter, a projection of expected expenditures and revenue for the next quarter, and an accounting of the expenditures and revenue for the 2021-2023 fiscal biennium to date. The quarterly reports are due no later than 30 days after the end of the applicable quarter.
(c) The first monthly report pursuant to (a) of this subsection is due no later than one month from February 19, 2021. Monthly reports are no longer required upon the department's determination that the remaining balance of the COVID-19 public health response account is less than $100,000.
[ 2022 c 297 s 955; 2022 c 157 s 7. Prior: 2021 c 334 s 1004; 2021 c 3 s 19.]
Notes:
Reviser's note: This section was amended by 2022 c 157 s 7 and by 2022 c 297 s 955, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
Effective date—2022 c 297: See note following RCW 43.79.565.
Conflict with federal requirements—Effective date—2021 c 334: See notes following RCW 43.79.555.
Conflict with federal requirements—2021 c 3: "If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not affect the operation of the remainder of this act in its application to the agencies concerned. Rules adopted under this act must meet federal requirements that are a necessary condition to the receipt of federal funds by the state." [ 2021 c 3 s 21.]
Effective date—2021 c 3: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [February 19, 2021]." [ 2021 c 3 s 22.]

catchline: COVID-19 public health response account.


title: RCW 43.70.720

text:
The universal vaccine purchase account is created in the custody of the state treasurer. Receipts from public and private sources for the purpose of increasing access to vaccines for children may be deposited into the account. Expenditures from the account must be used exclusively for the purchase of vaccines, at no cost to health care providers in Washington, to administer to children under nineteen years old who are not eligible to receive vaccines at no cost through federal programs. Only the secretary or the secretary's designee may authorize expenditures from the account. The account is subject to allotment procedures under chapter 43.88 RCW, but an appropriation is not required for expenditures.
[ 2010 c 174 s 10; 2009 c 564 s 934.]
Notes:
Effective date—2010 c 174: See RCW 70.290.900.
Effective date—2009 c 564: See note following RCW 2.68.020.

catchline: Universal vaccine purchase account.


title: RCW 43.70.723

text:
The medication for people living with HIV rebate revenue account is created in the custody of the state treasury. The early intervention program shall deposit any receipts from pharmaceutical rebates generated by the purchase of medications with federal grant funds and revenue generated from federal grant funds for any person enrolled in the early intervention program into the account. The expenditures may only be used for services defined in the grant award from the Ryan White HIV/AIDS program. Only the secretary or the secretary's designee may authorize expenditures from the account. An appropriation is not required for expenditures. The account is subject to allotment procedures under chapter 43.88 RCW.
[ 2023 c 12 s 1.]
Notes:
Effective date—2023 c 12: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 1, 2023." [ 2023 c 12 s 3.]

catchline: Medication for people living with HIV rebate revenue account.


title: RCW 43.70.725

text:
(1) Subject to the availability of amounts appropriated for this specific purpose, the department shall establish a health extension program to provide training, tools, and technical assistance to primary care, behavioral health, and other providers. The program must emphasize high quality preventive, chronic disease, and behavioral health care that is comprehensive and evidence-based.
(2) The health extension program must coordinate dissemination of evidence-based tools and resources that promote:
(a) Integration of physical and behavioral health;
(b) Clinical decision support to promote evidence-based care;
(c) Reports of the Robert Bree collaborative created by RCW 70.250.050 and findings of health technology assessments under RCW 70.14.080 through 70.14.130;
(d) Methods of formal assessment;
(e) Support for patients managing their own conditions;
(f) Identification and use of resources that are available in the community for patients and their families, including community health workers; and
(g) Identification of evidence-based models to effectively treat depression and other conditions in primary care settings, such as the program advancing integrated mental health solutions, and others.
(3) The department may adopt rules necessary to implement this section, but may not adopt rules, policies, or procedures beyond the scope of authority granted in this section.
[ 2014 c 223 s 5.]
Notes:
Finding—2014 c 223: See note following RCW 41.05.690.

catchline: Health extension program—Dissemination of evidence-based tools and resources—Rules.


title: RCW 43.70.738

text:
(1)(a) The department shall develop the following resources regarding Down syndrome:
(i) Up-to-date, evidence-based, written information about Down syndrome and people born with Down syndrome that has been reviewed by medical experts and national Down syndrome organizations; and
(ii) Contact information regarding support services, including information hotlines specific to Down syndrome, resource centers or clearinghouses, national and local Down syndrome organizations, and other education and support programs.
(b) The resources prepared by the department must:
(i) Be culturally and linguistically appropriate for expectant parents receiving a positive prenatal diagnosis or for the parents of a child receiving a postnatal diagnosis of Down syndrome; and
(ii) Include: Physical, developmental, educational, and psychosocial outcomes; life expectancy; clinical course; and intellectual and functional development and therapy options.
(2) The department shall make the information described in this section available to any person who renders prenatal care, postnatal care, or genetic counseling to expectant parents receiving a positive prenatal diagnosis or to the parents of a child receiving a postnatal diagnosis of Down syndrome.
(3) For the purposes of this section, "Down syndrome" means a chromosomal condition that results in the presence of an extra whole or partial copy of chromosome 21.
[ 2016 c 70 s 1.]

catchline: Down syndrome resources—Development.


title: RCW 43.70.740

text:
In all adjudicative proceedings before the secretary or the department, the secretary may delegate initial decision-making authority to a presiding officer. The presiding officer shall enter an initial order pursuant to RCW 34.05.461 subject to the review of the secretary or his or her designee. Pursuant to RCW 34.05.464, the secretary may, by rule, provide that initial orders in specified classes of cases may become final without further agency action unless, within a specified time period:
(1) The secretary upon his or her own motion determines that the initial order should be reviewed; or
(2) A party to the proceedings files a petition for administrative review of the initial order.
[ 2013 c 109 s 3.]

catchline: Adjudicative proceedings.


title: RCW 43.70.750

text:
The department of health must review the professional certification and training of health professionals participating in a community assistance referral and education program, review the certification and training requirements in other states with similar programs, and coordinate with the health care authority to link the certification requirements with the covered health care services recommended for payment in RCW 74.09.335. The department shall submit recommendations to the appropriate committees of the legislature for any changes and suggestions for implementation within six months of the development of the payment standards.
[ 2017 c 273 s 3.]

catchline: Community assistance referral and education program—Review of certification and training—Recommendations to the legislature.


title: RCW 43.70.765

text:
(1) The department must create a statement warning individuals about the risks of opioid use and abuse and provide information about safe disposal of opioids. The department must provide the warning on its website.
(2) The department must review the science, data, and best practices around the use of opioids and their associated risks. As evidence and best practices evolve, the department must update its warning to reflect these changes.
(3) The department must update its patient education materials to reflect the patient's right to refuse an opioid prescription or order.
[ 2019 c 314 s 11.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.

catchline: Opioid drugs—Warning—Patient education materials.


title: RCW 43.70.768

text:
(1) The department shall develop, implement, and maintain a statewide drug overdose prevention and awareness campaign to address the drug overdose epidemic.
(2)(a) The campaign must educate the public about the dangers of methamphetamines and opioids, including fentanyl, and the harms caused by drug use. The campaign must include outreach to both youth and adults aimed at preventing substance use and overdose deaths.
(b) The department, in consultation with the health care authority, may also include messaging focused on substance use disorder and overdose death prevention, resources for addiction treatment and services, and information on immunity for people who seek medical assistance in a drug overdose situation pursuant to RCW 69.50.315.
(3) The 2024 and 2025 campaigns must focus on increasing the awareness of the dangers of fentanyl and other synthetic opioids, including the high possibility that other drugs are contaminated with synthetic opioids and that even trace amounts of synthetic opioids can be lethal.
(4) Beginning June 30, 2025, and each year thereafter, the department must submit a report to the appropriate committees of the legislature on the content and distribution of the statewide drug overdose prevention and awareness campaign. The report must include a summary of the messages distributed during the campaign, the mediums through which the campaign was operated, and data on how many individuals received information through the campaign. The department must identify measurable benchmarks to determine the effectiveness of the campaign and recommend whether the campaign should continue and if any changes should be made to the campaign. The report must be submitted in compliance with RCW 43.01.036.
[ 2024 c 216 s 1.]

catchline: Statewide drug overdose prevention and awareness campaign.


title: RCW 43.70.769

text:
(1) Insofar as is appropriate and practicable, when conducting any public outreach campaign on the dangers of fentanyl and other synthetic opioids, the department shall ensure that campaign materials are:
(a) Culturally appropriate;
(b) Accessible in other languages, as appropriate; and
(c) Accessible to the deaf and blind communities.
(2) When designing public outreach campaigns on the dangers of fentanyl and other synthetic opioids, the department shall consider using the phrase, "Not Even Once" where appropriate.
[ 2024 c 309 s 2.]
Notes:
Findings—Intent—Short title—2024 c 309: "(1) The legislature finds that:
(a) Fentanyl is a synthetic opioid that is up to 50 times stronger than morphine and is a major contributor to fatal and nonfatal overdoses in the United States;
(b) There are two types of fentanyl: Pharmaceutical fentanyl and illegally made fentanyl;
(c) Fentanyl and other synthetic opioids are causing a public health crisis in Washington;
(d) Addiction, overdoses, and deaths caused by fentanyl and other synthetic opioids are on the rise, and health care and treatment systems are becoming overextended;
(e) Effective outreach programs about the negative health effects of fentanyl misuse and abuse are necessary to help curb the public health crisis;
(f) Individuals who purchase or recover motor vehicles in which fentanyl or other synthetic opioids have been used face unique challenges in understanding how to decontaminate the vehicles; and
(g) More should be done to connect individuals who are arrested while intoxicated on fentanyl or other synthetic opioids with needed health care and treatment services.
(2) The legislature therefore intends to address this public health issue by:
(a) Providing guidance on public outreach campaigns on the dangers of misusing or abusing fentanyl and other synthetic opioids;
(b) Compiling information for individuals who wish to decontaminate a vehicle in which fentanyl or other synthetic opioids were used; and
(c) Increasing the likelihood that individuals will seek necessary substance abuse disorder treatment by offering to connect them with treatment upon release from custody in jail.
(3) This act may be known and cited as Ivan's law." [ 2024 c 309 s 1.]

catchline: Opioid public outreach campaigns—Design.


title: RCW 43.70.770

text:
The secretary shall be responsible for coordinating the statewide response to the opioid epidemic and executing the state opioid response plan, in partnership with the health care authority. The department and the health care authority must collaborate with each of the agencies and organizations identified in the state opioid response plan.
[ 2019 c 314 s 12.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.

catchline: State opioid response plan.