AMTA-WA June 2023 Public Policy Report

Prepared by Leslie Emerick, Lobbyist

Legislative Landscape            

The WA State Legislative session ended on time April 23, but Governor Inslee did call the legislature back to finish their work in a Special Session on May 16th. In February 2021, the WA State Supreme Court in State v. Blake declared unconstitutional Washington’s strict liability drug possession law, which criminalized (as a felony) the unintentional, unknowing possession of a controlled substance. The 2023 legislative session ended without passage of a new drug use & possession law. In the Special Session, the Legislature adopted permanent drug-related legislation in SB 5536. The session was one day long and the Governor signed the bill that day!

Now that the session is over, state agencies now begin the work of developing the recently authorized rulemaking and establishing workgroups that were initiated in the legislative session. This work will roll out over the summer and fall as they move through the Administrative Procedures Act that requires a public process for new state agency rules. I will be reporting on these efforts in future reports over the interim!

2023-2025 Final State Operating Budget- $69.8 Bill (ESSB 5187): On May 16th Gov. Jay Inslee signed the new 2023–25 operating, capital and transportation budgets. The legislature spends $69.8 billion in the new operating budget, including $4.7 billion in new spending. Overall, this is a very good budget for health care. It adds approximately $4.7 billion in new spending; leaves a total of $3 billion in reserve accounts; and doesn’t include any broad tax increases. For perspective, the last biennial operating budget was around $64 billion dollars.

Department of Health (DOH) Board of Massage (BOM)

Board of Massage Business Meeting on May 5th: Here are decisions that were made at the May board of massage meeting:

  • There was a rules petition submitted about allowing licensed massage therapists to perform intravaginal pelvic floor massage.  The board denied the petition because it is not within the scope of practice as defined in subsection (6) of RCW 18.108.010: Definitions. (
  • They had a rules workshop for licensure by endorsement, and started discussions about addressing the two petitions that lead to the rule being opened.  Based on the discussion, I am bringing draft language for them to use as a starting point at the June 27th workshop.
  • They selected their delegate and alternate delegate for the FSMTB annual meeting.

Board of Massage special meeting agenda and packet: On May 24, 2023, the Board of Massage (board) in conjunction with the Department of Health filed a CR-101 as WSR #23-12-002 with the Office of the Code Reviser proposing to consider amendments to WAC 246-830-430 Education and training to include parameters on online and virtual education and adding health equity awareness training to initial licensure requirements for new massage licensees.

To address the difficulties related to the coronavirus disease 2019 (COVID-19) pandemic that impacted massage therapy schools, in March 2020, the board allowed all massage programs to continue to operate their board-approved program in a distance learning format upon approval by and in accordance with the Workforce Training and Education Coordinating Board’s requirements. Hybrid massage programs continue to operate, but no rules exist to guide a school on what topics or how many hours may be in a virtual/online/remote format versus what must be in person.

Please join the Board of Massage’s June 27, 2023, special meeting being held via Zoom webinar at 8:30 a.m. PST. During the special meeting, we will hold two rules workshops for the following:
WAC 246-830-035 Licensing by endorsement for out-of-state applicants.
WAC 246-830-430 Education and training.

Click on the blue “Register” button below to register to attend via Zoom webinar. A link is also available on the meeting agenda. After registering, you will receive a confirmation email with information about joining the webinar. The agenda and meeting packet will also be available on the Massage Therapy webpage under the Board Meetings tab.


Health Equity Continuing Education Rulemaking: The BOM health equity continuing education requirements CR 102 announcement is below. The CR-102 adds four hours of health equity education to be completed as part of the current continuing education requirements every two years. The proposed rule does not change total CE hours but requires four hours in health equity CE every two years which is absorbed into the existing number of CE hours required. The health equity CE requirement is counted under existing, unspecified CE requirements for the profession.

The BOM has a Rules meeting on July 14, 2023, at 9:00 AM. If you want to get this changed to lesser hours, the profession will have to show up in full force to oppose at the public hearing…it is kind of surprising to me that the comments from both WA associations did not slow them down on the higher number of hours. If there is a lot of opposition at the CR 102 meeting, they may be willing to reconsider…otherwise, this will be our last chance to alter this rulemaking.

“The Board of Massage (board) in coordination with the Department of Health filed a CR-102 on June 6, 2023, under WSR #23-12-095 proposing amendments to WAC 246-830-475 Continuing education requirements, to establish health equity continuing education requirements to implement Engrossed Substitute Senate Bill 5229. You may view the CR102 form and proposed rule here. A public hearing for the proposal will be held on July 14, 2023, at 9:00 AM. You may attend this hearing either in person or virtually via Zoom. There will also be an opportunity for public comment at the rules hearing.

In person: Lacey Community Center, 6729 Pacific Ave SE, Lacey, WA 98503

Virtual: To attend virtually, you must register in advance at:

Comments may be submitted in writing via mail, email, fax, or the agency rules webpage at:
Department of Health – Board of Massage, PO Box 47852, Olympia, WA 98504-7852

Email: or  Fax: 360-236-2901

Agency Rules Webpage:

CR-103 filed for chapter 246-830 WAC: On March 10, 2023, the Board of Massage (board) in conjunction with the Department of Health (department) filed a CR-103 as WSR #23-07-065 with the Office of the Code Reviser, adopting updates to existing sections of the massage therapy chapter. The updated rules went into effect April 10, 2023.  The revised language will also be on the massage therapy webpage at

The Concise Explanatory Statement summarizes differences between the proposed rules and adopted rules and the response to public comments. The updated rules:

• Corrects the name of the national examination,
• Clarify the training requirements for somatic education and intraoral massage education,
• Clarify and modernizes the language in the equipment and sanitation rule,
• Clarify and modernize the language in the hygiene rule.

Office of the Insurance Commissioner

Revising the prior authorization process rulemaking: Revising the prior authorization process Engrossed Second Substitute House Bill 1357 (2023) revises timelines for health plans processing of prior authorization requests related to decisions, electronic authorization standards, and communication requirements. Proposed rulemaking intends to address inconsistencies between the new law and current rule, such as WAC 284-43-2000 (Health care services utilization review), 284-43-2020 (Drug utilization review), and 284-43-2050 (Prior authorization processes).