SB 5513
In CommitteeSenate
Pharmacist scope of practice
Expanding pharmacists' scope of practice to improve access to health care and the management of chronic diseases.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill expands pharmacists’ authority to prescribe certain medications and devices without requiring a new diagnosis or prior prescriber order, aiming to improve access to care—especially in underserved areas. It allows pharmacists to provide services like immunizations, addiction treatment, and self-care medications for minor conditions, and takes effect in late 2026.
- Starting December 1, 2026, pharmacists may prescribe a range of medications and devices—including immunizations, opioid addiction treatments, epinephrine autoinjectors, tobacco cessation products, hormonal contraception, and HIV prevention medications—without requiring a new diagnosis or prior practitioner order.
- Pharmacists may also prescribe medications for minor, self-limiting conditions that have FDA-approved tests (e.g., rapid strep or flu tests), or when working in team-based practices with shared electronic health records.
- The bill amends definitions in RCW 18.64.011 to clarify terms like 'administer,' 'dispense,' and 'practice of pharmacy' to support expanded pharmacist roles.
- The bill amends RCW 69.41.030 to explicitly authorize pharmacists to prescribe and dispense medications within their expanded scope, removing outdated references to 'drug therapy guidelines' and aligning with current practice standards.
- The law includes a sunset clause, requiring the provisions to expire on January 1, 2030, unless extended by future legislation.
Who is affected
- Pharmacists — Pharmacists gain expanded authority to prescribe certain medications and devices without requiring a prior diagnosis or new patient visit, allowing them to provide more direct care—especially in areas with limited provider access.
- Patients — Patients—especially those in rural, underserved, or high-need communities—gain improved access to preventive and chronic disease management services through pharmacists, including access to immunizations, addiction treatments, and self-care medications.
- Pharmacies and pharmacy businesses — Pharmacies and pharmacy chains may need to adjust staffing, training, and operational procedures to support expanded prescribing functions, including implementing new protocols and electronic health record integrations.
- Pharmacy regulatory agencies — The Pharmacy Quality Assurance Commission gains rulemaking authority and oversight responsibility for pharmacist prescribing activities, including ensuring safe and appropriate use of expanded authority.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Expanding pharmacists’ authority to prescribe immunizations, HIV PrEP, addiction treatments, and self-care medications without requiring a new diagnosis significantly improves access to preventive and chronic disease management services—especially in rural and underserved communities where primary care providers are scarce.
HealthcarePeopleRef: Sec. 2 (new RCW 18.64.011(32))Allowing pharmacists to prescribe for minor, self-limiting conditions (e.g., strep, flu) using point-of-care tests in team-based practices with shared EHRs reduces barriers to care, decreases avoidable ED visits, and supports early intervention—particularly beneficial for low-income, underinsured, or transportation-limited patients.
HealthcarePeopleRef: Sec. 2 (new RCW 18.64.011(32)(j)(v))Expanding pharmacists’ authority to prescribe opioid antagonists (e.g., naloxone) and addiction treatments without prior diagnosis increases access to life-saving interventions for people with opioid use disorder, especially in communities with limited addiction medicine providers—potentially reducing overdose mortality.
Public SafetyPeopleRef: Sec. 2 (new RCW 18.64.011(32)(b))Allowing pharmacists to prescribe hormonal contraception improves reproductive health access, particularly for low-income women, young adults, and those in rural areas—reducing unintended pregnancies and supporting health equity without requiring a separate provider visit.
HealthcarePeopleRef: Sec. 2 (new RCW 18.64.011(32)(h))Permitting pharmacists to prescribe tobacco cessation products and antihistamines without a new diagnosis supports public health goals by increasing access to OTC-equivalent medications in a clinical context—especially beneficial for smokers and allergy sufferers who may delay care due to cost or access barriers.
HealthcareLean peopleRef: Sec. 2 (new RCW 18.64.011(32)(d))
Potential Concerns (5)
Pharmacists gain authority to prescribe controlled substances for addiction treatment (e.g., buprenorphine) without prior diagnosis or prescriber oversight, which may increase access but also risks inadequate screening for contraindications, substance use disorders, or co-occurring mental health conditions—particularly in settings without robust electronic health record integration or team-based supervision.
Public SafetyPeopleRef: Sec. 2 (new RCW 18.64.011(32))The bill removes the requirement that pharmacist prescribing be limited to ‘drug therapy guidelines or protocols established under RCW 18.64.011 and approved by a practitioner,’ potentially weakening clinical oversight and allowing pharmacists to prescribe medications like hormonal contraception or HIV PrEP without direct collaboration with physicians—raising concerns about missed contraindications or undiagnosed conditions.
Public SafetyPeopleRef: Sec. 4 (amended RCW 69.41.030)Expanding pharmacists’ scope to include ‘diagnosing conditions and diseases as authorized by this chapter and commission rules’ may improve continuity of care in underserved areas, but without clear clinical boundaries or mandatory consultation protocols for complex cases, it could lead to misdiagnosis or delayed referral for serious conditions—especially where pharmacists lack access to full patient histories or lab data.
HealthcareRef: Sec. 2 (new RCW 18.64.011(32))The Pharmacy Quality Assurance Commission must develop new rules and oversight mechanisms for pharmacist prescribing, which may strain its existing resources and staffing, particularly if it lacks authority to require staffing standards, training certifications, or audit protocols for prescribing pharmacists.
Local GovernmentRef: Sec. 5 (rulemaking authority)The sunset clause (expiration January 1, 2030) creates regulatory uncertainty for pharmacists, pharmacies, and patients, potentially discouraging long-term investment in infrastructure (e.g., EHR integration, training programs) and undermining the stability needed for sustainable care models.
HealthcareRef: Sec. 2 (new RCW 18.64.011(32))
Who Is Most Affected
Pharmacists gain expanded authority to prescribe medications and devices, increasing their scope of practice and potential revenue streams; however, they also assume greater clinical responsibility and liability risk without corresponding increases in compensation or staffing support.
Patients in rural, low-income, and underserved communities benefit from improved access to preventive care, addiction treatment, and chronic disease management—reducing travel time, wait times, and out-of-pocket costs; however, those with complex or undiagnosed conditions may face risks from delayed specialist evaluation.
Pharmacies and pharmacy chains may see increased demand for clinical services and potential revenue growth, but must invest in staff training, EHR integration, and compliance infrastructure—costs that disproportionately burden small, independent pharmacies with limited margins.
The Pharmacy Quality Assurance Commission gains rulemaking authority and oversight responsibility, increasing its workload and requiring new regulatory capacity; however, the agency lacks statutory authority to mandate staffing standards, training certifications, or prescribing audits, limiting its ability to ensure safe implementation.