Notifiable Conditions

The Notifiable Conditions rule outlines requirements for information that health care providers, health care facilities, laboratories, and other entities must report that is necessary for public health officials to protect the public's health by tracking communicable diseases and other conditions.

Since 2017 the Washington State Board of Health (Board) has engaged in both emergency and permanent rulemaking to update chapter 246-101 WAC and respond to the COVID-19 pandemic.

Permanent Rulemaking

On March 10, 2021 the Board adopted amendments to the Notifiable Conditions ruleChanges to the rules include, but are not limited to:

  • Adding notification and specimen submission requirements for “new conditions” and conditions currently identified as “other rare diseases of public health significance”
  • Updating and clarifying notification and specimen submission requirements for certain existing conditions
  • Clarifying and improving requirements for suspected cases
  • Adding requirements to report race, ethnicity, and preferred language
  • Revising the reporting requirements for veterinarians and the Department of Agriculture
  • Adding enhanced service facilities licensed under chapter 70.97 RCW to the definition of “health care facility”
  • Editorial revisions consistent with statutory changes made during the 2020 legislative session (Engrossed Substitute House Bill 1551, Modernizing the control of certain communicable diseases)
  • Updating statutory references in the rules, including updated references to the Security and Confidentiality Guidelines developed by the Centers for Disease Control and Prevention and
  • Improving overall clarity and usability of the chapter

The concise explanatory statement summarizes the differences between the proposed rules and adopted rules and the response to public comments. Revisions to the chapter went into effect January 1, 2023. The Department of Health (Department) issued letters to laboratory directors, clinicians, and public health partners to request additional data when reporting COVID-19, mpox, and carbapenem resistant and carbapenemase producing organisms to public health authorities.

Permanent Rulemaking Milestones:

Emergency Rulemaking

In response to the COVID-19 pandemic, the Board adopted a series of emergency rules that required health care providers, health care facilities, laboratories, local health jurisdictions, and the Department of Agriculture to report certain demographic, testing, and other relevant data for each COVID-19 test. These requirements were aligned with the federal CARES Act and guidance from the Department of Health and Human Services.

The ninth and final emergency rule was rescinded effective January 1, 2023 as COVID-19 became permanently notifiable went permanent rulemaking went into effect. To ensure continued compliance with federal reporting requirements, the Department issued a provisional notification letter to laboratory directors, clinicians, and public health partners to specify additional data components that must be reported with COVID-19 test results.

COVID-19 Permanent Rulemaking

The Board briefly pursued permanent rulemaking for COVID-19 reporting requirements. The scope of COVID-19 permanent rulemaking included considering revising chapter 246-101 WAC to:

  • Establish and clarify reporting requirements for COVID-19 for health care providers, health care facilities, laboratories, and local health jurisdictions, consistent with the Board’s COVID-19 Reporting emergency rules
  • Clarify the instances in which a health care provider or facility must report a notifiable condition to a local health jurisdiction or the Department
  • Make editorial revisions as necessary to improve clarity and usability

The Board determined further revisions to the rule were no longer needed as COVID-19 became permanently notifiable on January 1, 2023.

COVID-19 Permanent Rulemaking Milestones:

Statutory Authority: RCW 43.20.050RCW 43.70.545RCW 70.24.130RCW 70.28.032, and RCW 70.104.055

Contact Information

State Board of Health and Department of Health Contact:
For media or general inquiries about this rule, please contact 
the State Board of Health at 360-236-4110 or by email