Senate Bill 5513 reenacts and amends the pharmacy chapter (RCW 18.64.011) and adds a new section to chapter 18.64 RCW to expand pharmacists’ scope of practice, and it amends RCW 69.41.030. The bill establishes new and revised definitions used throughout chapter 18.64 RCW, recognizes legislative intent to allow pharmacists to practice at the top of their training, and gives the Pharmacy Quality Assurance Commission authority to adopt rules to implement the act. The act creates a temporary new authority allowing pharmacists, beginning December 1, 2026, to prescribe specified products and categories, with that pharmacist prescribing authority expiring January 1, 2030. The listed items pharmacists may prescribe include immunizations; opioid antagonists and addiction treatments; epinephrine autoinjectors; antihistamines; tobacco cessation products; medications to prevent HIV; tuberculin purified protein derivative products; hormonal contraception; medications for travel-related diseases; and drugs or devices for conditions that meet stated criteria (for example, no new diagnosis required, minor self-limiting conditions, CLIA-waived tests/devices, or prescriptions issued in team-based practices with a shared medical record). The amendment to RCW 69.41.030 revises who may lawfully sell, deliver, possess, or use legend drugs and adjusts penalties and diversion guidance: sale, delivery, or possession with intent to sell or deliver a legend drug is a class B felony; knowing possession of a legend drug, and knowing use of a legend drug in a public place, are misdemeanors, and prosecutors are encouraged to divert eligible people to assessment, treatment, or other services; law enforcement is encouraged in lieu of booking to offer referrals to assessment or diversion programs. The bill and the excerpted text leave some statutory details unclear or incomplete in the provided material, including the full text of the amended or new sections, the complete definition of “prescription,” and specifics of any required training, protocols, or rulemaking timelines.

If enacted, pharmacists would be able to directly prescribe a set of common preventive and urgent treatments (for example immunizations, naloxone and addiction treatments, epinephrine autoinjectors, antihistamines, tobacco cessation products, PrEP, hormonal contraception, TB skin test materials, and travel medicines) starting December 1, 2026 and only until January 1, 2030. Practically, patients—especially in rural and underserved areas—would likely get faster access to these services without a doctor visit, while pharmacies and pharmacists would take on new clinical responsibilities, training needs, and operational tasks that could increase staffing and administrative costs; who pays for pharmacist time, training, and how liability and clinical protocols are handled is left unclear until the pharmacy quality assurance commission issues rules. The bill also changes criminal enforcement around legend drugs by making sale or delivery with intent a class B felony while treating simple possession or use in public as misdemeanors and encouraging prosecutors and police to divert people to assessment, treatment, or community programs instead of charging them. This is likely to shift some cases away from prosecution toward diversion and treatment providers, affecting workloads for prosecutors, law enforcement, and addiction/recovery services, but the practical scale of that shift depends on how agencies implement the diversion guidance and related procedures, which the text does not fully specify.