Washington 2025-2026 Regular Session Status: In Committee 6 D cosponsors

HB 2425 — Concerning nursing delegation.

Last action — Referred to Rules 2 Review.

  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill is in committee in the House. Introduced January 13, 2026. It must pass committee before a floor vote.

Next likely step: a committee vote, then a floor vote in the House.

Odds of enactment

Low chance

Based on the sponsor, cosponsors, and committee posture, this bill has a low chance of becoming law.

Upgrade to see the exact probability and what's driving it.

A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.

Prognosis

Stalled 26% · moderate confidence

  • In Committee

    Current position in the legislative process.

  • 6 sponsors

    1 primary, 5 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (6 D).

Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.

Bill Text

What changed in the latest version

514 added · 340 removed

Plain-language change summary

The recent changes to House Bill 2425 clarify the responsibilities of registered nurses in providing care and administering treatments under the direction of licensed healthcare professionals. Specifically, the language now emphasizes that nurses can perform these actions with various types of medical professionals, ensuring their role is well-defined. This amendment is important because it strengthens the framework for nursing practice and may lead to improved patient care by clearly outlining the directions nurses can follow when administering care or medications.

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H-3252.2 SUBSTITUTE HOUSE BILL 2425 State of Washington 69th Legislature 2026 Regular Session By House Health Care & Wellness (originally sponsored by Representatives Thai, Obras, Parshley, Scott, Macri, and Reed;
Z-0428.2 HOUSE BILL 2425 State of Washington 69th Legislature 2026 Regular Session By Representatives Thai, Obras, Parshley, Scott, Macri, and Reed;
by request of Washington State Board of Nursing) READ FIRST TIME 02/03/26.
by request of Washington State Board of Nursing Read first time 01/13/26.
Referred to Committee on Health Care & Wellness.
amending RCW 18.79.260, 18.88A.210, 18.88A.230, 18.88B.070, and 70.127.010;
amending RCW 18.79.260, 18.79.260, 18.88A.210, 18.88A.210, 18.88A.230, 18.88B.070, and 70.127.010;
creating a new section;
providing effective dates;
and providing an effective date.
and providing expiration dates.
RCW 18.79.260 and 2024 c 239 s 15 are each amended to read as follows:
RCW 18.79.260 and 2025 c 58 s 5019 are each amended to read as follows:
(2) A registered nurse may, at or under the general direction of a licensed physician and surgeon, dentist, osteopathic physician and surgeon, naturopathic physician, optometrist, podiatric physician and surgeon, physician assistant, advanced practice registered nurse, or midwife acting within the scope of his or her license, administer medications, treatments, tests, and inoculations, whether or not the severing or penetrating of tissues is involved and whether or not a degree of independent judgment and skill is required.
(2) A registered nurse may, at or under the general direction of a licensed physician and surgeon, dentist, osteopathic physician and surgeon, naturopathic physician, optometrist, podiatric physician and surgeon, physician assistant, advanced registered nurse practitioner, or midwife acting within the scope of his or her license, administer medications, treatments, tests, and inoculations, whether or not the severing or penetrating of tissues is involved and whether or not a degree of independent judgment and skill is required.
(3) A registered nurse may delegate tasks ((of nursing care)) to other individuals in any setting where the registered nurse p.
p.
1 SHB 2425 determines that it is in the best interest of the patient and within the nurse's scope of practice.
1 HB 2425 (3) A registered nurse may delegate tasks ((of nursing care)) to other individuals in any setting where the registered nurse determines that it is in the best interest of the patient and within the nurse's scope of practice.
(4) Except as authorized in subsections (7) and (8) of this section, a registered nurse may not delegate the administration of medications, tasks involving piercing or severing of tissues, or acts that require substantial skill.
(4) Except as authorized in subsection (7) of this section, a registered nurse may not delegate the administration of medications, tasks involving piercing or severing of tissues, or acts that require substantial skill.
Simple care tasks such as blood pressure monitoring, personal care service, diabetic insulin device set up, verbal verification of p.
p.
2 SHB 2425 insulin dosage for sight-impaired individuals, or other tasks as defined by the board are exempted from this requirement.
2 HB 2425 Simple care tasks such as blood pressure monitoring, personal care service, diabetic insulin device set up, verbal verification of insulin dosage for sight-impaired individuals, or other tasks as defined by the board are exempted from this requirement.
3 SHB 2425 (B) Before commencing any specific nursing tasks authorized to be delegated in this section, a home care aide must be certified pursuant to chapter 18.88B RCW and must comply with RCW 18.88B.070.
3 HB 2425 (B) Before commencing any specific nursing tasks authorized to be delegated in this section, a home care aide must be certified pursuant to chapter 18.88B RCW and must comply with RCW 18.88B.070.
(((viii))) (7) If trained and delegated the task by a nurse, a nursing assistant or home care aide, credentialed under chapter 18.88A or 18.88B RCW, respectively, may administer medications, including those that pierce the skin through subcutaneous injections, and may perform capillary blood sticks.
(((viii))) (7) If trained and delegated the task by a nurse, a nursing assistant-certified or home care aide, licensed under chapter 18.88A or 18.88B RCW, respectively, may administer medications, including those that pierce the skin through subcutaneous injections, and may perform capillary blood sticks.
These tasks may never include administration of medication intramuscularly or intravenously.
(8) Nursing task delegation protocols are not intended to regulate the settings in which delegation may occur, but are intended to ensure that nursing care services have a consistent standard of practice upon which the public and the profession may rely, and to safeguard the authority of the nurse to make independent professional decisions regarding the delegation of a task.
(8) A nurse may delegate tasks to a medical assistant credentialed under chapter 18.360 RCW.
(9) Nursing task delegation protocols are not intended to regulate the settings in which delegation may occur, but are intended to ensure that nursing care services have a consistent standard of practice upon which the public and the profession may rely, and to safeguard the authority of the nurse to make independent professional decisions regarding the delegation of a task.
(g))) (10) Education and training provided by a registered nurse to a caregiver who is a parent, guardian, or family member who is designated to provide care for a patient is not considered delegation of nursing care tasks, regardless of whether the caregiver is paid to complete the task.
(g))) (9) Education and training provided by a registered nurse to a caregiver who is a parent, guardian, or family member who is designated to provide care for a patient is not considered delegation of nursing care tasks, regardless of whether the caregiver is paid to complete the task.
(11)(a) The board may adopt rules to implement this section.
(10)(a) The board may adopt rules to implement this section.
(5) Only a person licensed as a registered nurse may hold herself or himself out to the public or designate herself or himself as a registered nurse.)) (b) By January 1, 2028, the board shall adopt rules to address appropriate delegation parameters.
(5) Only a person licensed as a registered nurse may hold herself or himself out to the public or designate herself or himself as a registered nurse.)) (b) By July 1, 2028, the board shall adopt rules to address appropriate delegation parameters.
p.
Sec.
4 SHB 2425 Sec.
RCW 18.79.260 and 2024 c 239 s 15 are each amended to read as follows:
p.
4 HB 2425 (1) A registered nurse under his or her license may perform for compensation nursing care, as that term is usually understood, to individuals with illnesses, injuries, or disabilities.
(2) A registered nurse may, at or under the general direction of a licensed physician and surgeon, dentist, osteopathic physician and surgeon, naturopathic physician, optometrist, podiatric physician and surgeon, physician assistant, advanced practice registered nurse, or midwife acting within the scope of his or her license, administer medications, treatments, tests, and inoculations, whether or not the severing or penetrating of tissues is involved and whether or not a degree of independent judgment and skill is required.
Such direction must be for acts which are within the scope of registered nursing practice.
(3) A registered nurse may delegate tasks ((of nursing care)) to other individuals in any setting where the registered nurse determines that it is in the best interest of the patient and within the nurse's scope of practice.
(((a))) The delegating nurse shall:
(((i))) (a) Determine the competency of the individual to perform the tasks, including verifying certification or documentation where required by rule or law;
(((ii))) (b) Evaluate the stability of the patient and the appropriateness of the delegation;
and (((iii))) (c) Supervise the actions of the person performing the delegated task((;
and (iv) Delegate only those tasks that are within the registered nurse's scope of practice.
(b) A registered nurse, working for a home health or hospice agency regulated under chapter 70.127 RCW, may delegate the application, instillation, or insertion of medications to a registered or certified nursing assistant under a plan of care.
(c) Except as authorized in (b) or (e) of this subsection, a registered nurse may not delegate the administration of medications.
Except as authorized in (e) or (f) of this subsection, a registered nurse may not delegate acts requiring substantial skill, and may not delegate piercing or severing of tissues.
Acts that require nursing judgment shall not be delegated.
(d))).
(4) Except as authorized in subsection (7) of this section, a registered nurse may not delegate the administration of medications, p.
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5 HB 2425 tasks involving piercing or severing of tissues, or acts that require substantial skill.
Acts that require nursing judgment may not be delegated.
(5) No person may coerce a nurse into compromising patient safety by requiring the nurse to delegate if the nurse determines that it is inappropriate to do so.
Nurses shall not be subject to any employer reprisal or disciplinary action by the board for refusing to delegate tasks or refusing to provide the required training for delegation if the nurse determines delegation may compromise patient safety.
(((e) For delegation in community-based care settings or in-home care settings, a registered nurse may delegate nursing care tasks only to registered or certified nursing assistants under chapter 18.88A RCW or home care aides certified under chapter 18.88B RCW.
Simple care tasks such as blood pressure monitoring, personal care service, diabetic insulin device set up, verbal verification of insulin dosage for sight-impaired individuals, or other tasks as defined by the board are exempted from this requirement.
(i) "Community-based care settings" includes:
Community residential programs for people with developmental disabilities, certified by the department of social and health services under chapter 71A.12 RCW;
adult family homes licensed under chapter 70.128 RCW;
and assisted living facilities licensed under chapter 18.20 RCW.
Community-based care settings do not include acute care or skilled nursing facilities.
(ii) "In-home care settings" include an individual's place of temporary or permanent residence, but does not include acute care or skilled nursing facilities, and does not include community-based care settings as defined in (e)(i) of this subsection.
(iii) Delegation of nursing care tasks in community-based care settings and in-home care settings is only allowed for individuals who have a stable and predictable condition.
"Stable and predictable condition" means a situation in which the individual's clinical and behavioral status is known and does not require the frequent presence and evaluation of a registered nurse.
(iv) The determination of the appropriateness of delegation of a nursing task is at the discretion of the registered nurse.
Other than delegation of the administration of insulin by injection for the purpose of caring for individuals with diabetes, the administration of medications by injection, sterile procedures, and central line maintenance may never be delegated.
p.
6 HB 2425 (v) When delegating insulin injections under this section, the registered nurse delegator must instruct the individual regarding proper injection procedures and the use of insulin, demonstrate proper injection procedures, and must supervise and evaluate the individual performing the delegated task as required by the board by rule.
If the registered nurse delegator determines that the individual is competent to perform the injection properly and safely, supervision and evaluation shall occur at an interval determined by the board by rule.
(vi)(A) The registered nurse shall verify that the nursing assistant or home care aide, as the case may be, has completed the required core nurse delegation training required in chapter 18.88A or 18.88B RCW prior to authorizing delegation.
(B) Before commencing any specific nursing tasks authorized to be delegated in this section, a home care aide must be certified pursuant to chapter 18.88B RCW and must comply with RCW 18.88B.070.
(vii))) (6) The nurse is accountable for his or her own individual actions in the delegation process.
Nurses acting within ((the protocols of)) their delegation authority are immune from liability for any action performed in the course of their delegation duties.
(((viii))) (7) If trained and delegated the task by a nurse, a nursing assistant-certified or home care aide, licensed under chapter 18.88A or 18.88B RCW, respectively, may administer medications, including those that pierce the skin through subcutaneous injections, and may perform capillary blood sticks.
(8) Nursing task delegation protocols are not intended to regulate the settings in which delegation may occur, but are intended to ensure that nursing care services have a consistent standard of practice upon which the public and the profession may rely, and to safeguard the authority of the nurse to make independent professional decisions regarding the delegation of a task.
(((f) The delegation of nursing care tasks only to registered or certified nursing assistants under chapter 18.88A RCW or to home care aides certified under chapter 18.88B RCW may include glucose monitoring and testing.
(g))) (9) Education and training provided by a registered nurse to a caregiver who is a parent, guardian, or family member who is designated to provide care for a patient is not considered delegation p.
7 HB 2425 of nursing care tasks, regardless of whether the caregiver is paid to complete the task.
(10)(a) The board may adopt rules to implement this section.
(((4) Only a person licensed as a registered nurse may instruct nurses in technical subjects pertaining to nursing.
(5) Only a person licensed as a registered nurse may hold herself or himself out to the public or designate herself or himself as a registered nurse.)) (b) By July 1, 2028, the board shall adopt rules to address appropriate delegation parameters.
Sec.
3.
(((1))) A nursing assistant ((meeting the requirements of this section who provides care to individuals in community-based care settings or in-home care settings, as defined in RCW 18.79.260(3),)) may accept delegation of nursing care tasks by a ((registered)) nurse as provided in RCW 18.79.260(((3))).
(1) A nursing assistant ((meeting the requirements of this section who provides care to individuals in community-based care settings or in-home care settings, as defined in RCW 18.79.260(3),)) may accept delegation of nursing care tasks by a ((registered)) nurse as provided in RCW 18.79.260(((3))).
(((2) For the purposes of this section, "nursing assistant" means a nursing assistant-registered or a nursing assistant-certified.
(2) ((For the purposes of this section, "nursing assistant" means a nursing assistant-registered or a nursing assistant-certified.
The training must include, but is not limited to, instruction regarding diabetes, insulin, sliding scale insulin orders, and proper injection procedures.)) Sec.
The training must include, but is not limited to, instruction regarding diabetes, insulin, sliding scale insulin p.
3.
8 HB 2425 orders, and proper injection procedures.)) Nursing assistants are accountable for their own individual actions in the delegation process.
Nursing assistants accurately following delegation instructions from a nurse are immune from liability regarding the performance of the delegated duties.
Sec.
4.
RCW 18.88A.210 and 2025 c 58 s 5041 are each amended to read as follows:
(1) A nursing assistant ((meeting the requirements of this section who provides care to individuals in community-based care settings or in-home care settings, as defined in RCW 18.79.260(3),)) may accept delegation of nursing care tasks by a ((registered)) nurse as provided in RCW 18.79.260(((3))).
(2) ((For the purposes of this section, "nursing assistant" means a nursing assistant-registered or a nursing assistant-certified.
Nothing in this section may be construed to affect the authority of nurses to delegate nursing tasks to other persons, including licensed practical nurses, as authorized by law.
(3)(a) Before commencing any specific nursing care tasks authorized under this chapter, the nursing assistant must (i) provide to the delegating nurse a certificate of completion issued by the department of social and health services indicating the completion of basic core nurse delegation training, (ii) be regulated by the department of health pursuant to this chapter, subject to the uniform disciplinary act under chapter 18.130 RCW, and (iii) meet any additional training requirements identified by the board.
Exceptions to these training requirements must adhere to RCW 18.79.260(3)(e)(vi).
(b) In addition to meeting the requirements of (a) of this subsection, before commencing the care of individuals with diabetes that involves administration of insulin by injection, the nursing assistant must provide to the delegating nurse a certificate of completion issued by the department of social and health services indicating completion of specialized diabetes nurse delegation training.
The training must include, but is not limited to, instruction regarding diabetes, insulin, sliding scale insulin orders, and proper injection procedures.)) Nursing assistants are accountable for their own individual actions in the delegation process.
Nursing assistants accurately following delegation p.
9 HB 2425 instructions from a nurse are immune from liability regarding the performance of the delegated duties.
Sec.
5.
p.
(2) Nursing assistants shall not be subject to ((any)):
5 SHB 2425 (2) Nursing assistants shall not be subject to ((any)):
4.
6.
((Before administering insulin, a home care aide must also complete the specialized diabetes nurse delegation training under chapter 18.88A RCW.
((Before administering insulin, a home care aide must also complete the specialized diabetes nurse delegation training under p.
10 HB 2425 chapter 18.88A RCW.
(b) In addition to meeting the requirements of (a) of this subsection, before providing delegated nursing care tasks that involve administration of insulin by injection to individuals with p.
(b) In addition to meeting the requirements of (a) of this subsection, before providing delegated nursing care tasks that involve administration of insulin by injection to individuals with diabetes, the home care aide must provide to the delegating nurse a transcript or certificate of successful completion of training issued by an approved instructor or approved training entity indicating completion of specialized diabetes nurse delegation training.
6 SHB 2425 diabetes, the home care aide must provide to the delegating nurse a transcript or certificate of successful completion of training issued by an approved instructor or approved training entity indicating completion of specialized diabetes nurse delegation training.
5.
7.
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
p.
11 HB 2425 Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
p.
(5) "Home care agency" means a person administering or providing home care services directly or through a contract arrangement to individuals in places of temporary or permanent residence.
7 SHB 2425 (5) "Home care agency" means a person administering or providing home care services directly or through a contract arrangement to individuals in places of temporary or permanent residence.
(9) "Home health aide services" means services provided by a home health agency or a hospice agency under the supervision of a registered nurse, physical therapist, occupational therapist, or speech therapist who is employed by or under contract to a home health or hospice agency.
(9) "Home health aide services" means services provided by a home health agency or a hospice agency under the supervision of a p.
12 HB 2425 registered nurse, physical therapist, occupational therapist, or speech therapist who is employed by or under contract to a home health or hospice agency.
(11) "Hospice agency" means a person administering or providing hospice services directly or through a contract arrangement to p.
(11) "Hospice agency" means a person administering or providing hospice services directly or through a contract arrangement to individuals in places of temporary or permanent residence under the direction of an interdisciplinary team composed of at least a nurse, social worker, physician, spiritual counselor, and a volunteer.
8 SHB 2425 individuals in places of temporary or permanent residence under the direction of an interdisciplinary team composed of at least a nurse, social worker, physician, spiritual counselor, and a volunteer.
(18) "Quality improvement" means reviewing and evaluating appropriateness and effectiveness of services provided under this chapter.
p.
13 HB 2425 (18) "Quality improvement" means reviewing and evaluating appropriateness and effectiveness of services provided under this chapter.
p.
NEW SECTION.
9 SHB 2425 NEW SECTION.
6.
8.
The board of nursing and the department of health may adopt rules necessary to implement this act.
(1) Section 1 of this act expires June 30, 2027.
(2) Section 3 of this act expires July 1, 2026.
7.
9.
Sections 1 through 5 of this act take effect January 1, 2028.
(1) Section 2 of this act takes effect June 30, 2027.
(2) Section 4 of this act takes effect July 1, 2026.
(3) Section 6 of this act takes effect July 1, 2028.
10 SHB 2425
14 HB 2425
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Action History

  1. Referred to Rules 2 Review.

  2. HCW - Majority; 1st substitute bill be substituted, do pass.

  3. Executive action taken in the House Committee on Health Care & Wellness at 8:00 AM.

  4. Public hearing in the House Committee on Health Care & Wellness at 1:30 PM.

  5. First reading, referred to Health Care & Wellness.

Sponsors

Sponsorship breakdown

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1 sponsors · 5 co-sponsors · 145 not signed on

Sponsors (1)

Co-sponsors (5)

Not signed on (145)

145 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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healthcare labor
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Frequently asked questions

Who sponsors HB 2425?
HB 2425 is sponsored by Julia Reed (Democrat), Nicole Macri (Democrat), Shaun Scott (Democrat), Lisa Parshley (Democrat), Edwin Obras (Democrat), and My-Linh Thai (Democrat).
What is the current status of HB 2425?
This bill is in committee in the House. Introduced January 13, 2026. It must pass committee before a floor vote.
Where can I track HB 2425?
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