Health care information

AN ACT Relating to strengthening patients' rights regarding their 1
health care information by promoting access to information and 2
providing enforcement protections for the appropriate use of the 3
information; amending RCW 70.02.010, 70.02.030, 70.02.080, 70.02.090, 4
70.02.170, and 70.02.220; reenacting and amending RCW 70.02.260; and 5
adding a new section to chapter 70.02 RCW. 6
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:7
NEW SECTION. Sec. 1. A new section is added to chapter 70.02 8
RCW to read as follows: 9
(1) Except as provided in subsection (2) of this section and RCW 10
70.02.370, a health care provider or health care facility may charge 11
a reasonable fee, in accordance with the department's standards 12
established in subsection (3) of this section, for providing health 13
care information to a person and is not required to honor an 14
authorization until the fee is paid. 15
(2)(a) A health care provider or health care facility may not 16
charge a fee of more than $50 for providing a patient's health care 17
information to: 18
(i) The patient; 19
(ii) The patient's representative, including a person authorized 20
to consent to health care for the patient under RCW 70.02.130;21
S-0416.2
SENATE BILL 5254
State of Washington 69th Legislature 2025 Regular Session
By Senators Orwall, Trudeau, Frame, Nobles, Valdez, and C. Wilson
Read first time 01/14/25. Referred to Committee on Health & Long-
Term Care.
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(iii) A licensed attorney who is representing the patient or the 1
patient's estate; 2
(iv) A health care provider or health care facility providing 3
health care services to the patient; 4
(v) A community-based or system-based advocate designated by the 5
patient; or 6
(vi) The patient's guardian. 7
(b) The $50 fee limit in (a) of this subsection applies to any 8
third party acting on behalf of a health care provider or health care 9
facility, including any agent, vendor, or business associate.10
(3) The department shall adopt rules to establish standards for a 11
reasonable fee that a health care provider or health care facility 12
may charge for providing access to or exchanging health care 13
information. The standards must recognize the prevalence of the use 14
of electronic health record searching and exchange capabilities and 15
consider federal laws related to the establishment of fees for 16
accessing and exchanging health care information. The standards must 17
be based upon the actual costs of searching and producing the 18
particular patient's records and may not be based upon a per page 19
calculation. 20
Sec. 2. RCW 70.02.010 and 2024 c 209 s 31 are each amended to 21
read as follows: 22
The definitions in this section apply throughout this chapter 23
unless the context clearly requires otherwise. 24
(1) "Admission" has the same meaning as in RCW 71.05.020.25
(2) "Audit" means an assessment, evaluation, determination, or 26
investigation of a health care provider by a person not employed by 27
or affiliated with the provider to determine compliance with:28
(a) Statutory, regulatory, fiscal, medical, or scientific 29
standards; 30
(b) A private or public program of payments to a health care 31
provider; or 32
(c) Requirements for licensing, accreditation, or certification.33
(3) "Authority" means the Washington state health care authority.34
(4) "Commitment" has the same meaning as in RCW 71.05.020.35
(5) "Custody" has the same meaning as in RCW 71.05.020.36
(6) "Deidentified" means health information that does not 37
identify an individual and with respect to which there is no 38
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reasonable basis to believe that the information can be used to 1
identify an individual. 2
(7) "Department" means the department of social and health 3
services. 4
(8) "Designated crisis responder" has the same meaning as in RCW 5
71.05.020 or 71.34.020, as applicable. 6
(9) "Detention" or "detain" has the same meaning as in RCW 7
71.05.020. 8
(10) "Directory information" means information disclosing the 9
presence, and for the purpose of identification, the name, location 10
within a health care facility, and the general health condition of a 11
particular patient who is a patient in a health care facility or who 12
is currently receiving emergency health care in a health care 13
facility. 14
(11) "Discharge" has the same meaning as in RCW 71.05.020.15
(12) "Evaluation and treatment facility" has the same meaning as 16
in RCW 71.05.020 or 71.34.020, as applicable. 17
(13) "Federal, state, or local law enforcement authorities" means 18
an officer of any agency or authority in the United States, a state, 19
a tribe, a territory, or a political subdivision of a state, a tribe, 20
or a territory who is empowered by law to: (a) Investigate or conduct 21
an official inquiry into a potential criminal violation of law; or 22
(b) prosecute or otherwise conduct a criminal proceeding arising from 23
an alleged violation of law. 24
(14) "General health condition" means the patient's health status 25
described in terms of "critical," "poor," "fair," "good," 26
"excellent," or terms denoting similar conditions.27
(15) "Health care" means any care, service, or procedure provided 28
by a health care provider: 29
(a) To diagnose, treat, or maintain a patient's physical or 30
mental condition; or 31
(b) That affects the structure or any function of the human body.32
(16) "Health care facility" means a hospital, clinic, nursing 33
home, laboratory, office, or similar place where a health care 34
provider provides health care to patients. 35
(17) "Health care information" means any information, whether 36
oral or recorded in any form or medium, that identifies or can 37
readily be associated with the identity of a patient and directly 38
relates to the patient's health care, including a patient's 39
deoxyribonucleic acid and identified sequence of chemical base pairs. 40
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The term includes any required accounting of disclosures of health 1
care information. 2
(18) "Health care operations" means any of the following 3
activities of a health care provider, health care facility, or third-4
party payor to the extent that the activities are related to 5
functions that make an entity a health care provider, a health care 6
facility, or a third-party payor: 7
(a) Conducting: Quality assessment and improvement activities, 8
including outcomes evaluation and development of clinical guidelines, 9
if the obtaining of generalizable knowledge is not the primary 10
purpose of any studies resulting from such activities; population-11
based activities relating to improving health or reducing health care 12
costs, protocol development, case management and care coordination, 13
contacting of health care providers and patients with information 14
about treatment alternatives; and related functions that do not 15
include treatment; 16
(b) Reviewing the competence or qualifications of health care 17
professionals, evaluating practitioner and provider performance and 18
third-party payor performance, conducting training programs in which 19
students, trainees, or practitioners in areas of health care learn 20
under supervision to practice or improve their skills as health care 21
providers, training of nonhealth care professionals, accreditation, 22
certification, licensing, or credentialing activities;23
(c) Underwriting, premium rating, and other activities relating 24
to the creation, renewal, or replacement of a contract of health 25
insurance or health benefits, and ceding, securing, or placing a 26
contract for reinsurance of risk relating to claims for health care, 27
including stop-loss insurance and excess of loss insurance, if any 28
applicable legal requirements are met; 29
(d) Conducting or arranging for medical review, legal services, 30
and auditing functions, including fraud and abuse detection and 31
compliance programs; 32
(e) Business planning and development, such as conducting cost-33
management and planning-related analyses related to managing and 34
operating the health care facility or third-party payor, including 35
formulary development and administration, development, or improvement 36
of methods of payment or coverage policies; and 37
(f) Business management and general administrative activities of 38
the health care facility, health care provider, or third-party payor 39
including, but not limited to: 40
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(i) Management activities relating to implementation of and 1
compliance with the requirements of this chapter; 2
(ii) Customer service, including the provision of data analyses 3
for policyholders, plan sponsors, or other customers, provided that 4
health care information is not disclosed to such policyholder, plan 5
sponsor, or customer; 6
(iii) Resolution of internal grievances; 7
(iv) The sale, transfer, merger, or consolidation of all or part 8
of a health care provider, health care facility, or third-party payor 9
with another health care provider, health care facility, or third-10
party payor or an entity that following such activity will become a 11
health care provider, health care facility, or third-party payor, and 12
due diligence related to such activity; and 13
(v) Consistent with applicable legal requirements, creating 14
deidentified health care information or a limited data set for the 15
benefit of the health care provider, health care facility, or third-16
party payor. 17
(19) "Health care provider" means a person who is licensed, 18
certified, registered, or otherwise authorized by the law of this 19
state to provide health care in the ordinary course of business or 20
practice of a profession. 21
(20) "Human immunodeficiency virus" or "HIV" has the same meaning 22
as in RCW 70.24.017. 23
(21) "Imminent" has the same meaning as in RCW 71.05.020.24
(22) "Indian health care provider" has the same meaning as in RCW 25
43.71B.010(11). 26
(23) "Information and records related to mental health services" 27
means a type of health care information that relates to all 28
information and records compiled, obtained, or maintained in the 29
course of providing services by a mental health service agency or 30
mental health professional to persons who are receiving or have 31
received services for mental illness. The term includes mental health 32
information contained in a medical bill, registration records, and 33
all other records regarding the person maintained by the department, 34
by the authority, by behavioral health administrative services 35
organizations and their staff, managed care organizations contracted 36
with the authority under chapter 74.09 RCW and their staff, and by 37
treatment facilities. The term further includes documents of legal 38
proceedings under chapter 71.05, 71.34, or 10.77 RCW, or somatic 39
health care information. For health care information maintained by a 40
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hospital as defined in RCW 70.41.020 or a health care facility or 1
health care provider that participates with a hospital in an 2
organized health care arrangement defined under federal law, 3
"information and records related to mental health services" is 4
limited to information and records of services provided by a mental 5
health professional or information and records of services created by 6
a hospital-operated community behavioral health program as defined in 7
RCW 71.24.025. The term does not include psychotherapy notes.8
(24) "Information and records related to sexually transmitted 9
diseases" means a type of health care information that relates to the 10
identity of any person upon whom an HIV antibody test or other 11
sexually transmitted infection test is performed, the results of such 12
tests, and any information relating to diagnosis of or treatment for 13
any confirmed sexually transmitted infections. 14
(25) "Institutional review board" means any board, committee, or 15
other group formally designated by an institution, or authorized 16
under federal or state law, to review, approve the initiation of, or 17
conduct periodic review of research programs to assure the protection 18
of the rights and welfare of human research subjects.19
(26) (("Legal counsel" has the same meaning as in RCW 71.05.020.20
(27))) "Local public health officer" has the same meaning as the 21
term "local health officer" as defined in RCW 70.24.017.22
(((28))) (27) "Maintain," as related to health care information, 23
means to hold, possess, preserve, retain, store, or control that 24
information. 25
(((29))) (28) "Managed care organization" has the same meaning as 26
provided in RCW 71.24.025. 27
(((30))) (29) "Mental health professional" means a psychiatrist, 28
psychologist, psychiatric advanced registered nurse practitioner, 29
psychiatric nurse, or social worker, and such other mental health 30
professionals as may be defined by rules adopted by the secretary of 31
health under chapter 71.05 RCW, whether that person works in a 32
private or public setting. 33
(((31))) (30) "Mental health service agency" means a public or 34
private agency that provides services to persons with mental 35
disorders as defined under RCW 71.05.020 or 71.34.020 and receives 36
funding from public sources. This includes evaluation and treatment 37
facilities as defined in RCW 71.34.020, community mental health 38
service delivery systems, or community behavioral health programs, as 39
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defined in RCW 71.24.025, and facilities conducting competency 1
evaluations and restoration under chapter 10.77 RCW.2
(((32))) (31) "Minor" has the same meaning as in RCW 71.34.020.3
(((33))) (32) "Parent" has the same meaning as in RCW 71.34.020.4
(((34))) (33) "Patient" means an individual who receives or has 5
received health care. The term includes a deceased individual who has 6
received health care. 7
(((35))) (34) "Payment" means: 8
(a) The activities undertaken by: 9
(i) A third-party payor to obtain premiums or to determine or 10
fulfill its responsibility for coverage and provision of benefits by 11
the third-party payor; or 12
(ii) A health care provider, health care facility, or third-party 13
payor, to obtain or provide reimbursement for the provision of health 14
care; and 15
(b) The activities in (a) of this subsection that relate to the 16
patient to whom health care is provided and that include, but are not 17
limited to: 18
(i) Determinations of eligibility or coverage, including 19
coordination of benefits or the determination of cost-sharing 20
amounts, and adjudication or subrogation of health benefit claims;21
(ii) Risk adjusting amounts due based on enrollee health status 22
and demographic characteristics; 23
(iii) Billing, claims management, collection activities, 24
obtaining payment under a contract for reinsurance, including stop-25
loss insurance and excess of loss insurance, and related health care 26
data processing; 27
(iv) Review of health care services with respect to medical 28
necessity, coverage under a health plan, appropriateness of care, or 29
justification of charges; 30
(v) Utilization review activities, including precertification and 31
preauthorization of services, and concurrent and retrospective review 32
of services; and 33
(vi) Disclosure to consumer reporting agencies of any of the 34
following health care information relating to collection of premiums 35
or reimbursement: 36
(A) Name and address; 37
(B) Date of birth; 38
(C) Social security number; 39
(D) Payment history; 40
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(E) Account number; and 1
(F) Name and address of the health care provider, health care 2
facility, and/or third-party payor. 3
(((36))) (35) "Person" means an individual, corporation, business 4
trust, estate, trust, partnership, association, joint venture, 5
government, governmental subdivision or agency, or any other legal or 6
commercial entity. 7
(((37))) (36) "Professional person" has the same meaning as in 8
RCW 71.05.020. 9
(((38))) (37) "Psychiatric advanced registered nurse 10
practitioner" has the same meaning as in RCW 71.05.020.11
(((39))) (38) "Psychotherapy notes" means notes recorded, in any 12
medium, by a mental health professional documenting or analyzing the 13
contents of conversations during a private counseling session or 14
group, joint, or family counseling session, and that are separated 15
from the rest of the individual's medical record. The term excludes 16
((mediation)) medication prescription and monitoring, counseling 17
session start and stop times, the modalities and frequencies of 18
treatment furnished, results of clinical tests, and any summary of 19
the following items: Diagnosis, functional status, the treatment 20
plan, symptoms, prognosis, and progress to date. 21
(((40) "Reasonable fee" means the charges for duplicating or 22
searching the record, but shall not exceed 65 cents per page for the 23
first 30 pages and 50 cents per page for all other pages. In 24
addition, a clerical fee for searching and handling may be charged 25
not to exceed $15. These amounts shall be adjusted biennially in 26
accordance with changes in the consumer price index, all consumers, 27
for Seattle-Tacoma metropolitan statistical area as determined by the 28
secretary of health. However, where editing of records by a health 29
care provider is required by statute and is done by the provider 30
personally, the fee may be the usual and customary charge for a basic 31
office visit.32
(41))) (39) "Release" has the same meaning as in RCW 71.05.020.33
(((42))) (40) "Resource management services" has the same meaning 34
as in RCW 71.05.020. 35
(((43))) (41) "Serious violent offense" has the same meaning as 36
in RCW 9.94A.030. 37
(((44))) (42) "Sexually transmitted infection" or "sexually 38
transmitted disease" has the same meaning as "sexually transmitted 39
disease" in RCW 70.24.017. 40
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(((45))) (43) "Test for a sexually transmitted disease" has the 1
same meaning as in RCW 70.24.017. 2
(((46))) (44) "Third-party payor" means an insurer regulated 3
under Title 48 RCW authorized to transact business in this state or 4
other jurisdiction, including a health care service contractor, and 5
health maintenance organization; or an employee welfare benefit plan, 6
excluding fitness or wellness plans; or a state or federal health 7
benefit program. 8
(((47))) (45) "Treatment" means the provision, coordination, or 9
management of health care and related services by one or more health 10
care providers or health care facilities, including the coordination 11
or management of health care by a health care provider or health care 12
facility with a third party; consultation between health care 13
providers or health care facilities relating to a patient; or the 14
referral of a patient for health care from one health care provider 15
or health care facility to another. 16
(((48))) (46) "Tribal public health authority" means a tribe that 17
is responsible for public health matters as a part of its official 18
mandate. 19
(((49))) (47) "Tribal public health officer" means the individual 20
appointed as the health officer for the tribe. 21
(((50))) (48) "Tribe" has the same meaning as in RCW 71.24.025.22
Sec. 3. RCW 70.02.030 and 2024 c 150 s 2 are each amended to 23
read as follows: 24
(1) A patient may authorize a health care provider or health care 25
facility to disclose the patient's health care information. A health 26
care provider or health care facility shall honor an authorization 27
and, if requested, ((provide a copy of )) assist the designated 28
recipient with obtaining the recorded health care information unless 29
the health care provider or health care facility denies the patient 30
access to health care information under RCW 70.02.090 or an exemption 31
required under federal law. 32
(2)(((a) Except as provided in (b) of this subsection and RCW 33
70.02.370, a health care provider or health care facility may charge 34
a reasonable fee for providing the health care information and is not 35
required to honor an authorization until the fee is paid.36
(b) Upon request of a patient or a patient's personal 37
representative, a health care facility or health care provider shall 38
provide the patient or representative with one copy of the patient's 39
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health care information free of charge if the patient is appealing 1
the denial of federal supplemental security income or social security 2
disability benefits. The patient or representative may complete a 3
disclosure authorization specifying the health care information 4
requested and provide it to the health care facility or health care 5
provider. The health care facility or health care provider may 6
provide the health care information in either paper or electronic 7
format. A health care facility or health care provider is not 8
required to provide a patient or a patient's personal representative 9
with a free copy of health care information that has previously been 10
provided free of charge pursuant to a request within the preceding 11
two years. 12
(3))) To be valid, a disclosure authorization to a health care 13
provider or health care facility shall: 14
(a) Be in writing, dated, and signed by the patient , the 15
patient's personal representative, or any person or entity designated 16
by the patient to receive the information; 17
(b) Identify the nature of the information to be disclosed;18
(c) Identify the name and institutional affiliation of the person 19
or class of persons to whom the information is to be disclosed;20
(d) Identify the provider or class of providers who are to make 21
the disclosure; 22
(e) Identify the patient; and 23
(f) Contain an expiration date or an expiration event that 24
relates to the patient or the purpose of the use or disclosure.25
(((4))) (3) Unless disclosure without authorization is otherwise 26
permitted under RCW 70.02.050 or the federal health insurance 27
portability and accountability act of 1996 and its implementing 28
regulations, an authorization may permit the disclosure of health 29
care information to a class of persons that includes:30
(a) Researchers if the health care provider or health care 31
facility obtains the informed consent for the use of the patient's 32
health care information for research purposes; or 33
(b) Third-party payors if the information is only disclosed for 34
payment purposes. 35
(((5))) (4) Except as provided by this chapter, the signing of an 36
authorization by a patient is not a waiver of any rights a patient 37
has under other statutes, the rules of evidence, or common law.38
(((6))) (5) When an authorization permits the disclosure of 39
health care information to a financial institution or an employer of 40
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the patient for purposes other than payment, the authorization as it 1
pertains to those disclosures shall expire one year after the signing 2
of the authorization, unless the authorization is renewed by the 3
patient. 4
(((7))) (6) A health care provider or health care facility shall 5
retain the original or a copy of each authorization or revocation in 6
conjunction with any health care information from which disclosures 7
are made. 8
(((8))) (7) Where the patient is under the supervision of the 9
department of corrections, an authorization signed pursuant to this 10
section for health care information related to mental health or drug 11
or alcohol treatment expires at the end of the term of supervision, 12
unless the patient is part of a treatment program that requires the 13
continued exchange of information until the end of the period of 14
treatment. 15
Sec. 4. RCW 70.02.080 and 2018 c 87 s 3 are each amended to read 16
as follows: 17
(1) Upon receipt of a written request from a patient to ((examine 18
or copy )) obtain all or part of the patient's recorded health care 19
information, a health care provider, as promptly as required under 20
the circumstances, but no later than ((fifteen)) 15 working days 21
after receiving the request shall: 22
(a) Make the information available for examination during regular 23
business hours and provide a copy, if requested, to the patient , the 24
patient's personal representative, or any person or entity designated 25
by the patient to receive the information; 26
(b) Inform the patient if the information does not exist or 27
cannot be found; 28
(c) If the health care provider does not maintain a record of the 29
information, inform the patient and provide the name and address, if 30
known, of the health care provider who maintains the record;31
(d) If the information is in use or unusual circumstances have 32
delayed handling the request, inform the patient and specify in 33
writing the reasons for the delay and the earliest date, not later 34
than ((twenty-one)) 21 working days after receiving the request, when 35
the information will be available for examination or copying or when 36
the request will be otherwise disposed of; or 37
(e) Deny the request, in whole or in part, under RCW 70.02.090 38
and inform the patient. 39
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(2) Upon request, the health care provider shall provide an 1
explanation of any code or abbreviation used in the health care 2
information. If a record of the particular health care information 3
requested is not maintained by the health care provider in the 4
requested form, the health care provider is not required to create a 5
new record or reformulate an existing record to make the health care 6
information available in the requested form. Except as provided in 7
((RCW 70.02.030)) section 1 of this act , the health care provider may 8
charge a reasonable fee for ((providing)) assisting the designated 9
recipient to obtain the health care information and is not required 10
to ((permit examination or copying )) provide the health care 11
information until the fee is paid. 12
Sec. 5. RCW 70.02.090 and 2005 c 274 s 331 are each amended to 13
read as follows: 14
(1) Subject to any conflicting requirement in the public records 15
act, chapter 42.56 RCW, a health care provider may deny access to 16
health care information by a patient if the health care provider 17
reasonably concludes that: 18
(a) Knowledge of the health care information would be injurious 19
to the health of the patient; 20
(b) Knowledge of the health care information could reasonably be 21
expected to lead to the patient's identification of an individual who 22
provided the information in confidence and under circumstances in 23
which confidentiality was appropriate; 24
(c) Knowledge of the health care information could reasonably be 25
expected to cause danger to the life or safety of any individual;26
(d) The health care information was compiled and is used solely 27
for litigation, quality assurance, peer review, or administrative 28
purposes; or 29
(e) Access to the health care information is otherwise prohibited 30
by state or federal law. 31
(2) If a health care provider denies a request for ((examination 32
and copying )) the patient to obtain health care information under 33
this section, the provider, to the extent possible, shall segregate 34
health care information for which access has been denied under 35
subsection (1) of this section from information for which access 36
cannot be denied and permit the patient to ((examine or copy)) obtain 37
the disclosable information. 38
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(3) If a health care provider denies a patient's request for 1
((examination and copying )) obtaining health care information , in 2
whole or in part, under subsection (1)(a) or (c) of this section, the 3
provider shall permit ((examination and copying of the record by )) 4
another health care provider ((,)) to obtain the health care 5
information if the other health care provider has been selected by 6
the patient ((, who )) and is licensed, certified, registered, or 7
otherwise authorized under the laws of this state to treat the 8
patient for the same condition as the health care provider denying 9
the request. The health care provider denying the request shall 10
inform the patient of the patient's right to select another health 11
care provider under this subsection. The patient shall be responsible 12
for arranging for compensation of the other health care provider so 13
selected. 14
Sec. 6. RCW 70.02.170 and 1991 c 335 s 801 are each amended to 15
read as follows: 16
(1) A person who has complied with this chapter may maintain an 17
action for the relief provided in this section against a health care 18
provider or facility who has not complied with this chapter.19
(2) The court may order the health care provider or other person 20
to comply with this chapter. Such relief may include actual damages, 21
but shall not include consequential or incidental damages. The court 22
shall award reasonable attorneys' fees and all other expenses 23
reasonably incurred to the prevailing ((party)) patient.24
(3) Any action under this chapter is barred unless the action is 25
commenced within two years after the cause of action is discovered.26
(4) A violation of this chapter shall not be deemed a violation 27
of the consumer protection act, chapter 19.86 RCW.28
(5) For the purposes of this section, "prevailing patient" 29
includes:30
(a) The patient;31
(b) The patient's legal or authorized representative, including a 32
person authorized to consent to health care for the patient under RCW 33
70.02.130;34
(c) The patient's power of attorney;35
(d) The patient's guardian; and36
(e) The patient's estate.37
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Sec. 7. RCW 70.02.220 and 2021 c 270 s 5 are each amended to 1
read as follows: 2
(1) No person may disclose or be compelled to disclose the 3
identity of any person who has investigated, considered, or requested 4
a test or treatment for a sexually transmitted disease, except as 5
authorized by this section, RCW 70.02.210, or chapter 70.24 RCW.6
(2) No person may disclose or be compelled to disclose 7
information and records related to sexually transmitted diseases, 8
except as authorized by this section, RCW 70.02.210, 70.02.205, or 9
chapter 70.24 RCW. A person may disclose information related to 10
sexually transmitted diseases about a patient without the patient's 11
authorization, to the extent a recipient needs to know the 12
information, if the disclosure is to: 13
(a) The subject of the test or the subject's ((legal)) 14
representative for health care decisions in accordance with RCW 15
7.70.065, with the exception of such a representative of a minor 16
((fourteen)) 14 years of age or over and otherwise capable of making 17
health care decisions; 18
(b) The state health officer as defined in RCW 70.24.017, a local 19
public health officer, or the centers for disease control of the 20
United States public health service in accordance with reporting 21
requirements for a diagnosed case of a sexually transmitted disease;22
(c) A health facility or health care provider that procures, 23
processes, distributes, or uses: (i) A human body part, tissue, or 24
blood from a deceased person with respect to medical information 25
regarding that person; (ii) semen, including that was provided prior 26
to March 23, 1988, for the purpose of artificial insemination; or 27
(iii) blood specimens; 28
(d) Any state or local public health officer conducting an 29
investigation pursuant to RCW 70.24.024, so long as the record was 30
obtained by means of court-ordered HIV testing pursuant to RCW 31
70.24.340 or 70.24.024; 32
(e) A person allowed access to the record by a court order 33
granted after application showing good cause therefor. In assessing 34
good cause, the court shall weigh the public interest and the need 35
for disclosure against the injury to the patient, to the physician-36
patient relationship, and to the treatment services. Upon the 37
granting of the order, the court, in determining the extent to which 38
any disclosure of all or any part of the record of any such test is 39
necessary, shall impose appropriate safeguards against unauthorized 40
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disclosure. An order authorizing disclosure must: (i) Limit 1
disclosure to those parts of the patient's record deemed essential to 2
fulfill the objective for which the order was granted; (ii) limit 3
disclosure to those persons whose need for information is the basis 4
for the order; and (iii) include any other appropriate measures to 5
keep disclosure to a minimum for the protection of the patient, the 6
physician-patient relationship, and the treatment services;7
(f) Persons who, because of their behavioral interaction with the 8
infected individual, have been placed at risk for acquisition of a 9
sexually transmitted disease, as provided in RCW 70.24.022, if the 10
health officer or authorized representative believes that the exposed 11
person was unaware that a risk of disease exposure existed and that 12
the disclosure of the identity of the infected person is necessary;13
(g) A law enforcement officer, firefighter, health care provider, 14
health care facility staff person, department of correction's staff 15
person, jail staff person, or other persons as defined by the board 16
of health in rule pursuant to RCW 70.24.340, who has requested a test 17
of a person whose bodily fluids he or she has been substantially 18
exposed to, pursuant to RCW 70.24.340, if a state or local public 19
health officer performs the test; 20
(h) Claims management personnel employed by or associated with an 21
insurer, health care service contractor, health maintenance 22
organization, self-funded health plan, state administered health care 23
claims payer, or any other payer of health care claims where such 24
disclosure is to be used solely for the prompt and accurate 25
evaluation and payment of medical or related claims. Information 26
released under this subsection must be confidential and may not be 27
released or available to persons who are not involved in handling or 28
determining medical claims payment; and 29
(i) A department of children, youth, and families worker, a 30
child-placing agency worker, or a guardian ad litem who is 31
responsible for making or reviewing placement or case-planning 32
decisions or recommendations to the court regarding a child, who is 33
less than ((fourteen)) 14 years of age, has a sexually transmitted 34
disease, and is in the custody of the department of children, youth, 35
and families or a licensed child-placing agency. This information may 36
also be received by a person responsible for providing residential 37
care for such a child when the department of social and health 38
services, the department of children, youth, and families, or a 39
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licensed child-placing agency determines that it is necessary for the 1
provision of child care services. 2
(3) No person to whom the results of a test for a sexually 3
transmitted disease have been disclosed pursuant to subsection (2) of 4
this section may disclose the test results to another person except 5
as authorized by that subsection. 6
(4) The release of sexually transmitted disease information 7
regarding an offender or detained person, except as provided in 8
subsection (2)(d) of this section, is governed as follows:9
(a) The sexually transmitted disease status of a department of 10
corrections offender who has had a mandatory test conducted pursuant 11
to RCW 70.24.340(((1))), 70.24.360, or 70.24.370 must be made 12
available by department of corrections health care providers and 13
local public health officers to the department of corrections health 14
care administrator or infection control coordinator of the facility 15
in which the offender is housed. The information made available to 16
the health care administrator or the infection control coordinator 17
under this subsection (4)(a) may be used only for disease prevention 18
or control and for protection of the safety and security of the 19
staff, offenders, and the public. The information may be submitted to 20
transporting officers and receiving facilities, including facilities 21
that are not under the department of corrections' jurisdiction 22
according to the provisions of (d) and (e) of this subsection.23
(b) The sexually transmitted disease status of a person detained 24
in a jail who has had a mandatory test conducted pursuant to RCW 25
70.24.340(((1))), 70.24.360, or 70.24.370 must be made available by 26
the local public health officer to a jail health care administrator 27
or infection control coordinator. The information made available to a 28
health care administrator under this subsection (4)(b) may be used 29
only for disease prevention or control and for protection of the 30
safety and security of the staff, offenders, detainees, and the 31
public. The information may be submitted to transporting officers and 32
receiving facilities according to the provisions of (d) and (e) of 33
this subsection. 34
(c) Information regarding the sexually transmitted disease status 35
of an offender or detained person is confidential and may be 36
disclosed by a correctional health care administrator or infection 37
control coordinator or local jail health care administrator or 38
infection control coordinator only as necessary for disease 39
prevention or control and for protection of the safety and security 40
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of the staff, offenders, and the public. Unauthorized disclosure of 1
this information to any person may result in disciplinary action, in 2
addition to the penalties prescribed in RCW 70.24.080 or any other 3
penalties as may be prescribed by law. 4
(d) Notwithstanding the limitations on disclosure contained in 5
(a), (b), and (c) of this subsection, whenever any member of a jail 6
staff or department of corrections staff has been substantially 7
exposed to the bodily fluids of an offender or detained person, then 8
the results of any tests conducted pursuant to RCW 70.24.340(((1))), 9
70.24.360, or 70.24.370, must be immediately disclosed to the staff 10
person in accordance with the Washington Administrative Code rules 11
governing employees' occupational exposure to blood-borne pathogens. 12
Disclosure must be accompanied by appropriate counseling for the 13
staff member, including information regarding follow-up testing and 14
treatment. Disclosure must also include notice that subsequent 15
disclosure of the information in violation of this chapter or use of 16
the information to harass or discriminate against the offender or 17
detainee may result in disciplinary action, in addition to the 18
penalties prescribed in RCW 70.24.080, and imposition of other 19
penalties prescribed by law. 20
(e) The staff member must also be informed whether the offender 21
or detained person had any other communicable disease, as defined in 22
RCW 72.09.251(3), when the staff person was substantially exposed to 23
the offender's or detainee's bodily fluids. 24
(f) The test results of voluntary and anonymous HIV testing or 25
HIV-related condition ((, as defined in RCW 70.24.017,)) may not be 26
disclosed to a staff person except as provided in this section and 27
RCW 70.02.050(1)(d) and 70.24.340. A health care administrator or 28
infection control coordinator may provide the staff member with 29
information about how to obtain the offender's or detainee's test 30
results under this section and RCW 70.02.050(1)(d) and 70.24.340.31
(5) The requirements of this section do not apply to the 32
customary methods utilized for the exchange of medical information 33
among health care providers in order to provide health care services 34
to the patient, nor do they apply within health care facilities where 35
there is a need for access to confidential medical information to 36
fulfill professional duties. 37
(6) Upon request of the victim, disclosure of test results under 38
this section to victims of sexual offenses under chapter 9A.44 RCW 39
must be made if the result is negative or positive. The county 40
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prosecuting attorney shall notify the victim of the right to such 1
disclosure. The disclosure must be accompanied by appropriate 2
counseling, including information regarding follow-up testing.3
(7) A person, including a health care facility or health care 4
provider, shall disclose the identity of any person who has 5
investigated, considered, or requested a test or treatment for a 6
sexually transmitted disease and information and records related to 7
sexually transmitted diseases to federal, state, or local public 8
health authorities, to the extent the health care provider is 9
required by law to report health care information; when needed to 10
determine compliance with state or federal certification or 11
registration rules or laws; or when needed to protect the public 12
health. Any health care information obtained under this subsection is 13
exempt from public inspection and copying pursuant to chapter 42.56 14
RCW. 15
Sec. 8. RCW 70.02.260 and 2024 c 290 s 6 and 2024 c 209 s 34 are 16
each reenacted and amended to read as follows: 17
(1)(a) A mental health service agency shall release to the 18
persons authorized under subsection (2) of this section, upon 19
request: 20
(i) The fact, place, and date of an involuntary commitment, the 21
fact and date of discharge or release, and the last known address of 22
a person who has been committed under chapter 71.05 or 71.34 RCW.23
(ii) Information and records related to mental health services, 24
in the format determined under subsection (9) of this section, 25
concerning a person who: 26
(A) Is currently committed to the custody or supervision of the 27
department of corrections or the indeterminate sentence review board 28
under chapter 9.94A or 9.95 RCW; 29
(B) Has been convicted or found not guilty by reason of insanity 30
of a serious violent offense; or 31
(C) Was charged with a serious violent offense and the charges 32
were dismissed under RCW 10.77.086. 33
(b) Legal counsel for the mental health service agency, including 34
a county prosecutor or assistant attorney general who represents the 35
mental health service agency for the purpose of involuntary 36
commitment proceedings, may release this information on behalf of the 37
mental health service agency. 38
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(c) Nothing in this subsection requires the disclosure of 1
attorney work product or attorney-client privileged information.2
(2) The information subject to release under subsection (1) of 3
this section must be released to law enforcement officers, city or 4
county prosecuting attorneys, personnel of a county, city, or tribal 5
jail or tribal detention or holding facility, designated mental 6
health professionals or designated crisis responders, as appropriate, 7
public health officers, therapeutic court personnel as defined in RCW 8
71.05.020, or personnel of the department of corrections, including 9
the indeterminate sentence review board and personnel assigned to 10
perform board-related duties, when such information is requested 11
during the course of business and for the purpose of carrying out the 12
responsibilities of the requesting person's office. No mental health 13
service agency or person employed by a mental health service agency, 14
or its legal counsel, may be liable for information released to or 15
used under the provisions of this section or rules adopted under this 16
section except under RCW 71.05.680. 17
(3) A person who requests information under subsection (1)(a)(ii) 18
of this section must comply with the following restrictions:19
(a) Information must be requested only for the purposes permitted 20
by this subsection and for the purpose of carrying out the 21
responsibilities of the requesting person's office. Appropriate 22
purposes for requesting information under this section include:23
(i) Completing presentence investigations or risk assessment 24
reports; 25
(ii) Assessing a person's risk to the community;26
(iii) Assessing a person's risk of harm to self or others when 27
confined in a city or county jail; 28
(iv) Planning for and provision of supervision of an offender, 29
including decisions related to sanctions for violations of conditions 30
of community supervision; ((and))31
(v) Responding to an offender's failure to report for department 32
of corrections supervision; and 33
(vi) Assessing the need for an extreme risk protection order 34
under chapter 7.105 RCW; 35
(b) Information may not be requested under this section unless 36
the requesting person has reasonable suspicion that the individual 37
who is the subject of the information: 38
(i) Has engaged in activity indicating that a crime or a 39
violation of community custody or parole has been committed or, based 40
p. 19 SB 5254
upon his or her current or recent past behavior, is likely to be 1
committed in the near future; or 2
(ii) Is exhibiting signs of a deterioration in mental functioning 3
which may make the individual appropriate for civil commitment under 4
chapter 71.05 or 71.34 RCW, or which is associated with a recent 5
detention or order of commitment under chapter 71.05 or 71.34 RCW or 6
an order of commitment or dismissal of charges under chapter 10.77 7
RCW; and 8
(c) Any information received under this section must be held 9
confidential and subject to the limitations on disclosure outlined in 10
this chapter, except: 11
(i) The information may be shared with other persons who have the 12
right to request similar information under subsection (2) of this 13
section, solely for the purpose of coordinating activities related to 14
the individual who is the subject of the information in a manner 15
consistent with the official responsibilities of the persons 16
involved; 17
(ii) The information may be shared with a prosecuting attorney 18
who is acting in an advisory capacity for a person who receives 19
information under this section or who is carrying out other official 20
duties within the scope of this section. A prosecuting attorney under 21
this subsection is subject to the same restrictions and 22
confidentiality limitations as the person who requested the 23
information; and 24
(iii) As provided in RCW 72.09.585. 25
(4) A request for information and records related to mental 26
health services under this section does not require the consent of 27
the subject of the records. The request must be provided in writing, 28
except to the extent authorized in subsection (5) of this section. A 29
written request may include requests made by email or facsimile so 30
long as the requesting person is clearly identified. The request must 31
specify the information being requested. 32
(5) In the event of an emergency situation that poses a 33
significant risk to the public or the offender, a mental health 34
service agency, or its legal counsel, shall release information 35
related to mental health services delivered to the offender and, if 36
known, information regarding where the offender is likely to be found 37
to the department of corrections or law enforcement upon request. The 38
initial request may be written or oral. All oral requests must be 39
subsequently confirmed in writing. Information released in response 40
p. 20 SB 5254
to an oral request is limited to a statement as to whether the 1
offender is or is not being treated by the mental health service 2
agency and the address or information about the location or 3
whereabouts of the offender. 4
(6) Disclosure under this section to state or local law 5
enforcement authorities is mandatory for the purposes of the federal 6
health insurance portability and accountability act.7
(7) Whenever federal law or federal regulations restrict the 8
release of information contained in the treatment records of any 9
patient who receives treatment for alcoholism or drug dependency, the 10
release of the information may be restricted as necessary to comply 11
with federal law and regulations. 12
(8) This section does not modify the terms and conditions of 13
disclosure of information related to sexually transmitted diseases 14
under this chapter. 15
(9) In collaboration with interested organizations, the authority 16
shall develop a standard form for requests for information related to 17
mental health services made under this section and a standard format 18
for information provided in response to the requests. Consistent with 19
the goals of the health information privacy provisions of the federal 20
health insurance portability and accountability act, in developing 21
the standard form for responsive information, the authority shall 22
design the form in such a way that the information disclosed is 23
limited to the minimum necessary to serve the purpose for which the 24
information is requested. 25
(10) For the purposes of this section, "legal counsel" has the 26
same meaning as in RCW 71.05.020.27
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