SSB 5254
In CommitteeSenate
Health care information
Strengthening patients' rights regarding their health care information.
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 strengthens patient rights to access their health information by limiting fees, shortening record delivery timelines, and ensuring free copies in certain cases. It also clarifies when and how sensitive health data—including mental health and sexually transmitted disease records—can be shared with law enforcement, corrections, and public health agencies for safety, supervision, or public health purposes, while maintaining confidentiality safeguards.
- Limits fees for patients and designated representatives (e.g., attorneys, advocates, guardians, other providers) to obtain health records to $50, and prohibits per-page fees—fees must reflect actual search and production costs.
- Requires health care providers to provide patient records within 15 working days (with a possible extension to 21 days under unusual circumstances) upon written request.
- Allows patients to request one free copy of their health records if appealing Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits, once every two years.
- Strengthens enforcement: patients (or their representatives) can sue for actual damages and attorney fees if a provider violates the law, with a two-year statute of limitations.
- Expands access to mental health and sexually transmitted disease records for specific authorized officials (e.g., law enforcement, corrections, public health) under strict confidentiality and purpose-based limitations, including emergency access procedures.
Who is affected
- Patients — Patients have stronger rights to access their own health records, and protections against excessive fees when requesting them.
- Health care providers and facilities — Health care providers and facilities must comply with new rules about providing records, including fee limits and timelines, and may face legal liability for noncompliance.
- Legal representatives and patient advocates — Attorneys, advocates, and guardians may request patient records on behalf of patients at no cost above the $50 cap, supporting legal or care coordination needs.
- Law enforcement, corrections, and public health agencies — Law enforcement, corrections staff, and public health officials gain limited access to certain mental health and sexually transmitted disease records under strict conditions for safety, supervision, or public health purposes.
- Mental health service agencies — Mental health service agencies must respond to specific requests for records from authorized officials, following new procedures and confidentiality rules.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
The $50 cap on record access fees—prohibiting per-page charges and applying to patients, attorneys, advocates, guardians, and providers—dramatically reduces out-of-pocket costs for vulnerable populations (e.g., low-income patients, people with disabilities, families of cognitively impaired adults), who previously faced unpredictable and often high fees (e.g., $15–$65 per page under prior law), making record access more equitable and reducing financial barriers to care coordination.
HealthcarePeopleRef: Sec. 1(2)(a)(i)-(vi)The requirement to provide records within 15 working days (with a 21-day max) and one free copy every two years for SSDI/SSI appeals significantly strengthens patient agency in critical benefit disputes—this helps low-income and disabled Washingtonians who rely on federal benefits for survival, reducing delays that can lead to benefit denials and financial hardship.
HealthcarePeopleRef: Sec. 2(2)(b) & Sec. 4(1)The right to sue for actual damages and attorney fees (with a two-year statute of limitations) and the expanded definition of “prevailing patient” (including guardians and estates) creates a strong enforcement mechanism that deters provider noncompliance—this benefits patients and families who lack legal resources but can now access legal redress without bearing full litigation costs.
HealthcarePeopleRef: Sec. 5(2) & Sec. 6(2)The bill tightens access to mental health records by requiring written requests, reasonable suspicion, purpose-based limitations, and strict confidentiality—this prevents blanket disclosures to law enforcement and ensures records are used only for legitimate supervision, risk assessment, or public safety, balancing transparency with privacy.
Public SafetyPeopleRef: Sec. 8(2) & (3)(c)(i)-(ii)The provision allowing disclosure of STI status to at-risk individuals (e.g., sexual partners) under strict conditions supports public health goals while preserving confidentiality—this empowers individuals to make informed decisions about exposure and testing, promoting safer behaviors without compromising broader trust in clinical settings.
Public SafetyPeopleRef: Sec. 7(2)(f)
Potential Concerns (5)
The $50 fee cap for health record access applies to guardians, but does not eliminate the fee entirely—low-income guardians (e.g., family members caring for disabled adults or elderly parents) may still struggle to pay $50, especially if multiple requests are needed for complex cases or appeals. This creates a modest barrier for economically vulnerable caregivers who are not professional advocates or attorneys.
HealthcarePeopleRef: Sec. 1(2)(a)(vi)The free copy provision is limited to SSDI/SSI appeals and restricted to once every two years—many patients with disabilities or mental health conditions require frequent record access for ongoing care coordination, appeals, or insurance disputes, so the current limitation may not fully meet real-world needs, especially for those without legal representation.
HealthcarePeopleRef: Sec. 1(3) & Sec. 2(2)(b)While the bill adds confidentiality safeguards, it explicitly permits disclosure of sensitive STI/HIV records to claims management personnel at insurers and health plans for claims processing—this could deter some patients from seeking testing or treatment due to fears of insurance underwriting implications, even if direct discrimination is illegal, because of perceived privacy risks.
HealthcarePeopleRef: Sec. 7(2)(h)The bill authorizes release of mental health records for individuals whose serious violent offense charges were *dismissed* under RCW 10.77.086—this risks stigmatizing individuals who were not convicted and may have successfully completed treatment or restoration, potentially undermining rehabilitation and reintegration, and could discourage people from seeking mental health services for fear of future record exposure.
Public SafetyPeopleRef: Sec. 8(1)(a)(ii)(C)The emergency oral request provision allows law enforcement or corrections to obtain location and treatment status without prior written authorization—while intended for imminent threats, the lack of a mandatory cooling-off period or independent review could enable overuse or misuse, especially in jurisdictions with limited oversight, potentially chilling voluntary engagement with mental health services.
Public SafetyPeopleRef: Sec. 8(5)
Who Is Most Affected
Low- and moderate-income patients—especially those with disabilities, mental illness, or chronic conditions—benefit significantly from fee caps, faster access, and free copies for benefit appeals. They gain greater control over their health data and stronger legal recourse, reducing financial and administrative barriers to care. However, some may still face modest costs ($50) or limited free copies, and may be deterred by perceived privacy risks in insurance contexts.
Attorneys, advocates, and guardians gain predictable, capped fees for obtaining records on behalf of clients or dependents—reducing administrative friction in legal and care coordination. However, they may still bear the $50 fee if representing clients who cannot pay, and the bill does not eliminate all cost barriers for pro bono or underfunded legal aid programs.
Healthcare providers face new compliance burdens (timelines, fee standards, record production), but benefit from clear legal standards and liability protections. Small clinics and safety-net providers may struggle with operational costs of rapid record delivery, though the $50 cap reduces patient complaints and potential lawsuits—net impact is mixed but leans slightly negative due to fixed costs.
Law enforcement and corrections staff gain limited, purpose-bound access to mental health and STI records for safety and supervision, but are bound by strict confidentiality and reasonable suspicion requirements. This improves interagency coordination while protecting against overreach—net positive for public safety functions, but requires training and oversight to avoid misuse.
Mental health agencies face new mandatory disclosure obligations but benefit from standardized request forms and legal protections against liability. The requirement to release records for dismissed charges (Sec. 8(1)(a)(ii)(C)) may strain resources and raise ethical concerns about stigmatizing non-convicted individuals—net impact is mixed, leaning slightly negative due to operational and reputational risks.