SSB 5823
In CommitteeSenate
Patient advocates
Concerning patient advocates.
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 requires most Washington hospitals to have a patient advocate on staff and on-site 24/7 by January 1, 2027, to help patients navigate care, communicate with providers, and access services. Some rural, island, and tribal hospitals are exempt but must still provide access to a patient advocate through other means.
- Hospitals must employ a patient advocate who is physically present on-site 24 hours a day, 7 days a week, starting January 1, 2027.
- Certain hospitals are exempt—including rural hospitals certified as sole community or critical access hospitals, island-based hospitals in Skagit County, and certain tribal hospitals—but must still provide patients with access to a patient advocate via phone, video, or other means.
- Patient advocates must help patients access medical records, schedule appointments, understand treatment options, and communicate with providers and insurers.
- Hospitals must verify that any external patient advocacy services they refer patients to are active and familiar with Washington’s health care system.
- Hospitals must inform patients how to share medical information with the patient advocate, including how to release medical records.
Who is affected
- Hospital patients — Patients at hospitals covered by the law will gain access to a dedicated staff member available 24/7 to help them understand and navigate their care, communicate with providers, obtain records, and coordinate follow-up care.
- Hospitals (licensed under chapter 70.41 RCW) — Hospitals must hire and schedule a full-time patient advocate on-site daily, unless they qualify for an exemption.
- Exempt hospitals (e.g., rural, critical access, tribal, or island-based) — Rural hospitals, island-based public hospital districts in Skagit County, and certain tribal hospitals may be exempt from having an on-site advocate but must still provide access to a patient advocate service.
- Patient advocacy organizations and services — Patient advocacy services (e.g., state or regional programs) may see increased demand for coordination with hospitals to support patients who need help beyond the hospital setting.
Pro/Con Analysis
Potential Benefits (2)
Patients—especially those with limited health literacy, limited English proficiency, or complex chronic conditions—will gain consistent, on-demand support to understand treatment options, navigate insurance, and communicate effectively with providers, directly improving care quality and reducing avoidable complications.
HealthcarePeopleRef: Sec. 1(1), (4)By formalizing patient advocacy as a hospital responsibility, the bill strengthens patient autonomy and informed consent, empowering individuals to exercise agency over their care decisions and reducing the risk of miscommunication or coercion.
Rights & LibertiesPeopleRef: Sec. 1(4)(a)-(d)
Potential Concerns (3)
Hospitals—especially mid-sized and independent community hospitals—will face significant new staffing costs to hire and retain full-time, on-site patient advocates 24/7, potentially diverting resources from other clinical or operational priorities.
Business & EmploymentPeopleRef: Sec. 1(1)Rural, island-based, and tribal hospitals—many of which operate on thin margins and rely heavily on Medicaid/Medicare reimbursements—will face challenges meeting the requirement even with external access, as verifying and contracting with qualified advocacy services still incurs administrative and financial burdens.
Local GovernmentPeopleRef: Sec. 1(2)(a)-(c)The requirement to verify external advocacy services may create administrative delays and confusion for patients if hospitals lack capacity to vet or coordinate with third-party advocates, potentially undermining timely access to advocacy support.
HealthcarePeopleRef: Sec. 1(3)
Who Is Most Affected
Patients—particularly those with low income, limited English proficiency, or complex health needs—will benefit most, as they often lack the time, knowledge, or social capital to navigate complex hospital systems alone. The 24/7 on-site advocate directly addresses barriers to equitable care access.
Independent and rural hospitals—especially those operating at or near break-even—will face meaningful new labor and operational costs. While exempt hospitals avoid on-site staffing, they still must contract and verify external services, adding administrative burden without revenue support.
Nurses, social workers, and other clinical staff may see increased collaboration with patient advocates, but could also face role confusion or added workload if advocates are not clearly integrated into care teams. Some may benefit from reduced burden in patient education and coordination tasks.
Existing patient advocacy organizations (e.g., state health advocacy coalitions, nonprofit patient navigators) may see increased demand for contracts or referrals, but also pressure to scale services quickly—potentially straining capacity and quality if funding does not follow.
Insurers and providers may benefit indirectly from improved care coordination and reduced avoidable readmissions, but will not bear direct costs. The policy does not require insurer collaboration, so systemic benefits may be limited without additional incentives.