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Committee hears expansion of extraordinary medical placement, including longer prognosis window
Summary
House Bill 2490 would expand extraordinary medical placement (EMP) eligibility—raising the expected-death threshold from six months to approximately 18 months and requiring safeguards such as two-physician assessments and risk considerations—advocates argued it would reduce costly in-prison care and litigation while DOC cautioned about placement planning and legal standards.
The House Community Safety Committee heard Jan. 27 on House Bill 2490, which would revise criteria for extraordinary medical placement (EMP) so incarcerated people with severe, chronic, or degenerative conditions can be placed in community or non-total-confinement settings when appropriate.
Committee counsel Lena Langer summarized current EMP criteria used by the Department of Corrections (DOC): two physicians must assess the person, the individual must be low risk to public safety and granting EMP must be expected to save state costs. Empirically, staff said DOC considered 74 incarcerated people for EMP in the last available report and granted five EMPs in 2024.
The proposed substitute (H-3095.1) would modify eligibility to require a serious, chronic, permanent or degenerative condition that substantially limits the person’s ability to care for themselves in total confinement, or a prognosis of expected death in about 18 months (up from six months). The bill also requires individualized written explanations when DOC denies EMP and allows review by the Office of Corrections Ombuds.
Advocates and clinicians urged passage. Rachel Sievers of Disability Rights Washington said prior reforms (cited as Senate Bill 5101 in committee discussion) produced little change: five grants in 2024 and additional people who died while applications languished. Mark Stern, a correctional physician and former DOC official, argued that keeping high-acuity patients in total confinement is costly and that EMP likely produces savings; David Flynn, DOC’s assistant secretary for health services, said the department supports EMP conceptually but wanted care standards and placement planning that protect public safety and reduce legal exposure.
Witnesses discussed a longer prognosis window for planning and practical placement development; supporters said 18 months gives the department time to create safe, Medicaid-eligible community placements rather than having people die before they can exit custody.
Committee members pressed on fiscal impact, legal standards and safeguards. The public record shows an active debate between advocates pressing for greater use of EMP to protect dignity and reduce litigation costs and DOC and clinicians emphasizing safe placement planning.
Public testimony closed Jan. 27; no action was taken that day.
