This bill creates statewide electronic registries and processes for storing advance health care documents and portable orders for life-sustaining treatment (POLST). It directs the Department of Health (DOH) to adopt guidelines and protocols for how emergency medical personnel respond to people who have signed written directives or appointed durable powers of attorney that request withholding certain emergency treatment, to develop a simple statewide POLST form with an option to opt out of registry submission, and to establish and maintain a secure, accessible electronic registry to digitally store POLST forms and specified health care declarations (directives, durable powers of attorney for health care, and mental health advance directives). The bill sets submission standards and procedures (including that signing clinicians or their agents must submit a signed POLST unless the individual opted out, and that individuals or personal representatives may submit digital documents), requires DOH to provide continuous access to submitters and authorized providers, prescribes revocation and archival procedures, requires annual notices to submitters to review registry materials, authorizes DOH to contract for registry operation and accept donations, and requires DOH to research alternative evidence of POLST preferences and report to the legislature by June 30, 2026. Legally, the measure creates new statutory procedures and a new statewide registry, amends RCW 43.70.480 and references an amendment to RCW 70.122.130, establishes procedural rules for signatures (including allowing witnessed verbal confirmation in limited circumstances and applying chapter 1.80 RCW to POLST signatures), and confers liability protections: providers acting in good faith under a POLST are immune from civil, criminal, or professional liability absent negligence, and DOH is not civilly liable for registry administration except for gross negligence, willful misconduct, or intentional wrongdoing. The registry and its contents are made exempt from public inspection under the Public Records Act, and DOH may adopt implementing rules. The text available is incomplete in some respects: the specific amendment text to RCW 70.122.130 is not included here, the final sentence of section 3 (including an expiration date) is cut off, and the full language of the public records exemption in section 5 is not provided. These missing pieces are necessary for a complete legal understanding and are not stated in the extracted facts.

If enacted, the bill creates a statewide, secure registry run by the Department of Health where Washington residents’ POLST forms and other advance health care declarations can be kept and accessed by patients, their personal representatives, and authorized health providers around the clock. Doctors, physician assistants, and nurse practitioners would have to submit signed POLST forms on a patient’s behalf unless the patient opts out, patients or their representatives can submit declarations digitally, providers who follow a POLST in good faith receive liability protection, and the DOH must issue a statewide POLST form, annual review notices to submitters, and a report to the Legislature by June 30, 2026 on alternative ways to indicate no-resuscitation wishes. The Department of Health will take on new ongoing operational duties and will likely need legislative appropriations or contracts to run the system, though it may accept donations that cannot be spent until appropriated. Providers will face some added administrative responsibilities to submit and verify forms but gain clearer legal protections when acting in good faith; patients gain easier access and stronger confidentiality protections (the registry is exempt from public copying). Important details are missing from the extracted text—including certain amended sections, an incomplete expiration date, and the specific amendment to RCW 70.122.130—so the scope, timing, and some implementation responsibilities remain uncertain.