This bill reenacts and amends RCW 9.94A.728 and changes Washington law governing extraordinary medical placement and limits on partial confinement. It authorizes the secretary to approve an extraordinary medical placement when specified conditions are met: two physicians must assess that the incarcerated person has either a serious, chronic, degenerative medical condition that substantially limits self-care (or cannot be met in total confinement) or ill health with an expected death within approximately 18 months; a community risk assessment must find the person low risk at time of placement using factors such as institutional and programming history and the Washington one score; and the placement is expected to produce cost savings to the state. The provision expressly excludes people sentenced to death, life without parole, or sentenced as persistent offenders from eligibility. Physicians are responsible for medical diagnosis while department personnel assess risk. The bill creates procedural requirements for decisions: denials of extraordinary medical placement must include a written, individualized explanation and may be reviewed by the Office of Corrections Ombuds; electronic monitoring is required for all individuals in extraordinary medical placement unless monitoring is detrimental to health, interferes with medical equipment, or results in loss of medical funding, in which case an alternative monitoring method must be used; the secretary specifies the monitoring provider and terms and may revoke placement at any time. The governor, on recommendation of the Clemency and Pardons Board, may grant an extraordinary release for specified reasons or under RCW 9.94A.885. The bill also sets limits on partial confinement: no more than the final 18 months of a term can be served in work release or the parenting program; no more than the final 9 months may be served in home detention under the graduated reentry program except that individuals eligible under RCW 9.94A.733(1)(b) who serve at least three months in total confinement may serve up to the final 18 months in home detention. The department may release an incarcerated person any time within 10 days before a release date calculated under this section. The text defines "basic medical care needs" and describes the low-risk assessment factors, and cross-references multiple related RCWs. Certain details are not provided in the extracted text: the specific agency title for "the secretary" is not explicitly named here; "persistent offender" is not defined; the procedures for determining the required "cost savings to the state" are not described; who provides electronic monitoring and the specific monitoring terms are left to the secretary; and related definitions or eligibility details contained in the cited RCWs are not included.

If passed, the bill makes it more likely that seriously ill or terminal inmates who are assessed as low risk by the corrections department can be moved out of prison into community medical placements, subject to two independent physician assessments and an expectation of cost savings. The department will need to run community risk assessments, arrange and pay for electronic monitoring in most cases (or find approved alternatives when monitoring would harm health or jeopardize care funding), provide written explanations when placement is denied, and face possible review by the corrections ombuds; the governor and clemency board retain a path to extraordinary release. The primary impacts fall on incarcerated people who meet the medical and low‑risk criteria (who could get earlier community care but must accept monitoring and face possible revocation), the Department of Corrections (more assessments, monitoring arrangements, and written denials to manage, with potential cost savings but unclear calculation methods), and physicians (required to provide two medical opinions). Important details are left open here: the bill text does not explicitly name the secretary/department, does not define “persistent offender,” and does not specify how cost savings or monitoring providers and terms will be determined.