EFFECT:   Modifies transaction notice requirements such that all parties must provide basic notice regarding names, locations, and the transaction's nature, purpose, and date, while enhanced notice requirements apply to transactions that will foreseeably and directly cause a meaningful reduction in access to the provision of reproductive health care, gender affirming care, or end-of-life care in Washington or an affected community.

Modifies the provision restricting certain material change transactions by limiting it to transactions subject to enhanced notice requirements instead of all material change transactions. Provides transactions subject to enhanced notice requirements may not take place if they would detrimentally affect the continued existence of accessible, affordable reproductive health care, gender affirming care, or end-of-life health care in Washington state. Removes the general restriction on transactions detrimentally affecting any kind of health care, and the requirement that communities have the same or greater access to emergency care and primary care.

Modifies the provision governing the Attorney General's power to impose conditions or modifications on a material change transaction by specifying conditions or modifications may only be imposed to ensure access to affordable quality reproductive health care, gender affirming care, and end-of-life care.