On page 6, line 38, after "(3)" insert "For material change transactions where none of the parties are hospitals or hospital systems or an affiliate of a hospital or hospital system, and the material change transaction would not result in: Reducing access to health services, including reproductive health care services, end-of-life care services, and gender-affirming health care services, if appropriate; worsening health care outcomes; and increasing consumers' health care costs; the written notice provided by the parties, as required by RCW 19.390.030, must include:

(a) The information and documentation required under subsection (1)(a) through (d) of this section; and

(b) Documentation describing how the parties will address health care access, outcomes, and costs and how the material change transaction will likely impact the delivery and cost of health-related services to the community and help to address health inequities.

(4)"

EFFECT: Reduces the written notice requirements where none of the parties are hospitals, hospital systems, or an affiliate of a hospital or hospital system, and the material change transaction would not result in reducing access, worsening health care outcomes, and increasing consumer health costs.