This bill renames the governor's interagency coordinating council on health disparities to the governor's council for health justice and equity, reenacts and amends RCW 43.20.025 and amends RCW 43.20.270, 43.20.275, and 43.20.280. It directs the council to create an action plan and statewide policy addressing social determinants of health and to conduct health impact reviews of legislative and budgetary proposals. The state board of health is assigned to convene and assist the council, with possible Office of Financial Management staff support and only within expressly available funds. The bill prescribes council composition, a 24‑member size, at least two youth representatives (age 26 or younger), qualifications and appointment rules for non‑agency members, cochair appointment rules, decision‑making bylaws, and compensation/reimbursement per cited RCW sections. Some duties and the end of Sec. 4 are not fully shown in the provided text. The bill establishes a universal health care commission to plan immediate changes in access and delivery and to prepare for a unified financing system if federal authority becomes available. The Health Care Authority will staff the commission. Membership includes legislative appointees, executive agency heads or designees, and six governor appointees; meetings must be open to the public and the governor appoints the chair for a term up to three years. The commission must produce a baseline report (specified elements listed) and annual reports beginning after the baseline; it must start any necessary federal application process within 60 days of that authority becoming available but may not implement a unified financing system without further legislative and gubernatorial action. Commission members serve without compensation but are reimbursed for travel. The bill creates new hospital reporting and transparency requirements: hospitals must complete an initial community health needs assessment per IRS rules and then submit such assessments to the Department of Health and make them publicly available every three years. Beginning July 1, 2022, hospitals (with distinctions for Medicare‑designated critical access and sole community hospitals) must annually submit addenda reporting community health improvement services above specified cost thresholds with defined content, and the Department of Health must post submitted information, provide guidance and a standard form, and require demographic participant data (race, ethnicity, disability, gender identity, preferred language, zip code) subject to a six‑year review cycle. Hospitals must develop and publicly post community benefit implementation strategies within one year of each assessment and explain rejected stakeholder recommendations. The bill also repeals RCW 44.28.810. The provided text omits full language for some amendments (including those to RCW 41.05.840 and 70.41.470) and cuts off portions of several sections, so complete details and any additional deadlines or enforcement provisions are not visible here.

If enacted, the bill formally creates a governor's council for health justice and equity with 24 members, requires it to produce an action plan and statewide policy that includes health impact reviews and addresses social determinants of health, and requires regular public reports beginning October 31, 2027 and biennially through 2039. State agencies, the state board of health, and the Health Care Authority must provide staff time and coordination (the state board is assigned to convene the council and HCA will staff a separate universal health care commission), but those duties are to be carried out within expressly available funds, so agencies will likely need to reallocate existing staff and resources rather than receive guaranteed new funding. Council members and certain commission members will be eligible for travel reimbursement, and the council must use community engagement methods and coordinate with other equity and environmental justice bodies, increasing requirements for consultation and reporting across many state agencies and community groups. Hospitals that are nonprofit and other hospitals covered by the bill face new and ongoing reporting and transparency duties: triennial submission of IRS-aligned community health needs assessments to a state department, annual addenda reporting community health improvement activities costing $5,000 or more (or the top 10 for certain small hospitals), demographic participant data, and a publicly available community benefit implementation strategy developed with local stakeholders. These provisions will create additional administrative costs and data-collection responsibilities for hospitals and workload for the receiving department to post and guide reporting; participant demographic reporting is voluntary and refusal cannot be penalized. Key implementation details are unclear in the extracted text—most notably the identity of the receiving department for hospital submissions, full duties and timelines in one amended section, and whether new funding or enforcement mechanisms are provided—so the likely administrative burden and exact fiscal impact remain uncertain.