LBOH Tribal Membership

Clarifying Tribal Representation and Timelines for Modifying LBOH Membership

Summary

Engrossed Substitute House Bill (ESHB) 1946 passed during the 2025 legislative session. This law requires the State Board of Health (Board) to clarify its local board of health composition rules and timelines for including Tribal representation on local boards of health (Chapter 246-90 WAC). The law reinforces Tribal Sovereignty and self-determination by shifting appointment of Tribal members from the American Indian Health Commission (AIHC) to the Tribes and Urban Indian organizations within a health jurisdiction.

This law is effective July 27, 2025. Local boards of health must follow this law when adding non-elected individuals, including Tribal representatives to their boards. After July 27, 2025, local boards of health must add Tribal members to their local boards of health within 60 days of receiving an appointment by a Tribe or Urban Indian health organization. The law requires the Board to establish timelines for modifying local board of health membership in chapter 246-90 WAC by July 27, 2026.

Public Comment

Information will be updated here as the Board conducts rulemaking, including opportunities to provide informal and formal public comment.

For More Information

Statutory Authority: RCW 43.20.300

Board Contact: Ashley Bell, ashley.bell@sboh.wa.gov

Project Email: lbohcomposition@sboh.wa.gov

Interested Parties List: Join our interested parties list!

Additional Background

The State Board of Health (Board) will update chapter 246-90 WAC to implement Engrossed Substitute House Bill (ESHB) 1946. This law clarifies the requirements for Tribal representation on Local Boards of Health (LBOH). It also requires the Board to adopt rules to establish timelines for adjusting local board of health membership to keep a balanced mix of elected and non-elected members when Tribal representatives are added.

The previous law required the American Indian Health Commission (AIHC) to select Tribal representatives for LBOHs. The new law expands representation by allowing each Tribe and Urban Indian organization recognized by the Indian Health Service and registered as a 501(c)(3) within a jurisdiction to choose its representative for LBOHs or health district boards. It shifts the appointment authority from LBOHs to the Tribes and Organizations, respecting Tribal sovereignty and self-determination.

Under RCW 43.20.300, the Board has the authority to set rules for appointing non-elected members, including Tribal representatives, to LBOHs. ESHB 1946 goes into effect July 27, 2025. The law requires the Board to adopt rules for adjusting LBOH membership by July 27, 2026.