Clarifying Tribal Representation and Timelines for Modifying Local Board of Health (LBOH) Membership
Summary
The Washington State Board of Health (Board) sets rules for appointing non-elected members to local boards of health (LBOHs) under chapter 246-90 WAC. These rules ensure appointments are fair and unbiased and that boards include a balance of elected and non-elected members. In 2025, the Legislature passed Engrossed Substitute House Bill 1946, which clarifies how Tribal representatives are included on LBOHs. In response, the Board updated its rules in June 2026 to implement these changes. The updates clarify Tribal representation and extend the timeline for updating board membership from 60 to 90 days, giving LBOHs more flexibility. The rule takes effect July 27, 2026.
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) has adopted updates to chapter 246-90 WAC to implement Engrossed Substitute House Bill (ESHB) 1946 (Chapter 260, Laws of 2025).
Chapter 246-90 WAC provides local governments with a standard process for the recruitment and ultimate appointment of non-elected members of local boards of health (LBOHs). This includes Tribal representatives.
ESHB 1946 took effect on July 27, 2025. It updated LBOH composition laws to clarify the process for appointing Tribal representatives and directed the Board to update chapter 246-90 WAC to establish a timeline for modifying LBOH membership to maintain a balance of elected and non-elected members as Tribal representatives are added.
The Board approved changes to chapter 246-90 WAC at its public meeting on June 4, 2026. These changes, which are outlined in the concise explanatory statement, include:
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Clarifying that chapter 246-90 WAC applies to the appointment of Tribal representatives, consistent with state law, and confirming Tribal appointment authority
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Adding a definition of “Tribal representative” that aligns with state law
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Establishing timelines for county legislative authorities or boards of county commissioners to update LBOH membership after a Tribal representative is appointed by a Tribe or Tribal organization
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Extending the timeframe for updating LBOH membership from 60 to 90 days to provide additional flexibility for counties that do not meet monthly
These updates ensure that county legislative authorities, boards of county commissioners, and LBOHs comply with the new requirements established in ESHB 1946.
If you have questions or would like more information on these rules, please contact Ashley Bell at lbohcomposition@sboh.wa.gov.
To request documents in an alternative format or a different language or to request meeting accommodations, please contact the State Board of Health at 360-236-4110 or by email at wsboh@sboh.wa.gov.
This project was announced on September 10, 2025, under WSR 25-19-045 (CR-101).
The draft proposed rules and rules hearing were announced on April 20, 2026, and are listed under WSR 26-09-104 (CR-102).
The final adopted rules were announced on June 18, 2026. They are listed under WSR 26-14-015 (CR-103)
Related Links
Frequently Asked Questions (ESHB 1946) (PDF) - updated January 2026
Information Sheet (ESHB 1946) (PDF)
LBOH Tribal Rep (ESHB 1946) One-pager (PDF)
ESHB 1946 (2025): 1946-S.SL.pdf
Final Bill Report ESHB 1946 (2025)
HB 1946 Washington State Legislature
Previous Rulemaking: Local Board of Health Composition | SBOH
SB 5970 Washington State Legislature (2024 bill to adjust LBOH membership in Thurston County)
June 4, 2026, Public Meeting
April 8, 2026, Public Meeting
March 12, 2026, Public Meeting
Tribal Reservations and Trust Lands Map
The map below shows Tribal reservations and Tribal trust lands in Washington State as of October 2025. Tribal lands identified in this map may change. The map is intended to illustrate eligible Tribal lands and Tribal organizations that may appoint Tribal representatives to local boards of health under RCW 43.20.300 and was created for this rulemaking. This map is not a replacement for legal guidance. Local Boards of Health seeking clarity on how RCW 43.20.300 applies to them should contact their legal counsel. [SBOH Tribal Map Reference Information Sheet]
