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Local and Tribal Public Health

Local Public Health

Washington State law gives primary responsibility for the health and safety of Washington residents to 39 county governments. It charges the counties’ legislative authorities with establishing either a county department or a health district to assure the public’s health. (RCW 70.05, 70.08, 70.46) In Washington State the governmental public health system consists of 35 local public health agencies or local health jurisdictions (LHJs) that work with the state Department of Health. In three cases, county legislative authorities have formed multi-county health districts.

Each county legislative authority must also establish a local board of health, which 'shall have supervision over all matters pertaining to the preservation of the life and health of the people within its jurisdiction.' (RCW 70.05.060) Local boards of health approve the budgets, programs, and policies of local public health agencies and may also appoint the agency administrator. Board members include county commissioners or members of the county council and may include elected or non-elected officials. Elected officials must always make up the majority.

Federally Recognized Tribes

In Washington State, tribes and urban Indian health clinics have been working formally to advance tribal-state collaboration on the delivery of health care services for a decade. The involvement of Indian tribes in the development of public health and human services policy promotes locally relevant and culturally appropriate approaches to issues of mutual interest or concern. Read more about our partnership with Federally recognized tribes.