Legislation passed in the last session requires local health boards in Washington to add new members or at least mix members by July. Some of the legislation that calls for tribal representation on health boards has led to differing interpretations of the state’s new law.

While many believe the law intends to have a single tribal representative on each county health board, the American Indian Health Commission argues that it is broader and that each tribe owning land within the boundaries of a county would have a representative.

In Spokane County, this would mean the Spokane, Kalispel, and Colville Tribes, as well as the NATIVE Project, would be eligible to serve on the board.

The legislation directs the American Indian Health Commission to appoint tribal representation to statewide boards of health. The commission is made up of representatives from each tribe, the Urban Indian Health Organization and the state’s American Indian Community Center.

The commission asks tribes and organizations to use resolutions to appoint members to boards of health, said Vicki Lowe, executive director of the commission.

The legislation states that “if a federally recognized Indian tribe holds a reservation, trust land, or owns customary and customary areas in the county, or if a Washington-registered 501(c)(3) organization that serves the American Indians and Alaska Natives and provides services in the county, the health board must include a tribal representative selected by the American Indian Health Commission.

Lowe said the commission understands that means every tribe with reservation and trust land in a county as well as every nonprofit that serves Native Americans and Alaska Natives gets a seat on the board of health. local, if they wish to be represented. Lowe said it was an appropriate portrayal.

“Tribes are asked for representation all the time, and we know that’s inappropriate, but because of the systems that have been put in place, it’s either inappropriate representation or none at all,” Lowe said.

The commission asked the tribes to indicate whether they want a seat on the respective health boards by April, although Lowe said she was unsure whether all tribes would choose to send representation.

So far, only the NATIVE project has delegated its board member, clinic director Dylan Dressler. The American Indian Health Commission sent Spokane County Commissioners the NATIVE Project resolution with their nominee.

Earlier this month, county commissioners met to discuss this resolution. The county and the Washington State Association of Counties interpret the bill differently than the commission.

They think that means there is only one health board seat for a tribal representative, said Eric Johnson, the association’s executive director.

“I understand the way this law was written puts the American Indian Health Commission in the position of choosing between the tribes and that’s not something we’ve done, but we’re working to make sure there’s has a tribal representative on each local health board,” Johnson mentioned.

Several counties have started the process or will soon start the process of nominating new board members, and Spokane County is working ahead of the curve. The law won’t come into effect until July, and rulemaking isn’t expected to be completed until late spring.

The State Board of Health is leading rulemaking around the new law, but that process does not include tribal representation.

Rep. Marcus Riccelli, D-Spokane, who authored the legislation, said he modeled the language of another bill he previously worked on that established tribal representation in regional organizations. of transport planning, which called for a single seat on the board of directors.

However, he said he saw no problem with including all tribes in a county on the council, adding that the conversation was important.

“The goal is to be more inclusive and achieve better health outcomes, and I think it’s important to respect tribal sovereignty,” he said.

Spokane County commissioners sent a letter to Lowe on Feb. 7 explaining their interpretation of the bill. The commissioners wrote that they believed the legislation indicated that only one council representative would be appointed directly by the commission.

Commissioners have already selected the three community members to fill the additional seats on the Spokane Board of Health, which is due to meet in a week.

Riccelli said further amendments to the legislation may be needed in 2023 after reviewing how implementation is progressing. He said he could also seek formal or informal advice from the attorney general’s office.

Johnson said an opinion is just that, however, and ultimately a challenge to how a county interprets the law could be worked out in the court system. Alternatively, legislative clarity, he added, is another option.