The bill seeks to enhance the representation of tribal communities on local boards of health in Washington State by mandating the inclusion of tribal representatives when a federally recognized Indian tribe has reservation or trust lands within a county, or when an urban Indian organization operates in the area. The selection of these representatives will be made by the respective tribe or organization, with the American Indian Health Commission being notified of their appointment. Additionally, the bill modifies the composition of local boards of health to ensure that the number of members from specific categories matches the number of elected officials on the board, while also emphasizing the inclusion of individuals from historically marginalized communities.

Moreover, the bill introduces several amendments to existing laws governing local boards of health. It requires that any decisions regarding permits, licensing, and application fees be made solely by elected officials on the board. The bill also allows boards composed entirely of elected officials to maintain this structure if they had a public health advisory committee established by January 1, 2021, and sets a deadline for these committees to meet specific requirements by January 1, 2022. Additionally, it mandates the state board of health to adopt rules for modifying local board membership within one year of the bill's effective date. Changes include replacing "nurse practitioners" with "advanced practice registered nurses" and removing references to "usual and accustomed areas" concerning tribal lands.

Statutes affected:
Original Bill: 70.05.030, 70.05.035, 70.46.020, 70.46.031
Substitute Bill: 70.05.030, 70.05.035, 70.46.020, 70.46.031
Engrossed Substitute: 70.05.030, 70.05.035, 70.46.020, 70.46.031
Bill as Passed Legislature: 70.05.030, 70.05.035, 70.46.020, 70.46.031
Session Law: 70.05.030, 70.05.035, 70.46.020, 70.46.031