The Governmental Public Health System and DOH's Partnership with Federally Recognized Tribes
The governmental public health system includes tribal nations and Indian health programs as primary partners with Department of Health (DOH), the State Board of Health, and local health jurisdictions. These partners work together to build infrastructure in cross-cutting capabilities and core programs to support system transformation.

The Centennial Accord created a unique government-to-government relationship between many federally recognized tribal governments and the state of Washington. State agencies, including DOH, have responsibilities for their work with federally recognized tribes, as outlined in RCW 43.376. To ensure we fulfill these responsibilities, the Department of Health follows a consultation and collaboration procedure, which includes:
- Sending Dear Tribal Leader letters to elected tribal officials when developing and implementing policies, agreements, and programs that directly affect Indian tribes.
- Consulting with tribal nations to promote government-to-government partnerships and ensure effective health services for Indian people.
- Designating the Tribal Relations Director as the liaison to tribal nations.
- Ensuring staff who work with tribal governments and public health partners receive training on tribal history and culture and tribal relationships with federal and state governments.
- Submitting an annual report to the Governor for The Centennial Accord meeting.
Below you can find recent Dear Tribal Leader Letters and Consultations:
Dear Tribal Leader Letters
- Information on agency rulemaking for November 1-15 (November 16, 2023)
- Determination of Tribal Public Health Emergency and Preparedness (PHEP) funding allocation (November 15, 2023)
- Roundtable 1: 9:30-11 a.m. December 4
- Roundtable 2: 1:30-3 p.m. December 12
- Consultation: 11 a.m.-1 p.m. December 19
- Pregnancy Risk Assessment Monitoring System (PRAMS) Advisory Committee (November 9, 2023)
- Information on agency rulemaking for October 16-31 (November 6, 2023) (PDF)
- Definition and criteria of "disadvantaged communities" under the Drinking Water State Revolving Fund (November 6, 2023) (PDF)
- Listening session: 3-5 p.m. November 27
- Environmental justice grant program (October 30, 2023) (PDF)
- Comment period open until 11:59 p.m. November 13
- Women, Infants, and Children (WIC) nutritional program vendor and participant compliance rulemaking (October 26, 2023) (PDF)
- Information on agency rulemaking for October 1-15 (October 16, 2023) (PDF)
- Environmental justice grant program (October 10, 2023) (PDF)
- Second consultation: 8-10 a.m. October 27
- Adolescent and young adult health projects (October 5, 2023) (PDF)
- Presentation: 1 p.m. November 8
- HEAL Act engagement guides (October 3, 2023) (PDF)
- Tribal briefing: 1-2 p.m. October 23
- New DOH program to address environmental health issues associated with homelessness (September 14, 2023) (PDF)
- Vaccine engagement and funding survey – response requested by September 5 (August 23, 2023) (PDF)
- Rules designating 988 contact hubs (August 17, 2023) (PDF)
- Workshop 1: 2-4 p.m. September 26
- Workshop 2: 9-11 a.m. September 28
- Environmental justice grant program meetings (August 15, 2023) (PDF)
- Roundtable 1: 3:30-5 p.m. September 6
- Roundtable 2: 3:30-5 p.m. September 13
- Consultation: 3:30-5 p.m. September 27
- Improving diversity in clinical trials (August 3, 2023) (PDF)
- HEAL Act updates and map guidance (August 1, 2023) (PDF)
- Behavioral health support specialist rulemaking (July 31, 2023) (PDF)
- Building Community Capacity funding opportunity technical assistance session 10-11 a.m. on August 11 (July 28, 2023) (PDF)
- New peer specialist credentials (July 26, 2023) (PDF)
- DOH 2024 legislative package review listening session 11 a.m.-noon on August 30 (July 21, 2023) (PDF)
- Physician visa waivers rulemaking (July 20, 2023) (PDF)
- Rulemaking for acute care hospitals to help implement Senate Bill 5120 (July 20, 2023) (PDF)
- Rulemaking for behavioral health agencies to help implement Senate Bill 5120 (July 20, 2023) (PDF)
- Amendments to home care aide rules (July 18, 2023) (PDF)
- Massage therapy rulemaking about education and training requirements (July 17, 2023) (PDF)
- Tribal Foundational Public Health Services funding consultations closed (July 11, 2023) (PDF)
- Request legislation for state issued standing orders (July 7, 2023) (PDF)
- Transfer of public water systems (June 29, 2023) (PDF)
- Office of Tribal Public Health and Relations listening session 3-5 p.m. on July 20 (June 28, 2023) (PDF)
- Publication date for national radionuclide emissions standards (June 22, 2023) (PDF)
- New environmental justice and climate change grants listening session 3:30-5:30 p.m. on August 9 (June 14, 2023) (PDF)
- Maternal and Child Health Block Grant listening sessions: 3-5 p.m. on July 6 and 1-3 p.m. on September 7 (June 12, 2023) (PDF)
- Drinking Water State Revolving Fund Intended Use Plan (June 9, 2023) (PDF)
- Health care preparedness committee (June 7, 2023) (PDF)
- New Office of Tribal Public Health and Relations (May 31, 2023) (PDF)
- Drinking Water State Revolving Fund rulemaking (March 15, 2023) (PDF)
- Health equity continuing education (January 23, 2023) (PDF)
- Expand Naloxone access (January 6, 2023) (PDF)
- Chiropractic continuing education (December 22, 2022) (PDF)
For more information, call (360) 819-7626.