Tribal Public Health

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.


Governmental Public Health System - State Board of Health (SBOH), State Department of Health (DOH), Local Health Jurisdictions (LHJ), Sovereign Tribal Nations and Indian Health Programs (IHP)

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

For more information, call (360) 819-7626.