Tribal Foundational Public Health Services

Tribal Foundational Public Health Services

Contact: VIcki Lowe, Executive Director, American Indian Health Commission,

Foundational Public Health Services (FPHS) are basic underlying capabilities and programs that must be present in every community to protect the health and safety of all citizens. These are core governmental services needed in each community. Tribes exercise their sovereignty when they establish, control, operate and deliver public health services. Through the Tribal FPHS project, Tribes and UIHPs in Washington are working to establish definitions for Tribal FPHS, assess current capabilities and capacities to provide Tribal FPHS in order to assess gaps and understand funding needed to fully provide these services.

2020 Tribal and State Leaders Health Summit

Strengthening Tribal Foundational Public Health Services VIDEO

Tribal and Urban Indian Health Organization Representation on Local Boards of Health

ESSHB 1152 was passed by the Washington State legislature in 2021. Among other provisions, this bill requires local boards of health to offer a seat on the board to each “federally recognized Indian tribe” and “501(c)(3) organization registered in Washington that serves American Indian and Alaska Native people and provides services within the county”. This means that, if a Tribe or UIHO chooses, you can appoint a representative to serve on the local boards of health where your Tribe “holds reservation, trust lands, or has usual and accustomed areas within the county”.

At the last AIHC Delegates meeting, Dr. Tom Locke gave a presentation about this opportunity. This presentation can be viewed here:

Organization and Function of Public Health Services in Washington State | Presentation 02.02.2022 – YouTube

The Powers and Duties of Local Board of Health are set forth in RCW 70.05.060:

RCW 70.05.060: Powers and duties of local board of health. (

We understand there are many factors a Tribe or UIHO will consider in deciding whether to appoint a representative to any local board of health at this time, including a cost-benefit analysis related to the time investment, the direct impacts a specific board of health may or may not have on your tribal citizens, etc. Consequently, there may be boards of health for which you are eligible to have a tribal representative but choose not to appoint one at this time.


By April 30, please send Vicki Lowe, Executive Director, AIHC, ( a tribal resolution or other official tribal government document for each board of health to which you wish to appoint including: 1) name of the board of health, 2) name of appointee to serve on the local board of health, 3) title of appointee to serve on the local board of health, and 4) email address and phone number of appointee – if you do not submit one of these documents by April 30, this will indicate you are choosing to appoint a representative at a later date*; and

*NOTE: If you choose not to appoint a representative to a board which applies to your Tribe at this time, you can choose to appoint a representative at a later time. If so, there may be a delay from when you submit your appointment and when your appointee is seated on the board as it may require the local board of health changing its bylaws.

Also, please find the following reference materials:

  • 1152-S2.SL.pdf (
  • Model Tribal Engagement Protocols – this document was drafted by AIHC to assist local boards of health in implementing ESSHB 1152 properly

In the 2019 Washington State Legislative session, the Foundational Public Health Services policy bill passed into law.

This bill established the Foundational Public Health System (FPHS) comprised of the State of Washington Department of Health (DOH), Washington State Board of Health (SBOH), local health jurisdictions (LHJ), and Sovereign Tribal nations and Indian health programs, as well as establishing ongoing funding to support the delivery of services in an effective and efficient manner:

These governmental public health services should be delivered in ways that maximize the efficiency and effectiveness of the overall system, make the best use of the public health workforce and evolving technology, and address health equity.

In September of 2018, the AIHC Executive Committee and Executive Director began attending the Foundation Public Health Services Steering Committee meetings to get a broader understanding of the work being done and bring the voice of Tribes and Indian Health programs to the table.

In December of 2019, AIHC convened a Tribal FPHS Summit to introduce the project and prepare for regional meetings to work, to understand and define Tribal FPHS and developing model Tribal FPHS codes as a template for Tribes to adopt or to update codes.

Regional Meetings:

  • Tues, May 5th – 8 am to Noon at Skagit Resort: North Sound Tribes
  • Wed, May 20th – 8 am to Noon at Jamestown S’Klallam Tribe: Olympic and Pacific Coast Tribes
  • Mon, June 1st – 1 pm to 5 pm, Cowlitz Tribe at ilani: South Sound Tribes Including SIHB and Snoqualmie
  • Wed, June 17th – 8 am to Noon, Yakama: Eastside Tribes

The Tribal Foundational Public Health Services Summit, December 11th, 2019. 

Documents from the Summit in a Google folder.