HomeMy WebLinkAbout2026_07_16_BOH_PacketBoard of Health Meeting
July 16, 2026
Jefferso n C o u n ty
B o ard of H ealth
A ge nda
&
M inutes
ic Healt
July 16, 2026
Regular Meeting Agenda
Jefferson County Board of Health
Thursday, July 16, 2026 @ 2:30 PM
Jefferson County Courthouse - Commissioners' Chambers
1820 Jefferson Street, Port Townsend, WA
To view agenda items and meeting materials, click here: www.co.jefferson.wa.us - Services -
Laserfiche Web Portal (username and password is: public) - Health-Agendas_Minutes_Packets -
Board of Health Documents (then search by date: yyyy_mm_dd)
To view public comments received, www.co.jefferson.wa.us - Services - Laserfiche Web Portal
(username and password is: public) - Health- BOH Public Comments (search for folder of comments by
date, year first)
This is a hybrid meeting: Virtual and In-Person Attendance
You can join this meeting by using these methods:
• Zoom Meeting: https://us0Gweb.zoom.us/j/82378389363
This option will allow you to join the meeting live. You will need to enter an email address.
If you wish to provide public comment, click on the hand icon at the bottom of the
screen to "raise your hand." Participation will be up to the Chair and/or Clerk of the
meeting.
• Audio-only: Dial: 1-253-215-8782 and use Webinar ID: 823 7838 9363#
This option will allow you to listen to the meeting live. If you wish to provide public
comment, press *9 to "raise your hand." Participation will be up to the Chair and/or Clerk
of the meeting.
• In-Person: You are welcome to join the meeting in-person .
In the event of technical difficulties, at least one of the methods above will be accessible to the public. Please try all
methods first before calling 360-385-9100 to report any issues.
Public comment will be accepted and can be emailed to: BOH@co.jefferson.wa.us until 5:00 PM the
evening prior to the start of the meeting.
AGENDA
CALL TO ORDER - Chair MickHager
I. Public Comment (10 mins.)
Public Comment Periods are dedicated to listening to the public. Each person may address the Board one time
during these periods. To ensure equal opportunity for the public to comment, all comments shall be limited to 2 or
3 minutes per person, depending on the volume of public in attendance.
AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON
OTHER ITEMS NOT LISTED ON THIS AGENDA.
Americans with Disabilities Act (ADA) Accommodations Provided Upon Request
II. Appro val of Agenda
Ill . Appro val of M inutes of Ju ne 18, 2026 Board of Health M eeting
IV . Old Business and Info rm ation R eports
1. Jefferson County Public Health (JCPH) Report (Apple Martine) (10 mins.)
2. Jefferson Healthcare Report (Dr. Kees Kolff) (10 mins.)
3. Infectious Diseases Update (Dr. Allison Berry) (10 mins.)
V. New Business
1. Intellectual and Developmental Disabilities County Program Overview (Bonnie Obremski)
(20 mins.)
2. CR-103: Clarifying Tribal Representation and Timelines for Modifying Local Board of Health
Membership (Dr. Berry, Apple Martine) (20 mins.)
VI. Announcements
VII. Future Potential Agenda Topics:
Jefferson County Supports for Children with Autism Spectrum Disorder (AUGUST)
Local Sewage Management Plan Update (AUGUST)
JCPH Harm Reduction Program: Syringe Exchange Update
HB2442 Revenue tool for Local Government Part VIII - Public Health Clinic Property Tax
The County Strategic Plan
Opioid Settlement spending
Olympic Connect, the Community Care Hub model
Board of Health 101
Rural Reproductive Health
Emergency Fund for Public Health
The Child Development Center
ADJOURNMENT BY: 4:30 p.m.
Next Scheduled Meeting: August 20, 2026
2:30 -4:30 PM
Jefferson County Public Health
Hybrid Meeting
AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON
OTHER ITEMS NOT LISTED ON THIS AGENDA.
Americans with Disabilities Act (ADA) Accommodations Provided Upon Request
~ J,ffooon
PublicH~
REGULAR MEETING MINUTES
Jefferson County Board of Health
Thursday, June 18, 2026 @ 2:30 p.m.
Jefferson County Courthouse - Commissioners' Chambers
1820 Jefferson Street, Port Townsend, WA
Hybrid Meeting
Board Members
Greg Brotherton, County Commissioner, District #3
Heather Dudley-Nollette, County Commissioner, District #1
Celeste Dybeck, Tribal Representative
Heidi Eisenhour, County Commissioner, District #2
Amanda Grace, Vice-Chair, Community Stakeholder
Dr. Kees Kolff, Public Hospital District #2 Commissioner
Monica MickHager, Chair, Port Townsend City Council
Gabrielle Vanwert, Consumer of Public Health
Staff Members
Denise Banker, Community Health Director
Dr. Allison Berry, Health Officer
Lara Cittadini, CHIP Manager
Michael Dawson, Water Quality Manager
Carter Erickson, Environmental Health Manager
Apple Martine, Public Health Director
Pinky Mingo, Environmental Public Health Director
Jenn Mitchell, Finance Manager
Veronica Shaw, Public Health Deputy Director
Chair MickHager called the June 18, 2026 meeting of the Jefferson County Board of Health to order at 2:33 P.M.
Members Present: Chair Monica MickHager, Vice-Chair Amanda Grace, Members Heather Dudley-Nollette,
Celeste Dybeck, Heidi Eisenhour, and Dr. Kees Kolff.
Staff Present: Staff Members Denise Banker, Dr. Allison Berry, Lara Cittadini, Michael Dawson, Carter Erickson,
Apple Martine, Pinky Mingo, Jenn Mitchell and Veronica Shaw.
PUBLIC COMMENT
Chair MickHager called for public comment.
Commenter announced that Friends of Public Health (FPH) now has a website (friendsofpublichealthjefferson.com),
and suggested that Public Health might want to put a link to the new website on Public Health's web page.
Members (of the BOH) appreciated the website, yet commented that the FPH website might note that it is not
connected to Public Health and the comments and notes on the webpage are those of FPH, not of Jefferson County
Public Health. It was also suggested that the FPH website might have a link to the Board of Health's formal agendas
and minutes.
In response to written public comment:
Written comment expressed concern about the safety of the municipal water system, and also concern about the risk
of an event similar to the Longview paper mill explosion happening at the Port Townsend paper mill.
Respectfully submitted
G. Gilbert
Page 1 of 4
Members expressed a wish to place water safety , and the current lack of water (m entioned in the P.T. Leader), as a
future agenda item with a presentation. Staff mem ber Erickson advised there are opportunities fo r discussion of the
Coordinated W ater System Plan under the W ater Utility Coordinating Com m ittee. There is special meeting on June
24th at 3 PM in the Pacific Room at Public Health, an opportunity to discuss long-term planning for the city water
system.
Concerning paper mill safety, Member Dudley-Nollette mentioned that the Local Emergency Planning Committee
(LEPC) is addressing local paper mill chemical concerns at their public hybrid meeting on July 8 at 2:00 p.m.
Community members and various agencies are invited to attend, and a representative will report the committee's
hazardous material strategies back to the council. It was suggested that paper mill safety could also be a future BOH
agenda item.
APPROVAL OF AGEND A
Chair MickHager called for a motion to accept the agenda for June 18, 2026.
MOTION: Member Dudley-Nollette moved to approve the agenda. Member Grace seconded the motion, which
carried by a unanimous vote.
APPROVAL OF MINUTES
Chair MickHager requested a motion to approve the minutes of the May 21, 2026 meeting.
MOTION: Member Grace moved to approve the minutes. Member Dybeck seconded the motion, which carried
by a unanimous vote.
OLD BUSINESS AND INFORM ATIONAL ITEMS
1. Jefferson County Public Health (JCPH) Report
Staff member Martine's JCPH update included a tribute to retiring Environmental Health/Water Quality Director
Pinky Mingo.
JCPH is coming up to the end of its grant season, as most of its huge portfolio of grants are based on the state fiscal
year. This coincides with the beginning of budget season which, as the Board knows, was very complicated last year
due to budget cuts, and this season is likely to be similar.
Staff member Martine announced that recreational shellfish closures are covering almost all county beaches and that
paralytic shellfish poisoning toxins have reached lethal levels in some places. Recreational shellfish harvesters should
not determine safety on the presence of commercial harvesters, as commercial shellfish harvest batch can be tested by
the state or can be taken to clean waters to purge the toxin out of it, to sell at a later date.
2. Jefferson Healthcare Report
According to Member Kolff, Jefferson Healthcare has decided for this year to delay a potential levy lid lift to combat
financial headwinds, while outside consultants help identify potential operational efficiencies. A major source of this
financial strain is large commercial insurance companies reducing their reimbursement rates, prompting the hospital
to fight for better pricing. Additionally, Jefferson Healthcare is exploring regional alliances and resource-sharing with
Olympic Medical Center and other local healthcare entities to stabilize healthcare on the North Olympic Peninsula.
Discussion ensued, particularly in regard to the hospital's collection and sliding fee policy (discussion to be continued
at a later meeting).
3. Infectious Diseases Update
Dr. Berry reports that, while local COVID-19 transmission remains low and flu cases are sporadic, public health
officials are tracking a regional rise in pertussis cases among school-aged children. While Jefferson County currently
has no known outbreaks, there is a cluster in Clallam County and residents are urged to stay updated on their 10-year
Respectfully submitted
G. Gilbert
Page 2 of4
Tdap vaccines to prevent the severe, prolonged coughing characteristic of the infection. Nationally (not locally),
measles cases continue to climb and officials encourage up-to-date vaccinations and pre-visit phone calls for any
concerning childhood rashes.
Finally, returning travelers from the Democratic Republic of the Congo are being monitored to prevent any local
transmission of Ebola, and there are no known cases.
NEW BUSINESS
[NEW BUSINESS was reordered as a courtesy to guest student presenters]
2. Report on Port Townsend Schools' Mini-Grant
Former JCPH staff member Laura Tucker introduced students participating in the Students for Sustainability project
cleaning up trash from West Coast beaches (which was sponsored by a Youth Commercial Cannabis and Tobacco
Prevention Program mini-grant).
In May, a volunteer group of 15 teenagers (with chaperones) traveled to the coast to tackle a major beach cleanup.
The team braved muddy hikes to the beach, with even more grueling hikes back hauling 540 pounds of plastic and
styrofoam debris, waste which could have degraded into hazardous microplastics. Their efforts filled an entire cargo
van and inspired a separate passing group of hikers to help finish clearing the pile.
The volunteers recovered from their hard work with an overnight stay at a local Airbnb, bonding over games and
movies.
The students expressed great satisfaction in doing something to help the planet and hope to make the trip an annual
event.
1. HB2442 Revenue tool for Local Govern ment Part VIII - Public Health Clinic Property Tax
Accompanied by slides, JCPH Director Apple Martine discussed the complexity and special needs of a disparate,
largely rural county. JCPH's program of treatments which it provides is based on the particular needs of this
population. Government funding no longer keeps up with the need.
The new state law House Bill 2442 gives local governments new tax tools and flexibility to fund community services
such as public health. It provides for a new tax levy on property, intended to create sustainable funding for essential
health services.
Director Martine asked the Board's assistance to determine how best to proceed and how to judge county citizens'
willingness to financially support Public Health services.
Discussion ensued. Further consideration is required as other local entities (including the Parks Department and the
hospital) are also considering increased levies, and decisions made at the federal level have made life more expensive
for everyone. A public process for feedback is recommended.
AN NOUN CEM ENTS
Member Grace announced that graduation is tonight, June 18.
FUTURE POTENTIAL AGENDA TOPICS
No discussion.
AGENDA PLANNING CALENDAR
The Agenda Planning Meeting for the next regular meeting of the Board will be held on July 9, 2026 at 10:30 A.M.
The next regular Board of Health meeting will be held as a hybrid meeting on Thursday, July 16, 2026 from 2:30 P.M.
-4:30 P.M.
Respectfully submitted
G. Gilbert
Page 3 of 4
ADJOURN MENT
Chair MickH ager adjourned the June 18, 2026 Jefferson County Board of Health meeting at 4:31 P.M. until the
next Regular Meeting or Special Meeting as properly noticed.
JE FFERSON COUN TY BOARD OF HEALTH
Monica MickHager, Chair Glenn Gilbert, Public Health Assistant
Portions of these minutes were drafted with AI assistance.
Respectfully submitted
G. Gilbert
Page 4 of 4
J e ffe rso n C o u n ty
B o a rd o f H e a lth
IV .
O ld B u s in e s s a n d ln fo rm a tio n R e p o rt s
Ite m 1
J e ffe rs o n C o u n ty P u b lic H e a lth R e p o rt
[N o h a n d -o u t]
Ju ly 16 , 2 0 2 6
J e ffe rs o n C o u n ty
B o a rd o f H e a lth
IV .
O ld B u s in e s s a n d In fo rm a tio n R e p o rt s
It e m 2
J e ff e r s o n H e a lth c a re R e p o rt
[N o h a n d -o u t]
Ju ly 16 , 2 0 2 6
Jefferson County
Board of Health
IV.
Old Business and Information Reports
Item 3
Infectious Diseases Update
[No hand-out]
ub· eal
July 16, 2026
Jefferson County
Board of Health
V.
New Business
Item 1
Intellectual and Developmental Disabilities
County Program Overview
I
July 16, 2026
Intellectual & Developmental Disabilities Program
Intellectual & Developmental Disabilities
Program Coordinator
Bonnie Obremski
Began at Jefferson County Public Health
as a communications specialist in 2021
Moved to IDD Coordinator role for
the county in Nov. 2024
Contact:
BonnieO@jefferson.wa.us
(360) 385-9410
Moved to Jefferson County in 2014
Nationwide, rural regions have
higher densities of people living
with disabilities than urban regions.
Jef ferson County:
King County:
20.2%
10.3%
Percent of total population who identif ied
as having a disability characteristic including,
but not limited to a “cognitive diff iculty”
census.gov
Kitsap County: 15.9%
Source: https://data.census.gov/table?q=disabilities&g=050XX00US53031
2024Estimates
Jef ferson County, WA, pop. 33,036
Source: https://data.census.gov/table?q=disabilities&g=050XX00US53031
Source: https://www.census.gov/topics/health/disability/about/glossary.html#par_textimage_1149417898
2,809
Intellectual and developmental disabilities (IDD)
originate before age 18, continue indefinitely,
and cause substantial limitations.
A few examples of IDD include cerebral palsy, epilepsy, Down Syndrome,
Fetal Alcohol Spectrum Disorder (FASD), and Autism Spectrum Disorder (ASD).
Source: https://app.leg.wa.gov/wac/default.aspx?cite=388-823&full=true#388-823-0015
Total residents with IDD enrolled with the Washington State
Developmental Disabilities Administration (DDA)
Developmental Disabilties Administration (DDA)Enrollment in Jef ferson County
152
Of those enrolled are currently accessing DDA ser vices
I n other words, 78% of enrolled residents are accessing DDA ser vices,
which is the second highest percentage in the state af ter Cowlitz County.
118
Source:https://www.dshs.wa.gov/sites/default/files/DDA/dda/documents/25-1018-DDCS-Caseload-Report.pdf
Total Enrolled
Olympic Region Comparisons
Jefferson
Percent accessing ser vicesCounty
152 78%
Clallam 510 74%
Kitsap 2,421 66%
Source:https://www.dshs.wa.gov/sites/default/files/DDA/dda/documents/25-1018-DDCS-Caseload-Report.pdf
DDA Enrollment
2nd highest in state!
caregiving & family suppor t
housing suppor ts
therapies
assistive technologies
community inclusion
suppor ted employment
bir th to three ser vices
Ser vices available through DDA can include:
DDA ser vices overseen by county governments
Supported employment
Community inclusion
Birth-Three services
Find
Fund
Monitor
providers of:
County governments:
Supported employment providers help people with IDD
prepare for, find, and keep jobs, beginning as early as
high school with “Pre-Employment Transition Services,”
“Job Foundation,” and “School-to-Work” programs.
There are two categories of supported employment:
Group supported employment
Individual supported employment
Employment supports for high school
students are called “transition services.”
Jef ferson County residents enrolled
in DDA employment suppor ts:
I ndividual Suppor ted Employment: 32
Group Suppor ted Employment: 7
Job Foundation (transition): 3
School to Work (transition): 1
Source:https://www.dshs.wa.gov/sites/default/files/DDA/dda/documents/25-1018-DDCS-Caseload-Report.pdf
Transition services for students 14+
prepare them for the transition from
school to life as a working adult.
A provider may:
Document a student’s support
network, skills, and desires
Assist with job applications
Help stabilize a student in a job
...and more
Transition Ser vices Timeline
Ages 14+
Pre-Employment Transition
Ser vices (Pre-E TS)
overseen by the state
Division of Vocational
Rehabilitation (DVR)
Ages 19-20
School to Work
Pre-E TS may continue to educational programs beyond high school
Job Foundation
Ages 20-22
These two programs for students enrolled in high
school and DDA are overseen by county governments
Other programs overseen
by school districts
Anticipated Number of DDA*
Transition Students in Jef ferson County
by graduating year
2028: 2
2027: 3
*Number of students currently enrolled in DVR and/or school-managedtransition programs is higher, at more than 40.
Source:https://www.dshs.wa.gov/sites/default/files/DDA/dda/documents/25-1018-DDCS-Caseload-Report.pdf
Community Inclusion provides
opportunities to engage with
the general public in places
accessible by public transit
or a reasonable commute
from an individual’s home.
44 people access
Community Inclusion in the county.
There is one provider of
DDA employment,
transition,
and community inclusion
services in the county.
Case resource managers from the
Developmental Disabilties Administration
(DDA) refer enrolled clients for SE and CI
services. Enroll: (360) 912-8310.
Birth-Age 3 services
are for children who
need help reaching
developmental
milestones.
Service referrals may be provided by
a primary care doctor or through WIC.
You may also self-refer:
(360)-379-1315 or jnelson@ccpnw.org
Birth to Three service examples:
Family training, home visits, and counseling
Occupational and/or physical therapy
Vision services
Nutrition services
Social work services
Speech and language therapy
Nursing
Assistive technology
Transportation to services
...and more
There are 9 children enrolled for state-fundedBirth-Three services in Jefferson County.
Source:https://www.dshs.wa.gov/sites/default/f iles/DDA/dda/documents/25-1018-DDCS-Caseload-Report.pdf
There is one
provider of
Birth-3 services
in the county.
The state requires the county to continuously seek
applications from qualified providers.
The state requires the
county to conduct
specific activities to
evaluate provider
performance and issue
corrective actions,
when necessary.
WA State Guiding Values:
Inclusion
Status and Contribution
Being valued by others
Relationships
Power and Choice
Ability to direct or
influence one’s life
Health and Safety
Competence
Capable of doing what
we need and want
State Taxpayers
Federal Funds
IDD Funding Flow
Dept. of
Health
(DOH)
Department of Social &
Health Services (DSHS)
State Taxpayers
Federal Funds
JeffCo
Public
Health
School-Medical Autism
Review Team (SMART)
(360) 385-9431
DSHS
State Taxpayers
Federal Funds
Division of Vocational
Rehabilitation (DVR)Developmental Disabilities
Administration (DDA)
Division of
Vocational
Rehabilitation
Shorter-term,
job-focused
services
Developmental
Disabilities
Administration
Long-term support
for employment
maintenance
DVR DDA
...and lots of other services
DSHS
DDADVR
Pre-Employment
Transition Services
(Pre-ETS) for High
School Students
State Taxpayers
Federal Funds
DDA case resource managers and
administrators serving our region
Jefferson
County IDD
Program
Community Engagement
Assists with access to local
resources and reduces social isolation
DVR staff serving our region
Services: (360) 302-3472
Providers of some forms of
respite, caregiving, and housing
Job-related
assistive devices,
scholarships,
and more
Other county-managed funds& resources
School to Work fundi n g
SE, CI, B-3 fund i n g
DDADVR
Provider
trainings
(Wise)
Parent to
Parent
DSHS
State Taxpayers
Federal Funds
People
First of WA
Community
education
Coordinatoradministrativeactivities
(Supported Employment,
Job Foundation, School-to-Work,
and Community Inclusion)
(Birth-3)
OtherJeffCoIDD
Community
education
activities
Manages contracts with state, providers,
and supporting entities
Is the local “quality control” for providersCounty
Coordinator
Manages the Intellectual and Developmental
Disabilities Advisory Board (IDDAB)
Intellectual andDevelopmental DisabilitiesAdvisory Board (IDDAB)
The IDDAB is an open, public meeting that
convenes for 1.75hrs on 5 Tuesdays a year.
There are no meetings in
summer or in December.
Members lend their knowledge of intellectual and
developmental disabilities to inform the county
coordinator. Self-Advocate board members
receive a $50 stipend per meeting they attend.
Manages contracts with state, providers,
and supporting entities
Is the local “quality control” for providers
Manages the Intellectual and Developmental
Disabilities Advisory Board (IDDAB)
County
Coordinator
Manages the Accessible Community
Advisory Committee (ACAC)
Beach wheelchair
Portable access mats
Hearing-assistive devices
Accessibility guides
Accessible playground equipment
Many more...
The ACAC works with citizens to
apply for a state grant to make
public resources more accessible.
Funded project examples:
Manages contracts with state, providers,
and supporting entities
Is the local “quality control” for providers
Manages the IDDAB
Manages the ACAC
County
Coordinator
Supports efforts to educate the
public about IDD services
Cascade Community Connections staff (most days)
Washington State Developmental Disabilities Administration (DDA) Jefferson County Case Resource Managers
(CRMs) and/or their supervisors (many days)
Washington State Department of Social and Health Services (DSHS) managers (monthly)
Washington State Division of Vocational Rehabilitation (DVR) School-to-Work managers (monthly)
Washington State Association of County Human Services (ACHS) (daylong meeting every two months)
Wise: Washington State Initiative for Supported Employment (every two months)
Jefferson County School District special services administrators (quarterly)
People First of Washington, Jefferson County Chapter (quarterly)
Parent to Parent Coordinator, overseen by Olympic Neighbors and the Arc of Washington State (quarterly)
Concerned Citizens (quarterly)
Jefferson County Transition Network
Jefferson/Clallam Interagency Coordinating Council (ICC) (Birth to Three focus) (quarterly meeting)
Jefferson County Human Services Collaborative (quarterly meeting)
Washington State Governor’s Committee on Disability Issues and Employment (GCDE), (quarterly)
Primary External Partners
In order of frequency of contact
Website resource directory:
https://www.co.jefferson.wa.us/BusinessDirectoryii.aspx
First Step Family Support Center/Kaleidescope Playgroups
Gatheringplace
Olympic Neighbors (Hamilton House)
Camp Beausite
Special Olympics Washington-Peninsula Branch
Kiwanis Aktion Club
Disability Awareness Starts Here (DASH)
Among Friends
Peninsula Services
Businesses working with Cascade to employ people with IDD (10-20)
Orgs that apply for grant funding through the ACAC
The Production Alliance (TPA)
Jefferson Transit Authority
Ecumenical Christian Helping Hands Organization (ECHHO)
Jefferson County Economic Development Council (EDC)
Peninsula Support Organization (PSO) Bluebills
Secondary External Partners
The Arc of Washington State
Community Employment Alliance (CEA)
Washington State Developmental Disabilities Council (WADDC)
Washington State Independent Living Council (WASILC)
Washington Satte Center for Independence (CFI)
Local
Statewide
Jefferson County Fire Districts
Cold Pizza Creative
The Benji Project
OWL360/The Nest Port Townsend
The Parlor
Skillmation Community Connections
Olympic Peninsula YMCA-Jefferson County Branch
Salish Regional Family Youth System Partner Roundtable (FYSPRT)
Olympic Educational Service District 114 (OESD 114)
Olympic Community Action Partnership (OlyCAP)
Jefferson Community Foundation
Bayside Housing
The Washington Elks Therapy Program for Children
Port Townsend Equity, Access, and Rights Advisory Board
Olympic Community of Health
Individual self-advocates, parents, guardians, caregivers, local representatives,
and others.
Washington State Coalition on Inclusive Emergency Planning (CIEP)
Washington Partnerships for Action, Voices for Empowerment (PAVE)
Autism Society of Washington
Easterseals Washington
Washington State Rehabilitation Council
Public health assistant in charge of processing contracts
Finance Team
Director
Deputy Director
Communications Team
Jefferson County School Medical Autism Review Team (SMART)
WIC Coordinator
Members of the Intellectual and Developmental Disabilities Advisory
Board (IDDAB)
Members of the Accessible Communities Advisory Committee (ACAC)
Jefferson County Internal Partners
Public Health
Board of CountyCommissioners
Clerk of the Board/Office Manager
County Commissioners
Public Works
Solid Waste Manager
SherriffDepartment
Sherriff
Juvenile Services
Department ofEmergencyManagement
Public Information Officer (PIO)
CentralServices
Director/Americans with
Disabilities Act (ADA) Coordinator
IT Staff
Thank you!
Jefferson County
Board of Health
V.
New Business
Item 2
C R-103: Clarifying Tribal Representation and
T im e lin e s for M odify ing Lo cal Board of Health
M embership
bli ealt
July 16 , 2026
June 22, 2026
To Whom It May Concern,
The Washington State Board of Health (Board) adopted amendments to chapter 246-90
WAC at its June 4, 2026, meeting to implement requirements established by Engrossed
Substitute House Bill (ESHB) 1946. ESHB 1946 clarified Tribal membership on local
boards of health (LBOHs).
Purpose of Rulemaking
Chapter 246-90 WAC establishes a standard process for recruiting and appointing non-
elected members to local boards of health. The rules ensure a fair appointment process
and balanced representation among elected and non-elected members with diverse
expertise and lived experience.
Effective July 27, 2025, ESHB 1946 amended laws governing LBOH membership by
clarifying the appointment of Tribal representatives and directing the Board to establish
timelines for adjusting board membership as Tribal representatives are appointed.
The amendments implement ESHB 1946 by establishing those timelines and updating
the timeframe for modifying board membership from 60 to 90 days. The changes
provide additional flexibility for counties that do not meet monthly while helping LBOHs
maintain the required balance between elected and non-elected members. The rules
take effect July 27, 2026.
Changes to the Proposed Rules
The Board adopted the rule as proposed in Washington State Register (WSR 26-09-
104, CR-102). The amendments:
• Clarify that chapter 246-90 WAC applies to the appointment of Tribal
representatives, consistent with state law, and affirms Tribal appointment
authority
• Add a definition of “Tribal representative” that aligns with state law
• Establish timelines for county legislative authorities or boards of county
commissioners to update LBOH membership after a Tribal representative is
appointed by a Tribe or Tribal organization
• Extend the timeframe for updating LBOH membership from 60 to 90 days to
provide additional flexibility for counties that do not meet monthly
Comments on Proposed Rules
The Board received no written or verbal comments on the proposed rule.
Remaining Public Opposition to the Rule
The Board did not receive any opposition to the rule during the public comment period
or rules hearing. We do not anticipate any public opposition to the adopted rule.
Effective Date and Next Steps
The rule takes effect July 27, 2026. Anyone may petition the adoption or amendment of
this rule in accordance with RCW 34.05.330.
Send any questions regarding the adoption of this rule to Ashley Bell at
lbohcomposition@sboh.wa.gov.
Respectfully,
Michelle A. Davis
Executive Director
https://sboh.wa.gov/rulemaking/agency-rules-and-activity/2024-2025-school-rule-review-project
LOCAL BOARDS OF HEALTH - TRIBAL MEMBERSHIP (ESHB 1946)
What does the bill do?
Engrossed Substitute House Bill (ESHB) 1946, effective July 27, 2025, updates the law regarding
tribal representation on local boards of health. The updates enable tribal governments and Urban
Indian organizations to now appoint their own representatives, instead of the American Indian
Health Commission. The bill also requires the State Board of Health (Board) to adopt rules
establishing timelines for modifying membership of local boards of health (LBOH). LBOHs must
modify membership within 60 days of receiving notice of selection of a tribal representative in order
to maintain a balance between elected and non-elected members, as required by law. The 60-day
time frame applies at least until the Board adopts the new rules. The Board must update timelines
and membership rules in its Local Board of Health Membership rules, Chapter 246-90 WAC, by
July 27, 2026.
Why is the State Board of Health (Board) updating its rules on local board of
health (LBOH) membership?
Engrossed Substitute House Bill (ESHB) 1946 requires the Board to establish timelines for
modifying the membership of a local board of health as described in the answer above. LBOHs
must maintain a balance between elected and non-elected members. The purpose of this
rulemaking project is to establish a timeline for adding Tribal representation and maintaining a
balance of elected and non-elected members on a LBOH.
What changes are outside the scope of this rulemaking?
The following are outside the scope of ESHB 1946 and the State Board of Health’s current
rulemaking directive:
Tribal government outreach processes
Identifying Indian Reservations, Tribal trust lands, or Urban Indian Health organizations within
each county
Changing or maintaining the size of a LBOH
Filling vacancies
Quorum issues
Modifying the selection process for other non-elected members
LBOH statutory exemptions
LBOH voting authorities and structures for alternate members
What is the Board’s timeline for this rulemaking project?
The law (ESHB 1946) takes effect on July 27, 2025. It requires the Board to update its rules and
set timelines by July 27, 2026. The 60-day requirement may change based on the Board’s
rulemaking process.
Frequently Asked Questions
Washington State Board of Health 1FAQ - updated January 2026
https://sboh.wa.gov/rulemaking/agency-rules-and-activity/2024-2025-school-rule-review-project
LOCAL BOARDS OF HEALTH - TRIBAL MEMBERSHIP (ESHB 1946)
How long does a LBOH have to add a Tribal representative to their LBOH?
Starting July 27, 2025, LBOHs must add a Tribal representative within 60 days of receiving notice
of selection of a representative from a Tribe or Urban Indian health organization. The LBOH then
must notify AIHC when the Tribal representatives are added. The legislature gave the Board one
year to update its rules regarding local board of health membership. As part of the Board’s
rulemaking process, this 60-day board modification timeframe may change.
Is there a process for adding a Tribal representative to a LBOH and notifying
AIHC?
The county defines the process for adding a Tribal representative and notifying AIHC via email to
info@aihc-wa.com.
How do I know if my local board of health is exempt?
The Board recommends connecting with your legal representation if you have questions about
LBOH specifics. Exemption rule language can be found here.
Who will the Board collaborate with during the development of this rule?
The Board will be working with Tribes, Urban Indian organizations, local boards of health, and
other interested parties to gather feedback for the writing of these rules. Local boards of health
should use the same processes for onboarding their elected and non-elected members.
What if there are multiple Tribes or trust lands in a health jurisdiction?
State law allows a Tribe to appoint representatives to any local board of health in a county where
a Tribe has reservation or trust lands. If a Tribe has a reservation or trust lands in multiple
counties, the Tribe could appoint a representative to each local board of health. The law doesn’t
limit the number of representatives from Tribes or 501(c)3 Tribal Organizations serving on a
specific LBOH.
Can federally recognized Tribes without a Washington State recognition be
appointed to a WA local board of health?
Yes. The law refers to federally recognized Tribes. The Bureau of Indian Affairs has a Tribal
Leaders Directory.
Does the Tribe or qualified Tribal organization need to identify a Tribal
representative immediately?
No.Tribes and qualified Tribal organizations can identify a Tribal representative for a local board of
health at any time.
Washington State Board of Health 2FAQ - updated January 2026
LOCAL BOARDS OF HEALTH - TRIBAL MEMBERSHIP (ESHB 1946)
Will the Board address Tribal fee lands in the updated rules?
No. State law allows a Tribe to appoint representatives to any local board of health in a county
where a Tribe has reservation or trust lands. It does not specifically address fee lands.
When or how often should LBOHs ‘open’ the seats to tribes? Or how often
should they invite?
The county defines this process. Local boards of health are encouraged to develop relationships
with Tribes in their jurisdiction. Not all Tribes may have the capacity to appoint a Tribal
representative and may appoint one at a later time.
Is there guidance for how to keep quorum and a balanced composition while
increasing or decreasing board size?
The county defines this process. The Board will not provide guidance for keeping quorum and
balancing the local boards of health composition. The Board recommends connecting with your
legal counsel if you have questions about LBOH specifics.
Where can I receive additional information on this rulemaking project?
Visit the Board’s rulemaking webpage to view ESHB 1946 resources that have been developed.
How can I receive updates on this rulemaking project?
You can subscribe to the Board’s Local Board of Health Composition email distribution
list.Information will be updated on the Board’s rulemaking webpage as the Board conducts
rulemaking, including opportunities to provide informal and formal public comment. You may also
sign up to receive news releases, rule updates, and public meeting notices on the Board’s
general distribution list.
Washington State Board of Health 3
How can you communicate with the Board
about this rulemaking project?
Contact the Board’s Tribal liaison Ashley Bell
at ashley.bell@sboh.wa.gov.
You can also email the Board at
lbohcomposition@sboh.wa.gov.
Scan the QR code or visit the rulemaking page.
FAQ - updated January 2026
CERTIFICATION OF ENROLLMENT
ENGROSSED SUB STITUTE HOUSE BILL 1946
Chapter 260, Laws of 2025
69th Legislature
2025 Regular Session
LOCAL BOARDS OF HEALTH-TRIBAL MEMBERSHIP
EFFECTIVE DATE: July 27, 2025
Passed by the House April 21, 2025
Yeas 59 Nays 38
CERTIFICATE
LAURIE JINKINS
Speaker of the House of
Representatives
Passed by the Senate April 14, 2025
Yeas 40 Nays 9
I, Bernard Dean, Chief Clerk of the
House of Representatives of the
State of Washington, do hereby
certify that the attached is
ENGROSSED SUBSTITUTE HOUSE BILL
1946 as passed by the House of
Representatives and the Senate on
the dates hereon set forth.
BERNARD DEAN
DENNY HECK Chief Clerk
President of the Senate
Approved May 13, 2025 10:09 AM FILED
May 14, 2025
BOB FERGUSON
Secretary of State
State of Washington
Governor of the State of Washington
ENGROSSED SUB STITUTE HOUSE BILL 1946
AS AMENDED BY THE SENATE
Passed Legislature - 2025 Regular Session
State of Washington 69th Legislature
By House Local
Hill, Lekanoff,
Macri)
Government (originally sponsored
Reed, Parshley, Pollet, Obras,
2025 Regular Session
by Representatives
Nance, Ormsby, and
READ FIRST TIME 02/21/25.
1
2
AN ACT Relating to clarifying tribal membership on local boards
of health; amending RCW 70.05.030, 70.05.035, 70.46.020, and
3 70.46.031; and creating a new section.
4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
5 Sec. 1. RCW 70.05.030 and 2024 c 37 s 1 are each amended to read
6 as follows:
7
8
9
( 1) Except as
counties without
commissioners and
provided in subsection ( 2) of
a home rule charter, the
the members selected under (a)
this section, for
board of county
and (e) of this
10 subsection, shall constitute the local board of health, unless the
11 county is part of a health district pursuant to chapter 70.46 RCW.
12 For counties without a home rule charter where the board of county
13 commissioners is comprised of five commissioners, the board of county
14 commissioners may adopt an ordinance reducing the number of county
15 commissioners that are members of the local board of health, provided
16 that the board of health includes at least one county commissioner.
1 7 The jurisdiction of the local board of heal th shall be coextensive
18 with the boundaries of the county.
19 (a) The remaining board members must be persons who are not
20 elected officials and must be selected from the following categories
p. 1 ESHB 1946.SL
1 co n s i s t e n t w i t h th e re q u i r e m e n t s o f th i s se c t i o n an d th e ru l e s
2 ad o p t e d b y th e st a t e b o a r d o f h e a l t h un d e r R C W 43 .2 0 .3 0 0 :
3 ( i) Pu b l i c h e a l th , h e a l th ca r e fa c i l i t i e s , an d p r o v i d e r s . Th i s
4 ca t e g o r y co n s i s t s o f p e r s o n s p r a c t i c i n g or em p l o y e d in th e co u n t y w h o
5 ar e :
6 (A ) M e d i c a l et h i c i s t s ;
7
8
(B) Epidemiologists;
(C) Experienced in environmental public health, such as a
9 registered sanitarian;
10 (D) Community health workers;
11 (E) Holders of master's degrees or higher in public health or the
12 equivalent;
13 (F) Employees of a hospital located in the county; or
14 (G) Any of the following providers holding an active or retired
15 license in good standing under Title 18 RCW:
16 (I) Physicians or osteopathic physicians;
17 (II) Advanced practice registered ((nurse practitioners)) nurses;
18 (III) Physician assistants or osteopathic physician assistants;
19 (IV) Registered nurses;
20 (V) Dentists;
21 (VI) Naturopaths; or
22 (VII) Pharmacists;
23 (ii) Consumers of public health. This category consists of county
24 residents who have self-identified as having faced significant health
25 inequities or as having lived experiences with public health-related
26 programs such as: The special supplemental nutrition program for
27 women, infants, and children; the supplemental nutrition program;
28 home visiting; or treatment services. It is strongly encouraged that
29 individuals from historically marginalized and underrepresented
30 communities are given preference. These individuals may not be
31 elected officials and may not have any fiduciary obligation to a
32 heal th facility or other heal th agency, and may not have a material
33 financial interest in the rendering of health services; and
34 (iii) Other community stakeholders. This category consists of
35 persons representing the following types of organizations located in
36 the county:
37 (A) Community-based organizations or nonprofits that work with
38 populations experiencing health inequities in the county;
39 (B) Active, reserve, or retired armed services members;
40 (C) The business community; or
p. 2 ESHB 1946.SL
1 (D ) Th e env ironm en ta l pub lic hea lth regu lated comm un it y .
2 (b ) Th e boa rd m em ber s se le cted und er (a ) of th is su b se ction must
3 b e a p p r o v e d b y a m a j o r i t y v o t e o f t h e b oard of cou nty comm issio n er s .
4 (c ) If th e num ber of board m em bers se lected under (a ) of th is
5 s u b s e c t i o n i s e v e n l y d i v i s i b l e b y t h r e e , t h e r e m u s t b e a n eq ua l
6 n u m b e r o f m e m b e r s s e l e c t e d f r o m e a c h o f t h e t h r e e c a t e g o r i e s . I f
7 t h e r e a r e o n e o r tw o m em ber s ov er th e nea rest m ultip le of th ree ,
8 th ose m em bers m ay be se le cted from an y of th e th ree categ o ries .
9 How ev er , if th e boa rd of hea l th dem on st rates th at it attem pted to
10 rec ru it m em ber s from all th ree categ orie s and wa s unab le to do so ,
11 th e board m ay se lect m em ber s on ly from th e oth er tw o cate g or ie s .
12 (d ) There m ay be no m ore th an on e m em ber se lected un der (a ) of
1 3 t h i s s u b s e c t i o n f r o m o n e t y pe of background or po sition .
1 4 (e ) I f a f e d e r a l l y r e c o g n i zed In d ian tr ib e ho ld s rese rv at ion ((T ))
15 or tr ust land s with in th e coun ty , ( (o r has usu al an d accu st om ed area s
1 6 w i t h i n t h e c o u n ty ,)) or if an urb an In d ian organ ization recogn ized by
1 7 t h e I n d i a n h e a l t h s e r v i c e a n d reg iste red as a 501 (c ) (3 ) organ iza tio n
1 8 ((r e g i s t e r e d )) i n W a s h i n g t o n t h a t s e r v e s Am e r ic an In d ian an d A la sk a
1 9 N a t i v e p e o p l e ( (a-n-a-) ) provides services within the county, the board
20 of heal th must ( (include) ) allow a tribal representative ( ( selected
21 e-y)) from each tribe and each organization, as selected by such tribe
22 or organization, to serve as a member and must notify the American
23 Indian health commission.
24 ( f) The board of county commissioners may, at its discretion,
25 adopt an ordinance expanding the size and composition of the board of
26 health to include elected officials from cities and towns and persons
27 other than elected officials as members so long as the city and
2 8 county elected officials do not constitute a majority of the total
29 membership of the board.
30 (g) Except as provided in (a) and (e) of this subsection, an
31 ordinance adopted under this section shall include provisions for the
32 appointment, term, and compensation, or reimbursement of expenses.
33 (h) The jurisdiction of the local board of health shall be
34 coextensive with the boundaries of the county.
35 ( i) The local heal th officer, as described in RCW 7 0. 0 5. 0 50,
36 shall be appointed by the official designated under the provisions of
37 the county charter. The same official designated under the provisions
38 of the county charter may appoint an administrative officer, as
39 described in RCW 70.05.045.
p. 3 ESHB 1946.SL
1 (j ) Th e num ber of m em b e r s se le c te d or in c lu d ed un d er (a ) an d (e )
2 of th is su b se ction m ust eq u a l th e num b er of cit y an d cou n t y el e c t e d
3 offic ia ls on th e board of he a lt h . If a m em be r is ad d ed un d er (e l of
4 th is su b se cti on , th e bo a r d of co u n ty comm is si o n er s sh a ll m od if y th e
5 m em ber sh ip of th e board :
6 ( i) In com plian ce with tim el in es est ab li sh ed by th e st at e bo a rd
7 of hea lth in ru le on ce su c h ru le s ar e in ef f e c t ; an d
8 (i i ) Un ti l th e ru le s in ( j) ( i) of this subsection are in effect,
9 within 60 days of receipt of notice of the selection of a tribal
10
11
representative.
(k) At the first meeting of a district board of health the
12 members shall elect a chair to serve for a period of one year.
13 (1) Any decision by the board of health related to the setting or
14 modification of permit, licensing, and application fees may only be
15 determined by the city and county elected officials on the board.
16 (2) A local board of health comprised solely of elected officials
1 7 may retain this composition if the local heal th jurisdiction had a
18 public health advisory committee or board with its own bylaws
19 established on January 1, 2021. By January 1, 2022, the public health
20 advisory committee or board must meet the requirements established in
21 RCW 70.46.140 for community health advisory boards. Any future
22 changes to local board of heal th composition must meet the
23 requirements of subsection (1) of this section.
24
25
26
27
28
29
Sec. 2. RCW 70. 05. 035 and 2021 c 205 s 4 are each amended to
read as follows:
( 1) Except as provided in subsection ( 2) of this section, for
home rule charter counties, the county legislative authority shall
establish a local board of heal th and may prescribe the membership
and selection process for the board. The membership of the local
30 board of health must also include the members selected under (a) and
31 (e) of this subsection.
32 (a) The remaining board members must be persons who are not
33 elected officials and must be selected from the following categories
34 consistent with the requirements of this section and the rules
35 adopted by the state board of health under RCW 43.20.300:
36 (i) Public health, health care facilities, and providers. This
37 category consists of persons practicing or employed in the county who
38 are:
39 (A) Medical ethicists;
p. 4 ESHB 1946.SL
1
2
3
4
5
(B) Epidemiologists;
(C) Experienced in environmental public
registered sanitarian;
(D) Community health workers;
(E) Holders of master's degrees or higher in
health, such as a
public health or the
6 equivalent;
7 (F) Employees of a hospital located in the county; or
8 (G) Any of the following providers holding an active or retired
9 license in good standing under Title 18 RCW:
10 (I) Physicians or osteopathic physicians;
11 (II) Advanced practice registered ( (nurse practitioners)) nurses;
12 (III) Physician assistants or osteopathic physician assistants;
13 (IV) Registered nurses;
14 (V) Dentists;
15 (VI) Naturopaths; or
16 (VII) Pharmacists;
17 (ii) Consumers of public health. This category consists of county
18 residents who have self-identified as having faced significant health
19 inequities or as having lived experiences with public health-related
20 programs such as: The special supplemental nutrition program for
21 women, infants, and children; the supplemental nutrition program;
22 home visiting; or treatment services. It is strongly encouraged that
23 individuals from historically marginalized and underrepresented
24 communities are given preference. These individuals may not be
25 elected officials and may not have any fiduciary obligation to a
2 6 heal th facility or other heal th agency, and may not have a material
27 financial interest in the rendering of health services; and
28 (iii) Other community stakeholders. This category consists of
29 persons representing the following types of organizations located in
30 the county:
31 (A) Community-based organizations or nonprofits that work with
32 populations experiencing health inequities in the county;
33 (B) Active, reserve, or retired armed services members;
34 (C) The business community; or
35 (D) The environmental public health regulated community.
36 (b) The board members selected under (a) of this subsection must
37 be approved by a majority vote of the board of county commissioners.
38 (c) If the number of board members selected under (a) of this
39 subsection is evenly divisible by three, there must be an equal
4 0 number of members selected from each of the three categories. If
p. 5 ESHB 1946.SL
1 th e r e a r e on e o r tw o m e m b e r s ov e r th e n e a r e s t m u l t i p l e o f th r e e ,
2 th o s e m e m b e r s m a y b e se l e c t e d fr o m an y o f th e th r e e ca t e g o r i e s .
3 Ho w e v e r , if th e b o a r d o f h e a l th d e m o n s t r a t e s th a t it at t e m p t e d to
4 re c r u i t m e m b e r s fr o m a l l th r e e ca t e g o r i e s an d w a s u n a b l e to d o so ,
5 th e b o a r d m a y se l e c t m em b e r s on l y fr o m th e ot h e r tw o ca t e g o r i e s .
6 ( d ) Th e r e m a y b e n o m o r e th a n o n e m e m b e r se l e c t e d u n d e r (a ) o f
7 th i s su b s e c t i o n fr o m on e t y p e o f b a c k g r o u n d o r p o s i t i o n .
8 (e ) If a fe d e r a l l y re c o g n i z e d In d i a n tr i b e h o l d s re s e r v a t i o n ((,))
9 or tr u s t la n d s w i t h i n th e c o u n t y , ( (o r h a s u s u a l an d a c c u s t o m e d a r e a s
10 w i t h i n th e co u n t y ,)) o r if an u r b a n In d i a n o r g a n i z a t i o n r e c o g n i z e d b y
11 th e In d i a n h e a l t h se r v i c e an d re g i s t e r e d a s a 50 1 (c ) (3 ) or g a n i z a t i o n
12 ((r e g i s t e r e d )) in W a s h i n g t o n th a t se r v e s Am e r i c a n In d i a n an d A l a s k a
13 N a t i v e p e o p l e ( (-a-na )) provides services within the county, the board
14 of heal th must ( (include) ) allow a tribal representative ( ( selected
15 by)) from each tribe and each organization, as selected by such tribe
16 or organization, to serve as a member and must notify the American
17 Indian health commission.
18 (f) The county legislative authority may appoint to the board of
19 health elected officials from cities and towns and persons other than
20 elected officials as members so long as the city and county elected
21 officials do not constitute a majority of the total membership of the
22 board.
23 (g) Except as provided in (a) and (e) of this subsection, the
24 county legislative authority shall specify the appointment, term, and
25 compensation or reimbursement of expenses.
26 (h) The jurisdiction of the local board of health shall be
27
28
29
30
31
32
33
34
35
36
37
38
39
coextensive with the boundaries of the county.
(i) The local health officer, as described in RCW 70.05.050,
shall be appointed by the official designated under the provisions of
the county charter. The same official designated under the provisions
of the county charter may appoint an administrative officer, as
described in RCW 70.05.045.
(j) The number of members selected or included under (a) and (e)
of this subsection must equal the number of city and county elected
officials on the board of health. If a member is added under (e) of
this subsection, the county legislative authority shall modify the
membership of the board:
( i) In compliance with timelines established by the state board
of health in rule once such rules are in effect; and
p. 6 ESHB 1946.SL
1 (ii) Until the rules in ( j) ( i) of this subsection are in effect,
2 within 60 days of receipt of notice of the selection of a tribal
3 representative.
4 (k) At the first meeting of a district board of health the
5 members shall elect a chair to serve for a period of one year.
6 (1) Any decision by the board of health related to the setting or
7 modification of permit, licensing, and application fees may only be
8 determined by the city and county elected officials on the board.
9 (2) A local board of health comprised solely of elected officials
10 may retain this composition if the local health jurisdiction had a
11 public health advisory committee or board with its own bylaws
12 established on January 1, 2021. By January 1, 2022, the public health
13 advisory committee or board must meet the requirements established in
14 RCW 70.46.140 for community health advisory boards. Any future
15 changes to local board of heal th composition must meet the
16 requirements of subsection (1) of this section.
17 Sec. 3. RCW 70.46.020 and 2021 c 205 s 5 are each amended to
18 read as follows:
19 (1) Except as provided in subsections (2) and (3) of this
20 section, health districts .con s i s t i nq of two or more counties may be
21 created whenever two or more boards of county commissioners shall by
22 resolution establish a district for such purpose. Such a district
23 shall consist of all the area of the combined counties. The district
24 board of heal th of such a district shall consist of not less than
25 five members for districts of two counties and seven members for
2 6 districts of more than two counties, including two representatives
27 from each county who are members of the board of county commissioners
28 and who are appointed by the board of county commissioners of each
29 county within the district, and members selected under (a) and (e) of
30 this subsection, and shall have a jurisdiction coextensive with the
31 combined boundaries.
32 (a) The remaining board members must be persons who are not
33 elected officials and must be selected from the following categories
34 consistent with the requirements of this section and the rules
35 adopted by the state board of health under RCW 43.20.300:
36 (i) Public health, health care facilities, and providers. This
37 category consists of persons practicing or employed in the heal th
38 district who are:
39 (A) Medical ethicists;
p. 7 ESHB 1946.SL
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
(B) Epidemiologists;
(C) Experienced in environmental public health, such as a
registered sanitarian;
(D) Comm unity health workers;
(E) Holders of master's degrees or higher in public health or the
equivalent;
(F) Employees of a hospital located in the health district; or
(G) Any of the following providers holding an active or retired
license in good standing under Title 18 RCW:
(I) Physicians or osteopathic physicians;
(II) Advanced practice registered ( (nurse practitioners)) nurses;
(III) Physician assistants or osteopathic physician assistants;
(IV) Registered nurses;
(V) Dentists;
(VI) Naturopaths; or
(VII) Pharmacists;
(ii) Consumers of public health. This category consists of health
district residents who have
significant health inequities
public health-related programs
self-identified as having faced
or as having lived experiences with
such as: The special supplemental
nutrition program for women, infants,
nutrition program; home
strongly encouraged that
visiting;
individuals
and children; the supplemental
or treatment services. It is
from historically marginalized
24 and underrepresented comm unities are given preference. These
25 individuals may not be elected officials, and may not have any
26 fiduciary obligation to a health facility or other health agency, and
27 may not have a material financial interest in the rendering of health
28 services; and
29 (iii) Other community stakeholders. This category consists of
30 persons representing the following types of organizations located in
31 the health district:
32 (A) Community-based organizations or nonprofits that work with
33 populations experiencing health inequities in the health district;
34 (B) Active, reserve, or retired armed services members;
35 (C) The business comm unity; or
36 (D) The environmental public health regulated comm unity.
37 (b) The board members selected under (a) of this subsection must
38 be approved by a majority vote of the board of county commissioners.
39 (c) If the number of board members selected under (a) of this
40 subsection is evenly divisible by three, there must be an equal
p. 8 ESHB 1946.SL
1 number of members selected from each of the three categories. If
2 there are one or two members over the nearest multiple of three,
3 those members may be selected from any of the three categories.
4 However, if the board of health demonstrates that it attempted to
5 recruit members from all three categories and was unable to do so,
6 the board may select members only from the other two categories.
7 (d) There may be no more than one member selected under (a) of
8 this subsection from one type of background or position.
9 (e) If a federally recognized Indian tribe holds reservation((,))
10 or trust lands within the health district, ( (or has usual and
11 accustomed areas within the health district,)) or if an urban Indian
12 organization recognized by the Indian heal th service and registered
13 as a 501 (c) (3) organization ((registered)) in Washington that serves
14 Am erican Indian and Alaska Native people ( (-a-fttl:)) provides services
15 within the heal th district, the board of heal th must ( (include) )
16 allow a tribal representative ( (selected by)) from each tribe and
17 each organization, as selected by such tribe or organization, to
18 serve as a member and must notify the American Indian health
19 commission.
20 (f) The boards of county commissioners may by resolution or
21 ordinance provide for elected officials from cities and towns and
22 persons other than elected officials as members of the district board
23 of heal th so long as the city and county elected officials do not
24 constitute a majority of the total membership of the board.
25 (g) Except as provided in (a) and (e) of this subsection, a
26 resolution or ordinance adopted under this section must specify the
27 provisions for the appointment, term, and compensation, or
28 reimbursement of expenses.
29 (h) At the first meeting of a district board of health the
30 members shall elect a chair to serve for a period of one year.
31 (i) The jurisdiction of the local board of health shall be
32 coextensive with the boundaries of the county.
33 (j) The local health officer, as described in RCW 70.05.050,
34 shall be appointed by the official designated under the provisions of
35 the county charter. The same official designated under the provisions
36 of the county charter may appoint an administrative officer, as
37 described in RCW 70.05.045.
38 (k) The number of members selected or included under (a) and (e)
39 of this subsection must equal the number of city and county elected
40 officials on the board of health. If a member is added under (e) of
p. 9 ESHB 1946.SL
1 this subsection, the boards of county comm issioners shall modify the
2 membership of the district:
3 ( i) In compliance with timelines established by the state board
4 of health in rule once such rules are in effect; and
5 (ii) Until the rules in ( k) ( i) of this subsection are in effect,
6 within 60 days of receipt of notice of the selection of a tribal
7 representative.
8 (1) Any decision by the board of health related to the setting or
9 modification of permit, licensing, and application fees may only be
10 determined by the city and county elected officials on the board.
11 (2) A local board of health comprised solely of elected officials
12 may retain this composition if the local heal th jurisdiction had a
13 public health advisory comm ittee or board with its own bylaws
14 established on January 1, 2021. By January 1, 2022, the public health
15 advisory comm ittee or board must meet the requirements established in
16 RCW 70.46.140 for comm unity health advisory boards. Any future
1 7 changes to local · board of heal th composition must meet the
18 requirements of subsection (1) of this section.
19 (3) A local board of health comprised solely of elected officials
20 and made up of three counties east of the Cascade mountains may
21 retain their current composition if the local health jurisdiction has
22 a public health advisory comm ittee or board that meets the
23 requirements established in RCW 70.46.140 for comm unity health
24 advisory boards by July 1, 2022. If such a local board of health does
25 not establish the required comm unity health advisory board by July 1,
26 2022, it must comply with the requirements of subsection (1) of this
27 section. Any future changes to local board of health composition must
28 meet the requirements of subsection (1) of this section.
29 Sec. 4. RCW 70.46.031 and 2021 c 205 s 6 are each amended to
30 read as follows:
31 (1) Except as provided in subsection (2) of this section, a
32 health district to consist of one county may be created whenever the
33 county legislative authority of the county shall pass a resolution or
34 ordinance to organize such a health district under chapter 70.05 RCW
35 and this chapter. The resolution or ordinance may specify the
36 membership, representation on the district health board, or other
37 matters relative to the formation or operation of the health
38 district. In addition to the membership of the district health board
39 determined through resolution or ordinance, the district health board
p. 10 ESHB 1946.SL
1 must also include the members selected under (a) and (e ) of this
2 subsection.
3 (a ) The remaining board members must be persons who are not
4 elected officials and must be selected from the following categories
5 consistent with the requirements of this section and the rules
6 adopted by the state board of health under RCW 43.20.300:
7 ( i) Public heal th, heal th care facilities, and providers. This
8 category consists of persons practicing or employed in the county who
9 are:
10
11
12
(A) Medical ethicists;
(B) Epidemiologists;
(C) Experienced in environmental public health, such as a
13 registered sanitarian;
14 (D) Community health workers;
15 (E) Holders of master's degrees or higher in public health or the
16 equivalent;
17 (F) Employees of a hospital located in the -county; or
18 (G) Any of the following providers holding an active or retired
19 license in good standing under Title 18 RCW:
20 (I) Physicians or osteopathic physicians;
21 (II) Advanced practice registered ( (nurse practitioners)) nurses;
22 (III) Physician assistants or osteopathic physician assistants;
23 (IV) Registered nurses;
24 (V) Dentists;
25 (VI) Naturopaths; or
26 (VII) Pharmacists;
27 (ii) Consumers of public health. This category consists of county
28 residents who have self-identified as having faced significant health
29 inequities or as having lived experiences with public health-related
30 programs such as: The special supplemental nutrition program for
31 women, infants, and children; the supplemental nutrition program;
32 home visiting; or treatment services. It is strongly encouraged that
33 indi victuals from historically marginalized and underrepresented
34 communities are given preference. These individuals may not be
35 elected officials and may not have any fiduciary obligation to a
36 heal th facility or other heal th agency, and may not have a material
37 financial interest in the rendering of health services; and
38 (iii) Other community stakeholders. This category consists of
39 persons representing the following types of organizations located in
40 the county:
p. 11 ESHB 1946.SL
1 (A) Community-based organizations or nonprofits that work with
2 populations experiencing health inequities in the county;
3 (B) The business community; or
4 (C) The environmental public health regulated community.
5 (b) The board members selected under (a) of this subsection must
6 be approved by a majority vote of the board of county commissioners.
7 (c) If the number of board members selected under (a) of this
8 subsection is evenly divisible by three, there must be an equal
9 number of members selected from each of the three categories. If
10 there are one or two members over the nearest multiple of three,
11 those members may be selected from any of the three categories. If
12 there are two members over the nearest multiple of three, each member
13 over the nearest multiple of three must be selected from a different
14 category. However, if the board of health demonstrates that it
15 attempted to recruit members from all three categories and was unable
16 to do so, the board may select members only from the other two
17 categories.
18 (d) There may be no more than one member selected under (a) of
19 this subsection from one type of background or position.
20 (e) If a federally recognized Indian tribe holds reservation((,))
21 or trust lands within the county, ( (or has usual and accustomed areas
22 within the county,)) or if an urban Indian organization recognized by
23 the Indian health service and registered as a 501 (c) (3) organization
24 ((registered)) in Washington that serves American Indian and Alaska
25 Native people ((-a-B-Ei-)) provides services within the county, the board
2 6 of heal th must ( (include) ) allow a tribal representative ( ( selected
27 by)) from each tribe and each organization, as selected by such tribe
28 or organization, to serve as a member and must notify the American
29 Indian health commission.
30
31
32
33
34
35
36
37
(f) The county legislative authority may
officials from cities and towns and persons
officials as members of the health district board
and county elected officials do not constitute
total membership of the board.
(g) Except as provided in (a) and (e)
appoint
other than
elected
elected
so long as the city
a majority of the
resolution
provisions
or ordinance adopted under this
for the appointment, term,
of this subsection, a
section must specify the
and compensation, or
38 reimbursement of expenses.
39 (h) The jurisdiction of the local board of health shall be
40 coextensive with the boundaries of the county.
p. 12 ESHB 1946.SL
1 (i) The local health officer, as described in RCW 70.05.050,
2 shall be appointed by the official designated under the provisions of
3 the resolution or ordinance. The same official designated under the
4 provisions of the resolution or ordinance may appoint an
5 administrative officer, as described in RCW 70.05.045.
6 ( j) At the first meeting of a district board of heal th the
7 members shall elect a chair to serve for a period of one year.
8 (k) The number of members selected or included under (a) and (e)
9 of this subsection must equal the number of city and county elected
10 officials on the board of health. If a member is added under (el of
11 this subsection, the county legislative authority shall modify the
12 membership of the district:
13 ( i) In compliance with timelines established by the state board
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
of health in rule once such rules are in effect; and
(ii) Until the rules in ( k) ( i) of this subsection are in effect,
within 60 days of receipt of notice of the selection of a tribal
representative.
(1) Any decision by the board of health related to the setting or
modification of permit, licensing, and application fees may only be
determined by the city and county elected officials on the board.
(2) A local board of health comprised solely of elected officials
may retain this composition if the local heal th jurisdiction had a
public health advisory committee or board with its own bylaws
established on January 1, 2021. By January 1, 2022, the public health
advisory committee or board must meet the requirements established in
RCW 70.46.140 for community health advisory boards. Any future
changes to local board of health composition must meet the
requirements of subsection (1) of this section.
29
30
31
32
33
NEW SECTION. Sec. 5. The state board of health shall adopt
rules establishing timelines for modifying the membership of a local
board of heal th as required by sections 1 through 4 of this act,
which must go into effect no later than one year after the effective
date of this section.
Passed by the House April 21, 2025.
Passed by the Senate April 14, 2025.
Approved by the Governor May 13, 2025.
Filed in Office of Secretary of State May 14, 2025.
--- END ---
p. 13 ESHB 1946.SL
BYLAWS
OF THE
JEFFERSON COUNTY BOARD OF HEALTH
AR TICLE 1. NAME
The name of this organization shall be the Jefferson County Board of Health.
AR TICLE II. PURP OSE
The purpose of the Jefferson County Board of Health is to supervise all matters
pertaining to the preservation of the life and health of the people of Jefferson County
and to comply fully with the requirements of all applicable chapters of Title 70,
Revised Code of Washington. The Board of Health shall:
• Collect, analyze and disseminate to the community, through Jefferson
County Public Health, information about community health conditions,
risks and resources, and the availability of resources to address identified
problems.
• Enact such rules, regulations and policies as are necessary to preserve,
promote and improve the health status of Jefferson County residents, and
guide the allocation of appropriate and necessary public health resources.
• Assure that necessary, high quality, effective public health services are
available for the protection of the people of Jefferson County, including
the control and prevention of any dangerous, contagious or infectious
disease within the county.
• Provide for the prevention, control and abatement of nuisances detrimental
to public health.
• Enforce, through the Health Officer, the public health statutes of the state
and county.
• Establish fee schedules for issuing and renewing licenses and permits or
for such other services as are authorized by the law and rules of the State
Board of Health.
Jefferson C ounty B oard of Health B ylaw s (rev.04/2022) Page 1
ARTICLE III. REPRESENTATION
Membership: Membership of the Board of Health shall be established consistent
with applicable state law, including RCW 43.20.300, and promulgated regulations.
The appointment of Members to the Board shall proceed as follows:
Elected Officials: The Board shall include all Jefferson County Commissioners,
as well as one member of the Port Townsend City Council, selected by the Council,
and who shall then be appointed by the Board of County Commissioners.
Non-Elected Officials: The Board of County Commissioners shall appoint non-
elected officials to the Board of Health to ensure, to the extent practicable, that the
Board includes a balanced representation of elected officials and non-elected people
with a diversity of expertise and lived experience.
(1) Number: The number of non-elected members, including tribal
representatives, must equal the number of elected officials on the Board.
Elected members of the local board of health may not constitute a majority.
(2) Tribal Representation: As to any federally recognized Indian tribe that holds
reservation, trust lands, or has usual and accustomed areas within the County,
the Board must include at least one of the non-elected members as a tribal
representative selected by the American Indian Health Commission, according
to the selection process prescribed by the Commission.
(3) Residency Requirements: Except for a tribal representative, to be appointed,
an applicant must be able to demonstrate residency in Jefferson County.
(4) Appointment-Categories: Contingent upon there being at least three non-
elected members, one shall be selected from each of the categories below. A
fourth non-elected member may be appointed from any of the categories,
unless a tribal representative, in which case being from one of the categories is
optional.
a. Public health, health care facilities, and providers;
b. Consumers of public health; and
c. Other community stakeholders.
(5) Additional Required Considerations for Appointment as a Non-elected
member: The Board of County Commissioners shall assess the following
when selecting an applicant for appointment as a Non-elected member:
a. Whether the applicant's background meets the qualifications of the
applicant's selected category or categories, as defined below, or as
otherwise defined by a subsequent change in state law;
b. Potential conflict of interest;
c. The applicant's demonstrated commitment to public health;
d. Recommendation from current Board of Health members;
e. Whether the applicant represents a diversity of expertise and lived
experience;
Jefferson County Board of Health Bylaws Page 2
f. Whether the applicant represents the geographic diversity of the
community; and
g. Whether the applicant identifies with a historically underrepresented
community when being considered as a non-elected member
representing consumers of public health.
(6) Categories for Non-Elected Officials Defined: Consistent with WAC 246-
90-010, or as subsequently amended or replaced, the categories from which
Non-elected members must be selected are defined as follows:
a. "Consumers of public health" means the category of persons
consisting of county or health district residents who have self-
identified as having faced significant health inequities or as having
lived experiences with public health-related programs.
b. "Other community stakeholders" means the category of persons
representing the following types of organizations located in the county
or health district:
i. Community-based organizations or nonprofits that work with
populations experiencing health inequities in the county;
11 . Active, reserve, or retired armed services members;
m. The business community; or
1v. The environmental public health regulated community.
c. "Public health, health care facilities, and providers" means the
category of persons practicing or employed in the county or health
district who are:
i. Medical ethicists;
11. Epidemiologists;
m. Experienced in environmental public health;
iv. Community health-workers;
v. Holders of master's degrees or higher in public health or another
field with an emphasis or concentration in health care, public
health, or health policy;
vi. Employees of the public hospital districts located in the county; or
vii. Any of the following providers holding an active or retired license
in good standing under Title 18 RCW: Physicians or osteopathic
physicians; advanced registered nurse practitioners; physician
assistants or osteopathic physician assistants; registered nurses;
dentists; naturopaths; or pharmacists.
viii. In filling this position, preference will be given to appointing an
individual who meets the above criteria and is recommended by
the Public Hospital District No. 2.
Jefferson County Board of Health Bylaws Page 3
(7) Recruitment and Application Processes: The processes for the recruitment
and application for appointment as a Non-elected member of the Board shall,
in all respects, comply with applicable state law. Additionally:
Applicants for non-elected membership on the Board shall be recruited in a
manner intended to solicit a broad pool of applicants that represent a diversity
of expertise and lived experience by, among other things-
a. Providing reasonable advance notice for applicants to apply for
vacancies;
b. Posting of vacancy-announcements in public places, including the
newspaper with the most readership, if any, in the county;
c. Posting of vacancy-announcements in the most common languages
spoken in the county;
d. Posting of vacancy-announcements in all geographic regions
represented by the Board;
e. Working with local community organizations to distribute vacancy
notices; and
f. Complying with applicable provisions of the Americans with
Disabilities Act, Public Law Number 101-336 and chapter 49.60
RCW.
(8) The Board shall develop an application form or process that is consistent with
all applicable law, except that such application or process shall not require an
applicant to provide their political affiliation or voting history. In addition, the
application or process may require an applicant to designate the category or
categories they are applying for as identified and defined above. The Board
may consider applicants for any position for which they are qualified.
(9) All applicants for non-elected positions shall be interviewed in a panel format
by the Board subject to the following:
a. All applicants shall be asked the same questions; and
b. In the event of a substantial number of applicants, the local board of
health may elect to interview a smaller number of applicants as long as
the applicants interviewed include a diversity of expertise and lived
experience.
c. The recruitment process must be consistent with applicable provisions
of chapter 42.30 RCW.
Terms: Appointed members shall serve for three-year terms. Board of Health
members may serve more than one term, including consecutive terms.
Vacancies: In the event that a vacancy occurs for an appointed representative, the
Board of County Commissioners shall appoint another representative within thirty
(30) days, or as soon as practical, from the date of vacancy. In the event that a
vacancy occurs from the Port Townsend City Council or Jefferson Healthcare District
Jefferson County Board of Health Bylaws Page4
#2 member, the City or District shall nominate another representative from their
membership within thirty (30) days.
Absences: Board members shall notify the Chairperson in advance if unable to
attend any regular meeting of the Board of Health. Appointed Board members may
be removed from Board membership by action of the County Comm issioners for lack
of attendance. Three or more unexcused absences from regular Board of Health
meetings in one calendar year will be considered cause for removal.
Non- Voting Members: The Board, by majority vote, may appoint non-voting
members to the Board for a three-year term.
AR TICLE IV . O FFICER S
Chairperson: The presiding officer of the Board of Health shall be the
Chairperson, who shall serve for a term of one (1) year. The Chairperson shall be
selected by a majority vote of the Board members present at the first regular meeting
of each year.
Vice-Chairperson: At the same meeting, a Vice-Chairperson shall also be
selected for a term of one (1) year, who shall preside over all proceedings of the
Board in the absence of the Chairperson.
Vacancies: In the event of a vacancy in the office of Chairperson, the Vice-
Chairperson shall immediately assume the duties of the Chairperson for the remainder
of the year. Another representative shall be selected to serve as Vice-Chairperson at
the next regular or special meeting of the Board. 1
Consecutive Terms: Board members shall not serve consecutive terms as
Chairperson or Vice Chairperson.
AR TICLE V. R ULES O F BU SIN ESS
Business shall be conducted in accordance with the most current edition of
Robe1t's Rules of Order, so long as they are consistent with these Bylaws or
amendments thereto.
AR TICLE V I. CO MM ITTEES
The Chairperson shall appoint subcommittees from the Board of Health or
members of the community from time to time as the Chairperson shall deem
necessary. The Chairperson shall be an ex-officio member of all committees.
AR TICLE VI I. AD M IN ISTRA TIV E O FFICER
The Board of Health may appoint an Administrative Officer who shall fulfill the
responsibilities specified by RCW 70.05.045, including administering the operations
of the Health Department. The Administrative Offi cer shall serve at the will and
approval of the Board.
Jefferson County Board of Health Bylaws Page 5
ARTICLE VIII. HEAL TH OFFICER
The Board of Health shall appoint a County Health Officer, who shall be a
qualified physician trained and experienced in public health, who shall exercise the
powers, and perform the duties prescribed in RCW 70.05.070. The Health Officer
shall serve at the will an d approval of the Board.
ARTICLE IX. OPERATING RULES
Section 1. Meetings
Regular Meeting: Regular meetings of the Board of Health shall be held on the
third Thursday of each month. If the third Thursday is a legal holiday, an alternate
day may be selected by the Chair. Any regular meeting of the Board of Health may
be cancelled with the concurrence of a majority of the Board. The location of the
meetings shall be within Jefferson County.
Special Meeting: The Chair or tw o-thirds of the voting members of the Board
may call a special meeting of the Board consistent with RCW 42.30.080.
Executive Session: The Board may hold executive sessions from which the
public may be excluded for the purposes set forth in RCW 42.30.110.
Quorum: A majority of all voting Board members, including at least tw o
Jefferson County Commissioners, shall constitute a quorum for Board meetings.
Tape Recordings: The proceedings of all Board meetings shall be recorded
electronically. Any person may request a copy of electronic recording media of any
meeting of the Board by payment ofreasonable cost per policy.
Minutes: W ritten minutes of each Board meeting shall be prepared and approved
by the Board at the subsequent regular meeting. Minutes shall be sign ed by the
attending Members at the time of their approval by the Board.
Meetings Open to Public: All regular and special meetings of the Board and
Board committees shall be open to the public, in accordance with RCW 42.30.
M aterials to Board Members: Except in cases of emergency, the agenda and
materials related to action items shall be sent to Board members in advance of the
meeting at which the items will be considered.
Section 2. Voting
Actions Requiring a Vote: Each regular member of the Board shall be entitled to
one vote on all actions of the Board that require a vote. An affirmative vote of a
majority of voting Board members shall be required to pass an action of the Board,
pro vided that a quorum of the Board is present.
Voting on Fees: Any decision by the Board related to the setting or modification
of perm it, licensing, and application fees may only be determined by the votes of the
city and county elected officials on the Board.
Voting By Proxy: There will be no voting by proxy on any question before the
Board.
Je fferson County Boar d of H ealth Bylaws Page 6
Tied Votes: Any vote that results in an equal number of votes cast for and against
shall be resolved as follows: First, after further discussion, the Board shall vote a
second time on the matter, with a second tie-vote causing the matter to be not passed.
In the alternative, by a majority vote of the entire Board upon motion, the matter can
be tabled before taking a second vote and brought back for reconsideration at the next
regularly scheduled meeting, either in the same or revised form.
Section 3. Ethics
Conflict of Interest: Members of the Board of Health having personal or
professional interest on an action item that may be deemed conflicting or infringe
upon the appearance of fairness shall declare the conflict. If the member or the
Board, by majority vote, determines the conflict of interest to be significant, the
member shall refrain from discussing or voting on the matter.
Section 4. Public Testimony
General Public Comments: At each meeting, according to the usual order of
business, the Chair shall call for general comments. Persons wishing to comment
shall give their name and address. The Chair may establish time limits for individuals
who wish to speak.
Comments on Action Items: Prior to voting on any item requiring action by the
Board, the Chair may call for comments by persons interested in or affected by the
matter under consideration before the Board. Persons wishing to comment on action
items shall give their name and address. The Chair may establish time limits for
individuals who wish to speak.
Section 5. Public Hearing
The Board shall conduct public hearings prior to adoption of fees, ordinances, rules,
or other exercises of its quasi-legislative powers. All members of the public in
attendance at a public hearing will be allowed to speak if they so desire. Persons
wishing to provide testimony shall give their name. Time limits may be placed on
individual comments at the discretion of the Board Chair and the public should be
advised that comments must relate to the matter at hand. Order and decorum should
be maintained at all times. Rules for the conduct of the hearing should be stated by
the Board Chair at the beginning of the hearing. Following public testimony, the
Board Chair shall close the public hearing and the Board may deliberate and take
action on the matter at hand.
Call for Public Hearing: A public hearing may be called for by an affirmative
vote by a majority of the Board. Public notice will be given at least 10 days prior to a
public hearing of the Jefferson County Board of Health.
Section 6. Appeals Hearing
Board of Health appeal hearings shall be open to the public and presided over by the
chair of the Board of Health. Such hearings shall be recorded. Board of Health
hearings shall be opened with a recording of the time, date, and place of the hearing;
and a statement of the cause for the hearing. The hearing shall be limited to argument
of the parties submitted in writing prior to the meeting and no additional evidence
Jefferson County Board of Health Bylaws Page 7
shall be taken unless, in the judgment of the chair, such evidence could not have
reasonably been obtained and submitted prior to the hearing. Additional appeal
hearing procedures may be required by the specific public health code (e.g. On-site
Sewage, Solid Waste, or Food Safety) that governs the matter under appeal.
AR TICLE X. MISCELLAN EOUS
Reimbursement of Expenses: Board of Health members may receive
reimbursement for approved expenses related to completion of their responsibilities.
AR TICLE XI. AM ENDMENTS TO BYLAWS
These Bylaws can be amended at any regular meeting of the Board by two-thirds
(2/3) vote of total members, provided the amendment has been submitted in writing to
the Board of Health at least ten (10) days prior to said meeting.
\
D t~ 19th day of April, 2022
Greg Brotherton, Chairperson
Jefferson County Board of Health
Jefferson County Board of Health Bylaws Page 8
J e ffe rs o n C o u n ty
B o a r d o f H e a lth
V I.
A n n o u n c e m e n ts
Publi eal h
July 16, 2026
Jefferson County
Board of Health
VII.
Agenda Planninq
ubl eal
July 16, 2026