(The Center Square) – After years of confusion, the Spokane Regional Health District’s Board of Health may soon double in size to add several tribal representatives, as mandated by state law.
Some might argue that the power shift is coming three years too late. The Legislature passed a law in 2022 that required local health boards to include federally recognized tribes with lands in that area; however, Spokane County never appointed a tribal representative to the SRHD board.
The state clarified things earlier this year, as counties had varying interpretations of whether the law required a single tribal member or one for each tribe in the area. Special Deputy Prosecutor Jim Emacio told the Board of County Commissioners on Monday that it must comply by July 27.
“If you’re gonna to sit at the table, you gotta have skin in the game,” Commissioner Al French said.
SRHD relies on state, federal and local grants for more than half of its $57.5 million budget, with fees, donations and the county covering the rest. This puts the county commissioners in a tough spot, as they hold only three of eight seats on the health board but largely control the funding.
French wants to avoid a situation where the health board passes a budget that the county can’t pay for without additional taxes. Some cities used to put money behind SRHD, but he said that changed when the state had repealed the motor vehicle tax, which helped fund local health districts.
However, even if the commissioners appoint one, two or even three tribal members to the health board, it shouldn’t affect fiscal control. State law requires the county to appoint an equal number of nonelected and elected members, meaning both sides could see their membership increase.
While there isn’t any reservation land in Spokane, Emacio said the Kalispell and Spokane tribes have trust land there and that a Native organization may also meet the criteria. French noted that other tribes could also buy land that the Bureau of Indian Affairs could transfer to trust land.
“The Coeur d’Alene tribe has made a request to change property from fee to trust,” Emacio said, “so if this is approved, the Coeur d’Alene tribe will potentially have membership on the board … I’ve [also] been advised by the Kalispell attorney that they do intend to nominate someone.”
Emacio said if the commissioners don’t add members by July 27, SHRD should remove the city of Spokane’s elected representative from the board. Once they appoint a tribal member, SHRD can expand the board to include the city and another elected official for every tribe that joins.
He said the other elected officials joining the board would likely include someone from Spokane Valley and a smaller jurisdiction in the county before adding the other commissioners. The other option is expanding the county’s majority before adding elected officials from towns and cities.
What remains unclear is how many tribes will actually join. Emacio said the process isn’t cut and dry. The new state law requires tribes to notify the health board if they’re interested, who must then inform the American Indian Health Commission and add the representative within 60 days.
“We may be legally required to fund at some level,” Commissioner Chris Jordan said. “But we retain the discretion, I believe, to set at least at some level of what that amount is, in any event, regardless of what the board makeup is.”
