Tribal data

AN ACT Relating to improving the state governmental public health 1
system and the health system and health status of American Indians 2
and Alaska Natives through the sharing and protection of tribal data; 3
reenacting and amending RCW 43.71B.010; adding a new section to 4
chapter 43.71B RCW; adding a new section to chapter 43.20 RCW; and 5
adding a new section to chapter 42.56 RCW. 6
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:7
NEW SECTION. Sec. 1. A new section is added to chapter 43.71B 8
RCW to read as follows: 9
(1) State agencies listed in RCW 43.71B.020(1)(b)(i) shall use 10
and share tribal data in a manner consistent with the following 11
tribal data sovereignty principles: 12
(a) Tribes must have the same or enhanced access to state data as 13
other public health jurisdictions and nongovernmental entities to 14
effectively carry out their governmental duties including preventing 15
and controlling infectious and noninfectious conditions, providing 16
health care services, and improving the health status of their 17
community members; 18
(b) Tribes must possess the sovereign authority to manage the 19
collection, ownership, application, and interpretation of their own 20
H-3194.1
HOUSE BILL 2685
State of Washington 69th Legislature 2026 Regular Session
By Representatives Lekanoff, Parshley, Ramel, and Pollet
Read first time 01/27/26. Referred to Committee on Health Care &
Wellness.
p. 1 HB 2685
data even when it is collected by federal, state, or local 1
governments or other third parties; 2
(c) Tribes must retain an ownership interest in their data even 3
when the tribe's data is located in state, federal, or other data 4
sets. This interest remains when the tribe's data is aggregated with 5
other data; 6
(d) Unless otherwise required by law, tribes have the right to 7
informed consent on how their data, including protected health 8
information about tribal members, is used or shared with third 9
parties; and 10
(e) State agencies must meaningfully consult and engage with 11
tribes in accordance with chapter 43.376 RCW on how and when to 12
share, analyze, report, or interpret tribal data. 13
(2) State agencies listed in RCW 43.71B.020(1)(b)(i) shall:14
(a) Include the tribal data sovereignty principles provided in 15
this section in data sharing agreements; 16
(b) Refer to the governor's Indian health advisory council tribal 17
data sharing agreement checklist in the development of tribal data 18
sharing agreements; and 19
(c) Seek input and guidance from the governor's Indian health 20
advisory council tribal data sovereignty committee for implementation 21
of this section and on any other issues related to tribal data.22
(3) Any tribal data, as defined in RCW 43.71B.010, pertaining to 23
American Indians, Alaska Natives, or Indian tribes that is prepared, 24
owned, used, or retained by the agencies listed in RCW 25
43.71B.020(1)(b)(i) or by local health jurisdictions as defined in 26
RCW 43.70.575 is exempt from public disclosure under chapter 42.56 27
RCW. 28
Sec. 2. RCW 43.71B.010 and 2020 c 256 s 102 are each reenacted 29
and amended to read as follows: 30
The definitions in this section apply throughout this chapter 31
unless the context clearly requires otherwise. 32
(1) "Advisory council" means the governor's Indian health 33
advisory council established in RCW 43.71B.020. 34
(2) "Advisory plan" means the plan described in RCW 43.71B.030.35
(3) "American Indian" or "Alaska Native" means any individual who 36
is: (a) A member of a federally recognized tribe; or (b) eligible for 37
the Indian health service. 38
(4) "Authority" means the health care authority.39
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(5) "Board" means the northwest Portland area Indian health 1
board, an Oregon nonprofit corporation wholly controlled by the 2
tribes in the states of Idaho, Oregon, and Washington.3
(6) "Commission" means the American Indian health commission for 4
Washington state, a Washington nonprofit corporation wholly 5
controlled by the tribes and urban Indian organizations in the state.6
(7) "Community health aide" means a tribal community health 7
provider certified by a community health aide program of the Indian 8
health service or one or more tribes or tribal organizations 9
consistent with the provisions of 25 U.S.C. Sec. 1616l, who can 10
perform a wide range of duties within the provider's scope of 11
certified practice in health programs of a tribe, tribal 12
organization, Indian health service facility, or urban Indian 13
organization to improve access to culturally appropriate, quality 14
care for American Indians and Alaska Natives and their families and 15
communities, including but not limited to community health aides, 16
community health practitioners, behavioral health aides, behavioral 17
health practitioners, dental health aides, and dental health aide 18
therapists. 19
(8) "Community health aide program" means a community health aide 20
certification board for the state consistent with 25 U.S.C. Sec. 21
1616l and the training programs and certification requirements 22
established thereunder. 23
(9) "Fee-for-service" means the state's medicaid program for 24
which payments are made under the state plan, without a managed care 25
entity, in accordance with the fee-for-service payment methodology.26
(10) "Historical trauma" means situations where a community 27
experienced traumatic events, the events generated high levels of 28
collective distress, and the events were perpetuated by outsiders 29
with a destructive or genocidal intent. 30
(11) "Indian health care provider" means a health care program 31
operated by the Indian health service or by a tribe, tribal 32
organization, or urban Indian organization as those terms are defined 33
in 25 U.S.C. Sec. 1603. 34
(12) "Indian health service" means the federal agency within the 35
United States department of health and human services.36
(13) "New state savings" means the savings to the state general 37
fund that are achieved as a result of the centers for medicare and 38
medicaid services state health official letter 16-002 and related 39
guidance, calculated as the difference between (a) medicaid payments 40
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received from the centers for medicare and medicaid services based on 1
the one hundred percent federal medical assistance percentage; and 2
(b) medicaid payments received from the centers for medicare and 3
medicaid services based on the federal medical assistance percentage 4
that would apply in the absence of state health official letter 5
16-002 and related guidance. 6
(14) "Reinvestment account" means the Indian health improvement 7
reinvestment account created in RCW 43.71B.040. 8
(15) "Reinvestment committee" means the Indian health improvement 9
reinvestment committee established in RCW 43.71B.020(4).10
(16) "Tribal data" means data or information that is specific to 11
an individual tribe and includes public or private data or 12
information on or about a tribe or its people subject to tribal 13
rights of ownership and control. Tribal data also includes, but is 14
not limited to, tribal membership, tribal affiliation, events and 15
conditions within the tribe's jurisdiction and lands, information 16
about tribal members and any persons living within the tribe's 17
jurisdiction, tribal census tract, tribal land, and identification of 18
tribal facilities, entities, and enterprises and any individuals they 19
serve.20
(17) "Tribal data sovereignty" means the inherent legal authority 21
of tribes to:22
(a) Manage the collection, ownership, application, and 23
interpretation of tribal data or information even if it is collected 24
by federal, state, or local governments, or other third parties, 25
regardless of where data is collected;26
(b) Have the right to informed consent on how their data, 27
including but not limited to protected health information about their 28
tribal members, is used or shared with third parties;29
(c) Have the same or additional access to state data as other 30
public health jurisdictions in order to carry out their governmental 31
duties; and32
(d) Be notified by other entities holding tribal data of data 33
breaches and be informed of any policies regarding data disposition, 34
security, confidentiality, storage, and human subjects research 35
limitations.36
(18) "Tribal organization" has the meaning set forth in 25 U.S.C. 37
Sec. 5304. 38
(((17))) (19) "Tribally operated facility" means a health care 39
facility operated by one or more tribes or tribal organizations to 40
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provide specialty services, including but not limited to evaluation 1
and treatment services, secure detox services, inpatient psychiatric 2
services, nursing home services, and residential substance use 3
disorder services. 4
(((18))) (20) "Tribe" means any Indian tribe, band, nation, or 5
other organized group or community, including any Alaska Native 6
village or group or regional or village corporation as defined in or 7
established pursuant to the Alaska Native claims settlement act (43 8
U.S.C. Sec. 1601 et seq.) which is recognized as eligible for the 9
special programs and services provided by the United States to 10
Indians because of their status as Indians. 11
(((19))) (21) "Urban Indian" means any individual who resides in 12
an urban center and is: (a) A member of a tribe terminated since 1940 13
and those tribes recognized now or in the future by the state in 14
which they reside, or who is a descendant, in the first or second 15
degree, of any such member; (b) an Eskimo or Aleut or other Alaska 16
Native; (c) considered by the secretary of the interior to be an 17
Indian for any purpose; or (d) considered by the United States 18
secretary of health and human services to be an Indian for purposes 19
of eligibility for Indian health services, including as a California 20
Indian, Eskimo, Aleut, or other Alaska Native. 21
(((20))) (22) "Urban Indian organization" means an urban Indian 22
organization, as defined by 25 U.S.C. Sec. 1603. 23
NEW SECTION. Sec. 3. A new section is added to chapter 43.20 24
RCW to read as follows: 25
(1) The state board shall, no later than July 31, 2027, and in 26
accordance with RCW 43.20.050(2)(f), amend rules for the prevention 27
and control of infectious and noninfectious diseases, including food 28
borne and vector-borne illnesses as follows: 29
(a) Requiring health care providers, health care facilities, 30
laboratories, and other required entities to report notifiable 31
conditions to tribal health jurisdictions in Washington state where 32
the patient resides, or in the event the patient's residence cannot 33
be determined, the tribal health department in which the patient 34
received treatment; and 35
(b) Requiring notification to tribal health jurisdictions 36
wherever notification is required to local health jurisdictions.37
(2) Nothing in this section may be read as an assertion of state 38
jurisdiction or regulatory authority over a tribe.39
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NEW SECTION. Sec. 4. A new section is added to chapter 42.56 1
RCW to read as follows: 2
Any tribal data, as defined in RCW 43.71B.010, pertaining to 3
American Indians, Alaska Natives, or Indian tribes that is prepared, 4
owned, used, or retained by the agencies listed in RCW 5
43.71B.020(1)(b)(i) or by local health jurisdictions as defined in 6
RCW 43.70.575 is exempt from public disclosure. 7
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