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King County Board of Health authority and scope

The King County Board of Health is granted the authority to protect and promote the health of King County residents as outlined in RCW 70.05.060. State law allows the Board to set countywide public health policy, enact and enforce local public health regulations, enforce state public health laws, prevent the spread of infectious diseases, and establishes fee schedules for certain licenses and permits (such as food permits for restaurants).

The Board of Health

  • Supervises the health of King County residents by voicing and advocating priorities for protection of public health;
  • Collaborates with the Public Health Director and Health Officer to set an annual work plan which creates opportunities for action within the limits of the Board’s workload and legal authority; and
  • May enact local rules and regulations as necessary in order to preserve, promote and improve the public health and authorize for the enforcement thereof.

The Board's Powers

The Board’s operating rules1 provide 3 primary tools available to the Board: enactment of rules and regulations, resolutions, and guidelines and recommendations.

  1. Rules and Regulations

  2. Codified in the Board of Health Code, the Board enacts countywide rules and regulations, which establish requirements to broadly promote public health, prevent and control the spread of infectious disease, abate nuisances, and establish fee schedules for licenses, permits, and other services. Prior Board rules and regulations pertaining to secure medicine return, and permit requirements for farmers markets and other temporary food establishments. Rules and regulations have the force of law and are general and permanent in nature.

  3. Resolutions

  4. Resolutions are policy statements of the Board and are not considered permanent. Unlike rules and regulations, resolutions do not have the force of law and do not require a public hearing. Resolutions are typically used to express support for a project, program, or policy. Examples of prior resolutions include supporting efforts for the annual board of health strategic work plan and encouraging the Washington State Legislature to support funding for foundational public health services and declaring racism a public health crisis.

  5. Guidelines and Recommendations

  6. Guidelines and recommendations provide policy guidance and express the Board’s current thinking. They are advisory and, like resolutions, do not have the force of law. A typical use of a guideline and recommendation is to outline best practice based on the expertise and resources of Public Health – Seattle & King County. Examples include information for improving food and beverage nutritional quality in vending machines and healthy housing.

In addition to the above, advocacy is another strong role for the Board of Health. Board members can speak to the media, constituents, and other elected officials and county leaders to educate about health matters. A recent example is a Board member publishing an Op-Ed in the Puget Sound Business Journal on secure medicine return.

Fiscal Authority

The Board of Health does not have appropriation authority. The King County Council has sole appropriation authority over matters of public health. Any Board program or initiative requiring funding must go through the Council’s budget appropriation process.

The Board has the authority to enact permit or license fees may not exceed the reasonable cost of providing the particular service.2

An interlocal agreement between King County and the City of Seattle established Public Health – Seattle & King County, our joint city-county health department. The interlocal agreement outlines the city’s and county’s respective financial contributions towards the health department.


1 The Board sets operating rules for itself in conducting the business of the Board. These rules are codified in King County Board of Health Code chapter 2.04 and address membership and officers, staff, meetings, and procedures for adopting, amending, and/or repealing rules & regulations, guidelines & recommendations, and resolutions.

2 RCW 70.05.060(7)

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