Equitable Rulemaking at the Washington State Department of Health

Making health of the people, by the people, for the people

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Ashley Green, Equity & Social Justice Manager

An image of a group of people in a meeting.

Working under the vision of “equity and optimal health for all,” the Washington State Department of Health (DOH) has worked hard to make our rulemaking process more accessible and inclusive to all communities in our state. A team from across the agency created a video for these communities showing how they can get involved in DOH’s rulemaking process.

“Our first step was to create awareness about the equity in rulemaking process,” Health Equity Communications Consultant Rael Odengo explained. “Working with program staff from our Office of Public Affairs & Equity and Office of Policy, Planning and Evaluation, we created videos available in six languages — English, American Sign Language, Spanish, Vietnamese, Russian, Ukrainian, and Marshallese,” Rael added.

This work is a result of not only a legal mandate, but also best practices our agency has learned over the last five years. The Healthy Environment for All (HEAL) Act of 2021 and Gov. Jay Inslee’s 2022 Executive Order 22–04 directed state agencies to integrate both environmental justice and equity into their administrative processes. As we worked with local health departments and community organizations during the COVID-19 pandemic, we saw that some communities were left out of policy decisions that disproportionately impacted them.

Rulemaking is a central aspect of public health. When the Legislature and Governor write and pass legally binding laws, agencies like ours make rules that help support these laws. Rules made by DOH affect more parts of your life than you might realize, including access to safe drinking water and setting medical standards at your local health care provider’s office. Making rules is one of the most effective ways we can protect the public in public health.

The National Academy of Sciences explains that “public health is what we, as a society, do collectively to assure the conditions in which people can be healthy.” Helping communities be healthy requires listening directly to community members to understand their needs and concerns, and then we can act accordingly. We revised our rulemaking process to help communities be healthier and more involved. As we might reimagine Abraham Lincoln’s famous saying, our rulemaking process seeks to make 21st century public health “of the people, by the people, for the people.”

So, how did we make rulemaking at DOH more equitable and effective? Let’s dive into some areas we’ve been focusing on.

To improve communication with Tribal Nations and community partners, we created a system inviting them to participate in agency projects, work together on important topics, and share other relevant information. This system allows communities and partners to have a voice in rulemaking, expand the agency’s network, and establish relationships between the agency and additional communities.

“One chief concern we heard throughout the rulemaking revision process was that the public couldn’t participate if they didn’t know what the rulemaking process was and that they, as members of the public, were welcome to take part,” said Michael Ellsworth, DOH’s Director of Federal and Regulatory Affairs. This video describes the rulemaking process, how folks can be notified of opportunities to participate, and how the agency will use their feedback.

One way communities can get involved in public health is through something called “notification of opportunities.” Communities connected to our agency get an email inviting them to sign up to be notified about the topics that matter most to them. Topics include maternal and child health, environmental health, and rulemaking.

When the state begins work on a public health topic, a letter is sent to all community partners who signed up for updates on that topic or project. This letter invites them to get involved. The process helps agency staff connect with interested people, share more chances to work together, and show a commitment to transparency and open communication with communities. DOH wants to make sure community voices are heard during rulemaking and other agency activities.

You can learn more about the rulemaking process at the Washington State Department of Health by visiting our website, where you can dive deeper and also sign up to receive updates. Help us put the “public” in “public health,” and keep every community in the Evergreen State healthy, happy, and safe.

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