Washington State workers' compensation system spends about $500 million annually on medical care for injured workers. Making sure that money is spent on effective, high quality health care is a top priority at the Department of Labor and Industries (L&I). To ensure best practices are followed in the delivery of occupational health care to injured workers, L&I has participated in a number of projects to test various healthcare delivery systems.

Building on those experiences, L&I worked in collaboration with business and labor organizations, community health care leaders and a University of Washington (UW) research team to develop a community-based approach to health care that has been implemented through Centers of Occupational Health and Education (COHE).

In 1999, leaders from businesses and labor unions in Spokane approached Providence St. Luke's Rehabilitation Medical Center (formerly St. Luke's Rehabilitation Institute of Inland Northwest Health Services), expressing their desire to find a sponsor for a potential COHE pilot project benefiting workers, employers and health care providers. St. Luke's made a commitment to meet that community need by dedicating expertise and resources for the advancement of health-related best practices into our "communities of healthcare."

  • 2003 - The "Spokane COHE" was established, serving Spokane, Grant and Stevens counties.
  • 2005 - With the success of the pilot and the expansion into 13 additional counties, Spokane COHE changed its name to Eastern Washington COHE.
  • 2011 - State Legislature approved SSB 5801 calling for a state wide expansion of the COHE program by the end of 2015.
  • 2013 - Eastern Washington COHE expanded its service area to 19 counties including Benton, Franklin and Kittitas counties.
  • 2014 - Eastern Washington COHE became COHE Community of Eastern Washington and has expanded to include the Surgical Best Practices Pilot.
  • 2019 - COHE Community of Eastern Washington expanded its service area to 20 counties to include Klickitat County.

COHE Community of Eastern Washington Service Area

Map of counties included in COHE service area

Learn more about the COHE program at the L&I website.