Site selection is early step in long process, made possible through new encounter rate, says council members

NESPELEM - During Special Session, April 14, the Colville Business Council approved a resolution regarding the site selection of a new Colville Tribal Convalescent Center.

The resolution reads, “It is the recommendation of the Natural Resources Committee to approve site selection for construction of a new Skilled Nursing Facility (Convalescent Center) on portions of tribal tracts 101-T4090 and 101-T5052. The portions…will be designated for governmental use and will include approximately 67 acres…”

The decision came as an early step in a long process to rebuild the Colville Tribal Convalescent Center.

According to CBC members Norma Sanchez, chair of the CBC Health and Human Services Committee, and Andy Joseph Jr. the opportunity has come through the 2019 state law that allowed the Colville Tribes to renegotiate their encounter rate for patients at the Colville Tribal Convalescent Center.

The state’s Medicaid program includes a long-term service and assistance to low-income families that is financed by both the state and federal government at a cost-sharing rate based on the state’s per capita income, which was 50 percent for Washington state according to the Center for Medicare and Medicaid Services.

Funding for tribal long-term care facilities within Washington had previously passed through the state at a fixed rate equivalent to the state’s rate, but when signed by the governor, the 2019 law allowed the state to negotiate an enhanced rate for tribal facilities with a 100 percent match from the federal government, rather than working through the state’s fixed rate.

The law was seen as a win-win for both the state and Colville Tribes. It allowed the Colville Tribes - who had the only long term care facility on a reservation in the state at the time - to receive more funding for the services provided and save $2 million annually from the tribal general fund while also saving money for the state.

In Sept. 2019, the tribe was able to approve a new encounter rate that saw the encounter rate move from $169 to nearly $650 with annual increases, according to Joseph, who noted the Colville Tribes successfully negotiated $97 from each new encounter to go into a savings for a new Colville Tribal Convalescent Center.

“When we talked about the goals for the health committee this year, my first and foremost goal was the Omak Clinic, and my secondary goal was that we start working on the process for the Convalescent Center,” said Sanchez. “The Omak Clinic is it’s own walking tool right now. It has timelines, it has guidelines. That one is already moving and it doesn’t have to be babysat. The convalescent center is something that was in the negotiation for the new encounter rate.”

With the negotiated encounter rate, there is a plan, said Sanchez.

“Within the first five years, we are to get the employees up to a current rate scale, do the corrections and repairs to the current facility and improve the facility services to include psychiatric care. That’s the five year plan for the encounter rate increase,” said Sanchez. “As we build up capital for a new facility, we wanted to identify a site first… The site location will allow us to formulate how we spend on the funds.”

Next steps will include a discussion on what to include at the new facility, assessments on the land (though an environmental review has been conducted according to Sanchez), an updated business plan and then an engineering and design plan, said Sanchez.

Both Sanchez and Joseph suggested attaching an assisted living facility to the new facility.

“If we focus on it, I think we can have it built in the next 5 years,” said Sanchez, though no schedule has officially been set out. “We met with the health team. That was our discussion with them. I don’t want to overtax them. We have the treatment facility going right now. They have to furnish it, fill it with providers, set up the operational plan. There’s a lot of details that are minute but a lot of work. We have the Omak Clinic building at the same time. To put another project on top of that is asking for failure. I don’t want to start something before we get at least one of them with all the works and quirks taken out of it.”

The new site is located across from the Colville Tribal Agency in Nespelem on a bench overlooking the Nespelem Valley.

“The elders were actually surveyed about 10 years ago,” said Joseph. “I was curious. I went to Planning when they were in their old building. Smoker was in his office. I asked him about if we were ever going to do a Convalescent Center. He got excited. He said, ‘We surveyed the elders. They want to be up on the flat, up above where council is, up where they could see everything. They could see Moses Mountain. They could see the July Grounds. They could see what we are doing down here.’ They didn’t want to be in a hole where they can’t see anything. Some of the trees are nice, but the closest thing to them is the cemetery. So when we were looking, we went up there and the view was perfect.”

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