NESPELEM – Long before Gov. Jay Inslee issued coronavirus vaccine mandates, staff at the Colville Tribal Convalescent Center, a nursing home that takes care of tribal members and others on the reservation, had to be fully vaccinated to work there.

The Colville Business Council took swift action to mandate the vaccine this spring, when they passed a resolution that allowed only for medical exemptions.

Within two weeks of April 14, when the resolution was signed, staff at the 44-bed convalescent center had to begin their vaccination process.

So far, that mandate has appeared to pay off, with no residents testing positive for the virus to date.

Colville Business Council Chairman Andrew Joseph Jr. said protecting elders is a part of his tribe’s culture.

“We are brought up and told to respect our elders, and try to help them as much as possible because they are the most vulnerable,” Joseph said.

Joseph is still encouraging tribal members who are hesitant to get vaccinated, because, while the reservation’s high vaccination rate has helped during the delta variant surge, those who are unvaccinated are still at high risk.

Joseph said that when the pandemic hit, he and his sons held a traditional ceremony in a sweat house and prayed for a strong and powerful medicine or vaccination to help bring an end to it.

“I told my kids and grandsons when we were having that ceremony that when smallpox hit here, we probably had elders back then doing the same thing we’re doing,” Joseph said.

For Joseph and other council members, the Tribal Convalescent Center has been a focus throughout the pandemic.

Visitor restrictions remained tight throughout 2020, and even after vaccinations became available to both staff and residents, strict protocols remained to protect the most vulnerable.

Staff are tested twice a week, and any resident who leaves the facility must fill out attestation forms when they return in case they were exposed to the virus.

Even with the delta surge, fully vaccinating staff and layering other protocols have worked to keep COVID out of the facility.

No residents have tested positive for the virus, and while a couple of caregivers did test positive after being vaccinated, enhanced testing protocols caught those cases early and, so far, protected residents who might have been exposed.

“Most of those cases – because they were vaccinated – among employees were caught as a result of screening,” said Dr. Daniel Barbara, director of health and human services for the Confederated Tribes of the Colville Reservation. “They weren’t even symptomatic, so we were doubly successful at keeping virus out.”

The Colville Tribal Convalescent Center is a federally registered nursing home, meaning it takes Medicaid recipients as well as nontribal members. The first vaccines on the reservation went to the residents of the Nespelem center.

While the center is licensed for 44 beds, center administrator Sally Hutton said they usually have around 30 patients. Currently, there are 28 residents at the facility.

The vast majority of residents at the facility were vaccinated with the Moderna vaccine, and booster doses were administered to both staff and residents alike last week, with another clinic scheduled for this week.

The convalescent center opened in 1981, supported by the Colville Tribe. Joseph’s father was on the council at the time, he said, and since he spoke the tribal language, sometimes he would be called down to translate for elders who did not speak English.

The council intends to continue to prioritize the convalescent center, ensuring there is a space to care for elders in the community.

Joseph said the council is planning to build a new, larger convalescent center in Nespelem. It will be nested on a bluff above the government building in Nespelem and have great views of the Cascades all the way down to the Columbia River.

After years of lobbying, the Confederated Tribes of the Colville Reservation secured a federal reimbursement rate for tribal members at the center, which will help fund the new facility.

This cost-based rate means that tribal members who are treated at the center qualify for $97 more in funding than a typical patient would at a nursing home. This funding mechanism was approved by the Washington Legislature in 2019, although the funding is from the federal government. This funding went into effect during the pandemic, enabling the council to approve pay raises for staff at the center.

This rate has helped the center sustain its staff, paying them more than a typical nursing center would.

Barbara admitted that the facility is not immune to the staffing shortages and attrition seen in health care not only in Washington, but nationwide.

“We’ve seen staff challenges just like everywhere else,” Barbara said, noting that the facility is very rural. “The foresight from the council made it possible to prevent some attrition that resulted from the pandemic and elsewhere, but we do face staff shortages and are working on those.”

With President Joe Biden’s national vaccine mandate, which impacts all nursing homes that receive Medicaid funding, many facilities will soon be implementing mandates.

The Colville Tribal Convalescent Center only lost a few staff members due to the mandate, leaders said. The council’s proclamation says that employees who will not get vaccinated must be laid off until the pandemic is resolved, unless they have a medical exemption.

Barbara said transparency was important in the process, as well as communication from many different parties, including the community, the council and residents and staff at the facility.

“We were letting employees know they’re safer here than going out in the community,” Hutton said.