In the remote and beautiful northcentral part of Washington, the Colville Reservation is the largest in the state at 1.4 million acres. The Reservation contains incredible diversity of ecosystems from vast stretches of high desert plateau in the south near Grand Coulee Dam to high, forested mountains in the north. The Columbia River marks the southern boarder, the Okanogan River to the west and the Kettle River on the east.
Eleven tribes and one band comprise the Confederated Tribes of the Colville Reservation. There are over 9,000 enrolled tribal members, over half of whom live on or near the Reservation. The tribal government and other tribal services are located at Nespelem (population 240). The Reservation and surrounding area are sparsely populated with Omak (population 4,000) being the largest adjacent community to the west side of the Reservation. Spokane (population 200,000) is 104 miles southeast of Nespelem. Wenatchee (population 27,930) is 96 miles southwest of Omak.
The tribes operate several business ventures under a charter with the Colville Tribal Enterprise Corporation (CTEC), including forest products, tourism, and agriculture sectors. They also operating three gaming facilities, houseboats, and grocery stores.
The 17,110 square foot IHS facility in Nespelem was built in 1934 and offers family practice-oriented medical, dental, and optometry services. Lab, pharmacy, and x-ray services are also available on site. The Colville Service Unit (CSU) is in the midst of a major expansion project that will ultimately bring the facilities to a total of 40,000 square feet by the summer of 2006.
The Confederated Tribes also operate several of their own medical and dental facilities located across the reservation. In the community of Inchelium, located on the east side of the Reservation, the tribe opened a new health clinic consisting of 17,000 square feet; this is an IHS PL 93-638 contracted service delivery system launched in 1984. The next community, Keller, located between Inchelium and Nespelem, opened a small clinic consisting of 7,750 square feet. In 2003, the Tribe opened a small clinic in Omak through which IHS provides pharmacy and dental services.
The nearest hospital is 20 miles south of Nespelem in Grand Coulee Dam. For specialty care, patients are generally referred to physicians in Spokane or Wenatchee. The most complex cases may be referred to Seattle.
The CSU Chief Executive Office (CEO) is a member of the Confederated Tribes and has worked in health care systems in tribal and state governments, in addition to having been an elected tribal council representative in the past. The CEO manages about 48 staff for the delivery of ambulatory care, collaborates with other tribal IHS ‘638 programs for community health care, outpatient mental health and alcohol services, environmental health, and provides services to the tribes 35 bed convalescent center.
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