Health and Wellness Manager Orientation

1. Health and Wellness Manager Orientation Shannon Bentley, RN, Nurse Specialist Melissa Cusey, RN, Nurse Specialist

2. Job Corps General Information • America’s largest residential educational and career technical training program for economically challenged young adults aged 16-24 • In operation since 1964 • 124+ operational centers throughout the United States and Puerto Rico • Serves over 60,000 students annually

3. Job Corps National Snapshot

4. National Leadership National Office of Job Corps (Washington, D.C.) National Director Edna Primrose

5. Administration and Management National Office • The National Office Health and Wellness staff are responsible for developing and implementing the policies and procedures that guide the delivery of health care on center • National Office Health and Wellness staff contacts include: • Edward Benton, Division Chief • Carol Abnathy, MSW, MPH, National Health and Wellness Manager • Johnetta Davis, MPH, Program Analyst

6. Administration and Management (continued) Health Support Contractor • The health support contractor works with the National Office, Regional Offices, and centers to: • Develop and enhance center health and wellness services • Develop policy • Train center health staff • Develop resource materials • Collect and analyze program data • Pilot test new health initiatives • Manage Health Specialists • Provide technical assistance • Conduct center assessments

7. Administration and Management (continued) Regional Offices • Regional Offices award contracts and provide oversight, monitoring, and technical assistance • Six Regional Offices, headed by a Regional Director (Boston, Philadelphia, Atlanta, Dallas, Chicago, San Francisco) • Project Manager (PM)—the DOL representative and liaison who works closely with your center to ensure that you have the resources you need to do your job and that you are working successfully to meet the established program outcomes

8. Administration and Management (continued) Nurse Specialists and Health Specialists Each Region has the following Specialists: • Nurse Specialist • Medical Health Specialist • Mental Health Specialist • TEAP Health Specialist • Oral Health Specialist

9. Administration and Management (continued) Nurse and Health Specialists: • Provide technical assistance to center health and wellness staff • Answer questions • Clarify Job Corps policies • Provide training to regional and center staff • Provide up-to-date information that will assist center staff in meeting program requirements

10. Regional Office Center Assessments • Every 1 to 2 years, Health Specialists and Assessors visit each center as part of a Regional Office Center Assessment (ROCA) team • ROCA tools will be distributed to you and your staff to complete and return to the ROCA team prior to their visit • Using the Program Assessment Guide (PAG), in conjunction with the Policy and Requirements Handbook (PRH), this team will conduct an overall assessment of your center’s health and wellness program

11. Regional Office Center Assessments(continued) • Assessments highlight the strengths of your program and provide feedback about areas that could be changed or improved • Expect to have your health records, appointment books, and other records audited

12. Center Health and Wellness Team • All centers have the following staff as part of their health and wellness team: • Registered nurse (RN) • Staff nurse • Physician • Mental health consultant • TEAP specialist • Dentist and oral health staff • Disability coordinator • Minimum health and wellness center staffing levels are determined by the center’s contracted student enrollment capacity

13. Primary Objective of Job Corps Health and Wellness Program • Improve each student’s employability by establishing and maintaining the student at his or her optimal health level • Achieve this through provision and/or coordination of health care including case management of chronic illness, promotion of self management of health care, and through preventive health education to instill good wellness habits and prevent avoidable illness, injury, and death • Mentor, model, and monitor good employability skills

14. Wellness Philosophy • Allows the roles of the health care practitioners to be redefined so they impact the student’s entire Job Corps experience, including the body, mind, heart, and spirit • Health care practitioners interact with students not only when the student seeks health care due to illness, but also during times of good health • Health staff may take on roles ofteacher, mentor, role model, or advisor

15. Important Resources • PRH—The Policy and Requirements Handbook contains the rules by which all centers operate; Chapter 6 (Sections 6.10-6.12) provides policy on ensuring students receive health and wellness services, support, and education that will enhance their employability and encourage and maintain a healthy lifestyle • PAG—The Program Assessment Guide is a companion to the PRH and contains the parameters by which the quality of each center’s program is measured; it can also be used on an ongoing basis as a tool for determining program effectiveness

16. Important Resources (continued) • COPs/SOPs—Center Operating Procedures and/or Standard Operating Procedures for the health and wellness program; these procedures define how your program will operate on a day-to-day basis, describe staff roles and responsibilities, and provide guidance on center specific documentation, reporting, and communication protocols • TAGs—Technical Assistance Guides are designed to aid center staff in meeting health and wellness program requirements; they are how-to guides that offer many suggestions but no additional program requirements

17. Important Resources (continued) • DRGs—Desk Reference Guides provide information and strategies to meet and exceed health-related Policy and Requirements Handbook (PRH) requirements, and contain all health and wellness program-related documents and forms. The DRGs will help new center health and wellness staff learn the foundations of their position, and experienced health and wellness staff will find the central location of forms and information useful. DRGs are located on the Job Corps Community Website under the Health and Wellness Tab. Presently there are DRGs available for HWMs, center physicians, CMHCs, center dentists, and center disability coordinators.

18. Health Directives • PRH Change Notices—Contain new or revised policy with instructions to delete, replace, or add pages to the PRH • Program Instructions—Provide one-time instructions with a designated expiration date and usually require center response (e.g., survey) • Information Notices—Provide one-time announcements with information that is of interest to centers (e.g., data summaries, meeting or training announcement)

19. Job Corps Terminology 101 TEST YOUR SKILLS

20. TEAP ROCA CSIO OMS CD WTR TAG What do these mean? • PRH • CMHC • HIPAA • OBS • CDSS • PAG • PM

21. Interaction with Other Center Staff • Centers with an open flow of communication between departments usually function with better morale and efficiency • Develop relationships with staff from all Job Corps programs, including: • Academics • Residential Life • Vocations • Center Administration

22. Interaction with Community Contacts • Establish community linkages that can enhance your program • Become familiar with existing relationships (community hospitals, off-center health care facilities, local public health department, etc.) • Become more connected with community resources to help increase your success in meeting the health care needs of the students

23. Components of Chapter 6 PRH: Chapter 6: 6.10-6.12

24. Student Health ServicesPRH 6.10 • Health and Wellness Program • Oral Health and Wellness Program • Mental Health and Wellness Program

25. Health and Wellness Program(6.10, R1) • Requirements: • A cursory health evaluation within 48 hours of arrival on center to include: • Blood work • Drug test (urine) • Urinalysis (glucose/protein) • STI testing (Chlamydia and Gonorrhea) • Pregnancy testing • Pap (may be waived by physician) • Vital signs • Vision screening (near, distant, and color) • Cursory oral inspection • Tb skin test (Mantoux) • Immunizations (begin within 14 days of arrival) • Hearing screening

26. Health and Wellness Program(continued) • A complete physical examination (within 14 days of a student’s arrival on center) • Centers may provide one pair of glasses (when indicated) • A daily walk-in clinic that must be outside of training hours • An appointment system for follow up during the training day • Must have an off center specialist referral system • 24-hour emergency care system

27. Oral Health and Wellness Program(6.10, R2) • Cursory oral inspection completed within 48 hours of arrival and documented in SHR • Mandatory oral examination: • Completed prior to the student’s 75th day on center • Includes bitewing x-rays, priority classification, and treatment plan • Documented on the SF-603 and SF-603A • Oral health care beyond the oral examination is voluntary • Productivity reports must be kept by the center dentist

28. Oral Health and Wellness Program(continued) • Orthodontics • Not paid for by Job Corps • Applicants with orthodontic appliances must have a signed agreement in place before arrival that 1) all costs, including transportation, is the responsibility of the student/guardian, and 2) appointments will be kept and not exceed authorized leave days for elective dental treatment

29. Mental Health and Wellness Program(6.10, R3) • Centers shall provide basic mental health services: • Should focus on prevention, identification, short-term counseling, and crisis intervention with an EAP approach • A written referral/feedback system must be in place • Steps/procedures for mental health emergencies in place to include supervision • Accommodations for students not considered a danger to self or others • Regular case conferences for information exchange (should include at a minimum counselors, TEAP specialist, and health and wellness manager, if possible).

30. Jeopardy Questions • What is the timeframe for completing the entrance physical examination? • 5 days • 14 days • 30 days

31. Jeopardy Questions • True or False? The CMHC should have a written referral/ feedback system in place.

32. Jeopardy Questions • When should the mandatory oral examination be completed? • On day 5 • 3 months after entry • Prior to the 75th day

33. Related Health ProgramsPRH 6.11 • Trainee Employee Assistance Program (TEAP) • Health Aspects of Sports • Tobacco Use Prevention Program (TUPP) • Family Planning Program • HIV/AIDS • Sexual Assault Prevention and Response • Disability Program

34. Trainee Employee Assistance Program(6.11, R1) • At a minimum shall include: • Assessment • Intervention • Counseling • Relapse Prevention • Prevention and Education

35. Health Aspects of Sports(6.11, R2) • All students must be medically cleared to participate in organized sports activities by the center physician or designee • Document on the SF-88 or use a center-generated sports clearance form with copy in chart • Notify recreation manager of any students NOT cleared or if on sports restriction • After one year must have another physical examination with clearance • Center must make sure that staff certified in CPR and First Aid is present at all sports events including practice sessions • Adequate transportation must be available in the event of an emergency at all sponsored events

36. Tobacco Use Prevention Program(6.11, R3) • Be aware of federal and state laws regarding use of tobacco products by minors; minors who use tobacco products shall be referred to the TUPP • Promote smoke-free environment or no smoking during the training day • If center operators choose to allow smoking and use of tobacco products, designated smoking areas must be located at least 25 feet away from all building entrances

37. Family Planning Program(6.11, R4) • Provided to all students on a voluntary basis and shall include counseling, health promotion activities, and medical services • If student is more than 12 weeks pregnant on arrival, give MSWR • For students who are less than 12 weeks pregnant on arrival or who become pregnant after enrollment the center: • Provide or arrange for prenatal care • Be aware of applicable state laws on rather to notify the student’s guardian • Provide a MSWR at 28 weeks

38. HIV/AIDS(6.11, R5) • HIV/AIDS program includes education, testing, follow up, and counseling for all students, as well as case management for HIV positive students • Refer to PRH Change Notice No. 08-08 • Be aware of state laws regarding both pre- and post-test HIV counseling • Be knowledgeable of timelines for providing student with HIV-test results • Have student sign that they received their results

39. Sexual Assault Prevention and Response(6.11, R6) • Establish a program for sexual assault prevention, counseling, treatment, and follow-up care • Form a sexual assault response team (SART) that involves center staff and outside resources • Develop SOP with staff designations and outlined duties • Conduct regular SART meetings to discuss prevention and education strategies • Provide yearly training to the SART members • Report sexual assaults

40. Disability Program(6.11, R7) Centers must have a disability program to provide individualized and coordinated services to all students with disabilities; this program shall include: • A disability coordinator to oversee the program • SOPs to include: • Center review process of applicant folders • Reasonable accommodation process • Formation of a interdisciplinary team (IDT) • A written plan to develop and maintain partnerships with outside agencies • A written center self assessment plan describing current programmatic and architectural accessibility and plan for accessibility updates • A method to accurately collect and submit al required disability data in CIS

41. Jeopardy Questions • True or False? The TEAP Specialist should focus primarily on treatment.

42. Jeopardy Questions • When should you place a student with a normal pregnancy on MSWR? • At 16 weeks • At 28 weeks • At 38 weeks • Immediately

43. Jeopardy Questions • Where is the list of Basic Health Services located in the PRH? • Chapter 5 • Chapter 6 Exhibit 6-4 • Chapter 6.11

44. Jeopardy Questions • True or False? A waiver of medical care be granted for HIV testing.

45. Health AdministrationPRH 6.12 • Staffing • Authorizations • Basic Health Services • Health and Medical Costs Exceeding Basic Health Services • Professional Standards of Care • Controlled Substances • Waiver of Medical Care • FECA/OWCP • Health Care Guidelines • Student Introduction to Health Services • Medical Separations • Death • Communicable Disease and Infection Control • Equipment and Supplies • Continuous Quality Improvement • Monthly Meetings with Center Director • Reporting

46. Staffing(6.12, R1) • Refer to Exhibit 6-5 for health and wellness center staffing requirements • Minimum staffing qualifications are listed in Exhibit 5-3 • All subcontracted staff must be reviewed (license, contract ,insurance, and resume) by the RO and Health Specialists PRIOR to hiring • All HWM candidates that are a direct report (administrative staff) must go through same process

47. Authorizations/Consent for Treatment(6.12, R2) • Centers must ensure proper authorizations are obtained prior to delivery of health services • The signed ETA 6-53 serves as authorization for basic routine health care; it must be placed in the SHR before the arrival of the new student on center • In addition, the signed Informed Consent for Mental Health Treatment must be placed in the SHR before arrival of the new student on center

48. Basic Health Services Provided by Job Corps (6.12, R3) • Center operators are responsible for providing and paying for basic health care as detailed in Exhibit 6-4 • Center not responsible to pay for any health-related costs incurred by a student while on authorized leave or pass • Not responsible for non-resident students after training hours unless participating in center activities

49. Health and Medical Costs Exceeding Basic Health Services Provided by Job Corps(6.12, R4) • Centers should assist students in seeking third-party health insurance coverage that will be available should the student have medical needs or costs beyond the basic health services provided by the center • If a Job Corps student experiences a medical emergency or unanticipated serious illness requiring off-center treatment: • Evaluate the student’s medical condition to determine if a MSWR is appropriate • Request third-party payment only for services beyond those basic services stipulated in the center operator’s prime contract

50. Professional Standards of Care(6.12, R5) • All subcontracted staff must have a copy of current license and malpractice insurance in health and wellness center; center physician must also have current copy of DEA registration • Must document all prescribed medication and treatment in the SHR; must be in SOAP format • Document all labs and results in the SHR • Check off physician orders • Follow current standards of care • Have copies of current state nurse practice act for RN and LPN