PRESENTED BYMELISSA LORENZO, MPH

PAT JACKSON, RN

Preparing for the Health and Wellness ROCA

Overview

Purpose of the ROCAPre-ROCA: Preparing for ROCAROCA: On-site assessment activitiesPost-ROCA: Report release and Corrective

Action Plan processBest practices learned from ROCAsFAQs

Purpose of ROCA

What is the Regional Office Center Assessment (ROCA)? The ROCA is a thorough evaluation of Job

Corps centers and is conducted every 12 to 24 months. Job Corps Regional Offices (ROs) are charged with the responsibility of providing federal oversight of the Job Corps program to ensure that it is delivered with compliance, quality, and integrity.”

Purpose of ROCA

Role of Health Support Contractor – Humanitas, Inc. works with the National Office, all

Regional Offices, and all centers to develop and enhance center health and wellness services.

Two health assessors conduct the Health and Wellness portion of the ROCA. The assessors will review all program components (PRH-6: 6.10-6.12) from the past 12 months to 24 months.

Pre-ROCA: Preparing for the Review

Center will receive Notice from Regional Office followed by an email from lead health assessor regarding the Health and Wellness Review

Email will include the dates the health assessors will be on center (2-3 days)

The following information is requested prior to the arrival of the assessors on center: A schedule of when the subcontractors are on center Pre-ROCA forms listed on the Job Corps Community

Website

Pre-ROCA: Preparing for the Review

Pre-ROCA Forms can be accessed on CITRIX > Job Corps Community Website > Health and Wellness > Documents > Pre-Arrival ROCA Tools

Pre-ROCA: How to Prepare for the Review

Documents that will be reviewed during the ROCA:

List of best practices (3-5) Bloodborne Pathogen Plan CLIA certification (if applicable) Credentials for wellness staff Certifications Liability insurance Licenses Sub-contracts Waivers, if applicable HEALs Program Evaluation

Making the Grade Health Care Guidelines (HCGs) Health-related Standard Operating Procedures Logs/Spreadsheets CA-1/injury log Dental productivity HIPAA disclosures MSWR phone contact Narcotics log Refrigerator temperature monitoring Sharps exposure Spore testing log

Meeting minutes HEALs meeting minutes Monthly meeting with Center Director, Center

Physician, CMHC Quarterly SART meeting Schedule of meeting times SGA wellness committee Wellness staff meetings

Memoranda of Understanding MSWRs (past year) Materials Safety Data Sheet (MSDS) Personal authorizations Quality assurance

Student Surveys CQI studies

Reports/Surveys Annual H&W Program Description Assessments (most recent corporate and self review) H&W quality assurance surveys/results HMIS reports (past year) Student Satisfaction Survey Quarterly Alcohol Summary (past year)

SIRs (including nonmedical, past year) Staff roster (all center staff, positions included) Staff training hours (from HR including CPR/First Aid,

Bloodborne Pathogens, HCGs) percent of total staff trained, and of those not trained who are essential staff

ROCA: On-Site Activities

Brief – In Meet with HWM and Center Director

Student health records Will be randomly selected

Documents listed above will be reviewedStaff interviews

HWM, center physician(s), center dentist(s), CMHC, TEAP Specialist(s), family planning coordinator, SART coordinator, HEALs coordinator (recreation manager and food service manager), center nurses, dental hygienist, dental assistant, etc.

ROCA: On-Site Activities

Individual student interviewsStudent Focus Group

Students will be randomly selected or health assessors will request for certain students to participate

Observation of select staff meetingsBrief – Out

Brief summary of findings from the ROCA Center Director, HWM, Project Manager, ROCA Team

Lead, corporate representatives

Post-ROCA

Report Multi-tiered review process: Health Support Contractor >

Lead Health Specialists > National Office Released approximately 30 days after ROCA

Corrective Action Plan (CAP) process Center must submit a CAP to the Regional Office 45 days

after the ROCA report is released CAP should address impact of ROCA Regional nurse specialists, not assessors, who review and

approve the CAP If CAP is not received in 45 days, the National Office will

be notified

Scoring

Job Corps uses a Program Rating System (PRS) as a qualitative measure of performance for center/OA/CTS operations (PAG, pg 4, Aug 2008).

Scoring

PRS Rating Definitions:

Exceptional (8-9) – Programs, procedures, and systems are well organized, clearly communicated, and administered to ensure quality delivery of all requirements and achievement of quality indicators. Innovative approaches result in program enhancements and improved outcomes. Through rigorous self assessments and quality assurance, the operator safeguards program assets and maintains the integrity of program data.

Very Good (6-7) – Programs, procedures, and systems are consistently in place to ensure delivery of requirements and achievement of quality indicators. Some innovative approaches are employed to promote continuous improvement. A viable quality assurance plan ensures integrity and accountability of program assets and data.

Scoring

PRS Rating Definitions cont’d:

Satisfactory (4-5) – Requirement and quality indicators are generally evident in applicable program areas with minor exceptions. A quality assurance plan is in place that demonstrates adequate controls to ensure integrity and accountability of program assets and data.

Marginal (2-3) – Requirements and/or quality assurance indicators are missing or minimally evident in applicable program areas. Quality assurance is minimal resulting in inconsistencies in accountability and integrity of program assets and data.

Unsatisfactory (0-1) – Critical requirements are missing or minimally evident. Quality indicators are not achieved. The program lacks procedures and controls necessary to ensure compliance, quality, and data integrity.

Strengths and Best Practices

Definition – A method or technique that has consistently shown results superior to those achieved with other means, and that is used as a benchmark.

Examples Cassadaga JCC – The HWM teaches a Patient Empowerment

Class to all students during CPP-2. Jacksonville JCC – The HWC staff has worked diligently to

develop and implement community resources and internships that provide no cost to services on center.

San Jose JCC – Operates a Work Wellness Program with activities to help students adjust and cope with changes.

Strengths and Best Practices

Examples continued: Los Angeles JCC – The TEAP specialists have a

Corrective Action Team designed to help retain students who are struggling in the TEAP with unexcused absences or behavioral issues.

Woodstock JCC – CMHC created and leads the MINORS group, a group intervention in response to the high number of minors leaving Job Corps AWOL.

Pittsburgh JCC – Pittsburgh Action Against Rape conducts a healthy relationship class for students and provides sexual assault prevention training for staff on center.

Strengths and Best Practices

Examples continued: Inland Empire JCC – Planned Parenthood conducted a

peer counselor training program on center in 2011 and trained approximately 20 students to act as peer educators on center for discussions in the dormitories or classrooms regarding issues related to sexuality.

Mingo JCC – Strengths of HEALs: There is a garden on center which already provides some

vegetables to be used to enhance the students’ meals. The center has an annual work plan to facilitate center-

wide healthy eating and lifestyles. “HEALs Summer Olympics”

Discussion

Do you have an example of a best practice on your center?

FAQs

What are examples of continuous quality improvement (CQI) studies (PRH-6:6.12, R15)? According to the CDC, quality improvement is the use of a deliberate

and defined process, such as Plan-Do-Check-Act, which is focused on activities that are responsive to community needs and improving population health. It refers to a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality services or processes which achieve equity and improve the health of the community.

Examples: Pittsburgh JCC - The center cooperated with the local health department to

examine their student re-infection rates for gonorrhea and Chlamydia. The exercise was intended to determine if a risk assessment and prevention counseling had any impact on the re-infection rate of students three months after diagnosis and treatment of their STI.

FAQs

What is the problem list? The problem list should be

a “snapshot” of the current condition of the student. Include problem list(s) on the first page of the SHRs in order to identify acute and chronic illnesses, significant past medical/surgical history, medications, and allergies for coordination of care.

The problem list should be updated regularly, or as needed after a student’s visit to the HWC.

FAQs

How should chronic care management plans be used? Use of CCMPs is not a PRH requirement; however, the

case management of chronic illness is. CCMPs can be altered as the center sees fit.

Are health and wellness staff required to teach the Wellness topics listed in PRH-3: 3.17? Health and wellness staff are NOT required to teach the

Wellness topics in PRH-3: 317; however, the topics must be taught and can be done so in collaboration with health and wellness staff.

CONTACT INFORMATION:

M E L I SS A L O R E N Z O, M P HM E L I SS A . L O R E N Z O @ H U M A N I TA S. C O M

PAT J A C K S O N, R NP B JA C K S O N @ V E R I Z O N. N E T

L O I S S A C H E R , R NL S A C H E R @ A O L . C O M

Questions?