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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?
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