PRESENTED BYMELISSA LORENZO, MPH

SENIOR ASSESSOR, HUMANITAS

Surviving the Health and Wellness ROCA

Dallas edition

Overview

Background: What is Humanitas’ role?Pre-ROCA: Preparing for ROCAROCA: On-site assessment activitiesPost-ROCA: Report release and Corrective

Action Plan processROCA ScoresTips for surviving your next ROCA

What is Humanitas’ Role?

Role of Health Support Contractor – Works directly with the National Office

Provides support to all Regional Offices

Provides support to all centers by helping to develop and enhance center health and wellness services

Examples of Support

Develop policy

Provide education and training

Provide technical assistance

Review programs… ROCAs!

Humanitas’ Role on ROCAs

Two health assessors conduct Health and Wellness Portion of the ROCA. Assessors will review all program components in 6.10 – 6.12 over the past 12 – 24 months

Assessors on center 2-3 days

Provide written report with findings

Who’s Who?

Assessors:

Lois Sacher, RNPat Jackson, RN

Cheryl Walker, APRN, MSN, MBAGary Strokosch, MD

Melissa Lorenzo, MPH

Who’s Who?

Region 1 – BostonShannon Bentley, RNJohn Kulig, MD, MPHDavid Kraft, MD, MPHMaria Acevedo, PhDKevin Avery, DMD, PhDDiane Tennies, PhD

Region 2 – PhiladelphiaShannon Bentley, RNTeresa Lowery, MD, MPHValerie Cherry, PhDKevin Avery, DMD, PhDDiane Tennies, PhD

Region 3 – AtlantaMelissa Cusey, RNTeresa Lowery, MD, MPHSuzanne Martin, PsyD, MPHKevin Avery, DMD, MPHChristy Hicks, MSW

Region 4 – DallasShannon Bentley, RNDrew Alexander, MDLydia Santiago, PhDKevin Avery, DMD, MPHChristy Hicks, MSW

Region 5 – ChicagoMelissa Cusey, RNGary Strokosch, MDHelena Mackenzie, PhDPamela Alston, DDS, MPPChristy Hicks, MSW

Region 6 - San FranciscoMelissa Cusey, RNSara Mackenzie, MD, MPHVicki Boyd, PhDPamela Alston, DDS, MPPDiane Tennies, PhD

Significance of ROCAs

Helps identify problems on center level

Influence policy

Assess impact

Shapes training

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: Documents that will be reviewed

List of best practices (3-5)Bloodborne Pathogen PlanCLIA certification (if

applicable)Credentials for wellness

staffCertificationsLiability insuranceLicensesSub-contractsWaivers, if applicableHEALs Program Evaluation

Making the Grade

Health Care Guidelines (HCGs)

Health-related Standard Operating Procedures

Logs/Spreadsheets CA-1/injury log HIPAA disclosures MSWR phone contact Narcotics log Refrigerator temperature

monitoring Sharps exposure Spore testing log

Pre-ROCA: Documents that will be reviewed

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 Health Services Utilization Report 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/committee, HEALs coordinator/committee (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: Reports

Timeline Multi-tiered review process: Health Support Contractor

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

Definitions Weakness/Concern – refers to components that are

non-compliant with the PRH. Strengths – refers to Best Practices that go above and

beyond PRH requirements. Observations – suggestions that can improve quality

of program.

Post-ROCA: Corrective Action Plan

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 health specialists, not assessors, who review

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

will be notified

General follow-up

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.

ROCA Scores: Compliance

0.0 1.0 2.0 3.0 4.0 5.0 6.0

National Compliance Rating

Region 1

Region 2

Region 3

Region 4

Region 5

Region 6

Dallas: 4.6 versus National: 4.7

ROCA Scores: Quality

0.0 1.0 2.0 3.0 4.0 5.0 6.0

National Quality Rating

Region 1

Region 2

Region 3

Region 4

Region 5

Region 6

Dallas: 5.0 versus National: 4.9

ROCA Scores: Overall

0.0 1.0 2.0 3.0 4.0 5.0 6.0

National Overall Rating

Region 1

Region 2

Region 3

Region 4

Region 5

Region 6

Dallas: 4.8 versus National: 4.8

Tips for surviving your next ROCA

Review Webinars: Preparing for the Health and Wellness ROCA and ROCA Common Concerns

Review common concerns, particularly easy fixes, make sure they are done!

Have pre-ROCA forms complete and available to assessors prior to ROCA

List Best Practices!Participate on monthly conference callsMaintain a relationship with your nurse

specialist!Document, document, DOCUMENT!

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

Questions?