Managing the Health and Wellness Program

Shannon Bentley, RN

Melissa Cusey, RN

Delivery of Services

• Student Health Services– Oral Health Services– Mental Health Services– Medical Services

• Related Health Programs– Trainee employee assistance program (TEAP)– Tobacco Use Prevention Program (TUPP)– Healthy Eating and Active Lifestyles– Many more

Center Health and Wellness Team

• All centers have the following staff as part of their Health and Wellness team:– Medical: Center Physician, Nurse Practitioner/Physician

Assistant (NP/PA), HWM, nurses,– Clerical staff– Mental Health: Center Mental Health Consultant (CMHC)– Oral Health: Center Dentist, Dental Assistant, Dental

Hygienist– Trainee Employee Assistance Program (TEAP): TEAP

Specialist– Disability: Disability Coordinator (DC)

Focus of Oral Health and Wellness

• Focus on:– Early detection– Diagnosis of oral health problems– Dental hygiene– Basic oral health care– Prevention and education

• With focus of education on oral health and employability

• Elective services

Managing the Oral Health Program: Possible Duties

• Ensure the dental readiness inspection is be completed within 14 days after student arrival

• Manage the scheduling system for oral health and wellness inspections, examinations and treatment (may be done by dental assistant)

• Provide emergency oral health care as needed• Oversee a written agreement/referral plan with

community specialists

Possible Duties• Provide oral health and wellness staff with

information on Job Corps’ health and wellness program policies and procedures

• Ensure that the center dentist has access to the full student health record

• Ensure that oral health and wellness staff complete and submit all required forms

• Ensure that health records contain dental x-rays, prescriptions, and other required forms

Oral Health Program• Most Common Concerns

– Not fully staffed/inappropriate schedule – Equipment is not properly sterilized– Inadequate equipment (e.g., not enough hand

pieces)

• Achieving The Wow Factor:– Involving oral health and wellness in tobacco

cessation and TEAP– Involving oral health personnel in wellness education– Oral health personnel conduct ongoing surveys of

students/good customer service

Jeopardy Question

• Who is the medical director of the Wellness Center?– The Health and Wellness Manager– The Center Physician– The Center Director

Mental Health and Wellness Program

• Each centers' mental health and wellness program must include:– Services of a qualified center mental

health consultant (CMHC), and have a counseling component that focuses on students' individual needs and progress in personal and social development, basic education, and vocational training.

Role of Wellness Center in Mental Health and Wellness Program

• Identify students with emotional or behavioral disorders and refer them to center mental health and wellness staff

• Counsel and educate students about health-related issues, such as alcohol and drug use, sexuality, weight improvement, hypertension, and family planning

• Maintain a system of referral and feedback with mental health and wellness staff and participate in (or direct) case management of specific students

Health and Wellness Manager Responsibilities

• Provide daily management and oversight• Review and triage of applicant files with mental health

histories• Collaborate with CMHC in developing mental health

promotion and education activities• Collaborate with CMHC and Center Physician in the

monitoring of students on psychotropic medications• Assisting CMHC with off-center referrals for students

requiring mental health services in the community• Ensure that 24-hour emergency mental health and

wellness services are available

The Center Mental Health Consultant

• Provides assessments and recommendations for Job Corps applicants

• Coordinates a mental health promotion and education component for Job Corps staff and students

• Utilizes an employee assistance program approach that includes short-term counseling, referral to center support groups, and crisis intervention services for students with mental health conditions

Mental Health and Wellness Program

• Common Concerns– CMHC does not conduct staff training

– The CMHC has not developed or participated in ongoing center-wide mental health prevention activities

– The referral feedback system is not adequate

– There are no psycho-educational groups being conducted on center.

• Achieving The Wow Factor:– Strong employability focus

– Helps lead nutrition or weight improvement programs

– Strong internship program

Jeopardy Question

The CMHC should provide a treatment-focused program not based on employability.

True or False

Related Health Programs

TEAP (Trainee Employee Assistance Program):

• The general emphasis of TEAP shall be on prevention, education, identification of substance use problems, relapse prevention, and helping students overcome barriers to employability.

The TEAP Specialist• Ensures orientation of new students to the center's TEAP

program as a center-wide alcohol and drug prevention and education effort with a focus on barriers to employability.

• Provides center-wide substance prevention and education services that encourage healthy lifestyle choices.

• Conducts assessment of students to identify substance use problems and develops intervention services as needed.

• Coordinates relapse prevention services.• Assures adherence to Job Corps’ Zero Tolerance policy for

substance abuse among students.

Health and Wellness Manager Responsibilities

• Manage alcohol and drug-related medical emergencies

• Provide daily management and oversight• Delegate biochemical testing and prevention

activities to staff and ensure adequate training for staff involved in urine collection procedures

• Manage all aspects of the biochemical testing program and ensure the integrity of the program is maintained

Health and Wellness Manager Responsibilities

• Facilitate referrals to the CMHC, TEAP Specialist, and outside resources

• Ensure training of designated nonhealth staff in the use of alcohol testing devices

TEAP• Common Concerns

– Lacks required certification– Does not document appropriately in health record– No TEAP Specialist

• Achieving The Wow Factor:– TEAP mentoring programs– Strong relapse-prevention program– Contests, special outings, movie nights, etc.– Community Partnerships

Tobacco Use Prevention Program (TUPP)

• Every center is responsible for implementing a tobacco use prevention and cessation program

• Centers must implement a program to prevent the onset of tobacco use and to promote tobacco-free environments and individuals.

• Centers should establish a smoke-free, tobacco-free environment for the majority of the center.

Health and Wellness Manager Responsibilities

• Collaborate with Center Director to appoint a TUPP Coordinator

• Be aware of federal and state laws regarding use by minors

• Ensure all services provided are documented in the SHR.

Tobacco Use and Prevention Program (TUPP)

• Common Concerns:– Minors smoking on center– Students smoking outside of designated areas– TUPP services not documented in the SHR

• Achieving The Wow Factor:– Use color coded badges or other innovative

ways to identify minors– Go tobacco free during the training day– Have a TUPP Committee on center

Family Planning Program

• These services cover sexuality, family planning, sexually transmitted infections, and pregnancy management.

• Both female and male students should be included in family planning education and services.

Health and Wellness Manager Responsibilities

• Appoint a program coordinator, usually a member of the nursing staff

Family Planning

• Common Concerns:– There are no comprehensive gestational

records in the SHRs of pregnant students.

• Achieving The Wow Factor:– Extra services provided through local

community resources such as WIC Program or first time parent car seats provided.

– Free parenting classes and baby items are provided by off-center resources.

– Free birth control is provided to the center

HIV/AIDS

• All students receive HIV/AIDS education, testing on entry and when clinically indicated, follow up, and counseling.

• HIV-positive students receive case management on center but are often treated by off center infectious disease specialists.

Health and Wellness Manager Responsibilities

• Inform new students about HIV testing during new student orientation

• Conduct pre- and post-test counseling• Assist in coordinating off-center referrals

for HIV positive students• Submit specimens for HIV testing to the

nationally contracted laboratory• Participate in the case management team

working with HIV-positive students

HIV/AIDS

• Common Concerns:– Students are not tested for HIV

infection when they are diagnosed with a newly contracted sexually transmitted infection

• Achieving The Wow Factor:– Develop community resources to

provide free support and services to students with HIV

Sexual Assault Prevention and Response

• Each center must establish a program for sexual assault prevention, counseling, treatment, and follow-up care.

• Centers are required to develop a sexual assault response team (SART) that involves center staff and outside resources.

Health and Wellness Manager Responsibilities

• Serve on SART (strongly recommended)

• Be aware of state laws

• Establish a program for sexual assault prevention, counseling, treatment, and follow-up care.

Sexual Assault Prevention and Response

• Common Concerns:– The SART team does not meet on a regular basis.

– No active SART program on center.

• Achieving The Wow Factor: – Provide additional specialized counseling through local

agencies and grant programs at no or low cost.

– Have guest speakers provide prevention education at assemblies and through group activities.

– SART members are trained by sexual assault response team or SANE on how to appropriately respond, state, laws, and community resources available

Healthy Eating and Active Lifestyles (HEALs)

• Centers are required to establish a Healthy Eating and Active Lifestyles (HEALs) Committee to oversee and coordinate the HEALs program

Wellness Manager Responsibilities

• Serve on HEALs Committee

• Collaborate with various departments

• Record students’ BMI and waist circumference

Healthy Eating and Active Lifestyles (HEALs)

• Common Concerns:– Students are not included as part of the HEALS

committee.– Centers have not established a HEALs Committee to

oversee and coordinate this program– Not having a Weight Management Program overseen by

Wellness

• Achieving The Wow Factor:– Having healthy choices for snacks or in vending machines.– Disconnecting soda machines and offering healthy

beverage choices with meals.– Having Food Fairs with healthy choices

Jeopardy Question

• The TEAP Specialist must be the TUPP Coordinator.

• True or false

Health Administration• Staffing

• Authorizations

• Basic Health Services Provided by Job Corps Centers

• Health and Medical Costs Exceeding Basic Health Services Provided by Job Corps

• Professional Standards of Care

• Controlled Substances

• Waiver of Medical Care

• FECA/OWCP

Health Administration• 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

Additional Duties• Wellness Education—PRH 3.17, R1

• Standard Operating Plans and Procedures—PRH 5.1, R3

• Management and Reporting of Significant Incidents—PRH 5.5

• Minimum Staff Qualifications—PRH Exhibit 5-3

• Required Staff Training—PRH Exhibit 5-4

• Student Enrollments, Transfers and Separations—PRH 6.4

• Disability Program—PRH 6.14

Talk Time

• Questions and answers