a. Ensure that health services staffing is in compliance with the staffing levels presented in Exhibit 6-5 (Center Health Services Staffing Requirements) and the minimum staff qualifications identified in Exhibit 5-3 (Minimum Staff Qualifications).
b. For contract centers, employ or subcontract with medical, dental, TEAP, and mental health professionals who are subject to the prior approval of the Regional Office, in consultation with the Regional Health Specialists.
c. For USDA Forest Service Civilian Conservation Centers (CCCs), employ or subcontract with medical, dental, TEAP, and mental health professionals that are subject to the prior approval of the National Office, in consultation with the Regional Health Specialists.
d. Ensure that a health professional cannot serve as a consultant to, or an employee of, two or more Job Corps-related entities concurrently, when one entity has review and/or oversight responsibilities over the other(s). (Entities include Job Corps centers, health support contractors, and center operators.)
R2. Authorizations (Consent for Treatment)
Centers must ensure that proper authorizations are obtained prior to delivery of health services to students.
a. The signed consent form (ETA 653) serves as authorization for basic routine health care and must be placed in the student health record by the time a student arrives on center. Additionally, each student must have a signed Informed Consent to Receive Mental Health and Wellness Treatment form in the student health record by the time the student arrives on center.
b. Each time a student requires services other than those covered under the blanket consent signed on admission, written consent must be obtained from the student or parent/legal guardian.
c. In emergency situations, the Center Director may make an exception to the requirement for consent when a student who has reached the age of maturity cannot give consent or a parent/guardian of a student under the age of maturity cannot be contacted. This must be documented in the student’s health record.
R3. Basic Health Services Provided by Job Corps Centers
a. Center operators are responsible for providing and paying for basic health care as detailed in Exhibit 6-4 (Job Corps Basic Health Care Responsibilities).
b. Job Corps shall not pay for any health-related costs incurred by a student while on leave or pass unless previously authorized by the Center Director upon recommendation of a center health professional.
R4. Health and Medical Costs Exceeding Basic Health Services Provided by Job Corps Centers
a. 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.
b. If a student is determined to have a pre-existing or acquired health condition that significantly interferes with or precludes further training in Job Corps, or if a student is determined to have a health problem that is complicated to manage or for which necessary treatment will be unusually costly, the center must follow medical separation procedures (see R11 below, and PRH Chapter 6, Section 6.4, R4.c.5) and determine whether a referral to the Office of Workers’ Compensation Programs (OWCP) is required (see R8 below).
R5. Professional Standards of Care
All center health staff and providers must follow accepted professional standards of care and are subject to prevailing state laws, including but not limited to:
a. Maintaining a copy of current provider’s license, Drug Enforcement Agency (DEA) registration, and proof of liability insurance, if applicable, in center health facility.
b. Documenting all prescribed medications and treatment in student health record.
c. Documenting all laboratory procedures ordered and recording the results in student health record.
d. Following current standards of care when providing health services and treating illnesses and injuries.
R6. Medication Management (See Appendix 611, Medication Management Guidelines)
a. Centers must comply with all state and federal regulations regarding prescribed non-controlled medications, prescribed controlled substances, and over-the-counter medications.
b. Centers must follow medication management guidelines as specified in Appendix 611.
R7. Waiver of Medical Care
a. The Center Physician/Nurse Practitioner (NP)/Physician Assistant (PA) may waive any portion of the medical examination and laboratory testing except for the entrance drug testing if in his or her opinion there is sufficient justification or if a student refuses. Such a waiver must be clearly documented by the Center Physician/NP/PA in the student’s health record and include an explanation as to why the decision was made.
b. The Center Physician/NP/PA may grant waivers of immunization requirements for valid medical and/or religious reasons. Such a waiver must be clearly documented by the center physician in the student’s health record and include an explanation as to why the decision was made.
a. Students are considered federal employees for purposes of the Office of Workers’ Compensation Programs (OWCP). OWCP benefits do not begin to accrue until the day following a student’s separation from the program.
b. The center must complete the appropriate OWCP form(s) whenever a student is injured, develops an occupationally related illness, or dies while in the performance of duty. The center must immediately comply with the procedures set out in the Employment Standards Administration regulations at 20 CFR Chapter 1. The CA form portion of the Employee’s Compensation Operations and Management Portal (ECOMP) form and a copy of the ETA Form 6-61 (Notice of Student Separation) must be filed with the OWCP district office only when the injury or illness results in separation and consent is received from the Office of Job Corps. When separation does not occur, such forms must be maintained in the student’s health record.
c. If the student dies while in Job Corps, the center must:
1. Inform the next of kin of any possible FECA benefits if death occurred during the performance of duty. If the student did not die during the performance of duty, the government shall pay only for expenses involved in the preparation and transportation of the remains to a mortuary in the area selected by the next of kin, within the United States and the student's possessions.
2. Arrange for burial at a site close to the center and at a cost not to exceed the amount authorized in Section 8134(a) of the Federal Employees’ Compensation Act in the event that the next of kin refuses to accept the remains.
3. Provide the Office of Job Corps with documentation authorizing OWCP eligibility. If next of kin is eligible for benefits, further review by the Office of Job Corps shall determine if any additional gratuity payments, not to exceed $10,000 in accordance with Section 651 of Public Law 104-208 (The Omnibus Consolidated Appropriations Act), shall be awarded.
R9. Health Care Guidelines
a. All health-care guidelines must be approved and signed annually by the Center Physician, Center Mental Health Consultant, or Center Dentist, as appropriate.
b. Current signed and dated health care guidelines must be kept in the Health and Wellness Center.
c. Annually, each center must submit a memorandum to the Regional Office indicating which health care guidelines have been modified. Copies of any individual health staff authorizations and health care guidelines that have changed must be sent to the Regional Office for approval. (Refer to Exhibit 5-2, Plan and Report Submission Requirements, for reporting deadlines.)
R10. Student Introduction to Health Services
Centers must provide an overview of health services to new students by a member of the health services staff during the Career Preparation Period. This must include an explanation of procedures/tests that are performed as part of the medical and oral exam, information on HIV and other sexually transmitted diseases, safe sex practices, family planning services, TEAP services, mental health services, the importance of good health to obtain/maintain employment, and the Notice describing how medical information about students may be used, disclosed, and how students can get access to this information.
R11. Medical Separations
Centers must ensure that:
a. Medical separations are initiated by health services staff.
b. Students are medically separated when they are determined to have a pre-existing or acquired health condition that significantly interferes with or precludes further training in Job Corps, or the health problem is complicated to manage, or the necessary treatment will be unusually costly.
c. If the Center Physician estimates that the student will be able to return to the center within 180 days, a Medical Separation With Reinstatement rights (MSWR) will be given. If the student’s condition cannot be stabilized in 180 days, a regular medical separation will be given and the student may reapply in one year, unless the MSWR is extended (see R11.g below).
d. Health and social service referrals are provided for all separated students.
e. For MSWR, students are contacted monthly by the Health and Wellness Manager to assess progress and plan their return to Job Corps within the 180 days allowed.
f. Health and Wellness staff approve a student’s transportation plan for medical separation.
g. Center staff must submit a request to the Regional Office to extend an MSWR beyond 180 days for extenuating circumstances. The request should be accompanied by supporting documentation from the student’s health-care provider verifying that extension of leave is medically necessary. Requests will be reviewed on a case-by-case basis.
In the event of a student’s death, the center must follow Significant Incident Report (SIR) reporting requirements (see PRH Chapter 5, Section 5.5) and send the entire student personnel record (including sealed health record) to the Office of Job Corps by signature-required mail or delivery within 10 days. The sealed health record must include OWCP forms and written notification of death, plus the death certificate and autopsy and toxicology reports if available.
R13. Communicable Disease and Infection Control
The center must:
a. Report cases of disease to state and local health departments in accordance with state and local laws (see Chapter 5, Management).
b. Manage all cases of communicable disease and use protective measures as recommended by the Centers for Disease Control and Prevention (CDC).
c. Biologically monitor the function of autoclaves and maintain a log of spore test results.
d. Follow infection control measures as mandated by state and federal law.
R14. Equipment and Supplies
The center must:
a. Provide necessary equipment and supplies for routine and emergency delivery of basic medical, dental, and mental health services. All such equipment must comply with federal and state requirements.
b. Purchase major dental equipment according to the current dental equipment list published periodically by the Office of Job Corps.
c. Maintain records on the dispensing, inventory, and disposal of medical and dental supplies and pharmaceuticals.
d. Purchase from government supply service centers (General Services Administration [GSA], Health and Human Services [HHS], Veteran Administration [VA]), whenever possible.
R15. Continuous Quality Improvement
Center health staff must seek feedback from students, employ mechanisms to document quality of care provided, and document quality improvement activities.
R16. Monthly Meetings with Center Director
The Center Director must meet monthly with the Center Physician and Center Mental Health Consultant to discuss clinical and organizational issues.
Centers must ensure that the following reports are submitted (see Exhibit 5-2):
a. Health and Wellness Center Annual Program Description
b. Health Services Utilization Report
c. Alcohol Testing Report
R18. Biannual Health and Wellness Program Compliance Assessments
The National Office of Job Corps shall:
a. Provide subject matter experts to conduct biannual compliance assessments to evaluate the delivery of Health and Wellness Program services on centers in accordance with Federal and state laws and regulations, as well as requirements in PRH Sections 6.10, 6.11, and 6.12. Assessments will be conducted on a schedule set by the National Office of Job Corps.
b. Provide a written report to the Job Corps Regional Director and Center Director within 30 days after completion of assessment.