Regional Dental Consultants’ Meeting Presented by Emerson Robinson, DDS, MPH Region II and V Dental Consultant

2 MAXIMIZING OHWP RatingsThrough ROCA PREPARATION

3 Regional Health Consultants (RHCs) Every hub and affiliate office has the following: Every hub and affiliate office has the following: Regional Dental Consultant Regional Dental Consultant Regional Nurse Consultant Regional Nurse Consultant Regional Medical Consultant Regional Medical Consultant Regional Mental Health Consultant (also provides regional TEAP assistance) Regional Mental Health Consultant (also provides regional TEAP assistance)

4 Regional Office Center Assessments (ROCA) Using the Program Assessment Guide (PAG), the regional team will conduct an overall assessment of your center’s health and wellness program Using the Program Assessment Guide (PAG), the regional team will conduct an overall assessment of your center’s health and wellness program Assessments highlight the strengths of your program and provide feedback about areas that could be changed or improved Assessments highlight the strengths of your program and provide feedback about areas that could be changed or improved Expect to have your health records, appointment books, and other records audited Expect to have your health records, appointment books, and other records audited

5 Resources Policy and Requirements Handbook (PRH)―contains the rules by which all Job Corps centers operate Policy and Requirements Handbook (PRH)―contains the rules by which all Job Corps centers operate Program Assessment Guide (PAG)―is a companion to the PRH and contains the parameters by which the quality of each center’s program is measured. It can also be used on an ongoing basis as a tool for determining program effectiveness Program Assessment Guide (PAG)―is a companion to the PRH and contains the parameters by which the quality of each center’s program is measured. It can also be used on an ongoing basis as a tool for determining program effectiveness Center Operating Procedures (COPs)―related to the health and wellness program describe how the health and wellness center functions Center Operating Procedures (COPs)―related to the health and wellness program describe how the health and wellness center functions Technical Assistance Guides (TAGs)―are designed to aid Center staff in meeting health program requirements. They are how-to guides that offer many suggestions but no additional program requirements Technical Assistance Guides (TAGs)―are designed to aid Center staff in meeting health program requirements. They are how-to guides that offer many suggestions but no additional program requirements

6 What is a ROCA? A ROCA is an assessment process in which the RHCs participate as team members when Regional Office staff conduct center program assessments on an annual or biennial basis depending on the severity of center concerns A ROCA is an assessment process in which the RHCs participate as team members when Regional Office staff conduct center program assessments on an annual or biennial basis depending on the severity of center concerns

7 Why Do We Have ROCAs? These assessments serve to ensure that the Job Corps health and wellness center services and health-related program components deliver the outcomes and quality indicators prescribed in the PRH These assessments serve to ensure that the Job Corps health and wellness center services and health-related program components deliver the outcomes and quality indicators prescribed in the PRH

8 ROCA Process Pre-site Analysis Pre-site Analysis Review the last ROCA or technical assistance visit to determine whether outcomes/PRH requirements have been met. This pre-site analysis determines the type of assessment that will best serve the needs of the center as well as to ensure that the Regional Office needs are served Review the last ROCA or technical assistance visit to determine whether outcomes/PRH requirements have been met. This pre-site analysis determines the type of assessment that will best serve the needs of the center as well as to ensure that the Regional Office needs are served

9 On-Site Assessment When we arrive at the Center, we will verify issues identified during the pre-site analysis and verify targeted outcomes. We will review the various aspects of the Oral Health and Wellness Program (OHWP) as spelled out in the PRH to determine if the program is in compliance When we arrive at the Center, we will verify issues identified during the pre-site analysis and verify targeted outcomes. We will review the various aspects of the Oral Health and Wellness Program (OHWP) as spelled out in the PRH to determine if the program is in compliance

10 Gathering Information Various techniques are used in the information gathering process: Various techniques are used in the information gathering process: Interviews Interviews Focus groups Focus groups Document review Document review Observation Observation

11 Brief-out Dialogue Before leaving the center, the team will share assessment results with the Center Operator\Director and staff to create an environment in which improvements that are needed can be clarified and offer possible recommendations Before leaving the center, the team will share assessment results with the Center Operator\Director and staff to create an environment in which improvements that are needed can be clarified and offer possible recommendations

12 Issuance of Formal Reports After the assessments, the Regional Office issues a formal report detailing the assessment results, program ratings, and areas requiring improvements After the assessments, the Regional Office issues a formal report detailing the assessment results, program ratings, and areas requiring improvements

13 Corrective Action Plan The Center Operator/Director should submit a corrective action plan to respond to problems identified during the assessment, suggest and carry out ideas for improvement The Center Operator/Director should submit a corrective action plan to respond to problems identified during the assessment, suggest and carry out ideas for improvement

14 Follow-Up and Monitoring The project manager in conjunction with the RHCs will follow-up and monitor the suggested corrective action as indicated in the corrective action plan The project manager in conjunction with the RHCs will follow-up and monitor the suggested corrective action as indicated in the corrective action plan

15 OHWP Assessment…. Oral health team members should be prepared to describe to the assessment team the OHWP goals, performance expectations and standards, ways in which their individual performance contributes to the overall accomplishment of program and center goals, and their continuous quality improvement activities Oral health team members should be prepared to describe to the assessment team the OHWP goals, performance expectations and standards, ways in which their individual performance contributes to the overall accomplishment of program and center goals, and their continuous quality improvement activities

16 OHWP Assessment…. (continued) During a center program assessment, the RHCs focus on the concerns identified during the pre- site analyses to customize the assessment process to resolve concerns and support continuous quality improvement. This may include the following activities: During a center program assessment, the RHCs focus on the concerns identified during the pre- site analyses to customize the assessment process to resolve concerns and support continuous quality improvement. This may include the following activities: Examine quality indicators ─ the connection between program requirements and outcomes Examine quality indicators ─ the connection between program requirements and outcomes Evaluate the OHWP productivity from the perspective of cost versus quantity/quality of treatment Evaluate the OHWP productivity from the perspective of cost versus quantity/quality of treatment

17 OHWP Assessment…. (continued) Investigate how the OHWP contributes to student outcomes, especially employability Investigate how the OHWP contributes to student outcomes, especially employability Examine the extent to which the OHWP is integrated with health and wellness center services and other Job Corps program components Examine the extent to which the OHWP is integrated with health and wellness center services and other Job Corps program components Determine the extent to which corrective actions taken for continuous quality improvement are producing the desired effect Determine the extent to which corrective actions taken for continuous quality improvement are producing the desired effect

18 OHWP Assessment…. (continued) Organize and conduct student focus groups Organize and conduct student focus groups Determine the extent to which students are able to demonstrate the oral health and wellness skills they have mastered Determine the extent to which students are able to demonstrate the oral health and wellness skills they have mastered Provide OHWP assessment feedback to the assessment team Provide OHWP assessment feedback to the assessment team The RHC assesses the quality of oral health services provided by the center and the appropriateness of specified treatment plans through such activities as record reviews, staff interviews, student interviews, student focus groups, and observations of dental clinic activities The RHC assesses the quality of oral health services provided by the center and the appropriateness of specified treatment plans through such activities as record reviews, staff interviews, student interviews, student focus groups, and observations of dental clinic activities

19 Health and Wellness Program Quality Health and wellness staff are responsible for ensuring that all required health services are delivered and that a minimum level of quality is provided in the overall health and wellness program and is maintained on an ongoing basis Health and wellness staff are responsible for ensuring that all required health services are delivered and that a minimum level of quality is provided in the overall health and wellness program and is maintained on an ongoing basis Quality Rating System (QRS)―helps to define and quantify the quality of a Job Corps center’s program; this system is described in detail in the PAG Quality Rating System (QRS)―helps to define and quantify the quality of a Job Corps center’s program; this system is described in detail in the PAG

20 QRS QUALITY DEFINITION To ensure that the government is getting what it contracted for, each program function must meet a minimum defined set of expectations. The PRH quality indicators define the benchmark for the expectations. The QRS definition describes the degree to which indicators are met using acceptable and not acceptable To ensure that the government is getting what it contracted for, each program function must meet a minimum defined set of expectations. The PRH quality indicators define the benchmark for the expectations. The QRS definition describes the degree to which indicators are met using acceptable and not acceptable ACCEPTABLE Quality indicators are generally evident in applicable program areas with minor exceptions NOT ACCEPTABLE Quality indicators are missing or minimally evident in applicable program Each function is scored in the matrix based on the information gathered during the assessment that pertains to the quality indicators (QIs) for that function. Each chapter of the PAG presents the applicable PRD QIs by section. Suggested strategies for each QI are identified Each function is scored in the matrix based on the information gathered during the assessment that pertains to the quality indicators (QIs) for that function. Each chapter of the PAG presents the applicable PRD QIs by section. Suggested strategies for each QI are identified

21 Quality Rating Once evaluators have determined which definition most closely describes the performance for a function, a numerical rating is assigned and entered in the appropriate cell in the quality rating matrix. The six functional scores are combined to produce the overall summary score for the Center/operation. Once evaluators have determined which definition most closely describes the performance for a function, a numerical rating is assigned and entered in the appropriate cell in the quality rating matrix. The six functional scores are combined to produce the overall summary score for the Center/operation. The ratings are made against a nine-point scale, as shown below. The ratings are made against a nine-point scale, as shown below Not Acceptable Acceptable (1-4.9) ( )

22 Quality Rating Definitions 9.0 There are no quality problems and no concerns relating to contracting/PRH requirements. There is substantial evidence of many innovations above and beyond minimum requirements. 8.0Exceptional There are no quality problems and no concerns relating to contact/PRH requirements. There is evidence of some innovations above and beyond minimum requirements. 7.0 Very Good Concerns do not impact achievements of contract/PRH requirements. 6.0Satisfactory Concerns require minor resources to ensure achievement of contract/PRH requirements. 5.0Marginal Concerns require major resources to ensure achievement of contract/requirements. Acceptable:4.0Unsatisfactory Concerns are compromising the achievement of contract/PRH requirements. 0.0 to 3.0 Concerns are such that issues of integrity exist and are seriously compromising the achievement of contract/PRH requirements. Unacceptable:

23 Things To Do To Ensure Favorable Rating Regular self-assessment Regular self-assessment May want to assess the PRH requirements on: May want to assess the PRH requirements on: A monthly basis A monthly basis A quarterly basis A quarterly basis Ensure/enhance continuous improvement Ensure/enhance continuous improvement Enhance positive participation in the Regional Office Quality Assessment Process Enhance positive participation in the Regional Office Quality Assessment Process Review the pre-arrival ROCA questions for the Center Dentist Review the pre-arrival ROCA questions for the Center Dentist Should administer and review student’s dental satisfaction survey Should administer and review student’s dental satisfaction survey Make every effort to meet the minimum productive standards Make every effort to meet the minimum productive standards Make sure that all of the PRH requirements have been addressed and are in compliance Make sure that all of the PRH requirements have been addressed and are in compliance