Regional Dental Regional Dental Consultants’ MeetingConsultants’ Meeting

Presented byPresented byEmerson Robinson, DDS, MPHEmerson Robinson, DDS, MPH

Region II and V Dental Region II and V Dental ConsultantConsultant

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MAXIMIZING OHWP MAXIMIZING OHWP RatingsRatings

ThroughThroughROCA ROCA

PREPARATIONPREPARATION

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Regional Health Consultants Regional Health Consultants (RHCs)(RHCs)

Every hub and affiliate office has the Every hub and affiliate office has the following:following: Regional Dental ConsultantRegional Dental Consultant Regional Nurse ConsultantRegional Nurse Consultant Regional Medical ConsultantRegional Medical Consultant Regional Mental Health Consultant (also Regional Mental Health Consultant (also

provides regional TEAP assistance)provides regional TEAP assistance)

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Regional Office Center Regional Office Center Assessments (ROCA)Assessments (ROCA)

Using the Program Assessment Guide Using the Program Assessment Guide (PAG), the regional team will conduct an (PAG), the regional team will conduct an overall assessment of your center’s health overall assessment of your center’s health and wellness programand wellness program

Assessments highlight the strengths of Assessments highlight the strengths of your program and provide feedback about your program and provide feedback about areas that could be changed or improvedareas that could be changed or improved

Expect to have your health records, Expect to have your health records, appointment books, and other records appointment books, and other records auditedaudited

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ResourcesResources Policy and Requirements Handbook (PRH)―contains the Policy and Requirements Handbook (PRH)―contains the

rules by which all Job Corps centers operaterules by which all Job Corps centers operate Program Assessment Guide (PAG)―is a companion to Program Assessment Guide (PAG)―is a companion to

the PRH and contains the parameters by which the the PRH and contains the parameters by which the quality of each center’s program is measured. It can quality of each center’s program is measured. It can also be used on an ongoing basis as a tool for also be used on an ongoing basis as a tool for determining program effectivenessdetermining program effectiveness

Center Operating Procedures (COPs)―related to the Center Operating Procedures (COPs)―related to the health and wellness program describe how the health health and wellness program describe how the health and wellness center functionsand wellness center functions

Technical Assistance Guides (TAGs)―are designed to Technical Assistance Guides (TAGs)―are designed to aid Center staff in meeting health program aid Center staff in meeting health program requirements. They are how-to guides that offer many requirements. They are how-to guides that offer many suggestions but no additional program requirementssuggestions but no additional program requirements

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What is a ROCA?What is a ROCA? A ROCA is an assessment process in A ROCA is an assessment process in

which the RHCs participate as team which the RHCs participate as team members when Regional Office staff members when Regional Office staff conduct center program assessments conduct center program assessments on an annual or biennial basis on an annual or biennial basis depending on the severity of center depending on the severity of center concernsconcerns

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Why Do We Have ROCAs?Why Do We Have ROCAs? These assessments serve to ensure These assessments serve to ensure

that the Job Corps health and that the Job Corps health and wellness center services and health-wellness center services and health-related program components deliver related program components deliver the outcomes and quality indicators the outcomes and quality indicators prescribed in the PRHprescribed in the PRH

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ROCA ProcessROCA Process Pre-site AnalysisPre-site Analysis

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

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On-Site AssessmentOn-Site Assessment When we arrive at the Center, we will When we arrive at the Center, we will

verify issues identified during the verify issues identified during the pre-site analysis and verify targeted pre-site analysis and verify targeted outcomes. We will review the outcomes. We will review the various aspects of the Oral Health various aspects of the Oral Health and Wellness Program (OHWP) as and Wellness Program (OHWP) as spelled out in the PRH to determine if spelled out in the PRH to determine if the program is in compliancethe program is in compliance

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Gathering InformationGathering Information Various techniques are used in the Various techniques are used in the

information gathering process:information gathering process: InterviewsInterviews Focus groupsFocus groups Document reviewDocument review ObservationObservation

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Brief-out DialogueBrief-out Dialogue Before leaving the center, the team Before leaving the center, the team

will share assessment results with will share assessment results with the Center Operator\Director and the Center Operator\Director and staff to create an environment in staff to create an environment in which improvements that are needed which improvements that are needed can be clarified and offer possible can be clarified and offer possible recommendationsrecommendations

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Issuance of Formal ReportsIssuance of Formal Reports After the assessments, the Regional After the assessments, the Regional

Office issues a formal report detailing Office issues a formal report detailing the assessment results, program the assessment results, program ratings, and areas requiring ratings, and areas requiring improvementsimprovements

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Corrective Action PlanCorrective Action Plan The Center Operator/Director should The Center Operator/Director should

submit a corrective action plan to submit a corrective action plan to respond to problems identified during respond to problems identified during the assessment, suggest and carry the assessment, suggest and carry out ideas for improvementout ideas for improvement

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Follow-Up and MonitoringFollow-Up and Monitoring The project manager in conjunction The project manager in conjunction

with the RHCs will follow-up and with the RHCs will follow-up and monitor the suggested corrective monitor the suggested corrective action as indicated in the corrective action as indicated in the corrective action planaction plan

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OHWP Assessment….OHWP Assessment…. Oral health team members should be Oral health team members should be

prepared to describe to the assessment prepared to describe to the assessment team the OHWP goals, performance team the OHWP goals, performance expectations and standards, ways in which expectations and standards, ways in which their individual performance contributes to their individual performance contributes to the overall accomplishment of program the overall accomplishment of program and center goals, and their continuous and center goals, and their continuous quality improvement activitiesquality improvement activities

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OHWP Assessment…. OHWP Assessment…. (continued)(continued)

During a center program assessment, the During a center program assessment, the RHCs focus on the concerns identified during RHCs focus on the concerns identified during the pre-site analyses to customize the the pre-site analyses to customize the assessment process to resolve concerns and assessment process to resolve concerns and support continuous quality improvement. support continuous quality improvement. This may include the following activities:This may include the following activities: Examine quality indicators─the connection Examine quality indicators─the connection

between program requirements and outcomesbetween program requirements and outcomes Evaluate the OHWP productivity from the Evaluate the OHWP productivity from the

perspective of cost versus quantity/quality of perspective of cost versus quantity/quality of treatmenttreatment

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OHWP Assessment…. OHWP Assessment…. (continued)(continued)

Investigate how the OHWP contributes to Investigate how the OHWP contributes to student outcomes, especially employabilitystudent outcomes, especially employability

Examine the extent to which the OHWP is Examine the extent to which the OHWP is integrated with health and wellness center integrated with health and wellness center services and other Job Corps program services and other Job Corps program components components

Determine the extent to which corrective Determine the extent to which corrective actions taken for continuous quality actions taken for continuous quality improvement are producing the desired improvement are producing the desired effecteffect

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OHWP Assessment…. OHWP Assessment…. (continued)(continued)

Organize and conduct student focus groupsOrganize and conduct student focus groups Determine the extent to which students are able Determine the extent to which students are able

to demonstrate the oral health and wellness skills to demonstrate the oral health and wellness skills they have masteredthey have mastered

Provide OHWP assessment feedback to the Provide OHWP assessment feedback to the assessment teamassessment team

The RHC assesses the quality of oral health The RHC assesses the quality of oral health services provided by the center and the services provided by the center and the appropriateness of specified treatment plans appropriateness of specified treatment plans through such activities as record reviews, staff through such activities as record reviews, staff interviews, student interviews, student focus interviews, student interviews, student focus groups, and observations of dental clinic activitiesgroups, and observations of dental clinic activities

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Health and WellnessHealth and Wellness Program Quality Program Quality

Health and wellness staff are responsible Health and wellness staff are responsible for ensuring that all required health for ensuring that all required health services are delivered and that a minimum services are delivered and that a minimum level of quality is provided in the overall level of quality is provided in the overall health and wellness program and is health and wellness program and is maintained on an ongoing basismaintained on an ongoing basis

Quality Rating System (QRS)―helps to Quality Rating System (QRS)―helps to define and quantify the quality of a Job define and quantify the quality of a Job Corps center’s program; this system is Corps center’s program; this system is described in detail in the PAGdescribed in detail in the PAG

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QRS QUALITY DEFINITION QRS QUALITY DEFINITION To ensure that the government is getting what it contracted To ensure that the government is getting what it contracted

for, each program function must meet a minimum defined set for, each program function must meet a minimum defined set of expectations. The PRH quality indicators define the of expectations. The PRH quality indicators define the benchmark for the expectations. The QRS definition describes benchmark for the expectations. The QRS definition describes the degree to which indicators are met using acceptable and the degree to which indicators are met using acceptable and not acceptable not acceptable

ACCEPTABLEACCEPTABLEQuality indicators are generally evident in applicable program Quality indicators are generally evident in applicable program areas with minor exceptionsareas with minor exceptions

NOT ACCEPTABLENOT ACCEPTABLEQuality indicators are missing or minimally evident in applicable Quality indicators are missing or minimally evident in applicable programprogram

Each function is scored in the matrix based on the information Each function is scored in the matrix based on the information gathered during the assessment that pertains to the quality gathered during the assessment that pertains to the quality indicators (QIs) for that function. Each chapter of the PAG indicators (QIs) for that function. Each chapter of the PAG presents the applicable PRD QIs by section. Suggested presents the applicable PRD QIs by section. Suggested strategies for each QI are identifiedstrategies for each QI are identified

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Quality RatingQuality Rating

Once evaluators have determined which definition Once evaluators have determined which definition most closely describes the performance for a function, most closely describes the performance for a function, a numerical rating is assigned and entered in the a numerical rating is assigned and entered in the appropriate cell in the quality rating matrix. The six appropriate cell in the quality rating matrix. The six functional scores are combined to produce the overall functional scores are combined to produce the overall summary score for the Center/operation.summary score for the Center/operation.

The ratings are made against a nine-point scale, as The ratings are made against a nine-point scale, as shown below.shown below.11 22 33 44 55 66 77 88 9 9

Not Acceptable Acceptable (1-4.9) (5.0-9.0)

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Quality Rating DefinitionsQuality Rating Definitions9.09.0 There are no quality problems and no concerns relating to contracting/PRH There are no quality problems and no concerns relating to contracting/PRH

requirements. There is substantial evidence of many innovations above and requirements. There is substantial evidence of many innovations above and beyond minimum requirementsbeyond minimum requirements..

8.08.0ExceptionalExceptional

There are no quality problems and no concerns relating to contact/PRH There are no quality problems and no concerns relating to contact/PRH requirements. There is evidence of some innovations above and beyond requirements. There is evidence of some innovations above and beyond minimum requirements.minimum requirements.

7.0 7.0 Very GoodVery Good

Concerns do not impact achievements of contract/PRH requirements.Concerns do not impact achievements of contract/PRH requirements.

6.06.0SatisfactorySatisfactory

Concerns require minor resources to ensure achievement of contract/PRH Concerns require minor resources to ensure achievement of contract/PRH requirements.requirements.

5.05.0MarginalMarginal

Concerns require major resources to ensure achievement of Concerns require major resources to ensure achievement of contract/requirements.contract/requirements.

Acceptable:

4.04.0UnsatisfactoryUnsatisfactory

Concerns are compromising the achievement of contract/PRH Concerns are compromising the achievement of contract/PRH requirements.requirements.

0.0 to 3.00.0 to 3.0 Concerns are such that issues of integrity exist and are seriously Concerns are such that issues of integrity exist and are seriously compromising the achievement of contract/PRH requirements.compromising the achievement of contract/PRH requirements.

Unacceptable:

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Things To Do To Ensure Things To Do To Ensure Favorable Rating Favorable Rating

Regular self-assessmentRegular self-assessment May want to assess the PRH requirements on:May want to assess the PRH requirements on:

A monthly basisA monthly basis A quarterly basisA quarterly basis

Ensure/enhance continuous improvementEnsure/enhance continuous improvement Enhance positive participation in the Regional Office Enhance positive participation in the Regional Office

Quality Assessment ProcessQuality Assessment Process Review the pre-arrival ROCA questions for the Center DentistReview the pre-arrival ROCA questions for the Center Dentist Should administer and review student’s dental satisfaction Should administer and review student’s dental satisfaction

surveysurvey Make every effort to meet the minimum productive standardsMake every effort to meet the minimum productive standards Make sure that all of the PRH requirements have been Make sure that all of the PRH requirements have been

addressed and are in complianceaddressed and are in compliance