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​​​​​​​​​​​​​​​​​​​​​​​​​​​​​
 

 2.3 Health Services

 

 

 Requirements

 

R1. 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 (CPP). This must include an explanation of procedures/tests that are performed as part of the medical and oral exam, information on Human Immunodeficiency Virus (HIV) and other sexually transmitted diseases, safe sex practices, family planning services, Trainee Employee Assistance Program (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.

R2. Health and Wellness Program (See Exhibit 2-4, Job Corps Basic Health-Care Responsibilities.)

Centers must provide basic medical services to students. (NOTE: For a description of basic services, refer to Exhibit 2-4 Job Corps Basic Health Care Responsibilities​.) The Health and Wellness Program must include the following components:

a. A cursory health evaluation, laboratory testing, and a medical history within 48 hours of arrival on center. (NOTE: Reinstated and transfer students are exempt from the cursory health evaluation/physical examinations.)​ The medical history must be documented on the Job Corps Health History Form. The cursory health evaluation and medical history must be conducted by a qualified health professional designated by the Center Physician.

b. A complete entrance physical examination and a review of the medical history within 14 days. (NOTE: Near and distant vision screening, color vision screening, and hearing screening shall be part of the entrance physical examination​.) The cursory evaluation, with the exception of the required entrance laboratory testing, may be omitted if the physical examination is conducted within 72 hours of a student’s arrival on center. The physical examination must be provided by a qualified health professional and documented on the Job Corps Physical Examination Form. (NOTE: As determined by the center physician who authorizes the activity by a written personal authorization.)

1. When indicated, the center must furnish one pair of glasses that meet American National Standards Institute (ANSI) standards.

2. Contact lenses must be provided if clinically indicated. Students who lose or damage glasses provided by Job Corps must replace them at their own expense.

3. Students identified as having chronic health problems during the cursory or entrance physical must be monitored as directed by the Center Physician or other appropriate center health-care provider.

c. Laboratory tests within the time frames shown below:​


 

Entrance Laboratory Testing Requirements

Required Time Frame

HIV Antibody Test

Within 48 hours after arrival (see waiver condition, Section 2.3, R15)

Syphilis Serology

Optional (NOTE: Center physician may choose to continue screening for syphilis on entry if there is a significant prevalence in the center population.)

Hemoglobin or Hematocrit

Within 48 hours after arrival

Sickle Cell Screening

(must be offered to all at-risk students)

Within 48 hours after arrival

Urinalysis (dipstick) for Glucose/Protein

Within 48 hours after arrival

Drug Screen (urine)

Within 48 hours after arrival

(Males Only)

Urinalysis (dipstick) for Leukocyte Esterase

(gonorrhea screen)

Within 48 hours after arrival

Chlamydia Testing (urine)

Within 48 hours after arrival

Gonorrhea Testing if Leukocyte Esterase Screen is Positive (urine)

Within 48 hours after arrival

(Females Only)

Pregnancy Test (urine)

Within 48 hours after arrival

Pap Smear

Females age > 21 years (unless documented pap smear results within 24 months before arrival on center)

Within 14 days after arrival

Students younger than 21 years only require pelvic/speculum exam for clinical indications such as pelvic pain, vaginitis, menstrual disorders, pregnancy, etc.

Chlamydia Testing (endocervical or urine)

All females; perform on urine if 

age < 21 years

Within 48 hours after arrival (or at time of pelvic exam if age > 21 years)

Gonorrhea Testing (endocervical or urine)

All females; perform on urine if 

age < 21 years

Within 48 hours after arrival (or at time of pelvic exam if age > 21 years)



​​​d. Immunizations

​All applicants are required to provide Admissions Counselors with current immunization records at the time of application. Records will be reviewed by center health staff on entry to determine currency of immunizations. Centers must immunize students for the following as directed by the Office of Job Corps:

​1. Immunizations or boosters if the following immunization series are incomplete or if current immunization records cannot be produced:

(a) Tetanus and diphtheria toxoid (Td) or Tetanus-diphtheria-acellular pertussis (Tdap)

(b) Inactivated polio vaccine (IPV) for students younger than 18 years

(c) Measles, mumps, and rubella vaccine

​2. Hepatitis B vaccine series

At a minimum, Hepatitis B vaccine must be provided to health personnel and health occupations training students. Vaccination consent/declination must be documented in the staff member’s personnel file or student health record. Vaccination of health occupations training students must begin six weeks prior to on-site clinical work experience.

Refer to the Immunizations and Communicable Disease Control Technical Assistance Guide (TAG) for optional immunizations (e.g., influenza vaccine) that may be recommended but not required by the center physician, based upon availability.

Centers should utilize the Vaccines for Children program to provide immunizations for eligible students according to the latest Centers for Disease Control and Prevention (CDC) guidelines.

e. A tuberculosis skin test (Mantoux) is required of all new students who do not have documented proof of a previous negative Mantoux test taken within the last 12 months. Annual tuberculin testing should be done for students in health occupations and for students at increased risk of infection.  In addition, students in health occupations must receive a Mantoux test prior to clinical work experience in accordance with state or local health department requirements.

Results of tuberculin skin testing should be interpreted without regard to a prior history of BCG vaccination.

Refer to Treatment Guidelines in the Health-Care Guidelines TAG, for management of students with a positive Mantoux test.

f. A daily walk-in clinic outside of the training hours for students to receive routine health care.

g. An inpatient unit (during office hours) for minor conditions, such as respiratory infections or flu symptoms.

h. An appointment system for follow-up during the training day for treatment of chronic, urgent, and other conditions within the capabilities of center health professionals. Treatment guidelines for health must be used to manage common acute and chronic conditions.

i. Access to prescription medications.

j. An off-center specialist referral system.

k. A 24-hour emergency-care system, to include on-center Cardio Pulmonary Resuscitation (CPR) and first aid and written referral plan or agreement for off-center medical, oral health, mental health, substance use, and inpatient care.

l. Explain and have the student sign, on the first visit to health services, the notice describing how medical information about students may be used and disclosed, and how students can get access to this information (see Form 2-01, Notice of Medical Information Use, Disclosure, and Access).

R3. Oral Health and Wellness Program (See Exhibit 2-4, Job Corps Basic Health Care Responsibilities.)

Centers must provide basic dental services, as described below:

a. The general emphasis of the Oral Health and Wellness Program must be on early detection, diagnosis of oral health problems, basic oral-health care, dental hygiene, and prevention/education (e.g., oral hygiene instructions, caries risk assessments, the relationship between oral health and employability, oral health and wellness plans).

b. A dental readiness inspection must be completed within 14 days after arrival by the center dentist or designee as determined by the center dentist who authorizes the activity by a written personal authorization. The dental readiness inspection must be documented in the appropriate section on the Job Corps Physical Examination Form.

c. An elective oral examination, including bitewing X-rays, priority classification, and treatment plan, must be completed and recorded on the Job Corps approved oral examination form by the center dentist upon student request as a follow up to the dental readiness inspection. The X-ray images should be securely stored as part of the student’s health record.

d. Dental procedures to treat oral disease and correct oral health conditions that may represent employability barriers, to include: restorations, extraction of pathological teeth, root canal therapy on anterior/other strategic teeth, replacement of missing upper anterior teeth with a removable prosthesis, and dental hygiene treatment for periodontal disease.

e. Written referral plan or agreement with community facilities for emergent or urgent conditions treatable beyond the expertise of a general dentist.

f. Job Corps shall not pay for student orthodontics. Applicants with orthodontic appliances must furnish:

1. Proof of orthodontic care visits during previous three months consistent with orthodontic treatment plan.

2. Proof that a treatment plan is in place for continued care.

3. A signed agreement that the cost of continued treatment and transportation related to treatment will be borne by the student, parent, or legal guardian.

4. A signed agreement by the applicant (parent/guardian of a minor) that he or she will remain compliant with orthodontic care and schedule all orthodontic appointments such that he or she will not exceed authorized leave limits for elective dental treatment.

R4. Mental-Health and Wellness Program (See Exhibit 2-4, Job Corps Basic Health-Care Responsibilities​.)

Centers must provide basic mental-health services as described below:

a. The general emphasis of the Mental-Health and Wellness Program must be on the early identification and diagnosis of mental-health problems, basic mental-health care, and mental-health promotion, prevention, and education designed to help students overcome barriers to employability. The program uses an employee assistance program approach that includes short-term counseling with an employability focus, referral to center support groups, and crisis intervention.

b. Assessment and possible diagnosis, to include:

1. Assessments and recommendations for Job Corps applicants;

2. Review of Social Intake Form (SIF) or intake assessment performed by counseling staff of students who indicate mental-health history, current mental-health problems, or who request to see the Center Mental-Health Consultant within one week of arrival;

3. Mental-health assessments and recommendations for referred students. Students who are assessed as a safety risk to self or others must be continuously supervised, until their case is resolved. Disposition should occur as soon as possible;

4. Determination when a Medical Separation with Reinstatement Rights (MSWR) or medical separation is appropriate and recommended for students with mental health conditions and/or substance use co-occurring conditions.

c. Mental health promotion and education, to include:

​1. Minimum of a one-hour presentation on mental-health promotion for all new students during the Career Preparation Period with an emphasis on employability:

(a) Presentations must explain the Mental-Health and Wellness Program, what services are available, and how to make a self-referral.

(b) Students will learn basic skills in identifying and responding to a mental health crisis.

2. At least one annual center-wide mental-health promotion and education activity

3. Clinical consultation with Center Director, management staff, and Health and Wellness Director regarding mental health-related promotion and education efforts for students and staff

4. Coordination with other departments/programs on center, including, but not limited, to residential, recreation, student government association, and Healthy Eating and Active Lifestyles (HEALs), to develop integrated promotion and education services

d. Treatment, to include:

1. Short-term counseling with mental-health checks as needed. The focus of these sessions should be on retention and behaviors that represent employability barriers;

2. Collaboration with TEAP specialist for short-term counseling of students with co-occurring conditions of mental-health issues and substance use;

3. Collaboration with center physician and Health-and-Wellness staff on psychotropic medication monitoring of stable students, with the advice of consulting psychiatrist, if appropriate;

4. Collaboration with counseling staff in developing and/or leading psycho-educational skill-building groups to promote wellness (e.g., relaxation training, anger management, mood regulation, assertiveness skills, handling relationships, sleep hygiene, etc.);

5. Information exchange through regular case conferences between the Center Mental Health Consultant, counselors, and other appropriate staff based on individual student needs;

6. Crisis intervention, as needed. In the event of a mental health emergency, the Center Mental-Health Consultant or the Center Physician must conduct a mental health evaluation as soon as possible, and when necessary, refer the student for psychiatric care. If the Center Physician or Center Mental-Health Consultant is not available, the student must be referred immediately to the emergency room of the nearest medical facility. If there is a life-threatening situation, 911 or the emergency response team should be called;

7. Referral to off-center mental-health professionals or agencies for ongoing treatment and/or specialized services;

8. A written referral/feedback system must be established and documented in the student-health record.

R5. Trainee Employee Assistance Program (TEAP) (See Exhibit 2-4, Job Corps Basic Health-Care Responsibilities.)

Centers must provide basic TEAP services, as described below:

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

b. Substance use prevention and education, to include:

1. Minimum of a one-hour presentation on substance use prevention for all new students during the Career Preparation Period. This presentation must explain (1) TEAP prevention, education, and intervention services, (2) Job Corps drug and alcohol testing requirements and procedures, and (3) the consequences of testing positive for drug or alcohol use while in Job Corps

2. Presentation(s) on managing substance misuse, abuse, and dependency symptoms and issues in the workplace for students during the Career Development and Transition Periods

3. At least three annual center-wide substance use prevention and education activities

4. Clinical consultation with Center Director, management staff, Center Mental Health Consultant, and Health and Wellness Director regarding substance use prevention and education efforts for students and staff

5. Coordination with other departments/programs on center, to include, but not be limited to, residential, recreation, student government association, and HEALs, to develop integrated prevention and education services

c. Assessment for identification of students at risk for substance use problems to include:

1. Review of Social Intake Form (SIF) or intake assessment of all students performed by counseling staff within one week of arrival

2. Formalized assessment measures (e.g., SASSI3 or SASSIA2), and clinical judgment to determine students’ level of risk for substance use

3. Collaboration with the Center Mental-Health Consultant to determine when a MSWR or medical separation is appropriate and should be recommended for a student with substance use conditions (see Chapter 2, Section 2.3, R5, e.5)

d. Intervention services for students identified at an elevated risk for substance use, to include:

1. Individual and group intervention services with a focus on behaviors that represent employability barriers

2. Collaboration with the Center Mental-Health Consultant for students with co-occurring conditions of mental health issues and substance use

3. Referral to off-center substance abuse professionals or agencies for ongoing treatment and/or specialized services. Any student separating from Job Corps who has a substance use condition must be provided with a referral for support services in his or her home community

e. Drug and alcohol testing

​1. Drug testing procedures:

​​(a) Students in the following categories must be tested for drug use:

(1) New and readmitted students must be tested within 48 hours of arrival on center.

(2) Students who tested positive on entrance must be retested between the 37th and 40th day after arrival on center.

(3) Students who are reasonably suspected of using drugs at any point after arrival on center must be tested; this testing must take place as soon as possible after staff suspects use. (NOTE: Reasonable suspicion is context specific, supported by specific and articulable facts, and may include (1) direct observation of drug use or behavioral signs or symptoms suggestive of drug use, or (2) specific reliable information that a student recently used drugs.​)

(4) During a qualified emergency as defined in Section 3502(a)(4) of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), Pub. L. 116-136, the procedures in R5.e.1(a)(1)-(3) are not applicable to students participating in distance learning off-center until they begin or resume on-site participation at a Job Corps center.

(b) Biochemical testing is never permissible on a random basis, with the exception of designated licensed student drivers who are subject to 49 CFR Part 382 DOT Federal Motor Carriers Safety Administration. In addition, biochemical testing requested by work experience sites, union trades, or potential employers may only be performed by the requesting entity.

(c) If a student refuses to provide a specimen or has an unexcused absence from his or her follow-up drug test, he or she shall be presumed guilty of the Level I infraction Drugs: Use of drugs as evidenced by a positive drug test.  Students who state they are unable to produce a specimen must be referred to the center physician or designee for follow up.

(d) Collection of urine for drug testing must be in accord with chain-of-custody principles and conducted by health and wellness staff or a staff member trained in urine collection procedures.

(e) The Job Corps nationally contracted laboratory must be used for all required drug testing. On-center urine drug testing is prohibited.

(f) Reinstated students cannot be subject to entry drug testing upon return to the center. Transfer students cannot be subject to drug testing upon arrival at receiving center. Both reinstated and transfer students shall be subject to testing for drugs upon suspicion of use only.

​​2. Alcohol testing procedures:

(a) Students who are reasonably suspected of being intoxicated or consuming alcohol on center or under center supervision must be tested; this testing must take place immediately after staff suspects use. (NOTE: Reasonable suspicion is context specific, supported by specific and articulable facts, and may include (1) direct observation of alcohol use or behavioral signs or symptoms suggestive of alcohol use, or (2) specific reliable information that a student recently used alcohol.​)

(b) Centers must use devices that measure alcohol in the breath or saliva (e.g., breathalyzers or alcohol test strips/tubes/swabs). Alcohol testing must only be administered by a staff member trained in the use of these testing devices. All testing must be documented and the results submitted to the health and wellness center.

(c) If a student refuses to submit to a breathalyzer or provide a sample for alcohol testing, the student shall be presumed guilty of the Level I infraction Alcohol: Possession, consumption, or distribution while on center or under center supervision.

3. Students testing positive for drug or alcohol use:

(​​a) New students and readmitted students not previously separated for drug use (Zero Tolerance (ZT) separation code 5.2a); possession, use or distribution of drugs on center or under center supervision (ZT separation code 5.2b); possession, consumption, or distribution of alcohol while on center or under center supervision (ZT separation code 5.1b); or abuse of alcohol (ZT separation code 5.1b) who test positive on entry must receive intervention services and a follow-up drug test. The results of the follow-up drug test must be received on center prior to the end of the intervention period.

To remain in the program, students who test positive on entry must have a negative drug-test result at the end of the intervention period.

If an intervention period takes place during a center vacation period (i.e., winter break), the intervention period is suspended and resumes the day the student is scheduled to return to the center (e.g., if a student is on day #30 of his or her intervention period at the time of the center vacation, the day count will be suspended at 30 days, and resume as day #31 the day, he or she is due back on center).  If a student does not report to the center on the day he or she is expected to return, the intervention period still resumes and the student is labeled an Unauthorized Absence.

If an intervention period takes place during off-center distance learning due to a qualifying emergency under the CARES Act, the intervention period restarts the day the student returns to the center to resume on-site participation.

Students who are an Unauthorized Absence on the day of their scheduled follow-up drug test shall be presumed guilty of the Level I infraction Drugs: Use of drugs as evidenced by a positive drug test.

(b) Readmitted students previously separated for drug use (ZT separation code 05.2a) that test positive on entry or any time during their second enrollment at Job Corps must be separated immediately without an intervention period. Such students shall not be allowed to reapply to Job Corps.

(c) Students who test positive for drug use by an off-center facility must be retested on center using the Job Corps nationally contracted laboratory as soon as possible, to include:

(1) Work-based learning students who tested positive on a drug test administered by experience sites, union trades, or potential employers;

(2) Students who tested positive on a drug test administered at a referral health facility (e.g., hospital emergency department, urgent care facility).

This retest by the Job Corps nationally contracted laboratory must be classified as a suspicion-of-drug-use test. For students who test positive for drug use on this retest, centers must follow the same procedures outlined in (c) above.

(d) Student drivers who test positive for drug use under 49 CFR Part 382 DOT Federal Motor Carriers Safety Administration must follow the same procedures outlined in (c) above for positive suspicion tests. In addition, during the intervention period, student drivers who fall under DOT regulations are not permitted to drive.

(e) Students who test positive for alcohol use on suspicion must be referred to the TEAP specialist for assistance and the center’s student conduct system for disciplinary action.

​4. Student notification of drug or alcohol test results

(a) Students who test positive for drug use must be informed of their results by the TEAP specialist, Center Physician, or designee within 24 hours of receipt of positive result, or as soon as possible, given staff and student availability.  Minor student’s parent/guardian must be notified of positive test results as required by applicable state laws for the state in which the center is located.

(b) Alcohol test results must be provided to the student by the person administering the test.

(c) Drug and alcohol test results must be shared only with center personnel who have a need to know for purposes of discipline, counseling, administration, and delivery of services (in accordance with 42 CFR, Part 2​).

(d) If a student questions the validity of a confirmed positive drug test, he or she must be referred to the Center Physician or designee for counseling.

​5. Medical Separations with Reinstatement Rights (MSWR) for substance use conditions:

(a) Students may be given a MSWR for a diagnosed substance use condition, allowing the student to return to Job Corps to complete his or her training within 180 days. To return to Job Corps, proof of treatment completion from a qualified provider must be received.

(b) A MSWR for substance use conditions can only be given if the following conditions are met:

(1) The TEAP specialist and Center Director agree that the student has a diagnosed substance use condition.

(2) There is a documented assessment of the student’s diagnosed substance use condition by the TEAP specialist in collaboration with the center mental health consultant.

(c) A MSWR cannot be granted in lieu of ZT separation when a positive follow-up test is reported during the intervention period.

(d) If a student is placed on a MSWR during the intervention period, the intervention period is suspended and resumes the day the student is scheduled to return to the center.

R6. Tobacco Use Prevention Program (TUPP)

Implement a program to prevent the onset of tobacco use and to promote tobacco-free environments and individuals. To support this program, a TUPP Coordinator must be appointed (he or she need not be a health services staff member). At a minimum, this program must include:

a. Educational materials and activities that support delay and/or cessation of tobacco use

b. A smoke-free, tobacco-free environment that prohibits the use of all tobacco products in center buildings and center-operated vehicles

c. Designated outdoor smoking areas located a minimum of 25 feet, or as required by state law, away from the building entrance

d. Prohibition of the sale of tobacco products on center

e. Adherence to federal and state laws regarding the use of tobacco products by minors

f. Minors who use tobacco products must be referred to the TUPP

g. All services provided should be documented in the student health record

R7. Family Planning Program

a. A family planning program must be provided to all students on a voluntary basis. At a minimum, this program must include counseling, health promotion activities, and medical services, including birth control. The Center Director must appoint a staff member to implement and monitor this program.

b. Students who are pregnant and/or experiencing pregnancy-related medical conditions must be afforded the same access to medical services, leave and medical separation as any other student experiencing a medical condition, unless otherwise provided by law.

c. Once a center learns that a student is pregnant, pregnancy-related services must include:

1. Prenatal services on center and/or in the community until separation, to include a comprehensive gestational record.

2. The Center Physician, in conjunction with an obstetrical/gynecological provider and the student, will agree upon a care-management and separation plan that takes into account the health and safety of the pregnant student before and after childbirth.

3. The center must identify available community health/social resources and services, and will make arrangements for transportation for the purpose of obtaining such resources and services consistent with Chapter 6, Section 6.7, R9.d. In lieu of the center providing transportation, the center may approve a student’s request to be transported by a friend, partner or family member.

4. The center cannot pay for an abortion unless the pregnancy is the result of rape or incest or unless a physician has certified that the student suffers from a physical disorder, injury, illness, or condition that places her in danger of death unless an abortion is performed. (NOTE: The Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act of 2014, Title 5, Sec. 507(a) (P.L. 113-76) provides that the prohibition on the use of Federal funds for abortions described in Section 506 “shall not apply to an abortion (1) if the pregnancy is the result of an act of rape or incest; or (2) in the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed.”​)

5. A student that is experiencing a pregnancy-related medical condition may be placed on paid administrative leave in accordance with Exhibit 6-1 (see Pay status: Paid, Duty status: Not Present for Duty-Administrative Leave with Pay).

d.  Pregnancy-related services must include information on the options of continuing or terminating the pregnancy.

e.  If required by applicable state laws in which the center is located, the center must notify the student’s parent/guardian of her pregnancy if she is a minor, and if required by applicable state law, inform the student of this requirement prior to the disclosure.
R8. HIV/AIDS

​​Centers must:

a. Test students for HIV infection under the following circumstances:

1. As part of the cursory medical examination (see Chapter 2, Section 2.3, R2.c)

2. If a student exhibits signs and/or symptoms of a possible AIDS-related condition

3. Upon reasonable suspicion of student exposure to HIV

4. When student is diagnosed with a newly contracted sexually transmitted disease

5. Upon student request and after physician consultation

b. Submit specimens for HIV testing to the nationally contracted laboratory. Centers shall not be reimbursed for HIV tests performed at other than the nationally contracted lab.

c. Provide pre-test counseling, in accordance with state laws, to all students regarding the HIV test.

1. Counsel each student about the test and its implications and document in the health record that the student received the HIV pre-test counseling and signed the “HIV Testing Information Sheet” in Form 2-02

2. Student refusal (see Chapter 2, Section 2.3, R15)

3. Testing waiver (see Chapter 2, Section 2.3, R15, Waiver of Medical Care)

d. Provide post-test counseling, in accordance with state laws, to all students regarding HIV test results:

1. HIV Negative Students: Individually inform and counsel (e.g., measures to prevent HIV infection/transmission) all students with a negative HIV test result within 14 calendar days after receipt of test results.

2. HIV Indeterminate Students: Individually inform and counsel all students with an indeterminate HIV test result within five calendar days after receipt of test results. A student who has an indeterminate test result must be retested at three-month intervals until a conclusive test result (i.e., negative or positive) is obtained. If a conclusive result is not obtained within 6 months, no further testing is required.

3. HIV Positive Students:

(a) Inform and Counsel: Individually inform and counsel all students with a positive HIV test result, preferably within 24 hours, but not later than 5 calendar days, after receipt of the written positive result. The Center Mental Health Consultant must be in attendance to assist in informing and counseling.

(b) Contact Notification: HIV positive students must be instructed in how to notify their sexual contacts and intravenous drug contacts that they may have been exposed to HIV infection and to refer them for counseling and testing.

​​The Center Physician or designee must report the student’s HIV infection to the state and/or local health department, which will be responsible for contact notification both on- and off-center.

4. Students Off-Center: If a student is not on-center (e.g., Unauthorized Absence, Missing Minor Student, on leave) when his or her positive or indeterminate test result is received by the center, the Center Director or designee must make every attempt to contact and inform the student of his or her result. The health department at the student’s location must be used to assist with the task of informing students who are no longer on-center.

5. Document post-test informing and counseling activities in the student’s health record, including attempts to contact students not on-center (d.4 above).

e. Ensure that students who test positive for HIV infection are engaged in an interactive process to determine if an accommodation plan is needed (see center reasonable accommodation policy/process or national reasonable accommodation guidelines for specific requirements of accommodation process).

f. Ensure that students who test positive for HIV infection are engaged in case management for chronic illness on center.

g. Provide all students with information on HIV infection; including transmission and prevention (see Chapter 3, Section 3.4, R21, and Chapter 2, Section 2.3, R1).

R9. Healthy Eating and Active Lifestyles

Centers must provide students with an environment that supports healthy eating and active lifestyles, and provide students with education and experiences that promote lifelong health and physical well-being. At a minimum, this program must include the following components:

a. Planning

1. Establish a Healthy Eating and Active Lifestyles Committee to oversee and coordinate this program. At a minimum, this committee must include the Health and Wellness Director, Food Services Manager/Supervisor, Recreation Supervisor or Specialist, TEAP Specialist, Residential Manager/Counseling Manager, and student representative.

2. Incorporate student interests and preferences when planning activities.

3. Demonstrate collaboration between various departments on center.

b. Environment

1. Provide a variety of fitness activities open to all students, as outlined in Chapter 2, Section 2.2, R4.

2. Provide healthy eating selections and limit non-nutritious eating selections, as outlined in Chapter 5, Section 5.10, R3.

c. Education and counseling

1. Provide educational activities and materials to all students that support regular physical activity, nutrition, and achieving a healthy weight, as outlined in Chapter 3, Section 3.4, R21.

2. Provide individualized weight management programming and/or counseling.  Student participation in this program is highly recommended.

3. Incorporate motivational interviewing and goal setting at student’s level of readiness for change.

d. Assessment

1.Document, monitor, and assess program.

R10. Health Aspects of Sports

a. All students participating in organized contact or rigorous sports (e.g., football, basketball, boxing, and running) must be medically cleared by a health professional prior to participating. Physical examinations performed by center health personnel within one year of the organized sports activity can fulfill this requirement, at the discretion of the Center Physician. After one year, a current physical examination is required.

b. A staff member trained in CPR/First Aid, with specific authorization in the center’s standing orders, must be present at all organized contact or rigorous sports activities, including practice sessions and sports events.

c. At a minimum, staff certified in CPR/First Aid must be present at all student boxing events and contact football games.

d. In case of possible emergency, adequate transportation must be on the scene of all center-sponsored organized sports.

R11. 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 2-4 (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.

R12. 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 (Chapter 6, Chapter 6, Section 6.2, R5, and Chapter 6, Section 6.2, R4.c.5) and determine whether referral to the Office of Workers’ Compensation Programs (OWCP) is required (Chapter 5, Section 5.1, R40).

R13. 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.

R14. Medication Management (See Appendix 203, 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 203​.

R15. 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.

R16. 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.)

R17. 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. 

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.

R18. Inventory Records

Maintain records on the dispensing, inventory, and disposal of medical and dental supplies and pharmaceuticals.

R19. Continuous Quality Improvement

Center health staff must seek feedback from students, employ mechanisms to document quality of care provided, and document quality improvement activities.


 
 

 Forms

 
  
Form 2-01 Notice of Medical Information Use Disclosure and Access
Form 2-02 HIV Testing Information Sheet
 

 Exhibits

 
  
Exhibit 2-4 Job Corps Basic Health Care Responsibilities
Exhibit 5-2 Plan and Report Submission Requirements
Exhibit 6-1 Duty-Pay-Leave Status Chart
 

 Appendices

 
  
Appendix 203 Medication Management Guidelines
 

 Legal/CFR Requirements

 
  
42 CFR Part 2
49 CFR Part 382
Departments of Labor, Health and Human Services, and Education Related Agencies Appropriations Act of 2014