This section presents guidelines for health and wellness center facilities at Job Corps centers. The requirements for facility standards are listed in PRH Chapter 5, Section 5.9. Because facility needs increase as center size expands or contracts, guidelines differ for different sized centers. The facilities guidelines table covers centers with a capacity range of 150 to 2,300 students. These guidelines are designed for center staff members, regional project managers, regional health consultants, contractors, and architects concerned with remodeling or designing new center health and wellness facilities.

In developing these guidelines, consideration was given to the types of medical, dental, and mental health services that should be provided on center and/or in the nearby community. Services that should be provided in the on-center health and wellness facility include:

• Cursory health evaluation including cursory oral examination and medical history
• First aid and initial emergency care
• Daily health and wellness check hours or open appointments for injury and illness assessment
• Treatment by the center physician, dentist, center mental health consultant (CMHC), or trainee employee assistance program (TEAP) specialist, or as authorized and specified by the physician, dentist, or CMHC in written standing orders for other staff
• Inpatient (bed) care
• Isolation (bed) care
• Oral (dental) examination and treatment (including dental hygiene), particularly in centers of 400 or more students

Services that may be provided either on or off center include:

• Complete entrance physical examination and medical history
• Immunizations
• Examination and treatment by the center physician, dental, or mental health professionals, including definitive emergency care
• Primary dental examination and treatment (including dental hygiene) in centers under 400 capacity, including definitive emergency care
• Examination and treatment by medical, dental, and mental health specialists, including optometrists and ophthalmologists
• Hospital care (off center only)

Services that should be provided on center, but usually not in the health facility, include:

• Health education classes for students
• Mental health staff training
• Counseling

The larger the center, the more cost effective it becomes to supply certain health and wellness services on center rather than off center. Expansion of on-center services results in an increased need for space.

There are compelling reasons why oral health (dental) care should be provided on center. Off-center oral health care is usually contracted on a fee-for-service basis, hence more expensive than a typical on-center subcontract for the same volume of services. The quality of off-center oral health care and compliance with Job Corps standards is difficult to monitor. In addition, transportation of and wait times for students can cause substantial time away from education and training.

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