EXTENSION OF POSTING BOXELDER UNTIL JULY 27 2026 ADDED CMHC.pdf

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in FAR Part 12. This announcement constitutes the only solicitation that will be issued. Quotations are being requested, and separate written solicitation will not be issued.

Solicitation number 12318726Q0164 is issued as a Request for Quotation

(RFQ) for Job Corps Center Support Services – Boxelder This acquisition is set-aside for small business concerns. The applicable North American

Industry Classification Standard Code is 561320 Temporary Help Services. The small business size standard is $34 Million. This acquisition is a Total Small Business Set-Aside.

All responsible sources may submit a quotation which will be considered by the agency.

CLIN ITEM 0002 has been added, due to the required need of a Center Mental Health

Counselor

Submission:

Submit award to Contracting Officer Darlene Chase at Darlene.Chase@usda.gov

NLT Monday July 27, 2026, by 2pm EST.

Questions

Questions shall be submitted via email to Darlene.Chase@usda.gov and are due no later than July 22, 2026, at 1:00 PM EST. This will ensure enough time to respond before the solicitation period ends. Please include the solicitation name and number as the subject line of the email.

Schedule of Items (Attachment 1)

Schedule of Items (Attachment 1)

Signature:

Date:

CLIN Description Estimated

Quantity Unit of Issue

Unit

Cost /

Hour Total

0001 Drug/Alcohol Abuse Counselor 12:00- 8:00 M, W, F August 1, 2026 – July 31, 2027

HR 520hrs

0002 Center Mental Health Counselor *8:00- 5:00 M-F August 1, 2026 – July 31, 2027

HR 384hrs

HR = Hourly TOTAL mailto:Darlene.Chase@usda.gov mailto:Darlene.Chase@usda.gov

Employee Class Monetary Wage -- Fringe Benefits

Center Mental Health Counselor (Nursing

Asst. III)

$15.91

12223 Nursing Assistant III

12222 NURSING ASSISTANT II In addition to providing personal care, the Nursing Assistant

II performs common nursing procedures such as, observing and reporting on patient conditions;

taking and recording vital signs, collecting and labeling specimens, sterilizing equipment;

listening to and encouraging patients, giving sitz baths and enemas; applying and changing compresses and non-sterile dressings, checking and replenishing supplies, securing admission data from patients, and assisting in controlling aggressive or disruptive behavior. The Nursing

Assistant II follows specific instructions, and matters not covered are verified with the supervisor. (Positions involved with the above duties in forensic units of mental health institutions are classified as Nursing Assistant III.)

*A reasonable schedule would be considered providing services daily, M-F, 8am – 5pm; however, evenings and weekends can be considered reasonable if mutually agreed upon by Contractor and center personnel. The contract employee will receive two (2) 15-minute breaks and a non-paid lunch break of

30 minutes during an eight-hour day.

Statement of Work – Center Mental Health Consultant Project

Center Mental Health Consultant (CMHC) for ___Boxelder____ Job Corps Civilian Conservation Center (JCCC)

General Information

1.0 Scope of Work

1.1. The CMHC shall provide ON-SITE Mental Health Care services for all students on center, and preform applicant file reviews, staff training, student training, student support groups as requested in accordance with applicable Federal laws/regulations, OSHA and HIPAA requirements, state and local laws, and guidelines of the American Psychology Association.

1.2. Mental Health services must also include analysis and use of the most efficient and cost-effective practice of contemporary, evidence-based health care possible given available time, resources, and personnel. These services will involve coordinating and integrating the Mental Health care services program with other health and wellness components/activities on Center and providing Mental Health care services to enrollees and established students on Center.

1.3. The general emphasis of Mental Health services 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 as outlined in the Policy and Requirements Handbook (PRH)

Chapter 2, Support Student Services, Section 2.3, R4. Health Services at the link below; continuing links to other reference materials are held within that web page.

https://prh.jobcorps.gov/Pages/Home.aspx

1.4. In addition, contracted personnel shall adhere to any such standards as may be established by the Office of the

Director, Job Corps, US Department of Labor (DOL), and the Contractor. The contractor shall be responsible for the direct supervision of contractor’s personnel on the Center. Contractor’s on-Center staff shall coordinate with the Health and Wellness Director and/or Center Director on all matters of program operations and coordination with other Center activities.

2.0 Background

Job Corps is a U.S. Department of Labor (DOL), Employment and Training Administration (ETA) program. Job

Corps is designed to assist young people who need and can benefit from the wide range of services provided at a Job

Corps center. Services include the following: basic education, High School Diploma (HSD) program; General

Educational Development (GED); vocational skills training; residential living program; healthcare; and related support services. The comprehensive combination of training and support services is designed to help each student become a responsible and productive citizen. Student populations range from 100 to over 300 students depending on the Center’s On-Board Strength (OBS). Job Corps is a self-paced program: therefore, a student’s length of enrollment varies. Students may remain in the program for up to two years, but the average length of enrollment is approximately eight months.

3.0. Technical Requirements / Tasks

3.1. Task 1 - General

3.1.1. Possess the ability to work both independently and as a member of a healthcare team to provide optimal services to a population of financially disadvantaged youth, typically ranging from 16 to 24 years in age.

3.1.2. Attend monthly conference calls, webinars, and DOL trainings, on site trainings as available during regular scheduled hours of service. If unavailable to attend, notify the Health and Wellness Director and obtain notes and pertinent information.

https://prh.jobcorps.gov/Pages/Home.aspx

3.1.3. Ensure patient privacy for all assessments; maintain, safeguard, and ensure the confidentiality of all required student health records when they are in the health clinic or in the possession of health and wellness team members, in accordance with the Health Insurance Portability and Accountability Act

(HIPAA).

3.1.4. Provide Mental Health services in a positive and productive manner to facilitate student willingness to pursue recommended mental health treatment plan, if applicable. Services will have a general emphasis on early detection, diagnosis, and prevention/education. Provide student services in such a manner to obtain positive student satisfaction survey results as determined by Job Corps.

3.1.5. Not to engage in any research projects and/or publications relating to Job Corps health activities without prior written approval from the Job Corps National Office in Golden, CO.

3.1.6. Report adverse student behavior incidents to the HWD, Center Director or Contracting Officer’s (CO)

Representative (COR) in a timely manner.

3.1.7. Understand that mental health services shall be subject to monitoring and review by Job Corps assessment teams, and cooperation and compliance with such teams is required. Participate in DOL and Forest Service assessments, completing requested questionnaires, conferences, and monthly teleconferences in adherence to the PRH requirements.

3.1.8. Contractor shall provide a monthly status report (see attachment A) This is to be submitted to the

Health and Wellness Director by the 5th of each month.

3.1.9. Contractor will maintain a sign in sign out log for all time billed to the center. Each center will develop their own system for maintaining this information.

3.1.10. Contractor will document on each student interaction in the student health record (SHR) in a timely manner.

3.1.11 Comply with Job Corps infection control policies and procedures.

3.2. Task 2 - Assessment – PRH 2.3, R4(b)

3.2.1. Provide mental health assessments for applicants and students to examine mood, behavior, thinking, reasoning, and other areas related to emotional wellness. At a minimum there are three types of assessments that will occur:

3.2.1.1. For applicants during the admissions process, which may include individualized assessments for possible direct threat or health care needs.

3.2.1.2. For new students based on responses to the Social Intake Form (SIF) and/or the Job Corps

Health History Form.

3.2.1.3. For any student by referral using a written referral and feedback form.

3.2.2. Promptly review applicant files and complete required initial assessment (intake), and treatment plan, as applicable.

3.2.3. Participate in Disability Accommodations Committee (DAC) meetings & file applicant review team meetings during regular scheduled hours, when requested.

3.3. Task 3 - Care and Case Management

3.3.1. Monitor students identified as having a chronic mental health condition to include but not limited to:

communication among staff, monitoring, and follow up. Information exchange should occur with

CMHC, counseling staff, health and wellness staff and other appropriate staff based on “need to know”.

3.3.2. Participate in the management of, and provide written diagnoses for, a chronic care management plan for students with chronic conditions/disability related to mental health conditions, when appropriate.

3.3.3. Collaborate with Substance Abuse Counselor (TEAP) on services for students with co-occurring conditions of mental health issues and substance use.

3.3.4. Coordinate with center physician and Health & Wellness Manager (HWD) to discuss long-term medication management and Schedule II prescription management.

3.3.5. On a monthly basis, report to the Center Director and HWD on all health- related matters; including student medical separations, justification and costs of special needed services, health and non-healthcare equipment repair and replacement needs, depletion of medical supplies and medications, and other areas deemed appropriate.

3.4. Task 4 - Treatment – PRH 2.3 R4 (d)

3.4.1. Record all mental health documentation, such as, diagnosis, treatment and management plans, medication, reason of denial into the program (if recommended) etc. on the Student Health Record

(SHR), Job Corps Health and Wellness Program forms as well as in any Job Corps approved electronic systems such as CIS.

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

3.4.3. 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.

3.4.4. Provide various therapies to include but not limited to: Short-term therapy with mental health checks as needed, Brief Therapy and appropriate referrals to long term therapy. These therapies should focus on retention and behaviors that represent employability barriers.

3.4.5. Ensure that contact is maintained and documented with any off-center mental health provider to monitor the student’s compliance and progress.

3.5. Task 5 - Mental Health Promotion and Education – PRH 2.3, R4 (c)

3.5.1. Conduct a minimum of a one-hour presentation on mental health promotion for all new students in accordance with PRH 2.3, R4, with an emphasis on employability and how to respond to a mental health crisis.

3.5.2. Conduct at least one annual center-wide mental health promotion and education activity. Provide the

HWD with documentation of the activities.

3.5.3. Assist students to acquire health-related skills and knowledge of healthy mental health care.

3.5.4. Participate in health and wellness program continuous quality improvement activities and advise and assist the health education instructor in the development and implementation of the Mental Health

Education Program.

3.5.5. Coordination with other departments/programs on center, including, but not limited, to residential, recreation, education, vocation, student government association, and Healthy Eating and Active

Lifestyles (HEALs), to develop integrated promotion and education services.

3.5.6. 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.).

4.0. Government Furnished

Adequate workspace, equipment, supplies, and materials as needed to accomplish the work requirements outlined herein, including examination rooms and furniture, assessment equipment, telephone, computer, a fax machine, office supplies, PPE, and similar items. These supplies and property shall be utilized during the performance of this contract only while providing student care.

Contractor shall report to:

Boxeleder Job Corps Center

Address: 22023 Job Corps Pl., Nemo, SD 57759

5.0. Deliverables / Schedule

5.1. Deliverables

Key Deliverables

Item

No.

Deliverable /

Item Title

Description Frequency Reference Delivery Format Due By

1 Monthly CMHC

Utilization

Report

Report documenting monthly activity

Once per month

Ref. SOW, Section 3.1.8., General Tasks

Via email to the

Center Health and Wellness

Director and CO

The 5th day of each month after contract award

5.2. Schedule and Availability:

5.2.1. Mental Health services hours are required on a weekly basis, during days of the week and hours of the day established in coordination with Center personnel. The days and times of services shall be upon mutual agreement between the Contractor and center personnel and must be considered reasonable. A reasonable schedule would be considered providing services daily, M-F, 8am – 5pm; however, evenings and weekends can be considered reasonable if mutually agreed upon by Contractor and center personnel.

The contract employee will receive two (2) 15-minute breaks and a non-paid lunch break of 30 minutes during an eight-hour day.

5.2.2. Center OBS and the PRH may change at any time; consequently, the quantity of required Mental Health services hours may vary, depending on the needs of the student population. However, any changes to the required hours will be executed via a bilateral modification to the contract

5.2.3. Key Personnel must provide a current contact number to the Center’s Health and Wellness Director

(HWD) or COR. When Key Personnel are unavailable for an extended time, as determined by the

Contracting Officer, the Contractor will provide an acceptable substitute to provide services. All substitute personnel will be approved by the national and regional offices prior to work being performed.

5.2.4. Contractor will contact the CD or designee 24 hours in advanced for cancellation of services. For planned absences, the Contractor will coordinate with Center staff and the CO to provide an approved substitute, as well as a current emergency contact number. All substitute personnel will be approved by the national and regional offices prior to work being performed.

5.2.5. Contractor Personnel will not be scheduled to work on the following Government holidays:

• New Year’s Day – January 1

• Martin Luther King Junior’s Birthday – Third Monday in January,

• Presidents Day – third Monday in February,

• Memorial Day – Last Monday in May,

• Juneteenth Day – June 19th,

• Independence Day – July 4,

• Labor Day – First Monday in September.

• Columbus Day – Second Monday in October,

• Veteran’s Day – November 11,

• Thanksgiving Day – fourth Thursday in November

• Christmas Day – December 25

6.0. Travel

Travel is not anticipated or authorized for this statement of work.

7.0. Contractor’s Key Personnel

7.1. The CMHC is considered key personnel and must meet these minimum requirements. The job corps program is run by the Department of Labor (DOL). Key personnel shall be approved by DOL prior to award or replacement:

7.1.1. Have an active, unrestricted license to practice as an independent practitioner in the state where the center is located and does not require supervision to practice.

7.1.2. Minimum 1 year of experience as a licensed independent practitioner providing assessment and treatment services to adolescents and young adults.

7.1.3. Maintain licensing requirements/certification/accreditation and required insurance coverage at a minimum of $1 mil per occurrence/3 mil aggregate during the entire performance period with proof being submitted to the CO upon request

7.1.4. Agree to a criminal background check, and drug testing, as a prerequisite for contract performance, if determined necessary by the CO.

7.1.4.1. Information obtained through the background check may be used in determining contractor’s qualification for this contract. Information regarding a person’s race, national origin, color, sex, religion, disability, genetic information (including family medical history), or age will not be evaluated or have any impact on the determination of qualifications for this contract.

7.1.4.2. Government may terminate the contract if the background check is determined to be unacceptable or if any aspect would jeopardize the health and safety of the students.

8.0. Security Requirements

The space, equipment, and supplies used by contractor personnel shall be secured at all times, per Center requirements.

The Contractor shall review and be familiar with Center security procedures.

9.0. Data Rights

Student records and all reports generated are property of the US Government.

10.0. Governing Regulations, Handbooks, and References:

The Contractor shall provide Health and Wellness (H&W) services as specified in the following documents:

• Job Corps Federal Regulations (Title 20 Code of Federal Regulations, Part 684 as amended, Job

Corps Program under Title TV-B of the Job Training Partnership Act.

• Applicable Technical Assistance Guides (TAG s)

• Job Corps CMHC Desk Reference

• Job Corps Health & Wellness information and Department of Labor PRH:

https://supportservices.jobcorps.gov/health/Pages/default.aspx https://prh.jobcorps.gov/

• Job Corps Support Services: https://supportservices.jobcorps.gov/health/Pages/default.aspx

Attachments (Below):

1. Attachment A - Monthly CMHC Utilization Report

2. Attachment B - Center Mental Health Consultant (CMHC) Task and Frequency Chart https://supportservices.jobcorps.gov/health/Pages/default.aspx https://prh.jobcorps.gov/ https://supportservices.jobcorps.gov/health/Pages/default.aspx

Question 17 Week 1 Week 2 Week 3 Week 4 MONTH

TOTAL

AFR # Files Hours # Files

Hours # Files

Hours # Files Hours

Applicant file review w/ recommendation of denial submitted to RO (# files and hours)

0 0 0 0 0 0 0 0

Question 18- Do not include intern hours Week 1 Week 2 Week 3 Week 4 MONTH

TOTAL

DIRECT MENTAL HEALTH SERVICES # Students # Students # Students # Students

Intake screening/assessments of new referrals

0 0 0 0

Individual therapy/counseling sessions (scheduled or drop-in)

0 0 0 0

Crisis intervention assessment/therapy sessions

0 0 0 0

MSWR assessments 0 0 0 0

Group therapy sessions 0 0 0 0

Medication check-ins

Other: MSWR Check in 0 0 0 0

Weekly Total - Direct Services 0 0 0 0 0

Question 19 - Do not include intern hours Week 1 Week 2 Week 3 Week 4 MONTH

TOTAL

INDIRECT MH SERVICES Hours Hours Hours Hours

Applicant file review w/recommendation of enrollment

0 0 0 0

SIF revew 0 0 0 0 0

SHR review 0 0 0 0

Case management meeting with counselors 0 0 0 0

Consultation w/ HW staff (HWD, TEAP, CD, nurses)

0 0 0 0

Psychotropic medication review meetings 0 0 0 0

Consultation with non-HW staff (counselors, RAs, academic/trade instructors, other etc.)

0 0 0 0

Consultation with RMHS 0 0 0 0

Documentation of direct clinical services 0 0 0 0

Off-center referrals/consultation/case management

0 0 0 0

Participation in center meetings (SART, HEALS, etc.)

0 0 0 0

Other: CMHC/Counselor Meeting 0 0 0 0

Weekly Totals - Indirect Services 0 0 0 0 0

Question 20 Week 1 Week 2 Week 3 Week 4 MONTH

TOTAL

MH Promotion and Education Activities Hours Hours Hours Hours

Hosting/co-hosting center-wide MH event for students

0 0 0 0

Center-wide staff training 0 0 0 0

Planning activities (creating PPT/handouts, ordering supplies, collaborating w/ other staff, etc.)

0 0 0 0

Other: CPP Presentation 0 0 0 0

Weekly Totals - MH Education & Promotion 0 0 0 0 0

Question 21 Week 1 Week 2 Week 3 Week 4 MONTH

TOTAL

Attachment A Name: _____________________ Month: Year:

Disability Program Support Hours Hours Hours Hours

DAP meetings 0 0 0 0

Consultation with DC, follow-up, record review

0 0 0 0

Research appropriate accommodations (JAN, etc.)

0 0 0 0

Consultation with Regional Disability Coordinator

0 0 0 0

Other: 0 0 0 0

Weekly Totals - Disability Program Support 0 0 0 0 0

Name: _____________________ Month: Year:

Question 17 Week 1 Week 2 Week 3 Week 4

AFR # Files Hours # Files Hours # Files Hours # Files Hours

Applicant file review w/ recommendation of denial submitted to RO (# files and hours)

0 0 0 0 0 0 0 0

Question 18- Do not include intern hours Week 1 Week 2 Week 3 Week 4

DIRECT MENTAL HEALTH SERVICES # Students # Students # Students # Students

Intake screening/assessments of new referrals 0 0 0 0

Individual therapy/counseling sessions (scheduled or drop-in)

0 0 0 0

Crisis intervention assessment/therapy sessions 0 0 0 0

MSWR assessments 0 0 0 0

Group therapy sessions 0 0 0 0

Medication check-ins

Other: MSWR Check in 0 0 0 0

Weekly Total - Direct Services 0 0 0 0

Question 19 - Do not include intern hours Week 1 Week 2 Week 3 Week 4

INDIRECT MH SERVICES Hours Hours Hours Hours

Applicant file review w/recommendation of enrollment 0 0 0 0

SIF revew 0 0 0 0 0

SHR review 0 0 0 0

Case management meeting with counselors 0 0 0 0

Consultation w/ HW staff (HWD, TEAP, CD, nurses) 0 0 0 0

Psychotropic medication review meetings 0 0 0 0

Consultation with non-HW staff (counselors, RAs, academic/trade instructors, other etc.)

0 0 0 0

Consultation with RMHS 0 0 0 0

Documentation of direct clinical services 0 0 0 0

Off-center referrals/consultation/case management 0 0 0 0

Participation in center meetings (SART, HEALS, etc.) 0 0 0 0

Other: CMHC/Counselor Meeting 0 0 0 0

Weekly Totals - Indirect Services 0 0 0 0

Question 20 Week 1 Week 2 Week 3 Week 4

MH Promotion and Education Activities Hours Hours Hours Hours

Hosting/co-hosting center-wide MH event for students 0 0 0 0

Center-wide staff training 0 0 0 0

Planning activities (creating PPT/handouts, ordering supplies, collaborating w/ other staff, etc.)

0 0 0 0

Other: CPP Presentation 0 0 0 0

Weekly Totals - MH Education & Promotion 0 0 0 0

Question 21 Week 1 Week 2 Week 3 Week 4

Disability Program Support Hours Hours Hours Hours

DAP meetings 0 0 0 0

Consultation with DC, follow-up, record review 0 0 0 0

Research appropriate accommodations (JAN, etc.) 0 0 0 0

Consultation with Regional Disability Coordinator 0 0 0 0

Other: 0 0 0 0

Weekly Totals - Disability Program Support 0 0 0 0

Name: _____________________ Month: Year:

Question 17 Week 1 Week 2 Week 3 Week 4

AFR # Files Hours # Files Hours # Files Hours # Files Hours

Applicant file review w/ recommendation of denial submitted to RO (# files and hours)

0 0 0 0 0 0 0 0

Question 18- Do not include intern hours Week 1 Week 2 Week 3 Week 4

DIRECT MENTAL HEALTH SERVICES # Students # Students # Students # Students

Intake screening/assessments of new referrals 0 0 0 0

Individual therapy/counseling sessions (scheduled or drop-in)

0 0 0 0

Crisis intervention assessment/therapy sessions 0 0 0 0

MSWR assessments 0 0 0 0

Group therapy sessions 0 0 0 0

Medication check-ins

Other: MSWR Check in 0 0 0 0

Weekly Total - Direct Services 0 0 0 0

Question 19 - Do not include intern hours Week 1 Week 2 Week 3 Week 4

INDIRECT MH SERVICES Hours Hours Hours Hours

Applicant file review w/recommendation of enrollment 0 0 0 0

SIF revew 0 0 0 0 0

SHR review 0 0 0 0

Case management meeting with counselors 0 0 0 0

Consultation w/ HW staff (HWD, TEAP, CD, nurses) 0 0 0 0

Psychotropic medication review meetings 0 0 0 0

Consultation with non-HW staff (counselors, RAs, academic/trade instructors, other etc.)

0 0 0 0

Consultation with RMHS 0 0 0 0

Documentation of direct clinical services 0 0 0 0

Off-center referrals/consultation/case management 0 0 0 0

Participation in center meetings (SART, HEALS, etc.) 0 0 0 0

Other: CMHC/Counselor Meeting 0 0 0 0

Weekly Totals - Indirect Services 0 0 0 0

Question 20 Week 1 Week 2 Week 3 Week 4

MH Promotion and Education Activities Hours Hours Hours Hours

Hosting/co-hosting center-wide MH event for students 0 0 0 0

Center-wide staff training 0 0 0 0

Planning activities (creating PPT/handouts, ordering supplies, collaborating w/ other staff, etc.)

0 0 0 0

Other: CPP Presentation 0 0 0 0

Weekly Totals - MH Education & Promotion 0 0 0 0

Question 21 Week 1 Week 2 Week 3 Week 4

Disability Program Support Hours Hours Hours Hours

DAP meetings 0 0 0 0

Consultation with DC, follow-up, record review 0 0 0 0

Research appropriate accommodations (JAN, etc.) 0 0 0 0

Consultation with Regional Disability Coordinator 0 0 0 0

Other: 0 0 0 0

Weekly Totals - Disability Program Support 0 0 0 0

Attachment B

CENTER MENTAL HEALTH CONSULTANT (CMHC) TASK AND FREQUENCY CHART

This chart with active links outlines the specific CMHC tasks and frequency to assist in developing a comprehensive MHWP that meets Policy and Requirements Handbook (PRH) requirements. It also provides guidance on how to document each task.

MENTAL HEALTH TASK FREQUENCY OF TASK HOW TO DOCUMENT

Assessment

Conduct Applicant File Reviews As needed Make notation in the applicant file on SF 600 Chronological Record of Medical Care or center review form that file was reviewed

Participate in the Disability Accommodation Process (DAP) to support students with mental health (MH) disabilities

Weekly or as needed Ensure your name is included on DAP forms as participant

Complete Direct Threat and Health Care Needs Assessments

As needed Submit recommendations of denial to Regional Office on Forms 2-04 Individualized Assessment of Possible Direct Threat OR 2-05- Health Care Needs Assessment.

Review Social Intake Forms (SIFs) from counselors

Must complete within one week of every new student input group

Sign and date the last sheet of the SIF

Perform mental health intakes and assessments

Everyday CMHC is on center (per referrals)

Use of Mental Health Intake Form is strongly encouraged

Process Medical Separations with Reinstatement Rights (MSWR) when student is a direct threat to others or center is unable to meet health care needs of students.

• For all MSWRs for direct threat to others (whether student or guardian agrees or not) complete Form 2-04 and place in the student health record.

• If a student or guardian is not in agreement with MSWR due to health care needs, you must complete Form 2- 05 and place it in the student health record.

• Provide justification for MSWR, requirements to return, and referrals.

As needed Place MSWR justification note in the mental health section of the SHR.

Provide health and wellness director (HWD) with a separation diagnosis using SPAMIS Separation Medical Separation Codes for JCC.

Discuss and provide the following information in the MSWR form/letter prepared by HWD:

• Requirements to return

• Referrals for community-based follow-up care

• Transportation needs

• Anticipated date of return from MSWR

The use of the Sample Medical Separation with Reinstatement (MSWR) Form is strongly encouraged to document the above requested information. Formulario de Separación Médica Con Reinstalación (Spanish)

Mental Health Promotion and Education

Deliver presentation to new students during Career Preparation Period (CPP) which includes an overview of the MHWP and how students should respond to a mental health crisis.

Introduction to the Mental Health and Wellness Program

For all new student input groups during the first or second week on center

Create a binder with the title “MH Promotion and Education” and place CPP presentation outline as well as day and time presentation is conducted. This can be electronic.

Coordinate and offer center-wide mental health promotion activities

At least one annually Place flyers or other information regarding activity in MH Promotion and Education binder. This can be electronic.

https://supportservices.jobcorps.gov/disability/Documents/CN%2022-02/AFR/PRH%20Form%202-04%20-%202022.docx https://supportservices.jobcorps.gov/disability/Documents/CN%2022-02/AFR/PRH%20Form%202-04%20-%202022.docx https://supportservices.jobcorps.gov/disability/Documents/CN%2022-02/AFR/PRH%20Form%202-05%20-%202022.docx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Intake_Assessment_May2023.docx https://supportservices.jobcorps.gov/health/Documents/SPAMIS_MedicalSeparation_Codes_5.26.2023.docx https://supportservices.jobcorps.gov/health/Documents/SPAMIS_MedicalSeparation_Codes_5.26.2023.docx https://supportservices.jobcorps.gov/health/Documents/MSWR_Sample_Student_Health_Leave_Form_June2023.docx https://supportservices.jobcorps.gov/health/Documents/MSWR_Sample_Student_Health_Leave_Form_June2023.docx https://supportservices.jobcorps.gov/health/Documents/MSWR_Sample_Student_Health_Leave_Form_June2023.docx https://supportservices.jobcorps.gov/health/Documents/MSWR_Sample_Student_Health_Leave_Form_Spanish_June2023.docx https://supportservices.jobcorps.gov/health/Documents/MSWR_Sample_Student_Health_Leave_Form_Spanish_June2023.docx https://supportservices.jobcorps.gov/health/Documents/MSWR_Sample_Student_Health_Leave_Form_Spanish_June2023.docx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/CPP_PresentationPowerPoint_Sept2022.pptx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/CPP_PresentationPowerPoint_Sept2022.pptx

Coordinate and/or participate in consultation meetings with center director (CD), management staff, and HWD to plan mental health-related promotion and education efforts for students and staff

• Assist Human Resources (HR) with the required minimum of 5 hours of training in adolescent growth and development for staff.

Quarterly or as determined by center

Annual Requirement

Place student and staff training information in a binder; this could be a copy of the PowerPoint or simply the title, date, and time of training provided. This can be electronic.

Training courses are to be coordinated by HR manager/contractor and documented by HR manager.

Coordinate with other departments and programs on center to develop integrated promotion and education services

• Participate in trainings or special activities with residential staff, HEALs, Student Government Association (SGA), or instructors.

Quarterly or as determined by center

Place in a binder the titles and dates of any special meetings, activities, or trainings with other departments.

This can be electronic.

Treatment

Provide short-term treatment with check-ins as needed. Focus should be on retention and behaviors that represent employability barriers

Weekly, bi-weekly, or as needed Use Mental Health Progress Note OR chart in the SHR under MH section.

Collaborate with TEAP specialist for short-term counseling of students with co-occurring conditions

As agreed between CMHC and TEAP specialist – weekly, bi-weekly or monthly

Document in SHR for individual student consult

Maintain brief minutes from meetings in a folder titled “TEAP Collaboration” OR include TEAP specialist in the case management meeting with counselors and document their participation

Monitor students on psychotropic medication in collaboration with center physician (CP)/Nurse Practitioner (NP)/Physician Assistance (PA), and HW staff

At least monthly If possible, participate in the medication monthly meeting with HWD and CP/NP/PA, and ensure your name is included as a participant on the Medication Review, Rationale, and Monthly Case Conference Form.

If not possible establish a meeting procedure with an identified HW staff.

Chart medication check-ins with students in MH section of SHR or use Mental Health Progress Note.

Collaborate with counseling on developing/leading psychoeducational skill-building groups for students

As determined by CMHC and Counselor Manager

Counselors are responsible for documentation of groups provided.

https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Progress_Note_Final.docx https://supportservices.jobcorps.gov/health/Documents/MedicationManagement/Monthly_Medication_Review_Case_Conference_form_Oct2017_FINAL.docx https://supportservices.jobcorps.gov/health/Documents/MedicationManagement/Monthly_Medication_Review_Case_Conference_form_Oct2017_FINAL.docx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Progress_Note_Final.docx

Participate in regular case conferences to exchange information with counselors and other appropriate staff, as appropriate with a need to know.

Weekly or bi-weekly Use the Mental Health Feedback and Case Management Form

Refer students to on center skill-building groups conducted by counselors

As needed Use the Mental Health Feedback and Case Management Form

Provide crisis management As needed Chart in SHR under MH section or Mental Health Progress Note

Make referrals to off-center mental health services

As needed Use Off-center Appointment Verification Form.

Develop community relationships for long-term and/or specialized mental health treatment

As needed Verbal report, unless a MOU is established by the center

Complete referral and feedback documentation

With each new student referred Use Mental Health Referral and Feedback Form

Other Requirements

Provide HIV management assistance As needed Document services on the SF 600 progress note or MH section of the

SHR

Review and update Health Care Guidelines and Center/Standard Operating Procedures

Annually Maintain recent documents in binders titled “Health Care Guidelines” and “SOPs/COPs.”

HWD should have binders.

Report child and elder abuse As reported or upon reasonable suspicion and state regulations

Chart in SHR under MH section

Document all services in SHR Everyday CMHC is on center In SHR make notation on SF 600 chronological progress note “See CMHC Note” and then chart In SHR under MH section

Review and update credentials, as applicable

Annually or before expiration Provide to HWD to place in Credentials Folder

Additional Suggested Activities

Facilitate open appointment hours for unscheduled students

Weekly, bi-weekly, or as schedule allows

N/A

Collaborate with the Sexual Assault Prevention and Response team (SART). See SART Technical Assistance Guide.

As needed Document interventions in SHR under MH section or MH Progress Note

Promote positive mental health and update free materials from SAMHSA, NIMH, etc. (e.g., posters and flyers)

As needed Order materials and place in visible areas in health and wellness center (HWC) and other departments

Be visible on center (e.g., walking around center where students can see you, eating in the cafeteria, attending special events)

As schedule allows N/A

Attend regional videoconferences Monthly N/A

Develop and monitor intern/extern program, if applicable

Weekly supervision or as needed N/A

Attend conferences, videoconferences, webinars, etc.

As directed by the CD and Regional Office

N/A https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Case_Management_Form_Final.docx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Case_Management_Form_Final.docx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Case_Management_Form_Final.docx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Case_Management_Form_Final.docx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Progress_Note_Final.docx https://supportservices.jobcorps.gov/health/Documents/Off_Center_Appointment_Verification_Form_Mar2020.docx https://supportservices.jobcorps.gov/health/Documents/Off_Center_Appointment_Verification_Form_Mar2020.docx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Referral_Feedback_Form_June2023.docx https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Referral_Feedback_Form_June2023.docx https://supportservices.jobcorps.gov/health/Documents/TAGs/SART_TAG.pdf https://supportservices.jobcorps.gov/health/Documents/TAGs/SART_TAG.pdf https://supportservices.jobcorps.gov/health/Documents/MentalHealth/MH_Progress_Note_Final.docx

Consult with Department of Vocational Rehabilitation

As needed N/A

To access all referenced forms, go to CMHC Resource Bundles located on Job Corps Health and Wellness website.

https://supportservices.jobcorps.gov/health/Pages/MH-Resource-Bundles.aspx