Assigned to HHS & COMPS                                                                                                  FOR COMMITTEE

 

 

 

 

ARIZONA STATE SENATE

Fifty-Third Legislature, Second Regular Session

 

FACT SHEET FOR H.B. 2324

 

community health workers; voluntary certification

 

Purpose

 

Establishes scope of practice and voluntary certification requirements for certified community health workers (CHWs).

 

Background

 

Arizona’s Sunrise Review process provides a mechanism to request the regulation of health and non-health professions or an expansion in scope of practice for health professions. The Sunrise Review process begins with an applicant group presenting the Speaker of the House of Representatives and the President of the Senate with a report defining the need for the specified regulation or the scope of practice expansion. The Speaker and President subsequently assign the report to a Committee of Reference (COR) to conduct a review of the materials and to provide a recommendation regarding the regulation or practice expansion request.

 

The Senate Health and Human Services and the House of Representatives Health COR held a public meeting on November 28, 2017, to review and consider the Arizona Community Health Workers Association's Sunrise Application and to receive public testimony. The COR recommended that a bill be drafted for consideration by the full Legislature containing the items in the submitted Sunrise Application.

 

According to the American Public Health Association a CHW is a frontline public health worker who is a trusted member of, or has a close understanding of, the community served that enables the worker to serve as a liaison between health and social services and the community in order to facilitate access to services and improve the quality and cultural competence of service delivery. CHWs build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.

 

There is no anticipated fiscal impact to the state General Fund associated with H.B. 2324 as it establishes a voluntary certification process for CHWs.

 

Provisions

 

Scope of Practice

 

1.      Establishes that practice as a certified CHW includes the following:

a)      providing cultural mediation among individuals, communities and health and social service systems;

b)      providing culturally and linguistically appropriate health education and information;

c)      providing care coordination, case management and system navigation;

d)      providing coaching and social support;

e)      advocating for individuals and communities;

f)       building individual and community capacity;

g)      providing direct services, including home-based services, that are consistent with the education and training required for certification of CHWs;

h)      implementing individual environmental analyses and community needs assessments;

i)       conducting outreach; and

j)       participating in evaluation and research.

 

Certification

 

2.      Permits a person to apply to the Director of the Department of Health Services (Director) for a certificate to practice as a certified CHW on a form prescribed by the Director.

 

3.      Requires the Director to grant a CHW certificate to an individual who meets prescribed

qualifications and who pays applicable fees.

 

4.      Establishes that a certificate is valid for two years and can be renewed every two years.

 

5.      Requires that renewal applications be filed at least 30 days, and not more than 60 days, before

a certificate expiration date.

 

6.      Requires the Director, by rule, to do the following;

a)      prescribe the core competencies of certified CHWs, including skills and areas of knowledge essential to expand health and wellness in diverse communities and to reduce health disparities;

b)      describe and define reasonable and necessary minimum qualifications for CHWs;

c)      establish standards and requirements for the establishment of CHW education and training

programs;

d)      adopt standards and requirements for the approval or acceptance of continuing education

courses and programs for certificate renewal;

e)      establish minimum education, training, experience and other qualifications that a certified CHW must possess to qualify as a trainer in any training or education program for certified CHWs; and

f)       establish criteria for granting, denying, suspending and revoking a certificate.

 

7.      Allows the Director to adopt rules that are necessary for the administration and enforcement of certified CHW requirements and rules, and that allow for reciprocity agreements including the Indian Health Service.

 

 

 

 

 

Enforcement

 

8.      Authorizes the Director to deny, suspend or revoke the certification of a CHW who does any of the following:

a)      violates requirements or rules related to certified CHWs;

b)      is convicted of a felony or misdemeanor involving moral turpitude; or

c)      indulges in conduct or practice that is detrimental to public health or safety.

 

9.      Permits the Director to deny a certificate without holding a hearing and allows an applicant to appeal a denial with the Office of Administrative Hearings, and requires the Director to conduct hearings to suspend or revoke certifications in accordance with administrative hearing requirements.

 

10.  Authorizes the Director to suspend or revoke a certificate permanently, or for any period of time, under any condition the Director deems appropriate, if the Director makes a determination that grounds exist to suspend or revoke a certificate after a hearing.

 

11.  Allows an applicant to appeal the final decision of the Director.

 

12.  Permits the Director to assess a civil penalty of up to $100 for each violation of requirements and rules governing CHW certification and specifies that each day a violation continues is a separate violation.

 

13.  Authorizes the Attorney General or county attorney to bring an enforcement action and stipulates that such actions must be filed in the superior court or justice court in the county where the violation occurred.

 

14.  Permits the Director to apply to the superior court for an injunction to restrain a person from violating requirements and rules related to CHWs, and directs the court to grant a temporary restraining order, preliminary injunction or permanent injunction without bond.

 

15.  Stipulates that a certified CHW who is employed by a tribe and who violates requirements and rules related to certified CHWs is under tribal government jurisdiction, and specifies that internal hearings, appeals or penalties resulting from disciplinary actions by a tribal government are final.

 

16.  Establishes that information provided to the Director regarding violations of rules and requirements by a CHW can result in the denial, suspension or revocation of a certification.

 

17.  Permits the Director to investigate information that indicates a violation of certified CHW rules and requirements and allows the Director to examine and copy documents and other evidence that related to the conduct or competency of a CHW. 

 

 

 

 

18.  Authorizes the Director, during an investigation or administrative proceeding, to do the following:

a)      issue subpoenas to compel the testimony of witnesses or demand the production of relevant evidence; and

b)      apply to the superior court for an order to compel compliance if a person refuses to comply with a subpoena.

 

19.  Stipulates that patient records kept by the Director related to an investigation are not a public document and requires that the names of patients whose records are reviewed during an investigation remain confidential.

 

20.  Classifies, as a class six felony, the following actions:

a)      obtaining a certificate as a CHW by fraud, intentional misrepresentation or deceit; and

b)      purporting to be a certified CHW without having the proper certification.

 

Miscellaneous

 

21.  Requires the Director to establish fees by rule.

 

22.  Permits the Director to accept gifts, grants or donations to cover costs related to regulating certified CHWs.

 

23.  Prohibits a person who is not a certified CHW from representing themselves as a certified CHW.

 

24.  States that CHWs are not required to obtain certification to practice.

 

25.  Establishes the nine-member Community Health Workers Advisory Council (Council) and requires the Council to make recommendations to DHS regarding the following:

a)      core competencies for the certification of CHWs;

b)      minimum education and training qualifications for certified CHWs;

c)      standards and requirements for CHW education and training programs;

d)      standards and requirements for continuing education courses and programs;

e)      minimum education and training requirements for educators;

f)       the type of certification examination or other means to assess CHW competency for certification;

g)      standards for unprofessional conduct; and

h)      any other matter requested by the Director.

 

26.  Repeals the Council on January 1, 2023.

 

27.  Defines relevant terms.

 

28.  Becomes effective on the general effective date

 

 

 

House Action

 

HEALTH        2/01/18            DPA    8-0-0-1

3rd Read          2/21/18                        56-1-3

 

Prepared by Senate Research

March 5, 2018

CRS/lat