Assigned to HHS & COMPS AS
PASSED BY COW
Assigned to HHS & COMPS AS
PASSED BY COW
ARIZONA STATE SENATE
Fifty-Third Legislature, Second Regular Session
AMENDED
community health workers; voluntary certification
Purpose
Establishes 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
Certification
1. 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.
2. Requires the Director to grant a CHW certificate to an individual who meets prescribed
qualifications and who pays applicable fees.
3. Establishes that a certificate is valid for two years and can be renewed every two years.
4. Requires that renewal applications be filed at least 30 days, and not more than 60 days, before
a certificate expiration date.
5. Requires the Director, by rule, to do the following;
a) prescribe the scope of practice and 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 education and training 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.
6. Requires the Director to waive minimum training and education requirements for applicants who provide documentation of at least 960 hours of experience providing CHW services in the core competencies during the previous three years in a licensed health care facility or in the service of a licensed health care provider or contractor.
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, suspend or revoke a certificate without holding a hearing and allows an applicant to request a hearing with the Office of Administrative Hearings.
10. Requires the Director to conduct hearings to deny, suspend or revoke certifications in accordance with administrative hearing requirements.
11. Authorizes the Director to deny, 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 deny, suspend or revoke a certificate.
12. 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.
13. 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.
Miscellaneous
14. Requires the Director to establish fees by rule and directs the Department of Health Services (DHS) to deposit certification fees into a segregated account in the Health Services Licensing Fund.
15. States that CHWs are not required to obtain certification to practice.
16. 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.
17. Precludes the state and its political subdivisions from providing a preference in awarding public contracts for services provided by a certified CHW or an entity that employs certified CHWs.
18. Repeals the Council on January 1, 2023.
19. Defines relevant terms.
20. Becomes effective on the general effective date.
Amendments Adopted by the Health and Human Services Committee
1. Eliminates language establishing CHW scope of practice and instead allows the Director to establish the CHW scope of practice.
2. Removes language regarding certification denials and disciplinary actions.
3. Allows the Director to suspend, deny or revoke a certification and permits an applicant to request a hearing.
4. Makes technical and conforming changes.
Amendments Adopted by the Commerce and Public Safety Committee
1. Eliminates language establishing CHW scope of practice and instead allows the Director to establish the CHW scope of practice.
2. Removes language regarding certification denials and disciplinary actions.
3. Allows the Director to suspend, deny or revoke a certification and permits an applicant to request a hearing.
4. Removes language classifying fraudulently representing one's self as a CHW as a felony.
5. Directs DHS to deposit certification fees in a segregated account in the Health Services Licensing Fund.
6. Makes technical and conforming changes.
Amendments Adopted by Committee of the Whole
1. Health and Human Services Committee amendment was withdrawn.
2. Authorizes the Director of DHS to establish rules that prescribe minimum education and training requirements for CHWs.
3.
Requires the Director to waive training and education requirements for
an applicant who meets certain criteria.
4. Precludes the state and its political subdivisions from providing a preference in when awarding contracts for services provided by CHWs or entities that employ CHWs.
5. Makes technical and conforming changes.
House Action Senate Action
HEALTH 2/01/18 DPA 8-0-0-1 HHS 3/7/18 DPA 5-2-0
3rd Read 2/21/18 56-1-3 COMPS 3/12/18 DPA 7-0-1
Prepared by Senate Research
April 2, 2018
CRS/lat