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<chapter num="01" heading="Certification of Community Health Workers" title_num="10" subtitle_num="68">
  <regulation prefix="Regulation" num=".01" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Accreditation” means the approval a community health worker certification training program receives when it has met all the requirements of this chapter.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Accredited community health worker certification training program” means a community health worker certification training program that has been accredited by the Maryland Department of Health.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Applicant” means an individual who applies to the Maryland Department of Health to obtain a community health worker certificate.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Certificate” means a certificate issued by the Department to authorize an individual who meets the requirements of this chapter to represent to the public as a certified community health worker in the State.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Certified community health worker (CCHW)” means an individual who has successfully met the requirements stated in this chapter.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Community health worker (CHW)” has the meaning set forth in Health-General Article, §13-3701, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“Core competencies” means:</text>
        <paragraph num="(a)">
          <text>Advocacy and community capacity building skills;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Effective oral and written communication skills;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Cultural competency;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Understanding of ethics and confidentiality issues;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Knowledge of local resources and system navigation;</text>
        </paragraph>
        <paragraph num="(f)">
          <text>Care coordination support skills;</text>
        </paragraph>
        <paragraph num="(g)">
          <text>Teaching skills to promote healthy behavior change;</text>
        </paragraph>
        <paragraph num="(h)">
          <text>Outreach methods and strategies; and</text>
        </paragraph>
        <paragraph num="(i)">
          <text>Understanding of public health concepts and health literacy.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(8)">
        <text>“Department” means the Maryland Department of Health.</text>
      </paragraph>
      <paragraph num="(9)">
        <text>“Professional development activities” means knowledge and skill building opportunities related to the core competencies of community health workers or health principles that may include:</text>
        <paragraph num="(a)">
          <text>Courses;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Webinars;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Conferences;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Workshops;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Trainings; or</text>
        </paragraph>
        <paragraph num="(f)">
          <text>Lectures.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(10)">
        <text>“Secretary” means the Secretary of the Maryland Department of Health.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Application Procedures.">
    <paragraph num="A.">
      <text>Qualified Community Health Worker Applicant. A qualified community health worker applicant is an individual who:</text>
      <paragraph num="(1)">
        <text>Has successfully completed a CHW certification training program that is accredited by the Department; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Is eligible to be exempt from the training requirements as set forth in Regulation .03C of this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>To obtain a community health worker certification, the applicant shall submit to the Department:</text>
      <paragraph num="(1)">
        <text>A completed application on a form provided by the Department;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>An initial application fee set by the Department in regulation; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Documentation of training or training exemption requirements set forth in this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Incomplete Applications.</text>
      <paragraph num="(1)">
        <text>An application is not complete until the Department has received all the materials required under this chapter.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>If an incomplete application is submitted to the Department, the Department shall:</text>
        <paragraph num="(a)">
          <text>Notify the applicant within 30 calendar days after receipt of the incomplete application; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Specify the materials required to be submitted to complete the application.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>If the applicant fails to provide the required documentation within 120 calendar days of notification, the Department may:</text>
        <paragraph num="(a)">
          <text>Administratively close the application; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Deny the application, pursuant to the requirements set forth in this chapter.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>The Department may not refund a fee if an application is administratively closed or denied.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>An applicant whose application is administratively closed or denied may reapply and submit with the new application documentation in compliance with the requirements of this chapter.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Applicant Age, Training, and Experience Requirements.">
    <paragraph num="A.">
      <text>Age Requirement. An individual seeking community health worker certification shall be 18 years old or older.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Certification by Completion of a CHW Certification Training Program Accredited by the Department. An applicant for community health worker certification shall:</text>
      <paragraph num="(1)">
        <text>Provide documentation of successful completion of an accredited CHW certification training program as set forth in this chapter; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Possess a high school diploma or GED equivalent.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Exemption from Training Program Requirements.</text>
      <paragraph num="(1)">
        <text>The Department may exempt an individual occupied as a CHW on October 1, 2018, from the training program requirements set forth in this chapter if the applicant provides documentation of:</text>
        <paragraph num="(a)">
          <text>The completion of a minimum of 2,000 hours of CHW paid or volunteer experience 5 years prior to:</text>
          <paragraph num="(i)">
            <text>October 1, 2018; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>The application date;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>A minimum of two letters of validation, on a form that the Department requires, from a current or former CHW employer, supervisor, or agency representative that recommend the individual for certification and validate the minimum of 2,000 hours of required experience; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Proficiency in core competencies to be detailed by the applicant and verified in writing by a CHW employer, supervisor, or agency representative.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>The deadline for submission of an application for exemption from the training program requirements under this section is March 31, 2020.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>An applicant may request an extension to submit an application, not to exceed 60 days, if:</text>
        <paragraph num="(a)">
          <text>The applicant submits documentation of good cause for an extension; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The Department determines that an extension is reasonable under the circumstances.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Action on Application.">
    <paragraph num="A.">
      <text>Upon review of a completed application, the Department shall:</text>
      <paragraph num="(1)">
        <text>Approve the issuance of a certificate to the applicant if the applicant meets the requirements specified in this chapter;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Request additional information to make a determination; or</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Deny the issuance of a certificate to the applicant.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Approval for Certification and Issuance of Certificate.</text>
      <paragraph num="(1)">
        <text>If the Department approves the issuance of a certificate to an applicant, the Department shall:</text>
        <paragraph num="(a)">
          <text>Send the applicant a written notice that the applicant is qualified for a certificate; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Issue a certificate to the applicant.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>The Department shall include on each certificate:</text>
        <paragraph num="(a)">
          <text>The full name of the certificate holder;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The dates of issuance and expiration;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>A serial number; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>The signature of the Department representative.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Denial of Issuance of Certificate.</text>
      <paragraph num="(1)">
        <text>The Department may deny the issuance of a certificate if it determines the applicant has:</text>
        <paragraph num="(a)">
          <text>Not met the age, training, or experience requirements as set forth in this chapter;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Failed to remit a fee; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Failed to complete the application form.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>If the Department denies the issuance of a certificate, the Department shall:</text>
        <paragraph num="(a)">
          <text>Send the applicant written notice of the Department’s denial of the issuance of a certificate, including specification of deficiencies; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Notify the applicant of the right to appeal the denial and to request a formal hearing.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>An applicant who has been denied the issuance of a certificate by the Department may reapply and submit new application documentation in compliance with the requirements of this chapter.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Appealing a Decision to Deny Issuance of a Certificate. An applicant may appeal the decision to deny issuance of a certificate by submitting a request in writing to the Department within 30 calendar days of the date on the notice of denial of certification.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>If an applicant submits an appeal, the Department, within 60 calendar days, shall:</text>
        <paragraph num="(a)">
          <text>Sustain or reverse the decision on the application; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Provide written notice to the applicant:</text>
          <paragraph num="(i)">
            <text>Indicating whether the decision on the application has been sustained or reversed; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Providing an explanation of the decision.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>The Department may not refund a fee if the certification is denied.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>An applicant may request a hearing within 10 calendar days after the date of written notice of the Department’s denial of the issuance of a certificate. When the Department receives the request, it will follow hearing procedures in accordance with COMAR 10.01.03.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Certification Representation.">
    <text>An individual shall be certified by the Department before the individual may represent to the public that the individual is a certified community health worker.</text>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Requirement to Update Contact Information.">
    <text>An individual certified by the Department shall inform the Department, within a reasonable time period, of any changes to the certificate holder’s name and contact information.</text>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Expiration and Renewal.">
    <paragraph num="A.">
      <text>Unless the Department suspends or revokes the certificate, the certificate:</text>
      <paragraph num="(1)">
        <text>Is effective for 2 years from the date issued; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Authorizes the individual to represent to the public that the individual is a certified community health worker.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>At least 90 calendar days before the certificate expires, the Department shall send to the certified community health worker, by electronic or first-class mail to the last known electronic or physical address, a renewal notice that states:</text>
      <paragraph num="(1)">
        <text>The date on which the current certificate expires;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Any required renewal submission requirements;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The date by which the renewal application shall be received by the Department for the renewal to be issued; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>The amount of a renewal fee.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>The certificate holder shall notify the Department if a renewal notice is not received within 60 calendar days before the required renewal date.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The Department shall renew the certificate of a certified community health worker who:</text>
      <paragraph num="(1)">
        <text>Is eligible to obtain a certificate;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Pays to the Department a renewal fee set by the Department in regulation; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Submits to the Department:</text>
        <paragraph num="(a)">
          <text>A renewal application on the form required by the Department; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Satisfactory documentation of completion of 20 hours of a broad range of professional development activities that include a written explanation of acquired knowledge and/or skill application of duties on a form that the Department requires.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Renewal applications shall be received 30 calendar days prior to the expiration date.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Reinstatement of Certificate Due to Nonrenewal.">
    <paragraph num="A.">
      <text>The Department shall reinstate the certificate of a community health worker who has failed to renew the certificate, if the individual:</text>
      <paragraph num="(1)">
        <text>Has not had the certificate suspended or revoked;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Submits to the Department documentation of:</text>
        <paragraph num="(a)">
          <text>Completion of 20 hours of a broad range of professional development activities; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A written explanation of acquired knowledge and/or skill application of duties within the 2-year period immediately preceding the date of renewal;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>Applies to the Department for reinstatement of the certificate before 2 years after the certificate expires;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Pays to the Department a renewal fee set by the Department in regulation; and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Meets the requirements for certification set forth by the Department.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>If a CHW is not eligible for reinstatement of a certificate under this chapter, the community health worker may be eligible for the issuance of a certificate by meeting the current requirements for obtaining a new certificate under this chapter.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="Suspension or Revocation of a Certificate.">
    <paragraph num="A.">
      <text>The Department may suspend or revoke the certificate of a community health worker who no longer meets the requirements established under this chapter.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Subject to the hearing provisions of COMAR 10.01.03, the Department may suspend or revoke a certificate if the individual:</text>
      <paragraph num="(1)">
        <text>Fraudulently or deceptively obtains or attempts to obtain a certificate for a community health worker or for another individual;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Fraudulently or deceptively uses a certificate;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Otherwise fails to meet substantially the standards for certification adopted under this chapter;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Is convicted of or pleads guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Performs the duties of a community health worker while:</text>
        <paragraph num="(a)">
          <text>Under the influence of alcohol; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Using any narcotic or controlled dangerous substance, as defined in Criminal Law Article, §5–101, Annotated Code of Maryland, or other drug that is in excess of therapeutic amounts or without valid medical indication;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>Is disciplined by a licensing or disciplinary authority of any other state or country or convicted or disciplined by a court of any state, territory, or country for an act that would be grounds for suspension or revocation action under this title;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Performs the duties of a certified community health worker with an unauthorized person or supervises or aids an unauthorized person in performing the duties of a certified community health worker;</text>
      </paragraph>
      <paragraph num="(8)">
        <text>Willfully makes or files a false report or record while performing the duties of a certified community health worker;</text>
      </paragraph>
      <paragraph num="(9)">
        <text>Willfully fails to file or record any report as required under law, willfully impedes or obstructs the filing or recording of the report, or induces another to fail to file or record the report;</text>
      </paragraph>
      <paragraph num="(10)">
        <text>Commits an act of unprofessional conduct in performing the duties of a community health worker;</text>
      </paragraph>
      <paragraph num="(11)">
        <text>Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the individual is certified and qualified to render because of the individual’s race, sex, creed, color, national origin, marital status, sexual orientation, age, gender identity, or disability; or</text>
      </paragraph>
      <paragraph num="(12)">
        <text>Fails to maintain on file with the Department a current resident address or employment address or notify the Department when the residency or place of employment changes.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>The Department shall proceed with the suspension or revocation in accordance with the provisions in COMAR 10.01.03.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The Department shall send written notice of intent to suspend or revoke a certificate to the individual and identify the specific deficiencies.</text>
    </paragraph>
    <paragraph num="E.">
      <text>Within 30 calendar days after receipt of written notice, the individual may submit to the Department:</text>
      <paragraph num="(1)">
        <text>A written plan by the individual to meet the applicable deficiencies; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>A written response setting forth documentation that the individual is meeting and maintaining each of the applicable requirements as set forth in this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="F.">
      <text>Based on deficiencies and the individual’s response, if any, the Department may suspend, revoke, or reinstate a certificate.</text>
    </paragraph>
    <paragraph num="G.">
      <text>Appealing the Decision to Suspend or Revoke a Certificate.</text>
      <paragraph num="(1)">
        <text>An individual may appeal the decision to suspend or revoke a certificate by submitting a request in writing to the Department within 30 calendar days of the date on the notice of suspension or revocation of a certificate.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>If an individual submits an appeal, the Department, within 60 calendar days, shall:</text>
        <paragraph num="(a)">
          <text>Grant or deny the appeal; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Send individual written notice:</text>
          <paragraph num="(i)">
            <text>Indicating whether the appeal has been granted or denied; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Providing an explanation of the decision.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>The Department may not refund a fee if a certification is suspended or revoked.</text>
      </paragraph>
    </paragraph>
    <paragraph num="H.">
      <text>An individual may request a hearing within 10 calendar days after receipt of written notice.</text>
    </paragraph>
    <paragraph num="I.">
      <text>When the Department receives the request, it will follow hearing procedures in accordance with COMAR 10.01.03.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health-General Article, §13-3705, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: December 30, 2019 (46:26 Md. R. 1166)</annotation>
  </annotations>
</chapter>