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<chapter num="02" heading="Community Health Worker Certification Training Programs" 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 a community health worker training program that applies to the Maryland Department of Health for accreditation.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Community health worker (CHW)” has the meaning set forth in Health-General Article, §13-3701, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Community health worker certification training program” means a training program that has been accredited by the Department.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Department” means the Maryland Department of Health.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“Review Committee” means the CHW Training Program Application Review Committee.</text>
      </paragraph>
      <paragraph num="(8)">
        <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>Accreditation Requirements.</text>
      <paragraph num="(1)">
        <text>All CHW certification training programs shall be accredited by the Department.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The accreditation shall be issued before an organization may offer a CHW certification training program.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>To obtain accreditation of a CHW certification training program, an organization shall:</text>
      <paragraph num="(1)">
        <text>Obtain the CHW certification training program requirements and a program application from the Department;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Submit to the Department an application; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Pay to the Department a fee set by the Department in regulation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>A CHW certification training program that was in operation on or before October 1, 2018:</text>
      <paragraph num="(1)">
        <text>Will be notified by the Department by certified mail, electronic mail, or MDH website posting of the training program requirements for accreditation set forth in this chapter;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Shall comply with the accreditation requirements; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Shall complete an application for accreditation as set forth in this chapter by December 31, 2020.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>A CHW certification training program that trained individuals from October 1, 2018, through December 31, 2020, will be eligible to apply for accreditation for that time period if the training program:</text>
      <paragraph num="(1)">
        <text>Meets the CHW certified training program requirements as set forth in Regulation .03 of this chapter;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Submits to the Department an application;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Pays to the Department a fee set by the Department in regulation;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Becomes an accredited training program; and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Provides a list of students who successfully completed the training program during the stated time period.</text>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>The Department may provide technical assistance to CHW certification training programs to meet the requirements set forth in this chapter.</text>
    </paragraph>
    <paragraph num="F.">
      <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 notify the applicant within 30 calendar days after receipt of the incomplete application of the materials that are required to be submitted to complete the application.</text>
      </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 Regulation .04D of this chapter.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <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="Training Program Requirements.">
    <paragraph num="A.">
      <text>A CHW certification training program shall:</text>
      <paragraph num="(1)">
        <text>Provide a minimum of 100 hours of instruction;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Verify successful completion of an additional supervised 40-hour practicum by a student;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Employ a curriculum framework that incorporates, at a minimum, the following core competencies:</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; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>Include an objective knowledge assessment.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>To complete an accredited CHW certification training program, a student shall successfully meet all requirements of the program.</text>
    </paragraph>
    <paragraph num="C.">
      <text>Each accredited CHW certification training program shall submit to the Department, as requested, information on the program.</text>
    </paragraph>
    <paragraph num="D.">
      <text>Without the Department’s approval, an accredited CHW certification training program may not substantively modify an accredited curriculum in a way that results in the curriculum no longer satisfying the core competency requirements.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Action on Application.">
    <paragraph num="A.">
      <text>Application Review. Upon receipt of a completed application, the Department shall:</text>
      <paragraph num="(1)">
        <text>Accept and review applications for accreditation of a CHW certification training program in accordance with a schedule established by the Department and made publicly available;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Acknowledge receipt of an application within 10 calendar days after receiving the application;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Act on an application within 60 calendar days after the training program has met all the application requirements; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Make a decision regarding application accreditation within 120 calendar days.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Application Review Committee.</text>
      <paragraph num="(1)">
        <text>Training program applications will be reviewed by a Community Health Worker Training Program Application Review Committee consisting of:</text>
        <paragraph num="(a)">
          <text>A community health worker;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A State Community Health Worker Advisory Committee member;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>A health professions educator with expertise in curriculum development;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>AN MDH CHW certification program staff member; and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>As deemed necessary by the Department, an MDH program staff member with subject matter expertise in specialty areas.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Individuals will be selected for the Training Program Application Review Committee by the Secretary after review of an application.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The Review Committee shall review training program applications to determine whether a training program application meets the requirements set forth in this chapter.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>The Review Committee shall forward recommendations for accreditation of eligible training programs to the Secretary.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>The Secretary may approve and direct the Department to accredit a training program if the training program:</text>
        <paragraph num="(a)">
          <text>Satisfies the requirements set forth in this chapter;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Pays to the Department a fee set by the Department in regulation; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Participates in an on-site visit, if deemed necessary by the Department.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Approval of Accreditation Application. If the Department accredits a training program, the Department shall send the applicant written notice that the program is accredited.</text>
    </paragraph>
    <paragraph num="D.">
      <text>Denial of Accreditation Application.</text>
      <paragraph num="(1)">
        <text>The Department may deny accreditation if it determines that the training program has:</text>
        <paragraph num="(a)">
          <text>Not complied fully with the applicable requirements described 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 accreditation, the Department shall:</text>
        <paragraph num="(a)">
          <text>Send the applicant written notice of the Department’s denial of accreditation, including specific 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>Within 30 calendar days after receipt of the denial, the training program may submit to the Department either:</text>
        <paragraph num="(a)">
          <text>A written plan that sets forth the steps taken by the program to meet the applicable requirements described in this chapter; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A written response setting forth documentation that the program is meeting and maintaining each of the applicable requirements described in this chapter.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>Based on the deficiencies and the program’s written response, if any, the Department may approve or deny the application.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Appealing a Decision to Deny an Application for Accreditation. A CHW certification training program may appeal the decision to deny an application by submitting the request in writing to the Department within 30 calendar days of the date on the notice of denial of application.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>If a CHW certification training program 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>Provide written notice to the applicant:</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="(7)">
        <text>The Department may not refund a fee if an accreditation is denied.</text>
      </paragraph>
      <paragraph num="(8)">
        <text>An applicant may request a hearing within 10 calendar days after receipt of written notice of the Department’s denial. After receiving the request, the Department shall follow hearing procedures in accordance with COMAR 10.01.03.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Expiration and Renewal.">
    <paragraph num="A.">
      <text>Unless the Department suspends or revokes a CHW certification training program accreditation, the accreditation is effective for 3 years from the date issued.</text>
    </paragraph>
    <paragraph num="B.">
      <text>At least 90 calendar days before the accreditation expires, the Department shall send to the accredited CHW certification training program 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 accreditation 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 accredited CHW certification training program shall notify the Department if a renewal notice is not received within 60 calendar days of the renewal date.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The Department shall renew the accredited CHW certification training program that:</text>
      <paragraph num="(1)">
        <text>Is eligible to obtain accreditation;</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 a renewal application on a form that the Department requires.</text>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Renewal applications received less than 30 calendar days before the expiration date may not be processed before the expiration date.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Reinstatement of Accreditation Due to Nonrenewal.">
    <paragraph num="A.">
      <text>The Department shall reinstate the accreditation of a CHW certification training program that has failed to renew their accreditation, if the program:</text>
      <paragraph num="(1)">
        <text>Has not had the accreditation suspended or revoked;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Applies to the Department for reinstatement of the accreditation before 2 years after the accreditation expires;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Pays to the Department a renewal fee set by the Department in regulation; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Meets the requirements for accreditation set forth by the Department.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>If a CHW certification training program is not eligible for reinstatement of accreditation under this chapter, the program may be eligible for accreditation by meeting the current requirements for obtaining a new accreditation under this chapter.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Suspension or Revocation of Accreditation of a Training Program.">
    <paragraph num="A.">
      <text>The Department may suspend or revoke the accreditation from any program which:</text>
      <paragraph num="(1)">
        <text>No longer meets the requirements established under this chapter;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Fails to submit in a timely manner:</text>
        <paragraph num="(a)">
          <text>Any information requested by the Department; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Notification of curriculum modification;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>Falsifies training program information; or</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Fails to comply with applicable laws or regulations.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>The Department shall proceed with the suspension or revocation in accordance with the provisions in COMAR 10.01.03.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The Department shall send written notice of the suspension or revocation of accreditation to the training program and identify the specific deficiencies.</text>
    </paragraph>
    <paragraph num="D.">
      <text>Within 30 calendar days after receipt of written notice, the CHW certification training program may submit to the Department:</text>
      <paragraph num="(1)">
        <text>A written plan by the CHW certification training program to meet the applicable deficiencies; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>A written response setting forth documentation that the program is meeting and maintaining each of the applicable requirements described in this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Based on deficiencies and the program’s response, if any, the Department may suspend, revoke or reinstate accreditation.</text>
    </paragraph>
    <paragraph num="F.">
      <text>Appealing a Decision to Suspend or Revoke Accreditation.</text>
      <paragraph num="(1)">
        <text>A CHW certification training program may appeal the decision to suspend or revoke the accreditation by submitting a request in writing to the Department within 30 calendar days of the date on the notice of suspension or revocation of accreditation.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>If a CHW certification training program submits an appeal, the Department shall within 60 calendar days:</text>
        <paragraph num="(a)">
          <text>Grant or deny the appeal; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Respond in writing to the applicant:</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 an accreditation is suspended or revoked.</text>
      </paragraph>
    </paragraph>
    <paragraph num="G.">
      <text>An applicant may request a hearing within 10 calendar days after receipt of written notice.</text>
    </paragraph>
    <paragraph num="H.">
      <text>After receiving the request, the Department shall 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>