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The 193rd General Court of the Commonwealth of Massachusetts

AN ACT ESTABLISHING A BOARD OF CERTIFICATION OF COMMUNITY HEALTH WORKERS.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same as follows:

SECTION 1. Section 9 of chapter 13 of the General Laws, as amended by section 29 of chapter 4 of the acts of 2009, is hereby further amended by inserting after the word “counselors”, in line 7, the following words:- , the board of certification of community health workers.

SECTION 2. Said chapter 13 is hereby further amended by adding the following 3 sections:-

Section 106. There shall be a board of certification of community health workers, called the board in sections 106 to 108, inclusive. The board shall consist of 11 members who shall be residents of the commonwealth, 1 of whom shall be the commissioner of public health or the designee thereof, who shall serve as chair of the board, and 10 of whom shall be appointed by the governor. Of the appointed members of the board, 6 shall be appointed to ensure representation of all 6 geographic regions of the executive office of health and human services and shall include not fewer than 4 community health workers selected from recommendations offered by the Massachusetts Association of Community Health Workers; 1 shall represent a community health worker training organization; 1 shall represent the Massachusetts Public Health Association; 1 shall represent the Massachusetts Association of Health Plans; 1 shall represent the Massachusetts League of Community Health Centers; 1 shall represent a community-based community health worker employer; and 1 shall represent the public, subject to section 9B of chapter 13, and shall be familiar with community health worker services. Board members initially appointed to the board as community health workers shall be persons who are eligible for board certification as community health workers and shall obtain such certification within a time frame specified in regulations adopted by the board.

The term of office of each appointed member of the board shall be 3 years, except that of the initially appointed members of the board of which 3 members shall be appointed for terms of 1 year, 3 members for terms of 2 years, and 3 members for terms of 3 years, at least 1 of which is a community health worker. No member shall be appointed to more than 2 consecutive full terms; provided, however, a member appointed for less than a full term may serve 2 full terms and a former member shall again be eligible for appointment after a lapse of 1 or more years. Upon the expiration of his term of office, a member of the board shall continue to serve until the appointment of a successor. Any member of the board may be removed by the governor for neglect of duty, misconduct, malfeasance or misfeasance in office after being given a written statement of the charges against him and sufficient opportunity to be heard thereon. Upon the death, resignation or removal for cause of any member of the board, the governor shall fill the vacancy for the remainder of that member's term.

Section 107. The board shall meet at least quarterly or more often upon the call of the chair at such times and places as the chair shall designate. The board shall, at its first meeting and annually thereafter, elect from among its members a vice-chair and a secretary. Such officers shall serve until their successors are elected and qualified. A quorum of the board shall consist of a majority of the members. The board shall keep records and minutes as are necessary to carry out its duties and as otherwise required by law. Board members shall serve without compensation, but shall be reimbursed for actual and reasonable expenses incurred in the performance of their official duties. The board shall be supported with a director, administrative assistant and such other professional staff and operating expenses as are required to discharge its duties.

Section 108. In addition to the powers and duties set forth in sections 106 and 107, the board shall have the following powers and duties:
(a) to develop and administer a program for certification of community health workers, and to establish education, training, experience and other qualifications for such certification, application requirements and standards for practice as a certified community health worker;
(b) to set standards and requirements for the establishment, board evaluation and board approval or board acceptance of community health worker education and training programs in the commonwealth, the successful completion of which shall make individuals eligible to apply to the board for certification as a community health worker;
(c) to set standards and requirements for approval or acceptance of continuing education courses and programs as the board may require for the biennial renewal of a community health worker certificate;
(d) to establish minimum education, training, experience and other qualifications that a certified community health worker shall possess to qualify as a trainer in any education, training or continuing education program for community health workers approved or accepted by the board;
(e) to establish a means to acknowledge, document and assess relevant education, training, experience, mastery of core competencies or other qualifications acquired by community health workers practicing in the commonwealth before the effective dates of sections 106 to 108, inclusive, and sections 259 to 262, inclusive, of chapter 112 for purposes of certification without completion of a community health worker education and training program approved or accepted by the board;
(f) to establish and implement procedures for receipt, review and action upon applications for certification as a community health worker and the biennial renewal thereof, for which the board may require documentation of completion of continuing education, and the issuance of certificates of competency to practice as a community health worker;
(g) to make, adopt, amend, repeal and enforce such rules and regulations consistent with law as it deems necessary for the protection of the public health, safety and welfare and for the proper administration and enforcement of its responsibilities;
(h) to collect reasonable fees established pursuant to section 3B of chapter 7 and to deposit such fees into the Quality in Health Professions Trust Fund pursuant to section 35X of chapter 10 to support board operations and administration;
(i) to identify and adopt a certification examination or other means to assess community health worker competency in connection with board certification, should the board determine that such examination would enhance the advancement of the practice and profession of community health workers;
(j) to establish tiered classes or levels of practice as a certified community health worker and certification requirements for each established class or level, including a class or level which qualifies a board-certified community health worker to act as a trainer in an education, training or continuing education program approved or accepted by the board, for the purpose of enhancing career advancement as such tiered classes or levels of practice may be determined necessary by the board for that purpose following study and assessment by the board, with the assistance and advice of interested parties;
(k) to certify as a community health worker an applicant who has been duly certified as a community health worker under the laws of another state, territory or commonwealth of the United States or the District of Columbia where the requirements for certification are, in the opinion of the board, equivalent to those in the commonwealth for community health workers and such applicant submits documentation satisfactory to the board of such certification and the requirements therefor;
(l) to establish grounds for complaints related to the practice of community health workers and to establish and implement procedures for the review, investigation and resolution of such complaints;
(m) to establish the disciplinary actions available to the board in connection with complaint resolution, which may include a fine, reprimand, probation or censure or suspension, revocation or denial of a certificate issued by the board or a combination of the foregoing and to discipline certificate holders in accordance with procedures established by the board that shall conform with chapter 30A and 801 CMR 1.01 et seq.;
(n) to perform such other functions and duties as may be required to carry out this section.

SECTION 3. Chapter 112 of the General Laws is hereby amended by adding the following 4 sections:-

Section 259. The following words as used in sections 259 to 262, inclusive, unless the context otherwise requires, shall have the following meanings:-

“Board”, the board of certification of community health workers.

“Board-approved education and training program”, a training and education program for community health workers that meets standards established by the board for such education and training.

"Certificate", the document issued by the board to qualified applicants for certification as a community health worker.

"Certification", the voluntary process by which an agency grants recognition and use of a credential to individuals who have met predetermined and standardized requirements.

"Certified community health worker", a community health worker to whom the board has issued a certificate of competency to practice as a certified community health worker.

"Community health worker", a public health worker who applies his unique understanding of the experience, language and culture of the populations he serves through 1 or more of the following roles:

(a) providing culturally appropriate health education, information and outreach in community-based settings such as homes, schools, clinics, shelters, local businesses and community centers;
(b) bridging or culturally mediating between individuals, communities and health and human services, including actively building individual and community capacity;
(c) assuring that community members access the services they need;
(d) providing direct services, such as informal counseling, social support, care coordination and health screenings;
(e) advocating for individual and community needs; and
(f) additional roles as may be identified by the board that may emerge in the development of community health worker practice.
Community health workers may be distinguished from other health professionals in that they:
(a) are employed primarily for their understanding of, and connection with, the populations and communities they serve;
(b) conduct outreach during a significant portion of the time they provide services through 1 or more of the roles set forth in this section; and
(c) have experience providing services in community settings.

"Core competencies", a set of overlapping and mutually reinforcing skills and knowledge essential for effective community health work in core areas that include, but are not limited to:

(a) outreach methods and strategies;
(b) client and community assessment;
(c) effective communication;
(d) culturally-based communication and care;
(e) health education for behavior change;
(f) support, advocacy and coordination of care for clients;
(g) application of public health concepts and approaches;
(h) community capacity building; and
(i) writing and technical communication skills.

"Practice as a community health worker", use by a community health worker of the education, training and experience in the community health worker core competencies to effectively provide services to the communities and populations he serves through 1 or more of the roles of the community health worker.

Section 260. An application for certification as a community health worker shall be made on forms approved by the board, signed under the penalties of perjury by the person certifying the information contained therein and accompanied by the required fee. The fee for certification shall be determined by the secretary of administration and finance pursuant to section 3B of chapter 7. An applicant for certification as a community health worker shall furnish satisfactory proof that he is at least 18 years old, is of good moral character and has met all the education, training and experience requirements and qualifications as established by the board. Each certificate holder shall carry board-issued documentation of such certification, which shall be presented upon request in connection with practice as a certified community health worker.

Each certificate issued by the board shall be valid for 2 years and, if its holder desires to continue to use the title "certified community health worker" or to represent himself in any other way that he is so certified by the board, shall be timely renewed in accordance with procedures established by the board. Each renewal application submitted to the board shall be accompanied by a fee as determined by the secretary of administration and finance pursuant to section 3B of chapter 7.

Nothing in this section shall be construed as requiring reimbursement by the public employee plans in chapter 32A, an insurance company under chapter 175, a non-profit hospital corporation service plan as defined in chapter 176A, non-profit medical service plans under chapter 176B or a health maintenance organizations under chapter 176G.

Section 261. The title "certified community health worker" shall only be used by individuals who have met the requirements and qualifications for certification as a community health worker as established by the board and have been duly certified by the board. The use by any person not so certified of any words, letters, abbreviations or insignia indicating or implying a person holds such certification shall be in violation of this section for which the board may issue a cease and desist order and seek additional appropriate legal remedies.

Nothing in this section shall permit a certified community health worker to engage in or perform any act or service for which a license issued by a professional licensing board is required. Nothing in this section shall be construed to prevent or restrict the practice, service or activities of any person licensed, certified, or registered in the commonwealth under any laws other than board of certification of community health worker laws from engaging in activities within the scope of practice of the profession or occupation for which he is licensed, if he does not represent to the public, directly or indirectly, that he is certified under section 260 and does not use any name, title or designation indicating that the person is certified under said section 260.
Section 262. No person filing a complaint alleging a violation of law or of the regulations of the board, reporting information pursuant to such laws or regulations or assisting the board at its request in any manner in discharging its duties and functions shall be liable in any cause of action arising out of the board’s receipt of such information or assistance, if the person making the complaint, or reporting or providing such information or assistance, does so in good faith and without malice.

SECTION 4. This act shall take effect on January 1, 2012.

Approved, August 31, 2010.