Title 902 | Chapter 021 | Regulation 040


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CABINET FOR HEALTH AND FAMILY SERVICES
Department for Public Health
Division of Prevention and Quality Improvement
(New Administrative Regulation)

902 KAR 21:040.Community health worker certification.

Section 1.

Definitions.

(1)

"Applicant" means an individual applying to be certified or recertified as a community health worker;

(2)

"Certification" means the voluntary process by which the department grants recognition and use of a credential to individuals who are eligible to practice as certified community health workers;

(3)

"Certified community health worker" or "CCHW" is defined by Ky Acts ch. 86.

(4)

"Code of ethics" means the commonly understood principles and practices that all health and social service professionals are subject to. The Community Health Worker (CHW) code of ethics is maintained by the Kentucky Office of Community Health Workers and is available at https://chfs.ky.gov/agencies/dph/dpqi/cdpb/Pages/chwp.aspx.

(5)

"Core competencies" means the knowledge and skills gained through education and experience, and includes:

(a)

Communication;

(b)

Use of public health concepts and approaches;

(c)

Organizational and community outreach;

(d)

Advocacy and community capacity building;

(e)

Care coordination and system navigation;

(f)

Health coaching;

(g)

Documentation, reporting, and outcome management; and

(h)

Legal, ethical, and professional conduct.

(6)

"Department" means the Kentucky Department for Public Health.

(7)

"Program" means the Kentucky Office of Community Health Workers (KOCHW) in the Department for Public Health.

(8)

"Verifiable employment" means employment that can be confirmed by the department and that demonstrates achievement of a minimum standard of proficiency in the core competencies.

Section 2.

Application for Initial Certification.

(1)

An applicant for initial certification as a certified community health worker shall meet the qualifications listed in Ky Acts ch. 86.

(2)

Applications shall be submitted to the program for review and approval.

(3)

All applications shall include a color photograph of the applicant.

(4)

A nonrefundable application fee of fifty (50) dollars by check or money order made payable to the Kentucky State Treasurer shall be submitted to the program.

(5)

The application shall not be considered complete and shall not be processed until all information and any subsequent documentation requested by the program is provided.

(6)

If an application is denied, the applicant shall be notified in writing of the decision and given the opportunity to reapply or appeal the denial decision.

(7)

Once an application is approved, a certificate with a certificate number shall be issued.

Section 3.

Certified Community Health Worker Eligibility.

(1)

An applicant for certification as a community health worker may be eligible based on training or verifiable employment.

(2)

To be eligible based on training, the applicant shall submit:

(a)

Documentation of successful completion of a competency-based training program by a KOCHW approved organization. Training must be completed within three (3) years prior to application; and

(b)

Documentation of successful completion of a minimum of forty (40) hours of verifiable mentorship completed within three (3) years prior to application.

(3)

To be eligible based on experience the applicant shall have a minimum of 2,500 hours of verifiable employment as a community health worker within three (3) years prior to application.

Section 4.

Renewal of a Current Certificate.

(1)

All certificates for CCHWs shall be renewed annually by October 31.

(2)

A CCHW who holds a current certificate and has completed the continuing education requirements for renewal in Section 6 of this administrative regulation may apply to renew their certificate by:

(a)

Submitting a complete application; and

(b)

Payment of the twenty-five (25) dollar renewal application fee by check or money order made payable to the Kentucky State Treasurer.

Section 5.

Extension for Renewal.

(1)

A CCHW may submit a written request for an extension to submit the renewal paperwork. This written request shall:

(a)

Be received by the program on or before October 31; and

(b)

Provide justification for the request.

(2)

The program may grant an extension beyond the October 31 deadline based on extenuating circumstances beyond the control of the CCHW.

(3)

The CCHW shall be notified in writing of the program's decision to grant or deny the extension.

(4)

Failure to submit the renewal or request an extension by the October 31 deadline shall result in expiration of the certificate.

Section 6.

Continuing Education Requirements.

(1)

Continuing education requirements for renewal shall be fulfilled during each annual renewal period.

(2)

A CCHW shall complete a minimum of ten (10) contact hours of continuing education related to the core competencies each annual renewal period.

(3)

Credit for semester hours taken at a college or university shall be:

(a)

Consistent with the community health worker core competencies; and

(b)

Approved at three (3) credits for each semester hour.

(4)

Continuing education courses may be:

(a)

Completed in person before a live presenter;

(b)

Through home or self-study; or

(c)

Delivered through electronic media or technology including distance learning, online, or teleconference.

(5)

Effective October 31, 2023, all CCHWs must complete a KOCHW approved training in oral healthcare, infant and maternal healthcare, and geriatric healthcare.

(a)

CHWs who hold a current certification must complete the training by October 2023 for renewal.

(b)

CHWs who become newly certified must complete the training within 12 months of certification.

(c)

These are one-time requirements and will not need to be repeated.

(6)

The program shall maintain a record of all approved community health worker training providers on the program's website.

(7)

Providers of approved curricula shall notify the program within twenty (20) business days of a trainee's successful completion of a community health worker training.

Section 7.

Certified Community Health Worker Scope of Practice. A certified community health worker may:

(1)

Provide cultural mediation among individuals, communities, and health and social service systems;

(2)

Provide culturally appropriate health education and information;

(3)

Provide care coordination, case management, and system navigation services;

(4)

Provide coaching and social support;

(5)

Advocate for individuals and communities;

(6)

Build individual and community capacity;

(7)

Provide direct services;

(8)

Implement individual and community assessments;

(9)

Conduct outreach; or

(10)

Participate in evaluation and research.

Section 8.

Complaint Procedures.

(1)

Any organization or individual may file a signed written complaint.

(2)

The complaint shall be sent to the Kentucky Office of Community Health Workers, 275 East Main Street, HS2W-E, Frankfort, Kentucky 40621 or by email at chw.certification@ky.gov, subject line "Community Health Worker Complaint".

(3)

The complaint shall include:

(a)

A statement that the CCHW has violated the requirements of this administrative regulation or the CHW code of ethics;

(b)

The facts on which the complaint is based; and

(c)

The signature and contact information for the complainant.

(4)

The program shall provide notice to the CCHW named in the complaint that a complaint has been filed and provide the CCHW an opportunity to respond to the complaint, including a proposal to resolve the complaint.

(5)

The alleged violation shall have occurred not more than one (1) year before the date that the complaint is received by the program.

(6)

Within sixty (60) calendar days after a complaint is filed, the program shall:

(a)

Carry out an independent investigation, if the program determines that an investigation is necessary;

(b)

Give the complainant the opportunity to submit additional information, either orally or in writing, about the allegations in the complaint;

(c)

Review all relevant information and make a determination as to whether the CCHW has violated the requirements of this administrative regulation or the code of ethics; and

(d)

Issue a written decision to the complainant that addresses each allegation in the complaint and contains the reasons for the program's final decision.

Section 9.

Denial, Suspension, and Revocation of a Certificate.

(1)

The program reserves the right to:

(a)

Deny an application for certification or renewal; and

(b)

Conduct an audit of a CCHW.

(2)

Written notice of the denial of an application for certification or renewal shall be provided to the applicant and include:

(a)

The applicant's opportunity to reapply; or

(b)

Right to appeal.

(3)

A request to appeal the denial of a certificate shall be submitted to the department within ten (10) days from the date listed on the written notice issued pursuant to subsection (2) of this section and provide evidence that the denial was in error.

(4)

The department shall re-evaluate the evidence and issue a final notice to the applicant within ten (10) days.

(5)

An applicant whose application is denied following the appeal shall be ineligible to apply for a period of one (1) year following the final notice of denial.

(6)

A certificate may be suspended if:

(a)

Audit findings show the CCHW has violated the requirements of the program; or

(b)

The CCHW is found in violation of the CHW code of ethics.

(7)

Written notice of the suspension shall be provided to the CCHW and include the right to appeal.

(8)

A request to appeal the suspension shall be submitted to the program within ten (10) days of the notice and include evidence that the suspension is in error or the reason for the suspension has been corrected.

(9)

Failure to submit a request to appeal the suspension within ten (10) days shall result in permanent suspension of the certificate.

(10)

A certificate that has been suspended for one (1) year shall be considered revoked.

(11)

During the period of suspension, the CCHW shall return the certification and identification card to the program and shall not engage in the practice of community health work until the suspension is lifted or further disciplinary action is taken.

(12)

A certificate shall be revoked for repeated violations of the requirements of this administrative regulation or the CHW code of ethics.

(13)

Written notice of the revocation shall be provided to the CCHW and include the right to request a hearing in accordance with KRS Chapter 13B.

STEVEN J. STACK, MD, MBA, Commissioner
ERIC C. FRIEDLANDER, Secretary
APPROVED BY AGENCY: June 28, 2022
FILED WITH LRC: July 11, 2022 at 10:30 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall, if requested, be held on September 26, 2022, at 9:00 a.m. using the CHFS Office of Legislative and Regulatory Affairs Zoom meeting room. The Zoom invitation will be emailed to each requestor the week prior to the scheduled hearing. Individuals interested in attending this virtual hearing shall notify this agency in writing by September 19, 2022, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who attends virtually will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on this proposed administrative regulation until September 30, 2022. Send written notification of intent to attend the public hearing or written comments on the proposed administrative regulation to the contact person. Pursuant to KRS 13A.280(8), copies of the statement of consideration and, if applicable, the amended after comments version of the administrative regulation shall be made available upon request.
CONTACT PERSON: Krista Quarles, Policy Analyst, Office of Legislative and Regulatory Affairs, 275 East Main Street 5 W-A, Frankfort, Kentucky 40621; phone 502-564-6746; fax 502-564-7091; email CHFSregs@ky.gov.

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Julie Brooks or Krista Quarles
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes the initial and renewal certification process for certified community health workers including the process for certification suspension or revocation, and outlines the core competencies and scope of practice.
(b) The necessity of this administrative regulation:
2022 Ky. Acts ch. 86 authorizes the department to promulgate administrative regulations for the initial and renewal certification process including the required fee, the core competencies, continuing education requirements, scope of practice for certified community health workers, and the certification suspension, denial and revocation.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation outlines the application requirements, the core competencies and scope of practice for a community health worker. This administrative regulation provides the appeal process for an individual whose application has been denied, or current certification suspended or revoked.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation will ensure individuals currently certified as a community health worker understand the core competencies and the scope of practice. It will ensure those seeking initial certification are aware of the training and employment requirements.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This is a new administrative regulation.
(b) The necessity of the amendment to this administrative regulation:
This is a new administrative regulation.
(c) How the amendment conforms to the content of the authorizing statutes:
This is a new administrative regulation.
(d) How the amendment will assist in the effective administration of the statutes:
This is a new administrative regulation.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
Currently there are eighty-five (85) certified community health workers.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Individuals who are currently certified as a community health worker will need to be aware of the recertification requirements. Individuals seeking initial certification will need to be aware of the initial certification eligibility and application process. All certified community health workers will need to be aware of the core competencies and scope of practice.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
Community health workers who are currently certified by the Office of Community Health Workers will pay a twenty-five (25) dollars renewal fee each year, as well as costs associated with obtaining continuing education requirements. Individuals seeking initial certification as a community health worker will pay a fifty (50) dollar certification fee as well as costs associated with any required trainings.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Individuals certified by the department as a certified community health worker will be able to use the title of Certified Community Health Worker and will be able to be employed by an entity that is an enrolled Medicaid provider.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
The initial costs of the Office of Community Health Workers to implement this administrative regulation will be approximately $476,000. This includes all staff costs, and the costs associated with operating the program.
(b) On a continuing basis:
The ongoing costs to the Office of Community Health Workers to implement this administrative regulation will be approximately $476,000. This includes all staff costs, and the costs associated with operating the program.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
The Kentucky Office of Community Health Workers in the Department for Public Health is funded through a grant from the Centers for Disease Control and Prevention, state general fund dollars, and revenue received from the certification fees.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
An increase in fees or funding is not necessary to implement this administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This administrative regulation assesses a fifty (50) dollar initial certification fee and a twenty-five (25) dollar renewal fee.
(9) TIERING: Is tiering applied?
Tiering is not applied. While there are two (2) different methods for certification the requirements of this administrative regulation are applied equally to all applicants.

FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
This administrative regulation impacts the Office of Community Health Workers in the Division of Prevention and Quality Improvement and local health departments.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 194A.050 and 2022 Ky Acts ch. 86.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
This administrative regulation will generate between $2,000 and $4,000 in the first year.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
This administrative regulation will generate between $2,000 and $4,000 in subsequent years.
(c) How much will it cost to administer this program for the first year?
It will cost approximately $476,000 to administer this program in the first year. This includes all staff costs, and the costs associated with operating the program.
(d) How much will it cost to administer this program for subsequent years?
It will cost approximately $476,000 to administer this program in subsequent years. This includes all staff costs, and the costs associated with operating the program.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Expenditures (+/-):
Other Explanation:
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
This administrative regulation will generate minimal costs savings for the regulated entities in the first year.
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
This administrative regulation will generate minimal costs savings in subsequent years.
(c) How much will it cost the regulated entities for the first year?
This administrative regulation will cost initial applicants for certification fifty (50) dollars in their first year.
(d) How much will it cost the regulated entities for subsequent years?
This administrative regulation will cost applicants who renew their certification twenty-five (25) dollars in subsequent years.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
Expenditures (+/-):
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. [KRS 13A.010(13)] This administrative regulation does not have a major economic impact.

7-Year Expiration: 11/15/2029

Last Updated: 12/28/2022


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