TITLE 7 HEALTH
CHAPTER 29 PRIMARY AND RURAL HEALTH CARE SERVICES
PART 5 CERTIFICATION OF COMMUNITY
HEALTH WORKERS
7.29.5.1 ISSUING
AGENCY: New Mexico Department of Health.
[7.29.5.1
NMAC - N, 1/30/15]
7.29.5.2 SCOPE: This rule applies to any person seeking to
practice as a certified community health worker in the state of New Mexico.
[7.29.5.2
NMAC - N, 1/30/15]
7.29.5.3 STATUTORY
AUTHORITY: These rules are promulgated pursuant to the
following statutory authorities: 1) the Department of Health Act, Subsection E
of Section 9-7-6 NMSA 1978, which authorizes the secretary of the department of
health to “...make and adopt such reasonable and procedural rules and
regulations as may be necessary to carry out the duties of the department and
its divisions,” and; 2) the Community Health Workers Act, Sections 24-30-1
through 24-30-7 NMSA 1978, which authorizes the department to adopt regulations
to carry out the provisions of the act.
[7.29.5.3
NMAC - N, 1/30/15]
7.29.5.4 DURATION: Permanent.
[7.29.5.4
NMAC - N, 1/30/15]
7.29.5.5 EFFECTIVE
DATE: January 30, 2015, unless a later date is
cited at the end of a section.
[7.29.5.5
NMAC - N, 1/30/15]
7.29.5.6 OBJECTIVE: The objective of this rule is to implement
the Community Health Workers Act. This
rule governs the voluntary certification of community health workers (CHWs) in
New Mexico.
[7.29.5.6
NMAC - N, 1/30/15]
7.29.5.7 DEFINITIONS:
A. “Action against a
certificate” means any formal action taken by the department that adversely
affects certification status, including but not limited to denial of initial
certification or re-certification, suspension or revocation or a certificate,
probation or reprimand.
B. “Applicant”
means an individual applying for community health worker certification or
recertification.
C. “Board” means
the board of certification of community health workers established under these
rules.
D. “Certificate”
means the document issued by the department to qualified applicants who have
successfully completed the application process for certification as community
health workers.
E. “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.
F. “Certified community
health worker” or “CCHW” means a
community health worker to whom the department has issued a certificate to
practice as a certified community health worker.
G. “Community health worker” or “CHW” means a public health worker,
also known as a tribal community health representative or a promotora, who
applies an understanding of the experience, language, and culture of the
populations that the individual serves and who provides services aimed at optimizing
individual, family and community health outcomes.
H. “Continuing
education” means courses or training designed to develop and enhance
knowledge, skills, and professional development to ensure that CCHWs are up to date
with current practices in the field.
I. “Conviction”
means a plea or adjudication of guilt, a plea of nolo contendre, or an Alford
plea, and does not include a conditional discharge or deferred adjudication
that results in dismissal of a charge.
J. “Core competencies”
means a combination of qualities, practical skills and knowledge, defined by
the department as essential to the provision of services by community health
workers, demonstration of which is required for certification.
K. “Department”
means the department of health.
L. “Recertification”
means a renewal of certification.
M. “Scope of practice”
means the roles and related tasks performed by CCHWs in the provision of
services, including the knowledge, skills and attributes needed to perform
work-related functions, as defined by the department.
N. “Secretary”
means the secretary of the department of health.
[7.29.5.7
NMAC - N, 1/30/15]
7.29.5.8 BOARD
OF CERTIFICATION OF COMMUNITY HEALTH WORKERS:
A. Board membership:
(1) The
board shall be comprised of nine members who are residents of New Mexico,
appointed by the secretary, and shall include:
(a) three
currently practicing CHWs, including at least one tribal community health
representative;
(b) the
secretary or the secretary’s designee, who shall serve as chair of the board;
and
(c) five
additional members that the secretary shall endeavor to appoint from community
health stakeholders including but not limited to health care providers, tribal
representatives, individuals from institutions of higher learning, or members
of the community from various geographic regions of the state.
(2) Members
of the board other than the department’s representative shall serve for
staggered terms of four years. The
secretary shall appoint to the initial board three members to a four-year term,
three members to a three-year term, and two members to a two-year term. Each member shall hold office until his or
her successor is appointed.
(3) Board
members shall be reimbursed as provided for in the Per Diem and Mileage Act,
Section 10-8-1 et seq. NMSA 1978 and
shall receive no other compensation, perquisite or allowance.
B. Meetings: The board shall convene at least once per
quarter at the call of the chair and as frequently as reasonably necessary to
review and make recommendations regarding the CHW certification process.
(1) Meetings
shall be conducted in accordance with the Open Meetings Act, Section 10-15-1
through 10-15-4 NMSA 1978. A simple
majority of the members of the board shall constitute a quorum for the purpose
of transacting official business.
(2) Meeting
arrangements and attendance requirements shall be determined by the board. The board shall recommend to the secretary
removal of board members for non-participation or any other good cause.
C. Duties and
responsibilities: The board shall advise the secretary on the
implementation of standards, guidelines, and requirements relating to the
training and regulation of persons seeking certification or practicing as CCHWs.
(1) The
board shall make recommendations to the secretary on the following matters:
(a) standards
and requirements for the establishment and approval or acceptance of community
health worker education and training programs in the state;
(b) standards
and requirements for approval or acceptance of continuing education courses and
programs as the board may require for recertification every two years;
(c) 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;
(d) the
process to acknowledge, document, and assess relevant education, training and
experience or other qualifications acquired by CHWs practicing in the state
before the effective date of the Community Health Workers Act for purposes of
certification while waiving minimum training and experience requirements
established by the act (also known as “grandfathering”);
(e) the
means to assess community health worker competency in connection with
certification;
(f) the
core competencies to be required for certification, in consideration of current
New Mexico and national CHW workforce studies; and
(g) the
scope of practice for CCHWs.
(2) The
board may provide guidance to the program on issues or topics presented to the
board at the program’s discretion.
(3) Board
recommendations: The board shall provide
to the secretary written recommendations in accordance with the duties listed
in this section, including any supporting documentation or public
commentary. The secretary shall make a
final determination on all board recommendations.
[7.29.5.8
NMAC - N, 1/30/15]
7.29.5.9 NEW
MEXICO REGISTRY OF COMMUNITY HEALTH WORKERS: The New Mexico registry of community health
workers shall be maintained at the department. The registry is voluntary and open
to all persons who are CCHWs in the state of New Mexico. The registry shall contain the name,
certification number, certification status, and geographic location of the CCHW. Registry information is subject to public
inspection.
[7.29.5.9
NMAC - N, 1/30/15]
7.29.5.10 COMMUNITY HEALTH WORKER
CERTIFICATION:
A. Initial certification:
(1) All
applicants for initial certification in New Mexico shall:
(a) submit
to the department a completed application in a form specified by the department
to include verification that applicant has met the eligibility requirements;
(b) submit
to the department the designated application fee; and
(c) if
an applicant otherwise meets the eligibility requirements, then in accordance
with this rule, submit a request to the department of public safety (DPS) or a
DPS vendor for a state and national criminal history screening. The results of the criminal history screening
shall be received by the department before a certificate can be issued.
(2) Eligibility
requirements for applicants who were practicing CHWs before the effective date
of the Community Health Workers Act:
(a) proof
that applicant is at least 18 years of age; and
(b) verification
of proficiency in the core competencies through training or experience, signed
by a current or former supervisor; and
(c) two
letters of reference; and
(d) documentation
of 2,000 hours of work or volunteer experience as a CHW in the two years prior
to application, or documentation of at least half-time paid or volunteer
employment as a CHW in the five years prior to application.
(3) Eligibility
requirements for applicants who were not practicing CHWs before the effective
date of the Community Health Workers Act, or who otherwise do not meet the
criteria for grandfathering by waiver of minimum training and experience
requirements based on practice before the effective date of the Community
Health Workers Act:
(a) proof
that applicant is at least 18 years of age; and
(b) proof
of completion of a department-approved training program that contains an
examination component for each of the core competencies; and
(c) at
least a high school diploma or certificate of high school equivalency.
(4) Applicants
may be certified at the following levels:
(a) generalist:
an applicant who provides proof of completion of a department-approved training
program that contains an examination component for each of the core
competencies, or an applicant who meets the requirements for certification
through grandfathering;
(b) specialist
I: an applicant who meets the
requirements for a generalist and who demonstrates additional education or
training in at least one specialty area;
(c) specialist
II: an applicant who meets the
requirements for a generalist and who demonstrates additional education or
training in at least two specialty areas;
(d) specialist
III: an applicant who meets the
requirements for a generalist and who demonstrates additional education or
training in three or more specialty areas;
(e) specialty
areas include but are not limited to basic clinical support skills, heart
health, chronic disease, behavioral health, maternal and child health or
developmental disabilities.
(5) The
department shall issue certificates to applicants who satisfy the requirements
of this rule, unless the application is disapproved.
(6) Certificates
shall be valid for two years from the date of issuance. A CCHW shall carry the CCHW certificate and
present it upon request.
B. Recertification: An applicant for recertification shall:
(1) Submit
to the department a completed application in a form specified by the department
to include proof of current certification.
(2) Submit
to the department the designated application fee.
(3) Provide
proof of completion of at least 30 hours of department-approved continuing
education.
(4) Every
other recertification period (every four years), if an applicant otherwise
meets the eligibility requirements, then in accordance with this rule, submit a
request to DPS or a DPS vendor for a current state and national criminal
history screening.
C. Reinstatement after
lapse, suspension, or revocation:
(1) The
requirements for reinstatement of a certificate that has lapsed for one year or
less are the same as those for recertification, with the payment of fees as
identified for reinstatement after lapse in Subsection F of 7.29.5.10 NMAC and,
if required as part of recertification, then in accordance with this rule, submission
of a request to DPS or a DPS vendor for a current state and national criminal
history screening.
(2) The
requirements for reinstatement of a certificate that has lapsed more than one
year prior to the application date are the same as those for an initial
application.
(3) The
requirements for reinstatement of a certificate that has been suspended or revoked
are the same as those for recertification, provided that the term of suspension
has been completed or terminated or approval of reinstatement after revocation
has been granted. Applicant shall pay
the designated fees for reinstatement after suspension or revocation in
Subsection F of 7.29.5.10 NMAC and, in accordance with this rule, submit a
request to DPS or a DPS vendor for a current state and national criminal
history screening.
D. Disapproval:
(1) The
department may disapprove an application if an applicant has not met the
eligibility requirements as defined by the department or has submitted an
incomplete application. The department
shall send a notice of disapproval with the reasons why the applicant was
disapproved and the requirements necessary to reapply.
(2) An
applicant whose application has been disapproved under Paragraph (1) of Subsection
D of 7.29.5.10 NMAC may not appeal the disapproval. The applicant shall be permitted to reapply
and shall submit a current and complete application that meets the designated
requirements within 60 days of receipt of the notice of disapproval. If the re-submitted application is received
by the program within the 60 days, no new application fee is required. If the re-submitted application is received
after the 60 days, applicant shall be required to pay the application fee
designated in this rule.
E. Application
processing:
(1) Applications,
including associated fees, shall be sent to the department’s office of
community health workers.
(2) The
department shall review applications on a rolling basis. Applicants shall be notified in writing within
30 working days of receipt of the application by the department whether their
application has been approved or disapproved.
(3) If
an application has been disapproved, applicants shall be notified of their
ability to reapply pursuant to Paragraph (2) of Subsection D of 7.29.5.10 NMAC.
(4) If
an application has been approved, then applicants shall be directed to complete
a state and national criminal history screening. For applicants with no criminal history, or
with no history of felony convictions, the department shall issue a certificate
within 10 working days of receipt of the criminal history screening results.
(5) Applications
with an associated criminal history shall be referred to the certification
review committee and reviewed according to the procedure set forth in this rule.
F. Fees:
(1) The
department shall charge the following fees for certification or approval services.
(a) initial
certification: generalist $45
(b) initial
certification: specialist I $55
(c) initial
certification: specialist II $65
(d) initial
certification: specialist III $75
(e) recertification
for any level $45
(f) reinstatement
after lapse $75
(g) reinstatement
after suspension or revocation $100
(h) education,
training, or continuing education program approval $300
(i) program
approval renewal $200
(2) If
an applicant is certified as a generalist, prior to his or her recertification
the applicant may apply to be a specialist at any level and pay the difference
between the specialist fee and the generalist fee.
(3) Payment
of fees: Payment of fees will be accepted
in a form specified by the department.
Fees are not refundable.
(4) Use
of fees: The department shall apply any
fee it collects under these rules to cover the costs of administering the
community health worker certification program established pursuant to the
Community Health Workers Act.
G. Unauthorized
practice:
(1) In
order to use the title “certified community health worker,” the initials “CCHW”
or other designation indicating that the individual is a certified community
health worker, an individual shall be certified pursuant to the provisions of
the Community Health Workers Act and these rules.
(2) To
ensure compliance, the department may issue cease-and-desist orders to persons
violating the provisions of the Community Health Workers Act or these rules.
(3) A
CCHW shall engage only in those activities authorized pursuant to the Community
Health Workers Act and these rules.
While engaging in practice as a CCHW, an individual shall not engage in
or perform any act or service for which another professional certificate,
license or other legal authority is required unless he or she holds the
relevant professional certificate, license or other legal authority to perform
that act or service.
[7.29.5.10
NMAC - N, 1/30/15]
7.29.5.11 CRIMINAL HISTORY SCREENING:
A. The department
is authorized to obtain the criminal history records of applicants and to
exchange fingerprint data directly with the federal bureau of investigation
(FBI), DPS and any other law enforcement agency or organization. The department shall require fingerprinting
of applicants for the purposes of this section.
B. Procedure:
(1) If
an applicant otherwise meets the eligibility requirements, then the department
shall require the applicant to submit a request to DPS or a DPS vendor for a
current state and national criminal history screening.
(2) The
department shall provide applicants with the department’s originating agency identification
(ORI) number or other department identifier for the purposes of criminal
history screening.
(3) Applicant
shall provide to DPS or a DPS vendor a background check request, fingerprints,
and supporting documentation including an authorization for release of
information to the department in accordance with DPS or the designated vendor’s
procedures.
(4) DPS
or the designated DPS vendor shall review state records and also transmit the
fingerprints to the FBI for a national screening. The results of the screening shall be made
available to the department for review.
(5) The
department shall make a determination whether the applicant has been convicted
of a felony that bears upon the applicant’s fitness to provide services.
(6) Applicant
shall bear any costs associated with ordering or conducting criminal history
screening. Fees are determined by and
payable to DPS or the designated DPS vendor.
Fees cannot be waived by the department.
(7) The
department shall comply with applicable confidentiality requirements of DPS and
the FBI regarding the maintenance, dissemination, and destruction of criminal
background check information.
(8) For
applicants with no criminal history, or with no history of felony convictions, the
department shall issue a certificate in accordance with this rule if all other
requirements for certification have been satisfied.
[7.29.5.11
NMAC - N, 1/30/15]
7.29.5.12 CERTIFICATION REVIEW COMMITTEE:
A. A certification
review committee is hereby established.
The committee shall be appointed by the secretary and shall be comprised
of five employees of the public health division, to include the division
director, the deputy director of programs, and the CHW program manager. The committee shall conduct an individualized
review of the grounds for action against a certificate and shall determine
whether to pursue action against a certificate by a majority vote. A certificate may be denied, suspended or
revoked, or may be subject to any lesser action, including but not limited to
reprimand or probation.
B. Grounds for action against a certificate:
(1) Conviction
of a felony that bears upon the applicant’s fitness to provide services.
(2) Fraud,
deceit, or misrepresentation during the certification application process.
(3) Failure
to possess and apply the knowledge, skill or care that is ordinarily possessed
and exercised by CCHWs or as defined by the core competencies.
(4) Unprofessional
conduct, which includes but is not limited to:
(a) verbally
or physically abusing a client;
(b) unauthorized
practice or practice which is beyond the defined scope of practice for CCHWs,
including unauthorized use of the CCHW designation;
(c) unauthorized
disclosure of medical or other confidential information;
(d) obtaining
or attempting to obtain any fee for client services for one’s self or for
another through fraud, misrepresentation or deceit; or
(e) physical
or mental incapacity which could result or has resulted in performance of CCHW
duties in a manner which endangers the health and safety of others.
C. Committee review of
criminal history screening results:
(1) The
committee shall conduct an individualized review of applications with an associated
history of felony convictions, and shall determine whether to pursue action against
a certificate by a majority vote.
Committee members shall meet any DPS or FBI requirements regarding
individuals who handle criminal history information.
(2) The
committee may request that applicants provide additional information in writing
in order to make a final determination of certification, such as evidence of
acquittal, dismissal, conviction of a lesser included crime or rehabilitation.
(3) The
provisions of the Criminal Offender Employment Act, Section 28-2-1 through
28-2-6 NMSA 1978 shall govern any consideration of criminal records required or
permitted by the Community Health Workers Act.
The following factors may also be considered in order to make a final
determination on certification:
(a) total
number of felony convictions and type of crimes;
(b) time
elapsed since last conviction or since discharge of sentence;
(c) circumstances
of the crime including but not limited to whether violence was involved;
(d) activities
evidencing rehabilitation, including but not limited to substance abuse or
other rehabilitation programs;
(e) false
or misleading statements in the application; and
(f) relation
of crimes to the scope of practice.
(4) For
the purposes of this section and pursuant to the Criminal Offender Employment
Act, Section 28-2-4 NMSA 1978:
(a) if
an applicant has been convicted of a felony, and the conviction does not directly
relate to the scope of practice, there is a presumption of sufficient
rehabilitation if the applicant has completed probation or parole supervision
or a period of three years has lapsed after final discharge or release from any
term of imprisonment without subsequent conviction; and
(b) if
an applicant has been convicted of a felony, and the conviction directly relates
to the scope of practice, then the burden is on the applicant to prove by a
preponderance of the evidence that he or she has been sufficiently
rehabilitated.
(5) Applicants
shall be notified in writing of the decision to pursue action against a
certificate based on the results of a criminal history review, including a
statement of the grounds or subject upon which the action is based.
(6) An
applicant whose certification or recertification is denied, suspended or
revoked based on information obtained in a criminal history background check,
shall be entitled to review the information obtained and to appeal the decision
pursuant to the procedure in accordance with this rule.
D. Committee review of
other grounds for action:
(1) The
committee shall conduct an individualized review of the grounds for action
against a CCHW or applicant and shall determine whether to pursue action against
a certificate by a majority vote.
(2) The
committee may request that applicants provide additional information in writing
in order to make a final determination of certification.
(3) Applicants
shall be notified in writing of the decision to pursue action against a
certificate based on the results of the committee’s review, including a
statement of the grounds or subject upon which the proposed action is based.
(4) An
applicant whose certification or recertification is denied, suspended or
revoked shall be entitled to review the information obtained and to appeal the
decision pursuant to the procedure in accordance with this rule.
E. An applicant who
is reprimanded, placed on probation, or who is otherwise subjected to any
lesser form of action against a certificate than denial, suspension, or
revocation may upon good cause submit a verbal or written request to the
certification review committee for a secondary review. Requests for review must be submitted within
10 working days of the original decision to take action against a
certificate. All decisions by the
committee after a secondary review are considered final and are not subject to
appeal.
[7.29.5.12
NMAC - N, 1/30/15]
7.29.5.13 HEARINGS:
A. Right to appeal: An applicant may appeal a decision by the
department to deny, suspend or revoke a certificate by requesting a hearing by
mailing a certified return receipt letter to the address provided in the notice
of action within 20 days after service of notice.
B. Notice: The department shall serve upon an applicant
written notice containing the action against a certificate and a statement of
the grounds or subject upon which the action is based and instructions for
requesting a hearing.
C. Notice of hearing: Upon receipt of a timely request for a
hearing, the department shall appoint a hearing officer and schedule a hearing,
to be held in Santa Fe, New Mexico within 60 working days of receipt of the
request.
(1) Either
party may request a continuance at least 10 days prior to the scheduled
hearing, to be approved or denied by the hearing officer.
(2) If
an applicant fails to appear after requesting a hearing, the hearing officer
may proceed to consider the matter and render a report and recommendation.
(3) If
no request for a hearing is made in the time and manner specified, the committee
shall take the action against the certificate and such action shall be final.
D. Hearing officer
duties: The hearing officer shall
preside over the hearing, administer oaths, take evidence and decide
evidentiary objections and rule on any motions or other matters that arise
prior to the hearing.
E. Admissible evidence: The hearing officer may admit evidence and
may give probative effect to evidence that is of a kind commonly relied on by
reasonably prudent persons in the conduct of serious affairs. Rules of evidence shall not apply but may be
considered in determining the weight to be given to any item of evidence. Action against a certificate must not be
based solely on hearsay evidence.
F. Discovery: Any party is entitled to obtain the names and
addresses of witnesses who will or may be called by the other party to testify
and to inspect and copy any documents or items which the other party will or
may introduce in evidence at the hearing.
Additional discovery may be ordered at the hearing officer’s discretion.
G. Burden of proof: In accordance with the Criminal Offender
Employment Act:
(1) When
the action against a certificate is not based on a review of the applicant’s
criminal history report, the department has the burden of proving by a
preponderance of the evidence the basis for the action.
(2) When
the action against a certificate is based on a review of the applicant’s
criminal history report, and the applicant has been convicted of a felony directly
related to the scope of practice, the applicant has the burden of proving sufficient
rehabilitation by a preponderance of the evidence.
(3) When
the action against a certificate is based on a review of the applicant’s
criminal history report, and the applicant has been convicted of a felony not directly
related to the scope of practice, there is a presumption of rehabilitation and
the department has the burden of proving by a preponderance of the evidence
that the applicant has not been sufficiently rehabilitated.
H. Conduct of hearing: Hearings shall be open to the public but may
be closed at either party’s request, at the discretion of the hearing officer. The hearing officer shall state on the record
the reasons for holding a closed hearing.
I. Legal
representation: An individual
entitled to a hearing under this rule shall have the right to be represented by
an attorney licensed to practice in New Mexico or by a member of his or her profession
or occupation, or both.
J. Hearing officer
written report and recommendation(s): The hearing officer shall issue a
report and recommended finding to the department secretary within 30 working
days of the final submission in the case.
K. Decision of the
department: The secretary shall
render a final determination in writing, including the basis for the decision,
within 30 calendar days of the submission of the hearing officer’s written
report. A copy of the final decision
shall be mailed to the applicant by certified mail, return receipt requested to
the most current address provided by the applicant. It is the responsibility of the applicant to
provide current contact information to the program.
L. Reinstatement of a
suspended or revoked certificate:
(1) Requests
for reinstatement for a revoked certificate shall not be considered by the
department prior to the expiration of three years from the date of the
revocation indicated in the department’s final decision. Requests for reinstatement of a suspended
certificate shall not be considered by the department prior to the expiration
of one year from the date of the suspension indicated in the department’s final
decision.
(2) Individuals
who request reinstatement of their certificate shall provide the department
with substantial evidence to support their request in the form of notarized
written reports or sworn statements from individuals who have personal
knowledge of the individual’s activities and progress during the time that the
certificate is suspended or revoked.
(3) Reinstatement
of a suspended or revoked certificate requires proof of meeting the
recertification requirements as set forth in this rule including payment of the
reinstatement fee designated in this rule.
(4) If
reinstatement of a suspended or revoked certificate is denied, individuals have
a right to appeal in accordance with the hearing procedures set forth in this
rule.
[7.29.5.13
NMAC - N, 1/30/15]
7.29.5.14 INSPECTION OF RECORDS: The following records are not subject to
public inspection, and shall be maintained in a confidential manner:
A. Health
information protected by state and federal laws.
B. Materials
associated with reviews conducted by the certification review committee,
including but not limited to criminal history information.
C. Complaints or
allegations regarding a CCHW that are not substantiated following
investigation.
D. Personal
identifiers in applications, such as date of birth, social security numbers,
home address and phone numbers.
[7.29.5.14
NMAC - N, 1/30/15]
HISTORY OF
7.29.5 NMAC: [RESERVED]