HB291: HB291 Health; certification of community health workers; provide

26 LC 60 0349S The Senate Committee on Health and Human Services offered the following substitute to HB 291: A BILL TO BE ENTITLED AN ACT To amend Title 31 of the Official Code of Georgia Annotated, re lating to health, so as to1 provide for the certification of community health workers; to p rovide for definitions; to2 provide for the establishment of the Georgia Community Health W orker Certification3 Committee; to provide for membership, powers, and duties of the committee; to provide for4 committee abolishment and transfer of powers and duties to the Department of Public Health;5 to provide for administrative support; to provide for rules and regulations; to provide for6 standards; to provide for the approval of training programs; to provide for application7 procedures; to provide for requirements; to provide for related matters; to provide for an8 effective date conditioned on appropriations; to repeal conflic ting laws; and for other9 purposes.10 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:11 SECTION 1.12 Title 31 of the Official Code of Georgia Annotated, relating to health, is amended by revising13 Chapter 31, which is reserved, as follows:14 - 1 - 26 LC 60 0349S "CHAPTER 3115 31-31-1.16 As used in this chapter, the term:17 (1) 'Certified community health worker' means an individual to whom the committee has18 issued a certificate to serve as a certified community health worker based on standards19 and requirements approved by the department.20 (2) 'Commissioner' means the commissioner of public health.21 (3) 'Committee' means the Georgia Community Health Worker Certification Committee22 established by Code Section 31-31-2.23 (4) 'Community health worker' means a frontline public health worker who is a trusted24 member of a community or has a demonstrated knowledge of a comm unity and25 individuals served and:26 (A) Provides culturally appropriate health education, informat ion, and outreach in27 community based settings such as homes, schools, clinics, shelt ers, local businesses,28 and community centers;29 (B) Bridges or culturally mediates between individuals, communities, and health and30 human services, including actively building individual and community capacity;31 (C) Assures that community members access the services they need;32 (D) Provides direct services, such as informal counseling, soc ial support, care33 coordination, and health screenings;34 (E) Advocates for individual and community needs with an empha sis on healthcare35 needs; and36 (F) Provides any additional services that may emerge in the de velopment of37 community health worker practice.38 (5) 'Core competencies' means the knowledge and skills a certi fied community health39 worker is expected to demonstrate in order to carry out the mis sion and goals of the40 - 2 - 26 LC 60 0349S profession. Such term includes, but is not limited to, communication skills; interpersonal41 and relationship-building skills; service coordination and navi gation skills;42 capacity-building skills; patient advocacy skills; education an d facilitation skills;43 individual and community assessment skills; community outreach and engagement skills;44 evaluation and research skills; and knowledge base.45 (6) 'Department' means the Department of Public Health.46 (7) 'Training program' means an education and training program that meets the47 curriculum and training required for a community health worker to be eligible for48 certification and that has been approved by the department base d on standards and49 requirements recommended by the committee. Reserved.50 31-31-2.51 (a) There is established the Georgia Community Health Worker Certification Committee.52 The commissioner shall appoint the 11 voting members of the committee as follows:53 (1) One licensed physician with a specialization in primary care or family medicine;54 (2) One licensed physician with a specialization in maternal and child health;55 (3) One licensed physician with a specialization in geriatrics;56 (4) One licensed social worker;57 (5) Three representatives of community health worker employers , one of whom shall58 represent hospitals, one of whom shall represent a federally qualified health center, and59 one of whom shall represent a community based organization;60 (6) One person with experien ce and training in public health p olicy, with special61 consideration given to an active member of the Georgia Communit y Health Worker62 Advocacy Coalition;63 (7) Two practicing community health workers, provided that such persons are eligible64 for certification as community health workers in this state and shall obtain such65 certification within a time frame specified in bylaws adopted by the committee; and66 - 3 - 26 LC 60 0349S (8) One active member of the Georgia Community Health Worker Advisory Board.67 (b) The commissioner shall appoint two department representatives to serve as nonvoting68 members of the committee.69 (c) Any voting member of the committee shall serve a two-year term, and no such member70 shall serve on the committee for more than two consecutive full t e r m s . A m e m b e r71 appointed for less than a full term may serve two consecutive f ull terms, and a former72 member shall be eligible again for appointment after a lapse of one or more years.73 (d) If there is a vacancy on the committee, such position shall be filled in the same manner74 as the original appointment. Members of the committee may be removed from office by75 the commissioner under the same conditions for removal from off ice of members of76 professional licensing boards provided in Code Section 43-1-17.77 (e) Members shall serve without compensation, but they may be reimbursed by the78 department, subject to fund availability, in the same manner as state officials and79 employees for travel and other expenses actually incurred by th em in carrying out their80 duties as members of the committee.81 (f) The committee shall be abolished June 30, 2030, and the po wers and duties of the82 committee shall transfer to the department upon such abolishment.83 31-31-3.84 (a) The committee shall meet at least quarterly and may meet at such other times at the call85 of the chairperson or by a majority of the members as necessary to transact its business.86 Such meetings may be conducted in person, by telephone, by virt ual means, or any87 combination thereof.88 (b) The committee shall elect a chairperson, vice chairperson, and secretary from among89 its membership. Such officers shall serve for terms of two years.90 (c) A majority of the members of the committee shall constitute a quorum and shall have91 the authority to act upon any matter properly brought before th e committee. The92 - 4 - 26 LC 60 0349S committee shall follow all policies and procedures of Chapter 1 4 of Title 50, relating to93 open and public meetings.94 (d) The committee shall have the following powers and duties:95 (1) To make recommendations to the department on the standards and requirements for96 approval of training programs and a means for programs providing education and training97 to community health workers prior to July 1, 2027, to become ap proved training98 programs;99 (2) To make recommendations to the department on the standards and requirements for100 the certification of community health workers and a means for individuals employed or101 engaged as community health workers prior to July 1, 2027, to b ecome certified102 community health workers;103 (3) To make recommendations to the department on the standards and a means to assess104 the mastery of core competencies necessary for an individual to become a certified105 community health worker;106 (4) To provide for an expedited means for a community health worker duly certified in107 another jurisdiction to become a certified community health worker in this state;108 (5) To make recommendations to the department on the establishment of tiered levels of109 practice for certified community health workers and requirement s for each established110 level, including a level that qualifies a certified community h ealth worker to act as an111 educator or trainer in an approved training program;112 (6) To establish a process for the receipt, review, approval, and denial of applications for113 certification;114 (7) To establish a process for the receipt and review of complaints related to the practice115 of certified community health workers;116 (8) To establish disciplinary procedures and actions, includin g revocation or denial of117 a certificate issued, or a combination of the foregoing; and118 - 5 - 26 LC 60 0349S (9) To perform such other functions and duties in order to protect public health, safety,119 and welfare as may be required to carry out this chapter.120 (e) The department shall provide reasonably necessary administ rative support for121 committee activities.122 (f) The department shall be authorized to promulgate rules and regulations necessary to123 implement the provisions of this article, including recommendations from the committee.124 31-31-4.125 (a) All training programs in this state shall satisfy the requ irements established by the126 department. No entity shall hold itself out as providing training and education for certified127 community health workers in this state unless its training program has been approved by128 the committee.129 (b) The department shall post on its website the requirements and the application form for130 a training program to become approved and for the renewal of su ch approvals. Such131 requirements shall include 45 hours of core competency training, of which 16 hours shall132 include training on specific health topics.133 (c) An applicant for an approved training program shall submit an application to the134 committee demonstrating satisfaction of the requirements for a training program and pay135 a fee set by the department; provided, however, that, if an applicant provided education and136 training to community health workers prior to July 1, 2027, such applicant shall submit an137 application to the committee demonstrating satisfaction of requirements for such program,138 pay a fee set by the department, and provide a list of students who successfully completed139 such program at any time from January 1, 2016, to July 1, 2027.140 (d) An application is not complete until the committee has rec eived all the required141 materials. The committee shall notify the applicant within 15 calendar days after receipt142 of an application whether such application is complete or incom plete and identify any143 materials that are needed to complete such application. When the applicant fails to provide144 - 6 - 26 LC 60 0349S the required documentation within 120 calendar days of notification, the committee may145 administratively close such application or deny the application . An applicant whose146 application is administratively closed or denied may reapply and submit a new application147 and a new application fee.148 (e) The approvals of training programs under this Code section shall be valid for up to two149 years and shall expire biennially unless renewed. Suspension and revocation of approvals150 shall be subject to the administrative procedures contained in Chapter 13 of Title 50, the151 'Georgia Administrative Procedure Act.'152 31-31-5.153 (a) The title 'certified community health worker' shall only b e used by individuals who154 have met the requirements and qualifications for certification as a community health155 worker as established by the committee and have been duly certified by the committee. An156 individual certified as a community health worker shall identif y himself or herself as a157 certified community health worker during any patient interactions and shall not utilize any158 other titles that such individual is not certified or licensed to use.159 (b) The department shall post on its website the requirements and the application form for160 a community health worker to become certified and for the renewals of such certificates.161 (c) An applicant for a certified community health worker shall submit an application to the162 committee demonstrating satisfaction of the requirements for a certified community health163 worker and pay a fee set by the department. A certified community health worker shall:164 (1) Be 18 years of age or older;165 (2) Possess a high school diploma or its recognized equivalent;166 (3) Not be ineligible for certification on grounds established by the committee;167 (4) Provide professional references, one of which shall be a current or former supervisor,168 with direct knowledge of the applicant's work and ability in th e core competencies for169 community health workers;170 - 7 - 26 LC 60 0349S (5)(A) Have received satisfactory results from criminal backgr ound checks. The171 committee is authorized to conduct and receive criminal background checks, including,172 but not limited to, by the submission of fingerprints or other identifying information to173 the Federal Bureau of Investigation through the Georgia Crime Information Center. In174 order to determine an applicant's suitability for certification as a community health175 worker, the committee shall require the applicant to furnish the committee with a full176 set of fingerprints or other identifying information as may be necessary to enable177 criminal background checks to be conducted.178 (B) The committee shall submit the fingerprints or other ident ifying information179 furnished by an applicant to the Georgia Crime Information Cent er. The Georgia180 Crime Information Center is authorized to submit such fingerprints or information to181 the Federal Bureau of Investigation for a national criminal bac kground check. The182 Georgia Crime Information Center shall notify the committee in writing of its findings,183 including, but not limited to, the inability to identify a criminal record. Any findings184 received by the committee shall be used for the exclusive purpo se of carrying out its185 responsibilities under this Code section, shall not be public r e c o r d s , s h a l l b e186 confidential, and shall not be disclosed to any other person or agency, except to any187 person or agency which otherwise has a legal right to inspect such data. Any records188 obtained in furtherance of this Code section shall be maintaine d by the committee189 pursuant to laws regarding such records and the rules and regul ations of the Federal190 Bureau of Investigation and the Georgia Crime Information Center as applicable.191 (C) By applying for a license under this article, an applicant consents to the192 performance of criminal background checks as provided for in th is paragraph. The193 applicant shall be responsible for any fees associated with the performance of such194 background checks;195 - 8 - 26 LC 60 0349S (6) Submit proof of successful completion of an approved training program and 2,000196 hours of employment as a community health worker within ten yea rs of the date of197 application; and198 (7) Satisfy any other requirements established by rules and regulations promulgated by199 the department.200 (d) An applicant may satisfy the requirement provided in paragraph (6) of subsection (c)201 of this Code section if such applicant submits an application p rior to July 1, 2028, and202 proof of:203 (1) Successful completion of an education and training program for community health204 workers completed between July 1, 2016, and July 1, 2027, and 2 ,000 hours of205 employment as a community health worker within ten years of the date of application as206 established by the committee; or207 (2) At least 4,000 hours of employment as a community health worker within ten years208 of the date of application and an attestation from an employer that such applicant209 performed duties that included core competencies and is competent to perform activities210 as a certified community health worker as established by the committee.211 (e) An application for a certified community health worker is not complete until the212 committee has received all the required materials. The committee shall notify the applicant213 within 15 calendar days after receipt of an application whether such application is complete214 or incomplete and identify any materials that are needed to com plete such application.215 When the applicant fails to provide the required documentation within 120 calendar days216 of notification, the committee may administratively close such application or deny the217 application. An applicant whose application is administrativel y closed or denied may218 reapply and submit a new application and a new application fee.219 (f) Certificates issued pursuant to this Code section shall be valid for up to two years and220 shall expire biennially unless renewed. Suspension and revocation of certificates shall be221 - 9 - 26 LC 60 0349S subject to the administrative procedures contained in Chapter 13 of Title 50, the 'Georgia222 Administrative Procedure Act.'"223 SECTION 2.224 (a) This Act shall become effective only if funds are specific ally appropriated for the225 purposes of this Act in an appropriations Act enacted by the General Assembly.226 (b) If funds are so appropriated, then this Act shall become effective on the later of:227 (1) The date on which such appropriations Act becomes effective; or228 (2) The beginning date of the fiscal year for which such appropriations are made.229 SECTION 3.230 All laws and parts of laws in conflict with this Act are repealed.231 - 10 -