Initial Certification as a Community Health Worker

(1) The Board will consider an application for certification as a Community Health Worker, provided that the applicant has submitted a complete application on a form specified by the Board, and provided that the Board has also received: (a) A certificate of completion from a Board-approved Community Health Worker Education and Training Program, unless the applicant has submitted an application prior to July 31, 2023 and meets the criteria at 272 CMR 4.02(3)(b); (Mass. Register #1455 10/29/21) (b) At least three professional references prepared on a form specified by the Board for this purpose, that must be completed with no omissions, signed and submitted directly to the Board by persons who satisfy the criteria at 272 CMR 4.02(4). 1. Each reference form must include a rating other than “not-applicable” for at least eight of the ten core competencies; and 2. The combination of all three reference forms must include a rating other than “not- applicable” for all ten core-competencies. (c) An attestation that the applicant has read and understands the Board’s regulations at 272 CMR 8.00: Professional and Ethical Standards of Conduct for Certified Community Health Workers; (d) A passport size color photograph of the applicant; (e) Documentation as may be necessary pursuant to 803 CMR 2.00: Criminal Offender Record Information (CORI) to authorize the Board’s receipt of criminal offender record information to the extent allowed by law; (f) Payment of a non-refundable application fee in the amount set by the Executive Office of Administration and Finance; unless waived in accordance with M.G.L.c. 112, § 1B; and (g) Other documentation as the Board may require to determine whether the applicant qualifies for certification. (2) Processing of Applications (a) The Board will not review any materials intended to support an application for certification as a Community Health Worker unless the applicant has submitted a complete application. (b) The Board may refuse to act on an incomplete application. (c) Incomplete application forms shall expire one year from the date of the Board’s receipt of the form. The Board may refuse to act on an expired application and may require that the applicant submit a new application. (d) Applicants are responsible for ensuring that all information in the application is accurate and up to date and shall notify the Board of any material changes in the information previously submitted; and (e) The Board may require the applicant to submit additional documentation, or appear before it, or both, in order to determine whether the applicant meets all qualifications and is of Good Moral Character. (3) The Board may issue a certification to the applicant provided that the Board determines that the applicant is 18 years of age or older, of Good Moral Character and meets all qualifications set forth in M.G.L. c. 112, § 260 and 272 CMR. The Board may deny certification to an applicant on one or more of the following grounds: (a) The Board cannot verify to its satisfaction that the applicant meets all qualifications for certification; (b) The Board cannot verify to its satisfaction, based on the professional references submitted, that the applicant’s work experience includes successful application of each of the ten core competencies; (c) The Board determines that the applicant is not of Good Moral Character; (d) The applicant has not complied with the Board’s request(s) for additional information, or that the applicant appear before it, or both; (e) The application contains factual inaccuracies that are material in nature; (f) The applicant has not submitted valid payment of the application fee; or (g) Other grounds as permitted by law.