25 TAC §§146.1 - 146.10
The Executive Commissioner of the Health and Human Services
Commission on behalf of the Department of State Health Services (department)
proposes amendments to §§146.1-146.10, concerning the regulation
of training and certification of promotores(as) or community health workers.
BACKGROUND AND PURPOSE
The Promotor(a) or Community Health Worker Training and Certification Advisory
Committee (committee) has provided advice to the Health and Human Services
Commission and the department related to the review of applications and the
recommendation of qualifying applicants as sponsoring institutions, training
instructors or as promotores(as) or community health workers. The committee
also recommends new or amended rules for the approval of the Health and Human
Services Commission. This committee is a successor to, and continues many
functions of the Promotora Program Development Committee mentioned in Health
and Safety Code, §§48.002(a) and 48.003(a). The committee is established
under the Health and Safety Code, §11.016, which allows the Health and
Human Services Commission to establish advisory committees. The committee
is governed by the Government Code, Chapter 2110, concerning state agency
advisory committees.
Health and Safety Code, Chapter 48, requires the department to establish
a program designed to train and educate persons who act as promotoras or community
health workers. This chapter also requires minimum standards for the certification
of promotoras or community health workers. These rules are reasonable and
necessary to accomplish this legislative mandate.
SECTION-BY-SECTION SUMMARY
The proposed amendments cover definitions; the purpose of the advisory
committee; applicability; application requirements and procedures for promotores
or community health workers, instructors, and sponsoring institutions/training
programs; types of certificates and applicant eligibility; standards for the
approval of curricula; and continuing education requirements. Amendments also
reflect the new agency name as Department of State Health Services. The amended
language clarifies the rules and improves the ability of promotores(as) or
community health workers to obtain the training and certification established
by Health and Safety Code, Chapter 48. Also, it improves the ability of the
certification program to expedite the process of reviewing applications for
certification of instructors and training programs.
FISCAL NOTE
Cecilia Berrios, Regional and Local Services, Department of State Health
Services, has determined that for each year of the first five years the sections
are in effect, there will be no fiscal implications for state and local government
as a result of amending the sections as proposed. There may be impacts on
such entities to the extent they choose to become involved as employers, sponsors,
or education providers to promotores(as) or community health workers, but
such involvement is voluntary on their part.
SMALL AND MICRO-BUSINESS IMPACT ANALYSIS
There is no anticipated cost to small businesses or micro-businesses nor
to persons who are required to comply with the sections as proposed because
becoming a promotor(a) or community health worker or sponsor, or educator
is voluntary. Those who choose to become certified under these rules (or their
sponsors) will incur the cost of obtaining required education. This cost will
vary depending on where this education is obtained. There is no anticipated
impact on local employment.
PUBLIC BENEFIT
Ms. Berrios has determined that the public health benefits of the proposed
rules amendments include increased clarity of the rules, better conformance
to statute, and improved ability of promotores(as) or community health workers
to obtain the training and certification established by Health and Safety
Code, Chapter 48.
REGULATORY ANALYSIS
The department has determined that this proposal is not a "major environmental
rule" as defined by Government Code, §2001.0225. "Major environmental
rule" is defined to mean a rule the specific intent of which is to protect
the environment or reduce risk to human health from environmental exposure
and that may adversely affect, in a material way, the economy, a sector of
the economy, productivity, competition, jobs, the environment or the public
health and safety of a state or a sector of the state. This proposal is not
specifically intended to protect the environment or reduce risks to human
health from environmental exposure.
TAKINGS IMPACT ASSESSMENT
Under Government Code, §2007.003(b), the department has determined
that Chapter 2007 of the Government Code does not apply to these rules. The
changes these rules make do not implicate a recognized interest in private
rule property. Accordingly, the department is not required to complete a takings
assessment regarding these rules.
PUBLIC COMMENT
Comments may be submitted to Cecilia Berrios, Regional and Local Services,
Department of State Health Services, 1100 West 49th Street, Room T-608, Austin,
Texas 78756, telephone (512) 458-7770, or cecilia.berrios@dshs.state.tx.us.
Comments on the proposed sections will be accepted for 30 days following publication
in the
Texas Register
.
STATUTORY AUTHORITY
The amendments are proposed under Health and Safety Code, §48.003,
which requires the Texas Board of Health (board) to adopt rules that provide
minimum standards and guidelines on training; §48.002, which allows the
board to provide for exemption from certification by rule; §11.016, which
allows the board to appoint advisory committees to assist the board in performing
its duties; and §12.001, which provides the board with the authority
to adopt rules for the performance of every duty imposed by law on the board,
the Texas Department of Health and the commissioner of health. The Texas Department
of Health and the Texas Board of Health were abolished by Chapter 198, §§1.18
and 1.26, 78th Legislature, Regular Session, 2003. Government Code, §531.0055,
and Health and Safety Code, §1001.075, which authorize the Executive
Commissioner of the Health and Human Services Commission to adopt rules and
policies necessary for the operation and provision of health and human services
by the department and for the administration of Chapter 1001, Health and Safety
Code.
The amendments affect Health and Safety Code, Chapters 11 and 48.
§146.1.Definitions.
The following words and terms, when used in this chapter, shall have
the following meanings, unless the context clearly indicates otherwise.
(1)
(No change.)
(2)
Applicant--A promotor(a) or community health worker who
applies to the
Department of State Health Services
[
Texas
Department of Health
] for a certificate of competence, a sponsoring
institution or training program who applies to the department to offer training
or an instructor who applies to the department to train promotores(as) or
community health workers.
(3)
HHSC--The Texas Health and Human Services Commission
[
Board--The Texas Board of Health
].
(4)
Certificate of Competence--Promotor(a) or community health
worker certificates issued by the
Department of State Health Services
[
Texas Department of Health
].
(5)
(No change.)
(6)
Department--The
Department of State Health Services
[
Texas Department of Health
].
(7) - (12)
(No change.)
§146.2.Promotor(a) or Community Health Worker Training and Certification Advisory Committee.
(a)
The committee. An advisory committee shall be appointed
under and governed by this section.
(1)
(No change.)
(2)
The committee is established under the Health and Safety
Code, §11.016, which allows the
Executive Commissioner of HHSC
[
Board of Health (board)
] to establish advisory committees.
(b)
(No change.)
(c)
Purpose. The purpose of the committee is to [
review
applications and to recommend to the department qualifying applicants as sponsoring
institutions and training instructors until May 31, 2004. The committee shall
also
] recommend new or amended rules for the approval of the
Executive
Commissioner of HHSC
[
board
].
The committee may also
review applications and recommend to the department qualifying applicants
as sponsoring institutions or training programs and instructors.
(d)
Tasks.
(1)
The committee shall advise the
Executive Commissioner
of HHSC
[
board
] concerning rules to implement standards adopted
under the Health and Safety Code, Chapter
48,
[
46
] relating
to the training and regulation of persons working as promotores(as) or community
health workers.
(2)
The committee
may
[
shall
] recommend
to the department qualifying sponsoring institutions or training programs
and instructors [
until May 31, 2004
].
(3)
The committee shall carry out any other tasks given to
the committee by the
Executive Commissioner of HHSC
[
board
].
(e)
Review and duration. By November 1, 2007, the
Executive
Commissioner of HHSC
[
board
] will initiate and complete a
review of the committee to determine whether the committee should be continued,
consolidated with another committee, or abolished. If the committee is not
continued or consolidated, the committee shall be abolished on that date.
(f)
Composition. The committee shall be composed of nine members
appointed by the
Executive Commissioner of HHSC
[
board
].
The composition of
the
committee shall include:
(1) - (4)
(No change.)
(g)- (h)
(No change.)
(i)
Meetings. The committee shall meet only as necessary to
conduct committee business.
(1)
A meeting may be called by agreement of
the Department
of State Health Services
[
Texas Department of Health
] (department)
staff and either the presiding officer or at least three members of the committee.
(2) - (7)
(No change.)
(j)
Attendance. Members shall attend committee meetings as
scheduled. Members shall attend meetings of subcommittees to which the member
is assigned.
(1) - (3)
(No change.)
(4)
The attendance records of the members shall be reported
to the
Executive Commissioner of HHSC
[
board
]. The report
shall include attendance at committee and subcommittee meetings.
(k)
(No change.)
(l)
Procedures. Roberts Rules of Order, Newly Revised, shall
be the basis of parliamentary decisions except where otherwise provided by
law or rule.
(1) - (4)
(No change.)
(5)
Minutes of each committee meeting shall be taken by department
staff.
(A)
A draft of the minutes approved by the presiding officer
shall be provided to the
Executive Commissioner of HHSC
[
board
] and each member of the committee within 30 days of each meeting.
(B)
(No change.)
(m)
(No change.)
(n)
Statement by members.
(1)
The
Executive Commissioner of HHSC
[
board
], the department, and the committee shall not be bound in any way by
any statement or action on the part of any committee member except when a
statement or action is in pursuit of specific instructions from the
Executive Commissioner of HHSC
[
board
], department, or committee.
(2)
The committee and its members may not participate in legislative
activity in the name of the
Executive Commissioner of HHSC
[
board
], the department, or the committee except with approval through
the department's legislative process. Committee members are not prohibited
from representing themselves or other entities in the legislative process.
(3) - (6)
(No change.)
(o)
Reports to
the Executive Commissioner of HHSC
[
board
]. The committee shall file an annual written report with the
Executive Commissioner of HHSC
[
board
].
(1)
The report shall list the meeting dates of the committee
and any subcommittees, the attendance records of its members, a brief description
of actions taken by the committee, a description of how the committee has
accomplished the tasks given to the committee by the
Executive Commissioner
of HHSC
[
board
], the status of any rules which were recommended
by the committee to the
Executive Commissioner of HHSC
[
board
], anticipated activities of the committee for the next year, and any
amendments to this section requested by the committee.
(2)
(No change.)
(3)
The report shall cover the meetings and activities in the
immediate preceding 12 months and shall be filed with the
Executive Commissioner
of HHSC
[
board
] each January. It shall be signed by the presiding
officer and appropriate department staff.
(p)
(No change.)
§146.3.Applicability.
(a)
(No change.)
(b)
The provisions of this chapter apply to any promotor(a)
or community health worker, and instructor, representing that he or she performs
or will perform as a certified promotor(a) or community health worker or,
trains or will train promotores(as) or community health workers respectively.
It also applies to any institution or training program that will sponsor
/provide
or sponsors
/
[
or
] provides training programs
for promotores(as) or community health workers, who will expect certification
under this chapter.
(c)
(No change.)
§146.4.Application Requirements and Procedures for Promotores(as) or Community Health Workers.
(a) - (b)
(No change.)
(c)
Required application materials. The application form shall
contain the following items:
(1)
specific personal data, [
social security number or
status (optional),
] birth date, current and previous promotor(a) or
community health worker activity (if applicable), and any educational and
training background;
(2) - (9)
(No change.)
(d)
Application approval.
[
(1)
The committee shall be responsible
for reviewing all applications and recommending promotores(as) or community
health workers to be certified to the administrator.]
[
(2)
]
The administrator shall approve any application
which is in compliance with this chapter and which properly documents applicant
eligibility, unless the application is disapproved under the provisions of
subsection (e) of this section.
(e) - (f)
(No change.)
§146.5.Application Requirements and Procedures for Instructors.
(a) - (b)
(No change.)
(c)
Required application materials. The application form shall
contain the following items:
(1)
specific personal data, [
social security number or
status (optional),
] birth date, current and previous places of employment,
other state licenses and certificates held, and educational and training background;
(2) - (9)
(No change.)
(d)
Application approval.
(1)
The committee
may
[
shall
] be responsible
for reviewing [
all
] applications and recommending those to be certified
by the administrator.
(2)
(No change.)
(e) - (f)
(No change.)
§146.6.Application Requirements and Procedures for Sponsoring Institutions and Training Programs.
(a) - (c)
(No change.)
(d)
Application approval.
(1)
The committee
may
[
shall
] be responsible
for reviewing [
all
] applications and recommending those to be certified
to the administrator.
(2)
(No change.)
(e) - (f)
(No change.)
§146.7.Types of Certificates and Applicant Eligibility.
(a)
Purpose. The purpose of this section is to set out the
types of certificates issued and the qualifications of applicants.
(1)
The
Department of State Health Services
[
Texas Department of Health
] (department) shall issue promotor(a) or
community health worker certificates of competence, instructor certificates,
and sponsoring institutions or training program certificates. A certificate
will recognize all those who have performed promotor(a) or community health
worker services between July 1997 to January
2005
[
2004
]
and not less than 1000 cumulative hours between July 1997 to January
2005
[
2004
]. A certificate will recognize all those who have
successfully completed an entry-level training and certification program.
(2) - (7)
(No change.)
(b)
Special provisions for persons who have performed promotor(a)
or community health worker services between July 1997 to January
2005
[
2004
]. Upon submission of the application forms by the
practicing promotor(a) or community health worker and upon approval by the
department, the department shall issue a certificate of competence to a person
who has performed promotor(a) or community health worker services for not
less than 1000 cumulative hours between July 1997 to January
2005
[
2004
], as documented on form(s) prescribed by the department.
(c)
Special provisions for persons who are nationally certified
health education specialists in good standing, with experience in instructing
or training promotores(as) or community health workers for not less than 1000
cumulative hours between July 1997 to January
2005
[
2004
],
other licensed/certified healthcare professionals including social workers
in good standing as well as other professionals with Masters degrees in public
health, community health or related field
, or Bachelors degrees in social
services or related field
who have acted as instructors of promotores(as)
or community health workers, for not less than 1000 cumulative hours between
July 1997 to January
2005
[
2004
] and for promotores(as)
or community health workers who have acted as supervisors or as trainers and
have experience in instructing or training promotores(as) or community health
workers for not less than 1000 cumulative hours between July 1997 to January
2005
[
2004
]. Upon submission of the application forms by
an instructor, other licensed/certified healthcare professional or certified
health education specialist
, or instructor with Masters/Bachelors degree
and upon approval by the department, the department shall issue an
instructor certificate to a person who is certified by the National Commission
for Health Education Credentialing, Inc., or who is a licensed/certified healthcare
professional
, or instructor with a Masters/Bachelors degree
and
to a promotor(a) or community health worker who meets the above qualifications.
(d) - (f)
(No change.)
§146.8.Standards for the Approval of Curricula.
(a)
(No change.)
(b)
All curricula to be used and programs developed to train
individuals to perform promotor(a) or community health worker services or
to act as instructors must:
(1) - (5)
(No change.)
(6)
be submitted to the department along with supporting materials
in a three-ring binder with all pages clearly legible and consecutively numbered
with a table of contents
(follow Required Table of Contents on page ii
of application form)
and divided with tabs identified to correspond
to the core competencies, including evaluation materials and other programmatic
information and assurances required within this section;
(7) - (13)
(No change.)
§146.9.Certificate Issuance and Renewals.
(a) - (b)
(No change.)
(c)
Certificate renewal. Each promotor(a) or community health
worker, instructor and sponsoring institution or training program shall renew
the certificate biennially
(every two years)
.
(1) - (3)
(No change.)
(d) - (e)
(No change.)
§146.10.Continuing Education Requirements.
(a)
(No change.)
(b)
General. Continuing education requirements for recertification
shall be fulfilled during each biennial renewal period. A promotor(a) or community
health worker must complete 20 contact hours of continuing education acceptable
to the department during each biennial renewal period. An instructor must
complete at a minimum 20 contact hours of continuing education acceptable
to the department during each biennial renewal period.
(1)
At least 50% of the required number of hours shall be satisfied
by attendance and participation in instructor-directed activities
through
a department certified sponsoring institution/training program
.
(2)
No more than 50% of the required number of hours may be
satisfied through verifiable independent self-study. These activities include
reading materials, audio materials, audiovisual materials,
training not
certified by the department,
or a combination thereof which meet the
requirements set out in this section.
(3)
(No change.)
(c) - (f)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on June 22, 2005.
TRD-200502582
Cathy Campbell
Director, Legal Services
Department of State Health Services
Earliest possible date of adoption: August 7, 2005
For further information, please call: (512) 458-7236