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MASSACHUSETTS ASSOCIATION OF COMMUNITY HEALTH WORKERS

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THE BOARD DRAFTS POLICY ON SUITABILITY FOR CERTIFICATION

Members of the Board of Certification of CHWs have been working hard to develop policy guidelines for certifying individual CHWs and CHW training programs.  Last month alone, deliberations included the multi-faceted process that will determine an applicant’s suitability for certification, e.g. compliance with MA CHW Code of Ethics, understanding the CHW Professional Standards of Conduct, and an assessment policy on background check/CORI.  In addition, the Board’s new Executive Director, Roberlyne Cherfils, was announced, Erica Guimaraes was newly hired by the Office of CHWs at DPH, and Steve Bucchianeri was appointed to fulfill the seat of the Massachusetts Association of Health Plan Representatives.

But amidst staff changes, new appointments, and a visit from Dr. Monica Bharel, Commissioner of Public Health, Board members believe that CORI is a positive and consider MACHW’s employer waiver/affidavit useful.  However, others are confused and struggle with how to safeguard against legal issues (employers not being able to disclose information on CORI from their employees) and the technicalities this process can pose on the Division of Health Professions Licensure Department.

While voting on some of these matters is expected to take place during next month’s meeting, the Board’s overall consensus was observed to not wanting to take away from anyone (issuance of Certification to CHWs with CORIs) and understood that everyone deserves a second chance.  As Henrique Schmidt (MACHW seat holder) stated, “there is absolutely no question about that!”

Once the Board began to explore fact findings of the nature of criminal background/CORI issues, though, the concerns established in earlier meetings began to break down.  For example, Pauline Quirion of the Greater Boston Legal Services illustrated that considering matters Continued Without a Finding (CWOFs) could be an unfair practice because CWOFs for cases that are later dismissed are NOT convictions.  Since then, Board has proposed to only consider open cases and CWOFs that end in convictions.  Additionally, proposing a list with crimes that may not be related to CHW work was somewhat refuted.  The idea was to expand on a list of other relevant criminal convictions that are not sealed and which have a nexus to the job duties.  However, several Board members argued the document to be more confusing than helpful, and the complexity can further deter a CHW from applying.  Thus, the Board responded positively to the conducted research of considering a conviction history nexus determination matrix, but rejected such proposal until later use.  Furthermore, several Board members emphasized that Certification in MA will be based on Core Competencies and will not look at employment readiness but rather focus on the applicant’s competency in the 10 core areas.  Accordingly, the Board proposed to remove consideration of “other relevant criminal history” from the assessment.  Just as equally important, the proposed policy expanded on the list of evidence of rehabilitation efforts to be considered a plus for CHWs’ who have turned their lives around, such as education and training, substance abuse treatment, community contributions and/or volunteer work.

Even though arguments showed that “banning the box” on the application would with the Massachusetts provision in the law that went into effect in 2010 and makes it illegal for most to ask about any criminal record in initial applications, there are other reasons for the Board to know if an applicant may have a criminal history from another state, potentially compromising the public’s safety.  While the Board is committed to reducing barriers to employment for CHWs and reducing triggers that could deter a CHW from applying for Certification, a criminal background/CORI report in Massachusetts does not include history from other states.  Hence, the Board struggles with how to hold an applicant accountable in this matter, and further work on this topic is necessary.

Over the past 11 months, interest in how the Board will assess a CHW’s morale character has revived the voices and concerns of the CHW workforce, supporters and allies who know of affect and consequences of CORI’s relevancy for the advancement of the field.  After many months of fact finding, the process has illuminated that certain types of offenses will make a CHW less attractive as a hire for certain positions, but a CORI result should NOT be an automatic bar to Certification in Massachusetts and should not be a factor used to decide who can be Certified by the Board of Certification of CHWs.  Some of the potential best CHWs could be filtered out of the process before they even get the chance to help the clients and families who need them the most.  CHWs are distinguished from other health professionals because they are hired primarily for their understanding and shared-life experiences to the populations and communities they serve.  Indeed, Certification in Massachusetts will be voluntary and CHWs could opt out of applying while continuing to work in the field.  However, as changes in payment reform are being anticipated and payers see Certification as a prerequisite for payment, even as payment mechanisms are still being developed, a well-designed Certification process is crucial!

Next Steps on the Board of Certification of CHWs

The Board was acknowledged for listening to the concerns and issues of the workforce and understanding how this process could be challenging to carry out in perfection its first time around.  The results constituted support for the view that the merits of providing sustainable opportunities within the profession should be reviewed. The dialogue to make CORI a positive is certainly happening and the truth of the matter is (and it’s a sad truth) there are going to be people that do not want these jobs.  The Board’s draft policy on Suitability for Certification has improved language that provides criteria for the Board to use to establish the “good moral character” of CHWs.  MACHW members, staff, supporters and allies will continue to monitor this process and anticipate advocacy efforts to remain ongoing.

In the August meeting, it was stated the regulations are now moving, e.g. coming out of review by the Executive Office of Health and Human Services and on its way back to the Board with recommendations/edits.  Dr. Monica Bharel also addressed her commitment in advancing the field as she learned about the Board members’ and the general public’s interests and concerns in moving the regulations forward.  Thus, the Board contended the process could now move rather quickly and will be deciding on some of the standing issues, which include voting on the language proposed for Suitability for Certification during the next meeting.  There will be a 35-day public hearing comment period shortly thereafter.  Meanwhile, MACHW still stands to test-field the application and learn from CHW input on its perceived feasibility and applicability.

The next Board of Certification of CHWs meeting is scheduled for Tuesday, September 13, from 9:30am - 1:00pm at the Division of Health Professions Licensure, 239 Causeway St, Boston (near North Station T stop) in Conference Rooms 417 A&B. The agenda will be posted one week prior to the meeting on the Board's website.  The Board meetings are open to the public. MACHW members are welcome to attend.

Click HERE for a quick summary of the latest updates.