Law, Regulation and Policy
Law
Texas Health and Safety Code, Chapter 48 requires the Texas Department of State Health Services (DSHS) to establish and operate a certification program for persons who act as promotores or community health workers (CHWs) and outlines general provisions for the program.
Bills
House Bill 1864 was passed by the 76th Texas Legislature, Regular Session, in May 1999, to direct the Texas Department of Health (TDH) to establish a temporary promotora program development committee to study issues related to the development of outreach and education programs for promotoras or CHWs and advise the department, the governor, and the legislature of its findings. The act authorizes the committee to establish a series of neighborhood-based peer health outreach and education pilot projects to demonstrate the feasibility and benefits of employing promotoras to assist beneficiaries of the Medicaid managed care and Children's Health Insurance Program programs.
House Bill 1864 also required TDH to establish and operate a program designed to train and educate persons who act as promotoras by using as a resource the uniform curriculum for training and educating promotoras developed by the Health Education Training Centers Alliance of Texas. Additionally, TDH was required to establish and operate a certification program for persons who act as promotoras.
Senate Bill 751 was passed by the 77th Texas Legislature, Regular Session, in May 2001, to direct the Health and Human Services Commission to require health and human services agencies to use certified promotores to the extent possible in health outreach and education programs for medical assistance recipients.
Senate Bill 1051 was passed by the 77th Texas Legislature, Regular Session, in May 2001, to add CHWs to current law relating to the training and regulation of promotoras. The bill required TDH to consider and implement the recommendations of the Promotora Program Development Committee in establishing the training program. The bill made the training and education program voluntary for promotoras and community health workers who do not receive compensation and mandatory for those receiving compensation. The bill authorized the Texas Board of Health to exempt a promotora or CHW from mandatory training if the person has served for three or more years or has 1,000 or more hours of community service.
House Bill 2610 was passed by the 82nd Legislature, Regular Session, in May 2011, to establish a statewide Promotora and CHW Training and Certification Advisory Committee to advise DSHS and HHSC on certain matters relating to the training, regulation, employment, and funding of promotoras and community health workers. The bill required DSHS, in coordination with HHSC, to study matters relating to employing promotoras and CHWs to provide certain healthcare services; and to develop recommendations for increasing employment of and access to promotoras and CHWs and expanding funding and reimbursement for the provision of such services. DSHS was required to report the findings of the study to the legislature on or before December 1, 2012.
Read the Texas Community Health Worker Study Report (pdf) as required by HB 2610.
Regulation
As required by Texas Health and Safety Code, Chapter 48, DSHS implemented regulations in 25 Texas Administrative Code, Chapter 146 to provide the minimum standards and guidelines for operating the CHW Program. DSHS considers the applicable recommendations of the CHW Advisory Committee in adopting and revising these regulations.
These regulations are reviewed at least once every four years. Engaging CHWs, CHW Instructors, and other stakeholders is an important element of the rulemaking process. The CHW Program provides informal and formal opportunities for the public and stakeholders to participate in the process. You can participate by:
- offering informal comments.
- commenting on proposed rules published in the Texas Register.
- providing input to the CHW Advisory Committee.
- attending an HHSC Executive Council meeting.
- submitting a petition for rulemaking to the executive commissioner.
CHW Program Policy
The Community Health Worker (CHW) or Promotor(a) Training and Certification Program Policy establishes certification and renewal criteria for CHWs, CHW Instructors, and CHW training programs. The Policy implements and expands the general provisions in state law and the minimum standards and guidelines in state regulation within the authority they provide. You may view the Policy in English and Spanish.
Community Health Worker (CHW) or Promotor(a) Training and Certification Program Policy - English Version
Reglamento del Programa de Capacitación y Certificación de Trabajadores o Promotores de Salud Comunitaria - Spanish Version