Arizona Administrative Code
Title 9 - HEALTH SERVICES
Chapter 16 - DEPARTMENT OF HEALTH SERVICES - OCCUPATIONAL LICENSING
Article 8 - COMMUNITY HEALTH WORKERS
Section R9-16-805 - Certification Renewal

Universal Citation: AZ Admin Code R 9-16-805

Current through Register Vol. 30, No. 12, March 22, 2024

A. From the date of issuance, a CHW certification is valid for two years.

B. At least 30 calendar days before the expiration date of a certification, an applicant shall submit to the Department:

1. A renewal application in a Department-provided format that contains:
a. The applicant's name, home address, telephone number, and e-mail address;

b. The applicant's certification number and date of expiration;

c. Since the previous certification application, whether the applicant has been convicted of a felony or a misdemeanor involving moral turpitude in this or another state;

d. If the applicant was convicted of a felony or a misdemeanor involving moral turpitude:
i. The date of the conviction,

ii. The state or jurisdiction of the conviction,

iii. An explanation of the crime of which the applicant was convicted, and

iv. The disposition of the case;

e. Whether the applicant has had, within two years before the renewal application date, a certificate suspended or revoked by any state;

f. An attestation that:
i. The applicant has completed 24 hours of continuing education required in R9-16-806 and documentation of the completed continuing education is available upon the Department's request;

ii. The applicant authorizes the Department to verify all information provided in the renewal application packet;

iii. The information submitted as part of the renewal application packet is true and accurate; and

iv. The applicant's signature and date of signature.

2. A fee specified in R9-16-810.

C. Documentation of an applicant's conviction of a felony or a misdemeanor involving moral turpitude in this or another state that includes the information specified in subsection (A)(1)(d) issued by the prosecuting state or jurisdiction.

D. An applicant who does not submit the documentation and the fee in subsection (B) shall apply for a new certificate in R9-16-804.

E. The Department shall review the application and required documentation for renewal certification as a CHW according to R9-16-808 and Table 8.1.

Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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