What You Need
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To reactivate an expired Community Health Worker Certificate, you will need to complete and submit an application for reactivation. ● Submission of the notarized Criminal Offender Record Information Request Form (CORI). ● Documentation of compliance with the Board’s Continuing Education requirement. A minimum of 15 CEUs for the most recently completed CEU cycle are required. CEU renewal cycles begin July 31, odd year and end July 30, next odd year. NOTE: certificate holders are exempt from completing CEUs for the 2019-2021 renewal cycle. ● If you hold, or have ever held, any professional license or certification, you must request and submit a National Practitioner Data Bank-Healthcare Integrity and Protection Data Bank Self-Query. To request a Self- Query, please contact the National Practitioner Data Bank at 1-800-767-6732 or at www.npdb-hipdb.com. Include the ORIGINAL results with this application; keep a copy for your records. ● Check or money order payable to the Commonwealth of Massachusetts. Cash or foreign currency is not accepted. ● Submission of completed reactivation application and fee acknowledges that the licensee understands and agrees to all provisions herein. Reactivation applications are void if requirements for reactivation of a Community Health Worker Certification license are not met within one (1) year from the date of Board receipt of this reactivation application. All fees are non-refundable and non-transferable. ● Reactivation application must be submitted on single-sided paper. ● Retain a copy of the completed reactivation application and related documents for your records. |
Fees
We accept checks or credit cards as payment. Make checks payable to The Commonwealth of Massachusetts. All fees are non-refundable and non-transferable. Please don't send cash.
Please note, ALL applications for reactivation require a late renewal fee.”
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Name |
Fee |
Unit |
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Renewal for Fully Certified Community Health Workers |
$35 |
Each |
|
Late Renewal Fee |
$57 |
Per late license renewal (in addition to renewal fee) |