State Community Health Worker Models

As states transform their health systems many are turning to Community Health Workers (CHWs) to tackle some of the most challenging aspects of health improvement, such as facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health. While state definitions vary, CHWs are typically frontline workers who are trusted members of and/or have a unique and intimate understanding of the communities they serve. This map highlights state activity to integrate CHWs into evolving health care systems in key areas such as financing, education and training, certification, and state definitions, roles and scope of practice. The map includes enacted state CHW legislation and provides links to state CHW associations and other leading organizations working on CHW issues in states.

Updated August 2017 except for HI and NE

Development and ongoing updates of the State Community Health Worker Models Map would not be possible without the generous support of the Robert Wood Johnson Foundation and the National Center for Healthy Housing.

Map
Green Click for more information. (47 states and DC)
Light Blue No state activity on CHWs identified at this time. (3 states)

Financing
AL Alabama Medicaid does not reimburse CHW services.
AK The Community Health Aide Program (CHAP) was initially federally funded, with formal training standards established, in 1968. A State Plan Amendment effective July 1, 2017, allows all levels of certified Community Health Aides/Practitioners (CHA/Ps) to be reimbursed for services to Medicaid beneficiaries. Most funding still comes from the Indian Health Service, with additional tribal, grant, or federal Community Health Center funding. CHAs are not considered by some to be the same as CHWs.
AZ Funding for CHWs through community health centers, universities, and health care plans. Pursuing Medicaid and health insurance funding streams. Moving to value-based payment creates opportunity for plans to pay for CHWs. Funding from the HRSA Rural Network Development Planning Grant Program to develop a statewide network of stakeholders to support Arizona Community Health Outreach Workers Network in moving Arizona’s CHW agenda forward.
AR Medicaid does not currently reimburse for CHW services. CHWs are financed primarily through grants or core budget funding. The Arkansas Community Health Worker Association (ARCHWA) maintains a list of state CHW programs and their funding sources.
CA Currently, health plans, community-based organizations, and other employers of CHWs generally pay for them through grant funding or operating funds (CHW work group report p. 19).
CO Some CHW work is compensated through Medicaid Regional Care Collaborative Organizations (RCCOs) (See p. A-10 of this June 2016 report). A state grant programfunds some Community Health Worker and Patient Navigator training programs.
CT  CHW work receives grant funding through FQHCs, community-based organizations, and WISEWOMAN and other CDC funding.
DC CHWs are covered through payments to primary care teams participating in the Health Homes 2 Model for persons with multiple chronic conditions (My Health GPS) that includes CHWs among other providers. See also the National Center for Healthy Housing’s case study on Medicaid Reimbursement for Home-Based Asthma Services in the District of Columbia.
DE Christiana Care’s Health Ambassador Program is funded through the federal Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. The state’s CHW sub-committee recommends requiring certification for CHWs working under the supervision of a licensed Medicaid provider to allow for Medicaid reimbursement for CHW services.
FL CHWs are hired by community-based organizations, universities (especially those conducting research on disparities and population-based approaches to dealing with health equity), FQHCs, and Medicaid managed care organizations. Hiring at community-based organizations and universities depends on grant availability.
GA  Currently, CHW programs are funded through private, grant and organizational funds.
HI  Not currently.
IA Iowa Medicaid does not reimburse CHW services.
ID Healthy Connections, Idaho Medicaid’s Primary Care Case Management (PCCM) program, incentivizes primary care providers (PCPs) to incorporate CHWs into their care coordination model by offering a higher per-member per-month (PMPM) case management payment. However, in the year that the program has been in place, no PCPs have opted to implement CHWs into their care coordination model as of June 2017.
IL  Illinois Medicaid does not currently reimburse CHW services. The Illinois Community Health Worker Advisory Board recommended reimbursement options in its report.
IN  Indiana Medicaid does not reimburse CHW services.
KS Some KanCare (Medicaid) MCOs employ CHWs. There is no state requirement for MCOs to use CHWs, but connections are highly encouraged.
KY Mostly funded through grants or organizations large enough to absorb the costs (i.e., hospitals, FQHCs). One county health department funds a CHW program through a grant from the HRSA Office of Rural Health Policy. The Kentucky Cabinet for Health and Family Services supports Kentucky Homeplace, a CHW program in collaboration with the University of Kentucky Center of Excellence in Rural Health.
LA  All Louisiana Medicaid Managed Care Organizations (MCOs) employ CHWs.
ME Practices involved in Maine’s Health Homes program must include a Community Care Team (CCT), and CHWs are explicitly listed (p. 4) as potential team members. The CCTs are reimbursed through Medicaid Health Homes. Maine’s SIM grant (p. 8) included five CHW pilot sites.
MD CHWs are financed primarily through grant funding. While Medicaid does not reimburse for CHWs, Medicaid Health Maintenance Organizations (HMOs) are believed to employ CHWs. CHWs are a key element of the state’s SIM plan.
MA CHW positions are funded primarily through grants and health system operating and healthcare transformation funds. Additional sources include federal, state and local governments; health plans; and private and non-profit funding. The Delivery System Reform Incentive Payment (DSRIP) program in Massachusetts Medicaid’s section 1115 demonstration includes funding that can support CHWs.Massachusetts Medicaid’s demonstration program for dually eligible adults allows coverage for some CHW services. Pursuant to the 2012 payment reform law (Chapter 224), ACOs can pay for CHWs as part of multidisciplinary care teams in a global fee structure. The Prevention and Wellness Trust Fund supports CHW services, and the Health Care Workforce Transformation Fund supports the training of emerging health care workforces.
MI In its Medicaid managed care contract, the state requires health plans to maintain a ratio of at least one full-time CHW per 20,000 covered lives; provide or arrange for the provision of CHW or peer-support specialist services to enrollees with behavioral health issues and complex physical co-morbidities; and establish a reimbursement methodology for CHW work that promotes behavioral health integration. In addition, CHWs are part of the interdisciplinary MI Care Teams under the Section 2703 State Plan Amendment. Many health plans have contracted with programs that do asthma trigger reduction work with CHWs as well as other work.
MN Health plans that contract with Minnesota’s Medicaid agency to provide services to Minnesota Health Care Programs enrollees are required to cover diagnosis-related patient education on self-management services provided by certified CHWs working under clinical supervision. The state Medicaid program also reimburses CHWs on a fee-for-service basis as well as via managed care plan payments. CHWs also provide mental health patient education and care coordination pursuant to a Medicaid state plan amendment.
MS Private funding sources.
MO Currently, health care entities or community organizations fund CHW positions in Missouri. The Missouri HealthNet Division is piloting the use of CHWs in its Primary Care Health Home Program in Kansas City, Springfield, Branson and Joplin. In addition, Medicaid reimburses for home-based asthma services.
MT Montana has funded CHWs through CPC+ and through a HRSA Frontier Community Health Care Coordination Demonstration Grant (HRSA-11-202). The model used a care coordination approach involving frontier Community Access Hospital communities.
NC There is no formal structure to reimburse CHW services in North Carolina.
ND North Dakota Medicaid does not reimburse CHW services. A 2012 SPA allows Medicaid reimbursement for some services provided by tribal Community Health Representatives.
NE CHWs are funded by: grants to local hospitals, and the Nebraska Department of Health and Human Services (NDHHS), Division of Public Health. NDHHS administers Minority Health Initiative funding to counties with 5% or greater minority population, and those projects may choose to include CHWs in their work plans and budgets. Of the 16 current projects, 10 include CHWs in some capacity. In addition, DHHS funds patient navigation training for CHWs. There is additional funding available from other offices and programs within DHHS, but it varies from year to year. It is also affected by a variety of other factors (e.g., readiness of the evolving CHW structure to take on additional projects and outcomes). There is no long-term funding for CHWs from within DHHS and Medicaid does not pay for CHW services. CHW activities are not part of payment reform in NE and there is no plan to submit a Medicaid State Plan Amendment.
NH CHWs are primarily grant-funded. As part of the Delivery System Reform Incentive Payment (DSRIP) program under the section 1115 demonstration, New Hampshire established regional coalition of providers called Integrated Delivery Networks (IDNs) that include CHWs. The Division of Public Health Services has provided scholarship support for CHW training and has provided grant funding to support CHW positions.
NJ Medicaid managed care contracts encourage MCOs to employ CHWs.
NM  Through a Medicaid 1115 WaiverCentennial Care has leveraged contracts with Medicaid managed care organizations (MCOs) to support the use of CHWs in serving Medicaid enrollees. CHW salaries, training, and service costs are MCO administrative costs and embedded in capitated rates paid to Medicaid managed care organizations.
NV Nevada’s CHW Program is funded through the Preventive Health and Health Services Block Grant through the Center for Disease Control and Prevention.
NY CHWs can be optional team members of Health Home care teams, although the language used in the state plan amendment is “outreach workers including peer specialists” (p.8). According to the National Center for Healthy Housing’s case study on Medicaid Reimbursement for Home-Based Asthma Services., New York has proposed to use CHWs to deliver home-based asthma care in many of its pending Delivery System Reform Incentive Payment (DSRIP) initiatives.
OH  Not currently.
OK Oklahoma Medicaid does not reimburse CHW services.
OR The State Plan Amendment (SPA) that created Patient-Centered Primary Care Homes (PCPCHs) explicitly includes CHWs in its description of providers for four of the six core Health Home services. CCOs currently provide care within Medicaid, but are being expanded to other groups. CCOs are required to include “non-traditional healthcare workers” like CHWs on their care teams. CHWs must be certified to qualify for Medicaid reimbursement. A health professional must supervise a CHW in order for Medicaid to reimburse for services provided.
PA Medicaid is the largest source of funding for CHWs in Pennsylvania, followed by Federal Grant Categorical Funding. CHW programs at behavioral health organizations are funded primarily through Medicaid. Medicaid managed care organizations consider CHW expenditures as clinical care costs. Pennsylvania provides Medicaid coverage for Peer Support Specialists (PSS) in the behavioral health field, and some PSS providers are considered CHWs. The Department of Human Resources oversees PSS.
RI CHW positions in Rhode Island are grant-funded, incorporated into the operating budgets, and through bundled services (i.e., community health teams). Some CHWs may bill services under a portion of their jobs (specific licensure or services approved for reimbursement).  There is growing support for CHWs through value based payment options, RI’s Accountable Entities and Medicaid managed care.
SC The state encourages Medicaid MCOs to use CHWs. According to the National Center for Healthy Housing’s case study on Medicaid Reimbursement for Home-Based Asthma Services, there are ongoing efforts to better incorporate CHWs into the healthcare system.
SD No information at this time.
TX The Health and Human Services Commission (Medicaid agency) contracts with MCOs and allows CHW costs to be included in administrative costs in order to receive reimbursement. A 2016 HHSC survey of Texas Medicaid found 18 of 19 MCOs employing CHWs or contracting for CHW services. CHWs are incorporated in a number of quality improvement projects under the state’s 1115 waiver. Clinics and hospitals use waiver funds to hire CHWs. The Title V Maternal and Child Health block grant supports the Promotor(a) or Community Health Worker Training and Certification Program, and also supported Zika education for CHWs in 2017.
UT Primarily grant funded; grants usually received by community-based organizations. Some Accountable Care Organizations cover the costs of CHW services through Medicaid administrative payments. Molina Health Care hires CHWs to work with clients.
VT CHWs are a standard part of Vermont’s Community Health Teams (CHTs), which are an integral part of their SIM narrative. The CHTs are paid for by Vermont’s Multi-Payer Advanced Primary Care Practice Demonstration pilot, which involves a monthly care management fee for beneficiaries receiving primary care from advanced primary care (APC) practices. Costs are shared among Vermont’s major insurers, as well as Medicare and Medicaid. According to the National Center for Healthy Housing’s case study on Medicaid Reimbursement for Home-Based Asthma Services, CHWs provide environmental assessments to identify ways to reduce asthma triggers.
VA Virginia Medicaid does not reimburse CHW services.
WA Washington’s 1115 demonstration allows CHWs to be paid as a part of Medicaid value-based payment. CHWs can be part of Washington’s Health Homes, which allows them to receive Medicaid funding for each patient served. According to the National Center for Healthy Housing’s case study on Medicaid Reimbursement for Home-Based Asthma Services, CHWs provide environmental home assessments through a program supported by the Environmental Protection Agency.
WI Medicaid health plans can fund CHW care coordination work via non-administrative funds as of January 2017. Medicaid funds Prenatal Care Coordination and Peer Support Specialists, some of whom are Community Health Workers. Wisconsin stakeholders have written the Business Case for Coordinated Team-Based Care, which includes CHWs.
WV CHWs are listed as optional members of Behavioral Health Health Home care teams (p. 5), which are financed by Medicaid through pre-set payments per member, not Fee for Service.
Education
AL No state approval process for training programs or curricula.
AK The federally authorized Community Health Aide Program Certification Board approves training and continuing education programs in Alaska. Four regional training centers. Requirements vary based on level of practice.
AZ Arizona Community Health Outreach Workers Network offers annual trainings. Local Area Health Education Centers, Federally Qualified Health Centers, and the University of Arizona provide ongoing evidence-based training on a number of health issues.
AR ARCHWA endorsed the Community Health Worker Core Consensus (C3) Project’s 2016 Recommendations on CHW scope of practice and professional competencies. ARCHWA is developing a model standardized, competency-based educational program for state approval.
CA No state approval process for training programs or curricula.
CO  Two health navigator training programs are available but are not required or certified by the state.
CT Southwestern CT AHEC offers CHW training.
DC DC does not approve training programs or curricula.
DE  The CHW sub-committee recommends the establishment of a Curriculum Development Committee and two entry points for training (for high school students and non-high school students).
FL The Florida CHW Coalition (FCHWC) CHW Certification Implementation Team has developed 28 CHW tasks in five performance domains. The Florida AHEC network and community colleges around the state provide training. Many organizations working with CHWs, such as MHP SaludRural Women’s Health ProjectHealthstreet, and ConnectFamilias have developed their own training program. The Florida Certification Board approves curricula for CHWs.
GA  No state approval process for training programs or curricula.
HI Healthcare Innovation Plan includes CHW training (p.27).
IA No state approval process for training programs or curricula.
ID There is no state approval process for educational programs or curricula. The Idaho Department of Health and Welfare offers a CHW training course through Idaho State University, in support of its Statewide Healthcare Innovation Plan initiative (SIM Model Test).
IL The Community Health Worker Act creates minimum core competencies for CHWs; an Advisory Board can consider other competencies.
IN Indiana Community Health Workers Association reviews and certifies curriculum of training vendors.
KS No state approval process for training programs or curricula.
KY  There is no state approval process for training programs or curricula, although the Kentucky Homeplace program requires instruction and internship. All CHWs have received the American Lung Association‘s Healthy Homes training.
LA  The state approves a statewide training program for peer support specialists. The Louisiana Community Health Worker Training Institute offers a core competency training program that is not state approved.
ME CHW core curriculum training is supported by the state. There are also additional public health department trainings available for CHWs from the state (Maine CDC). Maine Community Health Worker Initiative (MECHWI) has developed a core competency/skills/roles cross-walk to inform the development of training recommendations. Training provided by employers or tied to specific projects.
MD No state approval process for training programs or curricula.
MA Core CHW training is offered by community-based organizations, a local health department, a university school of public health, and community colleges. Training programs address ten core competencies.
MI MiCHWA’s Education and Workforce working group develops CHW training standards.
MN Minnesota Medicaid recognizes the state-wide standardized, competency-based educational program based in accredited post-secondary school; overseen by MN State Colleges and Universities System.
MS No state approval process for training programs and curricula. .
MO CHW certificate training programs are provided at local community colleges. Core competencies include communication, organization and resources, life style choices, cultural beliefs and healthcare, legal and ethical considerations, and employability skills. Through federal funding, tuition reimbursement is available for individuals enrolling in the training program. A CHW ECHO (Extension for Community Healthcare Outcomes) is being developed to continue providing educational opportunities for CHWs.
MT Training developed by Montana Office of Rural Health and State AHEC office.
NC No state approval process for training programs or curricula.
ND No state approval process for training programs or curricula.
NE NE CHW Coalition has assessed training program and developed recommendations for core competencies and scope of practice recommendations, number of hours of classroom/online instruction and practicum requirement, and consideration of grandfathering CHWs. NDHHS offers patient navigation training for CHWs which includes a full-day, face-to-face training; then 10 weeks of computer-based learning; a second full-day face-to-face training; plus a practicum.
NH The Southern NH Area Health Education Center (AHEC) offers a CHW training program which includes a variety of topicsThe Northern NH Area Health Education Center (North Country Health Consortium) offers a hybrid online/in person CHW training program.
NJ The New Jersey Department of Labor and Workforce Development recognizes the Rutgers Health Care Talent Network’s CHW training program.
NM The NM Department of Health approves some CHW training and continuing education programs.
NV Nevada has two approved CHW training programs: 1) The Nevada System of Higher Education offers CHW trainings at two local community colleges; 2) The Nevada Division of Public and Behavioral Health (DPBH) offers a training course quarterly.
NY Department of Health’s CHW Program in maternal and child health trains CHWs to provide health education, referrals, and support for individuals navigating the health system.
OH  Training program must be state approved; at least 100 hours of classroom instruction and 130 hours of clinical instruction, standard training exam.
OK No state approval process for training programs or curricula.
OR Training centers are certified through the Traditional Health Worker CommissionCore competencies include outreach and mobilization; community liaising; care management, care coordination, and system navigation; and health promotion and coaching. CHWs are trained in lead prevention and asthma trigger reduction.
PA Academic institutions, health organizations, and health systems offer CHW training as well as Area Health Education Centers (AHECs). Pennsylvania Department of Health’s CHW Project Strategy includes recommending the eight core skills in the National CHW Workforce Study.
RI CHW training is largely subsidized by a variety of RI state departments (health, labor & training, Medicaid, and higher education), private foundations and some employers. There is no standardized curriculum for CHWs in RI; however, certification requires education in specified domains: engagement methods & strategies, individual & community assessment; culturally & linguistically appropriate responsiveness; promote health & well-being; care coordination & system navigation; public health concepts & approaches; advocacy & community capacity building; safety & self-care; and ethnical responsibilities & professional skills.
SC The SC CHW Association is developing a statewide continuing education program for certification.
SD Lake Area Technical Institute’s proposal to the Office of Career and Technical Education at the South Dakota Department of Education has been approved, and the institute will begin offering a Community Healthcare Worker program in fall 2018.
TX Community colleges, other academic institutions, AHECs, Federally Qualified Health Centers (FQHCs), a CHW network, and community-based organizations train CHWs. Other activities may serve as proxies for demonstration of core competencies
UT The Utah CHW Broad-Based Coalition (CHWC) Advisory Board is expected to approve a statewide curriculum developed by a group of CHWs commissioned by a group of cross-sector stakeholders.
VT No state approval process for training programs or curricula.
VA The CHW Association and CHW Advisory Group are looking at core competencies and training requirements.
WA Training through the Department of Health establishing core competencies for CHWs. CHW receives a certification of completion. The Community Health Worker Task Force’s report (p. 12) provides recommendations for developing CHW training and education initiatives and programs; the recommendations include framework, content, instructional, and organizational considerations.
WI There is a state-approved CHW Registered Apprenticeship, which was developed as part of a collaboration between State Department of Workforce Development and State Department of Health Services. CHW training programs are provided by the Milwaukee AHEC and UniteMKE Pathways Community HUB, through the Department of Workforce Development.
WV No state approval process for training programs or curricula.
Certification
AL Not required by the state.
AK The Community Health Aide Program Certification Board certifies CHA/Ps at all levels of practice. Certification is necessary for Medicaid reimbursement pursuant to the SPA.
AZ Four voluntary certificate programs administered by community colleges and one nonprofit training center. Certificate programs do not necessarily constitute certification.
AR Not required by the state.
CA Not required by the state.
CO Not required by the state. Stakeholders are working toward voluntary credentialing through the state.
CT Public Act No. 17-74 passed in June 2017 requires the Director of the State Innovation Model to study the feasibility of creating a CHW certification program.
DC Not currently required.
DE The CHW sub-committee recommends the state to establish a voluntary certification program and a CHW certification board.
FL FCHWC offers voluntary certification, administered by the Florida Certification Board.
GA No state approval process for training programs or curricula 
HI Not currently.
IA Not required by the state.
ID Not required by the state.
IL The Illinois Community Health Worker Advisory Board developed core competencies for training and certification of CHWs.
IN Indiana Community Health Workers Association (INCHWA) is the certifying body for Indiana and is developing a state certification exam that must be passed after testing done by an INCHWA-certified training vendor.
KS Not required by the state.
KY The CHW State Workgroup is developing a certification plan and curriculum.
LA Not required by the state.
ME Not required by the state.
MD Not required. The Workgroup on Workforce Development for CHWs recommended that certification be considered.
MA Board of Certification of CHWs will begin voluntary certification of CHWs in 2017. For the first three years that certification is available, there will be a grandparenting period. Approved CHW continuing education will be required for renewal every two years.
MI Not required by the state.
MN Not required for employment, but required for Medical Assistance reimbursement for services provided to MN Health Care Program enrollees.
MS Tougaloo CollegeCentral Mississippi Area Health Education Center and state Department of Health are working to establish a CHW certification program, but certification is not required by the state.
MO The Statewide CHW Advisory Committee is discussing certification and recommended core competencies, which were approved by the Department of Health and Senior Services.
MT Not required by the state; under discussion.
NC Not required by the state.
ND Not required by the state.
NE Not currently. Indian Health Service certifies Community Health Representatives. The NE CHW Coalition Steering Committee Standards Workgroup developed certification recommendations.
NH Not required by the state.
NJ A certificate is awarded to those who complete the CHW training program. Certificate programs do not necessarily constitute certification.
NM Certification is voluntary and through Department of Health. Applicants must complete a Department-approved training program and demonstrate proficiency in CHW core competencies.
NV Not required by the state.
NY Not currently.
OH Board of Nursing issues and renews certificates biennially; continuing education required. Individuals must be at least 18 years old, have a high school diploma, complete the CHW training program, and pass criminal background check. CHW must be supervised by a health professional and is restricted from performing services requiring a professional license.
OK Not required by the state.
OR Encouraged but not required for employment. Only certified CHWs participate in Health Homes. CHWs can apply for certification after completing a state-approved training program.
PA Not required by the state.
RI Certification is available for all CHWs (paid or volunteer) who meet certification standards through the Rhode Island Certification Board. Certification is not mandatory. The Rhode Island Department of Health endorses, promotes and supports certification.
SC The state does not grant certification, but training and certification are a part of each individual program throughout the state. SC CHW Association is developing a statewide certification program.
SD Students in the Community Healthcare Worker program will be able to earn a certificate after completing six months of the 18-month program. Certificate programs do not necessarily constitute certification.
TX Texas Department of State Health Services (DSHS) established and operates Promotor(a) or Community Health Worker Training and Certification Program for CHWs and instructors. Certification is for 2 years. DSHS reviews and approves all certification, training and continuing education. There are two CHW certification pathways in Texas: experience or training. The certification program also oversees certification for CHW training instructors and training programs/sponsoring organizations.
UT Not required by the state.
VT Not required by the state.
VA The CHW Association and CHW Advisory Group are looking at certification options.
WA Not required by the state.
WI Not required by the state.
WV Not required by the state.
State CHW Legislation
AL None
AK HB 209 (enacted 1993): Community Health Aide Program (CHAP) provided grants for third parties to train community health aides as Community Health Practitioners with an exam at the end of training.
AZ The Arizona CHW Workforce Coalition is exploring options for legislation.
AR None
CA Section 6332 of the California Labor Code contains a limited definition of CHWs.
CO None
CT Public Act No. 17-74 passed in June 2017 defines CHWs and requires the Director of the State Innovation Model to study the feasibility of creating a CHW certification program, including the fiscal impact of implementing the program, in consultation with the CHW Advisory Committee and the Commissioner of Public Health.
DC None
DE None
FL None
GA None
HI Not currently.
IA None
ID None
IL HB 5412 (enacted 2014) creates an Advisory Board in Department of Public Health. Prohibits CHWs from performing services requiring a professional license.
IN None
KS None
KY None
LA None
ME None
MD HB 856 established a Workgroup on Workforce Development for Community Health Workers to make recommendations on CHW training, credentialing, and financing. The Workgroup completed its final report in June 2015.
MA Chapter 58, Acts of 2006 Section 110; and Chapter 224, Acts of 2012Chapter 322, Acts of 2010 (enacted 2012) to establish a board in the Department of Public Health to certify CHWs. A law in 2007 created a seat on the Public Health Council for a representative from the Massachusetts Association of Community Health Workers, and the 2012 health reform law includes a similar seat for CHWs on the Prevention and Wellness Trust Fund Advisory Board.
MI None
MN Minnesota Statutes 256B.0625, Subd. 49 allows CHWs to participate in Medicaid program and receive payment for certain services.
MS None
MO None
MT None
NC None
ND None
NE Not currently.
NJ None
NH None
NM SB 58, Community Health Workers Act, creates a voluntary, statewide certification program for CHWs through the Department of Health.
NV SB 498 passed in 2015 mandates the licensure of CHW Pools, which are organizations or agencies that hire CHWs. The law does not provide for individual CHW certification or licensing.
NY Not currently.
OH HB 95 (enacted 2003) to require Board of Nursing to issue and renew CHW certificates.
OK None
OR HB 3650 mandated the Oregon Health Authority (OHA) to develop education and training requirements and authorized Coordinated Care Organizations to provide members with access to Traditional Health Workers. HB 3407 established the Traditional Health Worker Commission, which oversees CHWs, Peer Support and Peer Wellness Specialists, Personal Health Navigators, and Doulas. HB 2024 requires OHA to adopt rules and procedures for the training and certification of health workers to provide oral disease prevention services.
PA None
RI H 5633 (enacted 2011) established the Commission for Health Advocacy and Equity. Commission must make recommendations for increasing diversity of health care workforce, which may include recruitment, training and employment of CHWs.
SC None
SD No information at this time.
TX Texas Health and Safety Code Chapter 48 requires DSHS to establish and operate a certification program for CHWs. SB 1051 (enacted in 2001) requires DSHS to establish a CHW training program to oversee certification; certification is only mandatory for CHWs compensated for services. HB 2610 (enacted 2011) required DSHS to establish a statewide advisory committee to provide recommendations on CHW training, funding and employment.
UT None
VT None
VA Virginia is exploring legislation for introduction in January 2018.
WA None
WI None
WV None
Organizations & Workgroup
AL None
AK Alaska Community Health Aide ProgramCommunity Health Aide Association
AZ Arizona Community Health Worker Association
AR Arkansas Community Health Worker Association
CA California Association of Community Health WorkersVisión y CompromisoSan Diego County Promotores Coalition
CO Patient Navigator, Colorado Community Health Worker & Promotor de Salud Alliance
CT CHW Association of ConnecticutCHW Advisory CommitteeConnecticut Area Health Education Center Program
DC CHW Professional Association of Washington, DC
DE CHW sub-committee, guided by the Delaware Center for Health Innovation and Division of Public Health, was charged with developing recommendations to integrate CHWs into Delaware’s health professions’ workforce in a systemic and sustainable way. The sub-committee released its report in June 2017.
FL Florida Community Health Worker Coalition
GA The Georgia CHW Advisory Board was established in May 2017 with the purpose of aligning efforts statewide to define, train, and certify CHWs, and to provide recognition to this growing group of professionals.
HI Not currently.
IA The Iowa Chronic Care Consortium (ICCC) convened the Iowa CHW Alliance.
ID CHW Advisory Group
IL Chicago CHW Local Network; the Illinois Community Health Worker Association
IN Indiana Community Health Workers Association
KS Kansas Community Health Worker Coalition
KY The Kentucky Association of Community Health Workers (KYACHW) was formed in 2016. There is also a CHW State Workgroup.
LA Louisiana Community Health Outreach Network
ME Maine Community Health Worker Initiative
MD None
MA Massachusetts Association of Community Health Workers
MI Michigan Community Health Worker Alliance (MiCHWA)
MN Minnesota CHW Peer NetworkMinnesota Community Health Worker Alliance
MS None
MO The Statewide CHW Advisory Committee is discussing the development of a CHW organization.
MT None
NC Two workgroups formed to address CHW Core Competencies and Curriculum and Certification Requirements and Processes. They released their recommendations during a CHW Summit in November 2016.
ND None
NE In December 2014, the Public Health Association of Nebraska approved a CHW Section. This section will develop as a statewide association.
NH Southern NH AHEC and Northern NH AHEC. The NH CHW Coalition is active and building membership.
NJ None
NM New Mexico Community Health Worker Association
NV The Nevada CHW Association (NvCHWA) was established as the central agency for CHWs in Nevada.
NY Community Health Worker Network of New York City
OH Ohio Community Health Worker Association
OK None
OR Oregon Community Health Workers AssociationTraditional Health Worker Commission
PA A Statewide Summit in May 2015 led to the development of four task forces: the Steering Group, Policy Group, Employer Group, and Training Group.
RI Rhode Island College and the Rhode Island Department of Health sponsor the Community Health Worker Association of RI.
SC South Carolina Community Health Worker Association (SCCHWA)
SD No information at this time.
TX CHW Advisory Committee and regional organizations but no statewide CHW organization.
UT Utah Public Health Association CHW Special Interest Group.
VT None
VA Virginia CHW Advisory Group, Virginia CHW Association
WA There is not currently an active statewide network of CHWs. A state CHW task force published its recommendations to the state in 2016.
WI Wisconsin CHW AllianceUnited Voices
WV None
CHW Roles in State
AL Not defined by the state.
AK CHWs function as Community Health Aides and Practitioners, Dental Health Aides, and Behavioral Health Aides, each of whom is subject to specific standards of practice defined by Certification Board and in the CHAP manual.
AZ The Arizona Department of Human Services (DHS) has formed a CHW Leadership Council to define roles; the Arizona CHW Workforce Coalition and state DHS use the American Public Health Association’s (APHA) definition and defined competencies and scope of practice. CHWs in AZ provide preventive services, such as chronic disease management and health education.
AR CHWs provide outreach and resources to people in three rural counties as part of the AR Dept of Health’s STAR.Health initiative. A report to the Arkansas Health Reform Legislative Task Force also recommended using CHWs as care coordinators within the state’s new full-risk Medicaid managed care model. Many CHWs work in people’s homes to provide preventive services related to the home environment through National Center for Healthy Housing curricula.
CA The SIM CHW Work Group defines CHWs and identifies CHW roles in its report to the state. Job titles vary by employer
CO Colorado Department of Public Health and Environment provides definitions to distinguish CHWs and health navigators. The agency also defines the role of the health navigator. CHWs work in people’s homes and provide preventive services related to the home environment, chronic disease management, and maternal and child health.
CT Public Act No. 17-74 defines CHW roles. Some CHWs work in people’s homes and provide preventive services in asthma, breast and cervical cancer, etc.
DC Starting July 2017, DC Department of Health Care Finance (DHCF) is implementing My Health GPS, a Health Home pilot initiative that supports a CHW as a member of primary care teams to address the needs of persons with three or more chronic conditions. CHWs also conduct home visits to address various issues.
DE The CHW sub-committee has agreed on a definition, scope of practice, and core competencies (Appendix D).
FL Not defined by the state. CHWs conduct home visits to address conditions such as asthma or medication therapy management, as well as through the DOH Healthy Start program.
GA The CHW Advisory Board is tasked with determining an appropriate definition for CHWs in Georgia. Some CHW programs include home visiting as part of their activities, and CHWs provide preventive services in asthma.
HI Not currently.
IA Not defined by the state.
ID Follows APHA’s definition.
IL The Community Health Worker Advisory Board Act uses the APHA definition of a CHW.
IN Certified CHWs may serve in human services, home health, telemedicine, and outpatient medical/behavioral settings, including hospitals, medical clinics, schools, churches, and community centers.
KS Not defined by the state. Some CHWs conduct home visits to address healthy homes.
KY Kentucky Homeplace CHWs provide education on disease prevention and self-management, and aim to connect beneficiaries to health care and health–related services, and address health disparities. There is also a county CHW home visitation program that focuses on chronic disease self-management.
LA  Not defined by the state.
ME Maine’s SIM narrative (p. 8) includes five CHW pilot sites. The state has defined CHW roles. CHWs employed by the Maine Mobile Health Program work in homes, where appropriate, during the course of care coordination.
MD The Workgroup’s final report uses APHA’s definition and describes the roles of CHWs. CHWs conduct home visits and provide asthma, lead poisoning, and other services as needed.
MA Massachusetts Department of Public Health defines CHWs and their roles. CHWs in MA provide asthma, lead poisoning, and falls prevention services in people’s homes.
MI CHWs in the MI Care Teams identify community resources, coordinate and track referrals, support chronic disease self-management, provide health and wellness education, and help implement the client’s care plan goals. Many CHWs conduct home visits as part of their programs or job duties.
MN The Minnesota Department of Human Services has defined CHWs. CHWs in Minnesota provide diagnosis-related patient education, health promotion, and disease management. Some CHWs work in homes, schools, and the community, and some CHWs are engaged in oral health.
MS CHWs provide education on health conditions and medication adherence, help navigate the health system, and connect individuals to resources. They also provide education on environmental hazards during home visits.
MO Department of Health and Senior Services’ definition includes the APHA definition and adds that CHWs are liaisons with resources in the communities they serve and play a vital role in improving Missourians’ health by providing a connection between health systems and community resources, as well as education on how to reduce behavioral health risk factors. Some CHWs in Missouri work in people’s homes.
MT “CHW care coordinators are non-clinical paraprofessionals focusing on chronic disease management and linking patients with services to achieve selected health outcomes and decrease hospitalizations and emergency room visits.” Some CHWs work in people’s homes and address social determinants of health by connecting complex care patients to housing, transportation, and food resources.
NC Not defined by the state. CHWs in NC incorporate home visits into their activities.
ND Not defined by the state. Some CHWs in ND are involved in chronic disease management.
NE In December 2014, the Public Health Association of Nebraska approved a CHW Section. This section will develop as a statewide association.
NH Follows the APHA definition. Section 1115 Demonstration waiver identifies CHWs as part of the health and behavioral health workforce. CHWs in NH conduct home visits and provide preventive services related to the home environment, such as reducing asthma triggers or preventing lead poisoning.
NJ Not defined by the state.
NM The Office of Community Health Workers defined CHW roles and scope of practice. Centennial Care contracts define CHWs as lay members of communities who work either for pay or as volunteers in association with the local health care system in Tribal, Urban, Frontier, and Rural areas and usually share ethnicity, language, socioeconomic status and life experiences with the Members they serve. As part of the CMS Accountable Health Communities model, the University of New Mexico Health Sciences Center and other partners are engaging CHWs to screen Medicare and Medicaid beneficiaries and link them to services. There are frontline CHWs that work with individuals in their homes and also do home visits, providing care coordination and health risk assessment.
NV Follows the APHA definition. CHWs work in different settings throughout Nevada including, federally qualified health centers, non-profit organizations, clinical settings, schools, food bank, state programs, and hospitals.
NY Community Health Worker Network of New York City
OH  Not currently.
OK Not defined by the state.
OR The state has defined a scope of practice for different types of Traditional Health Workers, including CHWs. CHWs working in community-based organizations provide in-home services.
PA No official definition of CHWs; discussing options and working on adopting a standard job title for CHWs. An environmental scan report coordinated by Pennsylvania Department of Health lists common CHW roles in the state. CHWs may provide in-home services, such as nutrition education, home health and safety assessments, and prevention education.
RI CHWs serve as a liaison/link/intermediary between health/social services and the Community, and build individual and community capacity by increasing health knowledge and self‐sufficiency through engagement, community education, social support and advocacy. They enhance the cultural and linguistic appropriateness of care; advocate for the socioeconomic, environmental, and political rights of individuals and their communities; and link people to needed health information and services.
SC Not defined by the state. CHWs may provide in-home services, including preventive services related to home safety.
SD No information at this time.
TX Definition included in Texas Health and Safety Code Chapter 48. CHWs are employed by a variety of organizations, including clinics, hospitals, health or social service nonprofits, area health education centers, schools or universities, local health departments, health plans, and others. CHWs help patients navigate the healthcare system, access community resources, help manage chronic conditions, and engage in outreach and health education and promotion activities in people’s homes, schools, churches and neighborhoods. Prevention interventions are implemented by certified CHWs throughout Texas.
UT Uses APHA definition of CHWs. Molina’s CHWs assess members’ needs through home visits and provide preventive services.
VT As part of Community Health Teams, CHWs assist patients with insurance applications, following treatment plans, managing stress, and working toward personal wellness or disease-management goals. CHWs may accompany patients to appointments, help find transportation or childcare, and provide in-home services, including preventive services related to the home environment.
VA CHWs work in a variety of community settings, partnering to carry out one or more of the following roles: providing culturally appropriate health education and information, linking people to services, providing direct services (including informal counseling and social support), advocating for individual and community needs, and building individual and community capacity. Some CHWs in Virginia conduct home visits and provide preventive services; some conduct outreach.
WA The Community Health Worker Task Force’s report (p. 7) recommends the state adopt APHA’s definition and describes the roles of CHWs. CHW participating in Health Homes provide administrative support for the Health Home Care Coordinator, such as mailing health promotion material, arranging for beneficiary transportation to appointments, and calling the beneficiary to facilitate face-to-face Health Home visits with the Care Coordinator. In general, CHWs may provide in-home services, including preventive services related to the home environment.
WI Follows the seven roles for CHWs: case management and care coordination; community-cultural liaison; health promotion and health coaching; home-based support; outreach and community mobilization; participatory research; and system navigation. CHWs conduct home visits and provide preventive services related to the home environment, such as reducing asthma triggers or preventing lead poisoning.
WV Optional members of Behavioral Health Health Home care teams. Targeted case managers may provide in-home services.
State Agency
AL
AK Office of Healthcare Access within the Division of Public Health of Alaska Department of Health and Social Services
AZ Office of Chronic Disease in Arizona Department of Health Services
AR Arkansas Department of Health
CA California Health and Human Services Agency – CalSIM
CO Colorado Department of Public Health and Environment
CT Connecticut Department of Public Health
DC DC Department of Health Care Finance and Department of Health
DE Division of Public Health in Department of Health and Social Services
FL Division of Community Health Promotion and Division of Disease Control in Florida Department of Health
GA Georgia Department of Public Health
HI
IA
ID Division of Public Health in the Idaho Department of Health and Welfare.
IL  Illinois Department of Public Health
IN Family and Social Services Administration and Indiana State Department of Health
KY Kentucky Department for Public Health
KS Kansas Department of Health and Environment
LA Office of Public Health
ME Maine Center for Disease Control & Prevention (CDC)
MD Office of Minority Health and Health Disparities in Maryland Department of Health
MA Office of Community Health Workers in Massachusetts Department of Public Health
MI Division of Chronic Disease and Injury Control in Michigan Department of Health and Human Services
MN Minnesota Department of Health and Department of Human Services(Medicaid).
MS Mississippi State Department of Health
MO Missouri Department of Health and Senior ServicesDepartment of Social Services, and Department of Mental Health
MT Department of Public Health and Human Services
NC Division of Public Health in North Carolina Department of Health and Human Services
ND Department of Human Services
NE
NH New Hampshire Office of Minority Health & Refugee Affairs
NJ New Jersey Department of Labor
NM Office of Community Health Workers in New Mexico Department of Health
NV The Community Health Worker Program with the Nevada Division of Public and Behavioral Health-Chronic Disease Prevention and Health Promotion Section.
NY
OH
OK
OR Office of Equity and Inclusion in Oregon Health Authority
PA Division of Cancer Prevention and Control in Pennsylvania Department of Health
RI Rhode Island Department of Health, Health Equity Institute
Rhode Island College, Institute for Education in Healthcare
SC SC Department of Health and Environmental Control (DHEC) and Department of Health and Human Services (DHHS)
SD South Dakota Department of Health and Department of Social Services
TX The Promotor(a) or CHW Training and Certification Program sits within the Family and Community Health Services Division in the Community Health Improvement Section, Texas Department of State Health Services
UT Utah Department of Health’s Healthy Living through Environment, Policy and Improved Clinical Care (EPICC) Program, housed in the Bureau of Health Promotion, is the backbone organization of the Utah Broad-Based CHW Coalition (CHWC).
VT Department of Vermont Health Access (Medicaid agency)
VA The Chronic Diseases Unit within Virginia Department of Health
WA Office of Healthy Communities in Department of Health
WI Chronic Diseases Prevention Unit in Division of Public Health
WV Bureau for Medical Services and Bureau for Behavior Health and Health Facilities