State Community Health Worker Models

Updated December 10, 2021

Community Health Worker (CHW) is an umbrella term that encompasses several categories of frontline public health workers — including Community Navigator, Promotora, Health Coach, Community Health Advisor, Community Health Aid, or Outreach Worker—who are often also trusted members of the community they serve. CHWs reach out to and engage with communities and individual community members, facilitate care coordination with health and health-related providers, enhance access to community-based services, address social determinants of health, and provide health education. Read More

Many states are looking to build on their community-based workforce and are looking for sustainable funding sources for CHWs. The information on this map comes from a 50-state survey of a variety of stakeholders, ranging from Medicaid officials to Community Health Workers, on their states’ approaches to integrating 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 reflects one of three possibilities: (1) the state’s Medicaid program reimburses for CHW services, (2) the state’s Medicaid program does not cover CHW services, and (3) a state’s Medicaid program does not reimburse directly for CHW services, but Managed care plans or entities in the state do reimburse for CHW services or directly hire CHWs through their administrative dollars.  A note: All Medicaid managed care organizations (MCOs) can reimburse for CHW services through administrative dollars, so unless a state explicitly noted their MCOs do reimburse for services, that is not included in the category.

The map identifies state approaches for Medicaid reimbursement of CHW services and the chart provides details about other ways that states are supporting a CHW workforce.

If a state official or CHW association representative did not respond to the survey, NASHP used a combination of publicly available information and information from the previous map update, from 2015. If you have an update to share from your state, please email Elinor Higgins.

Support for this work was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the foundation. 

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