State Certification Programs

Some states require community health workers (CHWs) to have state-level certification, requiring completion of an approved training program and acquiring specific skills. Credentialing and certification programs are often administered by a local health department or another agency at the state level.

A number of educational institutions offer courses, certificates, or degrees in the CHW field, with related trends being:

  • Community college based training provides academic credit and career advancement opportunities through formal education
  • Certification at the state level, which recognizes and legitimizes the work of CHWs, and opens up potential reimbursement opportunities for CHW services
  • On-the-job training offered to improve capacities of CHWs and enhance their standards of practice

State Approaches

In 2013, the Centers for Disease Control and Prevention (CDC) compiled a review of states’ regulations of CHWs, which includes information on which states require certification, have specific curricula, and require reimbursement for services, among other related topics. In addition, the Association of State and Territorial Health Officials (ASTHO) tracks the current status of state CHW training/certification standards.

Examples of states with CHW programs and their certification approach include:

  • Texas: Was the first state to develop legislation to govern CHW activities in 1999. Offers a Promotor(a) or CHW certification program and requires CHW programs in health and human services agencies to hire state-certified CHWs when possible.
  • Ohio: Developed a CHW certification program in 2003, administered by the State Board of Nursing and also maintains a list of approved community health worker programs.
  • Alaska: Certification programs authorize CHWs to conduct specific activities, such as clinical service delivery and home visits, respectively. Alaska’s certification programs date back to the 1950s.
  • Oregon, Nevada and Washington: Have implemented state-level standards for training and education for CHWs and provide training at the state level.
  • Arizona, Southern California, Colorado, and Virginia: Curriculum and CHW programs are offered at community colleges; states may be moving towards certification.
  • Massachusetts: State established a Board of Certification of Community Health Workers, which is establishing education standards, training program curricula, and requirements for certification.
  • Kentucky, New Mexico, Minnesota, Mississippi, and Hawaii: Provide non-state-mandated certification programs and/or are exploring certification and utilization of CHWs.
  • New York, Wisconsin: Working on developing statewide alliances and networks for CHWs.
  • Illinois: Establishing an advisory board to develop a training and certification process.
  • Indiana: Working to establish the scope of community health workers’ practice and integrate into the health system

In addition to certification programs, many states have CHW associations.

Resources to Learn More

These resources provide in-depth information about state certification programs for community health workers.

Alaska Community Health Aide Program
Network of Community Health Aides/Practitioners (CHA/Ps) in over 170 rural Alaska villages that works within the guidelines of the 2006 Alaska Community Health Aide/Practitioner Manual (CHAM). This manual outlines assessment and treatment protocols and is available from CHA/P.
Organization(s): Alaska Community Health Aide Program

Approved community health worker training programs in Ohio
Current list of approved community health worker training programs in Ohio.
Organization(s): Ohio Board of Nursing

Chicago Community Health Workers Local Network - Training and Events
Lists community health worker training and certificate programs in the Chicago area.
Organization(s): Chicago Community Health Workers Local Network

Community Health Worker Certificate Curriculum
Lists the curriculum (courses and descriptions) required for the Ohio Board of Nursing Community Health Workers certificate.
Organization(s): Cincinnati State Technical and Community College

Community Health Worker (CHW) Certification and Training: A National Survey of Regionally and State-Based Programs
Provides the results of a qualitative study of states and a national overview of state policy and state involvement in the standardized training and certification of Community Health Workers.
Organization(s): Southwest Rural Health Research Center
Date: 5/2005

Community Health Worker National Workforce Study
Describes a national study of the community health worker workforce, and its utilization and development in both urban and rural settings.
Organization(s): Health Resources and Services Administration, Bureau of Health Professions
Date: 3/2007

Community Health Worker Training and Certificate Program
Provides information about community health workers (CHW) and lists the curriculum for the CHW certificate program in the Harris County Hospital District of Texas.
Organization(s): Harris County Hospital District

Community Health Worker Training and Certification Programs in the United States: Findings From a National Survey
Data from a national survey of CHW training and certification programs was used to analyze trends and various approaches to professional development in selected community health worker (CHW) programs in the United States.
Author(s): B.A. Kash, M.L. May, M. Tai-Seale, M.
Organization(s): School of Rural Public Health, Texas A&M University Health Science Center
Date: 2007

Community Health Worker Training System
Provides a free eight week training for CHWs. The training involves both online and in-person trainings. It is offered four times per year in seven regions through Washington state.
Organization(s): Washington State Department of Health

Community Health Workers in Massachusetts: Improving Health Care and Public Health
Final Report
Reports on the use, funding and impacts of community health workers in Massachusetts.
Organization(s): Massachusetts Department of Public Health
Date: 2009

Final Report on the Status, Impact, and Utilization of Community Health Workers: To the Governor and the General Assembly of Virginia
Focuses on ways to elevate the role of community health workers in the healthcare delivery system; integrate effectively such workers in public agencies; and maximize the value and utilization of community health workers.
Organization(s): Virginia Center for Health Outreach, James Madison University
Date: 2006

I Am Who I Serve - Community Health Workers In Family Planning Programs
Discusses current issues affecting programs served by community health workers.
Author(s): Rachel Benson Gold
Journal citation: Guttmacher Policy Review, Summer 2010, Volume 13, Number 3
Date: 2010

Liberal Arts: Community Health Certificate - Program Curriculum
Identifies program curriculum and admission requirements for certificate in Liberal Arts with a concentration in Community Health.
Organization(s): MassBay Community College
Date: 2010

Massachusetts Association of Community Health Workers - Policy Brief: Part 3 of 3
Policy Brief
Policy brief in supporting the development of a certificate program for community health workers in Massachusetts.
Organization(s): Massachusetts Association of Community Health Workers
Date: 2008

MDHC Clinical Initiatives – Community Health Workers
Describes rural and urban initiatives in the state of Mississippi to implement CHW programs. The Mississippi State Department of Health is working with the Tougaloo College/Central Mississippi Area Health Education Center (CMAHEC) to develop a standardized CHW certification program.
Organization(s): Mississippi State Department of Health

Ohio Board of Nursing Community Health Worker Certificate
Lists the curriculum and descriptions of courses required for completion of the Ohio Board of Nursing Community Health Worker certificate program.
Organization(s): North Central State College, Ohio

Outreach Manual: A Guide for Farmworker Health Outreach Staff
Provides guidance on incorporating outreach workers into health services programs, including definitions of the specific services, a description on how to carry out the service, the required documentation, and a list of evaluation questions.
Organization(s): North Carolina Department of Health and Human Services, Office of Rural Health and Community Care, North Carolina Farmworker Health Program
Date: Updated 7/2012

Outreach Worker Training Institute (OWTI)
Program overview and curriculum for outreach worker training institute in Central Massachusetts.
Organization(s): Central Massachusetts Area Health Education Center

Report on Community Health Worker Programs
Provides information on selected state CHW programs, including titles used, reimbursement policies, training/certifications, and curriculum. States reviewed include: Minnesota, Massachusetts, New Mexico, New York, Colorado, Washington, and Wisconsin.
Author(s): Dickson, L., Yahna, R.
Organization(s): Center for Rural Health
Date: 6/2012

State Community Health Worker Models
This map highlights state-specific 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. 
Organization(s): National Academy for State Health Policy

Training Curriculum for Community Health Workers
Manual for online and in-person CHW training in the state of Washington.
Organization(s): Washington State Department of Health
Date: 2012