What Massachusetts Did
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Massachusetts followed a similar, but not identical, path to state policy change and has produced some wide-ranging results.

It has:
- Created active statewide CHW association
- Office of CHWs in state public health department
- Policy mandate for state contractors
- 2006 state health care reform act:
- Added CHW to state Public Health Council
- Mandated report to legislature on CHW policy
- Follow-up enrollment activity demonstrated value of CHWs
- Led to creation of CHW credentialing board
- Resulted in inclusion of CHWs in 2012 payment reform law