State Policy Support

How might state policy support statewide CHW workforce development, including certification?

Where it is feasible, state policy could help support CHW workforce development, including statewide CHW certification. For example, state legislation has helped to establish CHW certification programs in several states. The policy process could also provide opportunities for CHWs to directly influence statewide CHW certification.

Case examples

State legislation has helped to establish CHW certification programs in several states.

• The Utah Broad-Based CHW Coalition developed a scope of practice and standardized training for CHWs in Utah to advance statewide CHW certification and financing through Medicaid. At the same time, a major data collection effort allowed Utah to better understand CHWs and CHW employers across the state. This involved local health departments conducting environmental scans and interviews with CHW employers addressing various social determinants of health.
• In Arizona, legislation to establish a voluntary CHW certification program was proposed twice in 2017, both times led by the Arizona CHW Association. The second filing was designed to be budget neutral, gained support from the Arizona Nurses Association, and was passed in December 2017. Stakeholders in Arizona recall the importance of continually educating everyone involved in the legislative process about the value of certification and CHW roles.
• CHWs in Oregon offered arguments against standard criminal background check requirements for certification through the public forums associated with the state rule-making process. As a result, Oregon now has a weighted process for the background check for CHW certification that allows consideration of supporting documentation, such as recommendation letters from previous employers or coworkers and documentation of volunteer efforts. This allows the consideration of mitigating circumstances to help otherwise qualified CHWs obtain certification.