Ensuring Community Membership

How can a statewide CHW certification process address CHW prior experience and community membership?

Community membership is central to the definition of a CHW. It means being part of the community served, or sharing key life experiences with other community members. The statewide CHW certification process may provide opportunities to ensure that CHWs have the experience and membership needed to work effectively in their communities.

Potential actions for stakeholders
  • Staying up to date on the activities of the National Association of Community Health WorkersExternal
  • Meeting with current CHWs to determine how the proposed certification process will impact interest in becoming a CHW, and ensuring continued recruitment of a CHW workforce with membership in target communities
  • Determining how CHWs who are not working in the healthcare arena will be affected by statewide CHW certification
  • Considering adopting a statewide CHW definition that requires community membership—for example, the American Public Health Association’s CHW definitionExternal—and including this definition in certification descriptions
  • Creating opportunities to help CHWs obtain experience hours that could be documented for certification—for example, creating fellowships and apprenticeships
  • Creating a grandfathering pathway to certification for CHWs who have sufficient experience—for example, by allowing submission of evidence of previous work experience in the community
  • Considering adding an orientation meeting or interview to the certification application process to confirm community membership
  • Considering asking for letters of recommendation from the community as part of the certification application process
  • Ensuring that the application process appropriately addresses language access, immigration status, history of incarceration, and other factors that may strengthen a CHW’s credibility in the community

Case examples

A group of community health workers in a meeting.

The statewide CHW certification process may ensure that CHWs have the experience and membership needed to work effectively.

  • In June 2017, Connecticut passed Senate Bill No. 126. This senate bill established a statewide definition for a CHW as a “public health outreach professional with an in-depth understanding of the experience, language, culture and socioeconomic needs of the community.” This definition has guided the state’s mandated study of the feasibility of statewide CHW certification.
  • Oregon has created two pathways to state CHW certification. One is to be “grandfathered” in, using past trainings completed, certificates earned, and 3,000 documented hours of community involvement or engagement as a CHW. The other pathway is to complete the state-approved training and certification process, which requires applicants to identify and document the community they belong to or identify with. Some Oregon CHW training programs now require a letter of recommendation from the community before accepting applicants.
  • In Rhode Island, CHW community membership was addressed initially through grandfathering, which involved a specific, limited look-back period for CHWs to apply for certification using their work and experience in the community. The current training pathway requires that CHWs document 1,000 hours of supervised experience in the community.Rhode Island has also created CHW fellowships at community-based organizations. These fellowships have helped CHWs obtain the experience to qualify for certification. When asked how the certification changed the outlook of their work at the end of the fellowship program, CHWs expressed that the fellowship strengthened and validated their work and left them feeling professional and empowered.