Legal Considerations for Community Health Workers and their Employers

Authors: The Network for Public Health Law
Year: 2020
State: NatDoc: National Document
Website link:
Publicly Available: Yes
Certification: Administration - certification boards state health departments etc., CHW role scope of practice, General other, Legislative language bills etc., Lessons learned from other states, National guidance, Process and development, Reciprocity between states, Role of state government
Policy: General language around CHW WD, General other, Lessons learned from other states, National guidance especially in new policy areas
Sustainable Financing: General other, National-level guidance, Reimbursement TA for FQHCs Medicaid etc.
Workforce Development: General other (including mention of “employment practices”)

This issue brief explores legal issues relating to the regulation and employment of community health workers. It outlines the authority for states to regulate CHWs, describes types of state legislation and activity currently affecting CHWs, and provides considerations for employers utilizing the services of CHWs.

Accompanying CHWs’ professional growth is an evolving area of legislation and regulation as well as legal considerations for employers as they integrate CHWs into their workforce.

States use a variety of methods to regulate health care professionals depending on the nature of the occupation involved. Possible methods—listed below from most restrictive to least restrictive—include licensure, certification, and registration. Two key functions that may be considered in developing a regulatory framework include title regulation (i.e., defining who may use a particular title) and practice regulation (i.e., defining functions that a credentialed practitioner is deemed competent to perform and possibly limiting performance of those functions to credentialed practitioners). Regulation may also be accomplished by requiring members of an occupation to practice under the supervision of another licensed practitioner; this strategy may be coupled with one of the other regulatory frameworks or may stand alone.

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