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Processes for Implementing Community Health Worker Workforce Development Initiatives

NatDoc: National Document
Website Link:
Publicly Available:
Billing and Reimbursement:
Evidence Generation:
General other, Surveys and assessment tools to define and develop workforce, White papers
Building partnerships, General language around CHW WD
Sustainable Financing:​
Workforce Development:
CDC expand CHW work into SDOH, CDC input on state-level strategic planning, CHW training programs (not cert.), General other (including mention of “employment practices”), Outreach education and TA to employers on CHW generally, Recruiting and convening CHWs stakeholders


Introduction: The objective of this observational, cross-sectional study was to identify, document, and assess the progress made to date in implementing various processes involved in statewide community health worker (CHW) workforce development initiatives.

Methods: From September 2017 to December 2020, we developed and applied a conceptual model of processes involved in implementing statewide CHW initiatives. One or more outputs were identified for each model process and assessed across the 50 states, D.C., and Puerto Rico using peer-reviewed and gray literature available as of September 2020.

Results: Twelve statewide CHW workforce development processes were identified, and 21 outputs were assessed. We found an average of eight processes implemented per state, with seven states implementing all 12 processes. As of September 2020, 45 states had a multi-stakeholder CHW coalition and 31 states had a statewide CHW organization. In 20 states CHWs were included in Medicaid Managed Care Organizations or Health Plans. We found routine monitoring of statewide CHW employment in six states.

Discussion: Stakeholders have advanced statewide CHW workforce development initiatives using the processes reflected in our conceptual model. Our results could help to inform future CHW initiative design, measurement, monitoring, and evaluation efforts, especially at the state level.