Community health workers (CHWs) are trusted peers who work in underserved communities to increase access to health care and save excess costs.
Why Hire CHWs?
Everyone everywhere needs some kind of health care, and community health workers (CHWs) can help. About 60 million people, or one in five people (approximately 19.3%), live in rural America, and that makes it hard for them to access healthcare. Adults who have gone without care because of cost is starting to climb again—some states have very poor access to care. These are people who die from preventable or treatable conditions.
CHWs work in communities all around the US, both addressing a massive shortage in health workers and also helping health systems reach communities they might have trouble reaching.
CHWs can save lives, and making an investment in putting together a team is one that’s bound to pay out.
We’re here to help with this comprehensive guide to the information and resources you need to hire and train CHWs to work in your community.
CHW Training and Certification Examples
CHWs are trained and certified in several ways around the US.
CHW training programs provide CHWs with the knowledge and skills they need to connect community members, patients and clients with high-quality care. These programs typically include coursework, clinical training, and certification. CHW certification is not always required, but it can be beneficial for CHWs who want to advance their careers.
CHW Training Programs
CHW training requirements in the United States vary by state, as there is no national standardization. However, many states have developed or are considering certification programs to establish clear competencies and qualifications for CHWs.
State-Level Certification Programs
As of 2024, 23 states have implemented or are developing CHW certification programs. These programs typically include:
- Core competency training
- Practicum or internship experience
- Evaluation of skills and knowledge
The number of training hours required varies by state, ranging from 40 to 160 hours.
Common Elements of CHW Training
While specific requirements differ, most CHW training programs cover the following core competencies:
- Health core competencies
- Social services resources knowledge
- Communication skills
- Advocacy information
- Cultural competence
- Legal and ethical considerations
Many programs also include specialized training in areas such as:
- CPR certification
- Mental Health First Aid
- Lifespan development
Examples of State Requirements
California
In California, CHW core competency training is designed to equip individuals with essential skills for effectively serving their communities. An example of such training is offered by CHWTraining, which provides an 80-hour core competency program aligned with state requirements for Medi-Cal reimbursement. This program is informed by the competencies recognized in both the 1998 National Community Health Advisor Study and the 2016 Community Health Worker Core Consensus (C3) Project.
Read more about California CHW core competencies.
Colorado
The Colorado Department of Public Health and Environment (CDPHE) established the CHW certification program to promote healthy behavior change and improve health outcomes in Colorado. To become a certified CHW in Colorado, individuals must meet the certification requirements outlined in the Colorado CHW Core Competencies.
Read more about Colorado CHW core competencies.
Massachusetts
Massachusetts’ core competencies align with a national consensus. Massachusetts CHWs work in a wide variety of settings. They’re in including community health centers, schools, hospitals, community-based organizations, housing authorities, immigrant and refugee associations, and faith-based organizations.
Voluntary vs. Mandatory Certification
Most states offer voluntary certification, meaning CHWs can practice without being certified. However, some states require certification for CHWs to be reimbursed for services or to work in certain settings.
Some states, like Louisiana and Wisconsin, have chosen not to create certification programs. Instead, they focus on developing robust training programs that build core competencies among the CHW workforce.
Continuing Education
Many states require continuing education for certified CHWs to maintain their certification. For example:
New Mexico: 30 hours of continuing education every 2 years
Ohio: 15 hours of continuing education every 2 years
CHW Job Descriptions and Skills
CHW job descriptions and skills tests will help you with hiring and training CHWs. A well-written job description can help you attract the right candidates, while a skills assessment can help you identify the best candidates for the job.
CHW Job Description Template
While the skills of community health workers (CHWs) are well-defined, creating a clear job description can be challenging due to variations in titles, duties, and settings. CHWs may be known as community health representatives, promotoras de salud, or peer educators, and their roles differ across health departments, community agencies, and clinical settings. Specific projects, like reducing ER admissions or promoting vaccinations, also shape the role. Despite these variations, it’s possible to craft a job description that attracts the right candidates.
Download a job description template for hiring a CHW.
About
The About section provides potential candidates with insight into the organization’s mission, values, and culture. It should include:
- Company Overview: A brief description of the company, including its history, industry, and key achievements.
- Mission and Values: Highlight the core mission and values that guide the organization.
- Culture: Describe the work environment, team dynamics, and any unique cultural aspects (e.g., teamwork, diversity initiatives).
- Why Join Us: Emphasize what makes working at the company appealing, such as career growth opportunities, benefits, or community involvement.
Job Overview
The Job Overview section summarizes the role’s purpose and its significance within the organization. It should include:
- Position Title: The official title of the job.
- Purpose of the Role: A concise statement explaining why the position exists and how it contributes to the company’s goals.
- Reporting Structure: Information on whom the role reports to and any supervisory responsibilities.
- Location: Details on where the job is based (e.g., remote, hybrid, in-office).
Job Responsibilities
In the Job Responsibilities section, outline the specific duties associated with the position. This should include:
- Core Responsibilities: A list of primary tasks that define the role, ideally presented in bullet points for clarity.
- Day-to-Day Activities: Describe typical daily activities to give candidates a realistic view of what to expect.
- Performance Expectations: Mention any key performance indicators (KPIs) or outcomes that are expected from the role.
- Collaboration: Indicate who the candidate will work with regularly (e.g., teams, departments).
Education and Training
The Education and Training section specifies the educational background and training required for candidates. It should cover:
- Minimum Education Requirements: The least amount of education necessary (e.g., high school diploma, bachelor’s degree).
- Preferred Qualifications: Additional educational qualifications that are desirable but not mandatory.
- Certifications or Licenses: Any specific certifications or licenses required for the role.
- Training Programs: Mention any training programs or onboarding processes that new hires will undergo.
Skills and Qualifications
In this section, detail the skills and qualifications necessary for success in the role. This includes:
- Technical Skills: Specific skills required for performing job tasks (e.g., software proficiency, technical expertise).
- Soft Skills: Interpersonal skills that are important for collaboration and communication (e.g., teamwork, problem-solving).
- Experience Requirements: Specify any relevant work experience needed (e.g., years in a similar role).
- Additional Attributes: Any other qualities that would help a candidate excel in this position (e.g., adaptability, leadership abilities).
CHW Recruitment and Hiring
CHW recruitment and hiring can be a challenging task, but with the right strategies and resources, you can attract and hire the best candidates. Here are some tips and resources to help you recruit and hire CHWs.
CHW recruitment and hiring can be a challenging task, but with the right strategies and resources, you can attract and hire the best candidates. Here are some tips and resources to help you recruit and hire CHWs.
CHW Recruitment Strategies
A recruitment strategy is a plan you use to attract, identify and hire qualified candidates. It’s not only a rock solid way of building a team, it will make your life easier.
Your recruitment strategy should be adapted to your workplace, but in general, it should have these elements:
- Set Goals: Define specific hiring goals, including the number of positions, diversity targets, and community familiarity needed.
- Job Analysis: Identify key tasks, responsibilities, and qualifications for the CHW role to create an accurate job description.
- Sourcing Channels: Use a variety of recruiting channels, such as job boards, community partners, referrals, and industry events, to reach candidates.
- Timeline and Budget: Set a clear recruitment timeline and budget for each stage to manage the hiring process efficiently.
- Ideal Candidate: Develop a candidate persona with specific skills, experience, and community knowledge to target the best fit for the role.
- Selection Process: Establish a consistent interview and assessment process to fairly evaluate all applicants.
- Diverse and Inclusive Workforce: Focus on building a team that reflects the community, using resources to promote diversity and eliminate bias.
- Technology Investment: Consider tools like ATS or HR software for efficient resume screening and interview scheduling.
- Onboarding Process: Plan an onboarding process tailored to the CHW role, including virtual options if needed.
CHW Interviews
Just as you’d look for exceptional skills and dedication in an “all-star employee,” you’ll want to find those qualities in a CHW. Be sure in your interview to aligne CHW skills and backgrounds with the community’s unique needs, covering both essential technical skills—like technology use, certifications, and health literacy—and soft skills, including cultural sensitivity, resilience, and communication. Come up with baseline questions to gauge candidates’ motivations and background, as well as skills-focused inquiries to assess their suitability for the role.
Read more about how to interview and hire a CHW.
Structured Interviews
If you’re expanding your community health team and need to hire a new CHW, a structured interview can be your new best friend. A structured interview can help you choose the best candidate for the position by creating a fair and organized framework for interviewing.
It’s a kind of job interview in which the person doing the interviewing (probably you), asks a set list of questions to each candidate. You’ll ask only those questions, and you’ll ask them consistently. Then you’ll use a numeric scale or a ranking chart to compare each CHW.
The idea behind this method is to fairly gauge every candidate’s responses to your questions against all the other candidates.
Read more about structured interviews.
FAQs
What are the qualifications to become a CHW?
Candidates typically need to meet a variety of qualifications that may include educational requirements, training, and sometimes certification (see above). This varies by state.
Many states require them to meet minimum educational requirements, but some agencies don’t. Many entry-level positions only require a high school diploma or equivalent, along with on-the-job training.
Most CHWs need core competencies training and also receive short-term on-the-job training that covers essential skills such as health communication, advocacy, and understanding local health resources.
Who can supervise CHWs?
Being a supervisor for CHWs requires specific skills that may not be present in candidates with general management experience. CHWs deal with difficult and complicated situations related to health and social issues. A committed CHW supervisor plays an important role by offering necessary support and guidance to CHWs, helping them carry out their responsibilities. They provide mentorship, address any concerns and offer solutions to challenges faced by CHWs in their work.
Can CHWs provide services via telehealth?
Yes, many CHWs provide services via telehealth. CHWs can deliver a variety of services through telehealth, including health education, referrals to care, and support for chronic disease management. They can use video conferencing and mobile health applications to connect with patients and facilitate their healthcare needs. They assist with pre-visit preparations, ensuring that patients are comfortable with the technology, and can provide follow-up support after telehealth appointments to address any issues encountered during the visit.