Community Health Workers, Promotores & Representatives

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Welcome!#

Welcome to the Community Health Workers, Promotores, and Representatives (CHW/P/R) Initiative webpage. On this webpage, you can learn about California’s efforts to expand and support the CHW/P/R workforce, including our background, timeline of activities and key milestones, the CHW/P/R Community Dialogue Summary report and webinar, the latest funding framework, updates, and our contact information. Whether you’re a CHW/P/R, employer, trainer, or ally, we invite you to explore how your voice has shaped the path forward and how you can stay involved.

Background#

Community Health Workers, Promotores, and Representatives (CHW/P/Rs) have long provided critical preventive, promotive, and referral services for communities in California that have been historically marginalized and disconnected from the health system. CHW/P/Rs speak a variety of languages and serve diverse communities with diverse needs across the state.

As part of the Workforce for a Healthy California Initiative, the California Health and Human Services Agency (CalHHS), the Department of Health Care Access and Information (HCAI), and the Department of Health Care Services (DHCS) launched the CHW/P/R Initiative. 

Timeline of Activities and Key Milestones#

June 30, 2022: Welfare & Inst Code Sec. 18998 charged HCAI with developing and implementing statewide CHW/P/R certificate program requirements.

July 2022: To sustainably expand CHW/P/R services across the state, funding for those services needs to be reliably available. To address this, starting July 1, 2022, the Department of Health Care Services (DHCS) added CHW/P/R work as a billable service to Medi-Cal.

July 1, 2023: Following a lengthy stakeholder engagement process and in line with statutory requirements, HCAI issued a guidance letter outlining the statewide requirements for: a state-issued CHW/P/R Certificate, certificate renewal, and for state-issued specialty certificates, as well as the requirements for recognizing the experience of existing CHW/P/Rs. This letter also provided statewide requirements for CHW/P/R training programs to become approved training programs.

November 2023: In response to stakeholder input, specifically concerns from some stakeholders that they had not been adequately engaged and that the solutions outlined in the guidance letter might not be fit-for-purpose, CalHHS, HCAI, and DHCS paused the guidance in November 2023 to allow for additional community engagement. This guidance has been paused indefinitely as HCAI continues to shape its best path forward based on community input and any future funding and policy decisions.

February to November 2024: CalHHS, HCAI, and DHCS held a second round of community engagement and convened a short-term advisory group (ad-hoc) to reassess workforce needs, gather additional input on a statewide certificate, and investment opportunities for the CHW/P/R initiative. During this process, the 2024 Budget Act significantly reduced the original CHW/P/R workforce budget allocation removing the resources needed to implement a statewide certificate function – leaving HCAI approximately $12 million in one-time resources.

December 2024: HCAI established a formal Advisory Workgroup, composed of a majority active CHW/P/Rs to provide input on state plans for funding and policy recommendations.

December 2024 to March 2025: HCAI developed a funding framework for one-time CHW/P/R funding based on findings from community dialogues, with input from and endorsement by our CHW/P/R Advisory Workgroup. 

May 2025 to June 2025: HCAI published the CHW/P/R Community Dialogue Summary Report that summarizes the statewide community dialogues conducted by HCAI that engaged over 680 CHW/P/Rs, administrators, and allies across 23 sessions hosted by 20 organizations to re-examine workforce needs. HCAI hosted a public webinar on June 18, 2025, to share the report findings and continued to engage with the communities invested in the CHW/P/R work.

HCAI Investments and the Path Forward#

The formal Advisory Workgroup is expected to continue to provide input until June 2026 to shape and refine the initiative, particularly around the funding pillars and workforce sustainability. The funding framework supports CHW/P/Rs and the organizations that train, employ, and sustain them, focusing on community needs.

CHW/P/R Community Dialogue Summary Report (May 2025)#

We are proud to share the Community Health Workers, Promotores, and Representatives (CHW/P/R) Community Dialogue Summary Report, which summarizes what we heard from the CHW/P/R workforce during our 2024 community dialogue sessions. This report highlights what CHW/P/Rs need to succeed and remain in the workforce, perspectives on a statewide certificate and state-funded training, as well as funding priorities and strategies that uplift the workforce. It also outlines how community voices shaped the state’s investment strategy to support and strengthen this vital workforce. Explore the full report to learn how these insights are guiding the next steps in the CHW/P/R Initiative by clicking the link below.

To effectively communicate the report’s insights, and continue the conversation, we invite you to join us for a CHW/P/R Community Dialogue Summary Report Webinar. This virtual event will walk through key themes from the report, highlight how the state is responding to your input, and outline what’s ahead for the CHW/P/R Initiative.

CHW/P/R Community Dialogue Summary Webinar Follow-Up Materials (June 2025)#

The CHW/P/R Community Dialogue Summary Webinar follow-up materials are now available. We invite you to explore them below.

Webinar presentation
Webinar recording
Please refer to the FAQ document for all discussion questions and responses received during this webinar

DHCS Medi-Cal Benefit #

The CHW/P/R Medi-Cal benefit as outlined in the CHW Provider Manual and the DHCS All Plan Letter of September 18, 2023, remains in place. As before, CHW/P/Rs that seek to support Medi-Cal members via the Medi-Cal CHW benefit must: 

• Demonstrate minimum qualifications via 1) a certificate of completion or 2) work experience (2,000 hours); 
• Have lived experience that aligns with and provides a connection between the CHW and the community or population being served; and, 
• Be supervised by a licensed provider, clinic, hospital, CBO, or Local Health Jurisdiction who is enrolled in the Medi-Cal program. 

Details on these qualifications can be found in the CHW provider manual. 

Contact Us#

• Email: CHW@hcai.ca.gov
• Phone: (916) 326-3700

Subscribe#

To receive updates regarding the CHW/P/R initiative specifically, please email CHW@hcai.ca.gov and share your name, affiliation, and email. You will be added to a listserv through which periodic updates and invitations for engagement are shared.