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Community Health Workers, Promotores & Representatives

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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.

Read the full report

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 Report Webinar

Date: June 18, 2025
Time: 3:05 p.m. – 4:30 p.m.

Zoom Public Participation Link

English and Spanish translation will be available during the webinar.

Together, we’re expanding and supporting the CHW/P/R workforce! We look forward to seeing you at the webinar!

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. 

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

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.

On 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.

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. 

2024 CHW/P/R Community Engagement

From February to November 2024, CalHHS, HCAI, and DHCS conducted a second round of community engagement and convened an ad hoc advisory group to gather further input on a statewide certificate, workforce needs, and investment opportunities. Notably, during the second round of community engagement, the Budget Act of 2024 reduced nearly all of the original CHW/P/R workforce budget allocation.

HCAI Investments and the Path Forward

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

From December 2024 to March 2025, HCAI developed a funding framework for one-time CHW/P/R funding based on findings from dialogues and with guidance from the formal Advisory Workgroup.

The funding framework supports CHW/P/Rs and the groups that train, hire, and support them, focusing on community needs. To learn more, read our CHW/P/R Community Dialogue Summary Report (May 2025).

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

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.

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