Community Health Worker Certification Process in Texas: Implications for Practice and Policy

Research center:
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Project completed:
August 2003

There is a move in several states to formalize the training and qualifications of community health workers (CHWs), such as promatoras/es, through requirements for licensure, certification, or credentialing. For example, the Texas legislature has recently mandated the certification of CHWs. This policy trend raises several critical issues, with key stakeholders having interests that may be at odds. States clearly wish to assure quality health care while using CHWs to improve access in geographically isolated and other underserved areas. States also wish to contain costs. CHW organizations, however, are concerned about the impact of such policies on their organizational culture and program sustainability. Given this trend and the associated concerns, the two main project goals are to provide a national overview of state policy, including current legislative proposals, on licensure/certification of lay community health workers and to analyze the likely effect of these policy trends on the sustainability and effectiveness of CHW programs.