This information was collected through a combination of state surveys and NASHP staff research. It offers a snapshot of how the state is defining, training, certifying, and paying for the CHW workforce — as well as how the state is developing cross-agency and state-to-local strategies to improve community health in partnership with CHWs.
This is a dynamic policy space, and states are continuing to develop new approaches. We will continue to make periodic updates to this page. Learn more about state CHW policies across the U.S.
State CHW Definition
The Nebraska Department of Health and Human Services (NDHHS) website draws from the APHA definition of CHWsand defines a CHW as “an individual who:
- Serves as a liaison/link between public health, health care, behavioral health services, social services and the community to assist individuals and communities in adopting healthy behaviors;
- Conducts outreach that promotes and improves individual and community health; and
- Facilitates access to services, decreases health disparities, and improves the quality and cultural competence of service delivery in Nebraska.
A CHW is a trusted member of, or has good understanding of, the community they serve. They are able to build trusting relationships and are able to link individuals with the systems of care in the communities they serve. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy. CHW is an umbrella term used to define other professional titles.”
State CHW Governance
There is no dedicated state office of CHWs in Nebraska. CHW work in the state is supported through the Nebraska Department of Health and Human Services.
Certification and Training
Certification is not currently offered in Nebraska, but there is an active cross-sector workgroup working to establish certification requirements and inform any required legislation.
Since 2022, the University of Nebraska Medical Center (UNMC), Creighton University, and Nebraska Association of Local Health Directors (NALHD) have been HRSA to train more than 400 CHWs by 2025. Their programs include both curriculum-based didactic learning and experiential training opportunities provided through an apprenticeship. NALHD’s funding supports CHW staff time in 14 of 19 local health departments and provides trainings to build their skills more specifically related to supporting program management.
Medicaid Reimbursement
Nebraska does not reimburse for CHW services through its Medicaid program.
Other Funding or Financing Mechanisms
Funds from the Title V MCH Block Grant are used to support CHW activity in Nebraska.
Nebraska Association of Local Health Directors (through HRSA funding) supports CHW staff time in 14 of 19 local health departments and provides trainings to build their skills more specifically related to supporting program management.
Key Partnerships
In 2021, Nebraska Department of Health and Human Services (NDHHS) developed a Community Health Worker / Promotores (CHW/P) Collaborative, led by and comprised of CHWs from across the state. The Collaborative members were recruited by the NDHHS Maternal and Child Health Program with the goal of providing leadership in CHW workforce development activities in Nebraska. The CHW/P Collaborative has broad representation from CHWs across Nebraska. Collaborative members work in local health departments, federally qualified health centers, clinics, and hospital systems.
State CHW Legislation
Information is unavailable.
State Resources
Through partnership with the University of Nebraska Medical Center, the Nebraska Department of Health and Human Services has completed the following reports on the status of CHWs in Nebraska:
- Nebraska Community Health Worker Training and Curricula Assessment: Rubric Development and Testing (2019)
- Nebraska Community Health Workers: Financing and Sustainability Models, Report of a Cross-Sector Workgroup, September 2019 to April 2020 (2020)
- Developing the Community Health Worker Workforce to Promote Maternal and Child Health in Nebraska (2021)
- Urban and Rural Differences in Community Health Worker Workforce in Nebraska (2021)
- An Assessment of the Community Health Worker Workforce in Nebraska during COVID-19 (2022)
ACO – Accountable care organization
AHEC – Area Health Education Centers
APHA – American Public Health Association
APM – Alternative payment model
CBO – Community-based organization
CDC – Centers for Disease Control and Prevention
CDC CCR Funding – Community Health Workers for COVID Response and Resilient Communities Funding
CHR – Community health representative
CHW – Community health worker
CPT Codes – Current Procedural Terminology Codes
C3 Project – CHW Core Competency Project
FFS – Fee for services
HCSPCS Codes – Healthcare Common Procedure Coding System Codes
HRSA – Health Resources & Services Administration
MCO – Managed care organization
NACHW – National Association of Community Health Workers
SDOH – Social determinants of health
VBP – Value-based payment
State CHW Definition: This category indicates where states have a formal definition of a CHW. In some cases, where there is not a definition in statute, this category may draw information from provider manuals and state websites or reports.
Certification and Training: This category includes information about how CHWs are trained in the state, which entities provide training, whether or not the state runs or recognizes a CHW certification program, and information about the entities that administer existing certification programs.
Medicaid Reimbursement: This category includes information about state Medicaid strategies that provide enrollees access to CHW services. Entries indicate whether state Medicaid programs currently reimburse for CHW services or incorporate CHWs into alternative payment models under the authority of a state plan amendment (SPA), or where states have earmarked funds to support CHW services under the authority of an 1115 demonstration waiver. It also indicates where CHW services might be supported through managed care approaches (e.g., where MCOs are paying for CHW services using administrative dollars or where states are using managed care contracts to incentivize or require MCOs to cover CHW services).
Other Funding or Financing Mechanisms: This category includes information about other state funding or financing approaches that cover CHW services or CHW positions. It includes information about federal grant dollars for which the state is the grantee.
Key Partnerships: This category offers information about key partners outside state government, including state CHW associations and CHW training entities, and highlights formal cross-agency partnerships within the state that support alignment of funding and resources for the CHW workforce.
State CHW Legislation: This category highlights any state legislation relevant to the CHW workforce. This might include statutory language directing agencies to develop a Medicaid reimbursement approach, laws that established state CHW certification, or other relevant statutes.
State Resources: This category offers links to any key reports or resources that states elected to highlight as critical to CHW policy and partnership.
