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State Community Health Worker Policies: New Mexico

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 New Mexico Department of Health’s Office of Community Health Workers defines CHWs as “frontline public health workers and critical members of health care delivery teams. They focus on the social aspects of care that support and enhance critical clinical activities such as diagnosis, treatment, or clinical procedures that are performed by licensed health professionals like doctors and nurses. These social and routine aspects of chronic care often are not prioritized in busy and resource-low clinical settings, which can be managing high patient loads each day. This care is essential to assist families to adopt and maintain behavior change skills needed to manage their health, and to overcome barriers encountered in the health care system.

Because CHWs may face the same barriers as the individuals and families they serve, and because they share the same language, ethnicity, cultural, educational, and class background, they are uniquely positioned to act as bridges between their communities and the health and social service systems. By providing a wide variety of services and health information in a linguistically and culturally appropriate manner CHWs can extend the reach and quality of health care services to improve health outcomes.”

State CHW Governance

New Mexico has a dedicated Office of Community Health Workers housed within the Department of Health.

Certification and Training

The NM CHW Certification Board determines requirements for CHW state certification and serves in the advisory capacity for the NM Department of Health, Office of Community Health Workers. The state offers certification through both workforce experience and formalized training pathways. CHWs may also receive certification in specialized health topics.

The New Mexico Department of Health (NMDOH) Office of Community Health Workers (OCHW) approves and endorses training entities interested in becoming an approved core competency training program to support state CHW certification and meet workforce training needs statewide. Additionally, NMDOH/OCHW endorses training entities as continuing education providers to support professional development of CHWs, state CHW certification and renewal, and upskilling opportunities to meet employer requirements.

Medicaid Reimbursement

New Mexico Medicaid reimburses for CHW and community health representative (CHR) services under its State Plan, which was approved by CMS on February 12, 2024.

CHW/CHRs can submit claims for reimbursement under a standing order made available by the Healthcare Authority’s Chief Medical Officer. All Claims submitted are required to have the standing order attached.

Tribal 638s and FQHCs can also bill for CHW services using the same rates and CPT codes as other CHWs outside of their regular encounter rates. Turquoise Care MCOs are also able to employ CHWs and CHRs through their administrative payments.

As part of New Mexico’s section 1115 demonstration waiver, “New Mexico Turquoise Care,” CHWs are eligible to provide pre-release services to qualified incarcerated individuals within 90 days prior to release.

Other Funding or Financing Mechanisms

Other CHW programs and activities in New Mexico are covered under grant funding, including the CDC Health Disparities Grant and CDC Vaccination Supplemental Funding, or philanthropic opportunities, including from the W.K. Kellogg Foundation.

Key Partnerships

Key partners include the New Mexico and Southern Colorado CHR Association, New Mexico Southern Promotora Committee, New Mexico CHW Certification Board, and the National Association of Community Health Workers.

State CHW Legislation

SB 58, the Community Health Workers Act, creates a voluntary statewide certification program for CHWs in New Mexico through the Department of Health.

The New Mexico Administrative Code (NMAC) 7.29.5 Certification of Community Health Workers supports the implementation of the Community Health Workers Act (SB 58).

State Resources

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 FundingCommunity 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. 

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