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
Arizona uses the definition of CHWs from the American Public Health Association, with the following addition: “[CHWs] are essential components to the current and future infrastructure of healthcare. CHW is an umbrella term used to encompass many different job descriptions, including Community Health Representatives, Patient Navigator, Promotores de Salud, Community Health Advisors, and Cultural Health Navigators, to name a few.”
In state statue and in rules for the state’s voluntary CHW certification, “community health worker” is defined as “a nonmedical health worker who serves as a liaison for health and community service providers and enrollees to facilitate access to services and improve the quality-of-service delivery, including the coordination of services to improve medical and behavioral health outcomes.”
State CHW Governance
Arizona does not have a dedicated state office of CHWs. However, the Arizona Department of Health Services has a CHW program housed within the Office of Chronic Disease and Population Health in the Bureau of Chronic Disease and Health Promotion. The program manager is responsible for overseeing initiatives to advocate for and support engagement, professional development, and sustainability of the Arizona CHW workforce in addition to working with the Department’s Bureau of Licensing for Professions & Occupations to oversee the state’s CHW voluntary certification.
Certification and Training
The Arizona Department of Health Services (ADHS) finalized the rules for voluntary certification in November 2022. The final rules outline the scope of work and core competencies of CHWs in Arizona. To be reimbursed for CHW services under Medicaid, CHWs must obtain their voluntary certification through ADHS and be employed by an eligible Arizona Health Care Cost Containment System-registered provider, under whom services will be provided and billed.
The Arizona Community Health Workers Association, ADHS, and University of Arizona Prevention Research Center partner to implement the CHW Training Program Approval process. Organizations looking to offer training for CHWs that meet the requirements for certification submit a training plan that is reviewed by a committee featuring CHWs and key partners.
Medicaid Reimbursement
Arizona’s state Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS), reimburses for CHW services under its state plan. AHCCCS’s State Plan Amendment was approved in February 2023, with an effective date of April 1, 2023.
As of March 4, 2024, AHCCCS has established a new provider type called “CHW Organization.” This allows for community-based organizations, localities, Tribal organizations, and other institutions employing certified CHW/CHRs to enroll with AHCCCS and be eligible for Medicaid reimbursement.
As part Arizona’s Section 1115 Demonstration waiver, Arizona Health Care Cost Containment System (AHCCCS), certified CHWs are eligible to provide pre-tenancy housing services, as well as outreach and educational services under AHCCCS’s Housing and Health Opportunities program.
Other Funding or Financing Mechanisms
The Arizona Advisory Council on Indian Health Care receives Community Health Workers for COVID Response and Resilient Communities funding from the Centers for Disease Control and Prevention to train CHRs and bolster community resilience in response to the COVID-19 pandemic.
Indian Health Services funds CHRs employed by Tribes in the state.
Key Partnerships
- The University of Arizona Prevention Research Center is working with the Arizona Department of Health Services, AzCHOW, and other partners to evaluate the impact of certification and other efforts to support the workforce.
- The AzCHOW, Arizona Advisory Council on Indian Health Care, Northern Arizona University Center for Health Equity Research, Arizona CHW Workforce Coalition , and Indian Health Services support the workforce through advocacy, CHW and supervisor training, technical assistance, and engagement.
- Other partners include Promotores HOPE Network, Rural Arizona CHW Workforce Development Network, Northern Arizona CHW Workforce Network, Health Disparities CHW Community of Practice, Pima County CHW Coalition/Community of Practice, Yuma County CHW Coalition, and Cochise County CHW Coalition.
State CHW Legislation
HB2324, signed into law in May 2018, established a voluntary certification for CHWs, including convening of a CHW Advisory Council responsible for making recommendations to ADHS on the certification requirements and process.
State Resources
- Arizona Department of Health Services — Community Health Workers
- Special Licensing
- Arizona Health Care Cost Containment System — Community Health Workers and Community Health Representatives
- Arizona Health Care Cost Containment System — FAQ CHWs/CHRs
- Arizona Community Health Workers Association
- Arizona Advisory Council on Indian Health Care — Community Health Representatives
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.
