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
Colorado’s Department of Health Care Policy and Financing (HCPF), which houses the state’s Medicaid program, uses the American Public Health Association CHW definition with the following addition: “‘Community health worker’ is meant to be an umbrella term for individuals who may go by many names, such as health promoters, community outreach workers, promotores de salud, health navigators, and patient navigators.”
State CHW Governance
Colorado does not have a state office of CHWs. However, the CHW credentialing team is housed at the Colorado Department of Public Health and Environment (CDPHE) in the Prevention Services Division and the Health Promotion Chronic Disease Prevention Branch. Staff are funded to work on the CHW initiative through a mixture of state and federal funding sources.
Certification and Training
The Colorado Department of Public Health and Environment (CDPHE) maintains a voluntary registry of CHWs who have completed a CDPHE-recognized training program and passed a competency assessment. CDPHE works with a vendor to administer a CHW assessment that is required to become a credentialed CHW in the state. In 2025, additional credentialing pathways will be available, including a work experience pathway.
Medicaid Reimbursement
Effective July 1, 2025, Colorado will reimburse for CHW services through State Plan Amendment CO-24-0025. To receive Medicaid reimbursement, CHWs must receive credentialling through the Colorado Department of Public Health and Environment.
The Department of Health Care Policy and Financing (HCPF) will release guidance on fee schedule reimbursement and collaboration with regional accountable entities (RAEs) before July 1, 2025.
Health navigation-related services will be funded through the state’s RAEs. CHW services in managed-care organizations (MCOs) will be reimbursed as fee-for-service for the first two years to identify utilization. HCPF does not anticipate MCOs using administrative dollars for CHW-covered services.
Other Funding or Financing Mechanisms
Information is unavailable.
Key Partnerships
The Colorado Department of Public Health and Environment’s CHW Workforce Development Initiative has convened a diverse group of partners across Colorado to assess the current and future state of community health work.
The Alliance of Colorado CHWs, Patient Navigators and Promotores de Salud is also an active partner.
State CHW Legislation
SB23-002 was enacted in May 2023, allowing the Department of Health Care Policy and Financing to seek federal authorization from the Centers for Medicare and Medicaid Services to provide Medicaid reimbursement for CHW services.
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 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.
