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
Delaware Health and Social Services defines a CHW as “a valued part of the health team who serves as a frontline liaison, guiding individuals and families through the health, social, and community services systems to foster health and well-being. As a trusted member of the community, the CHW is sensitive to the demographics and experiences of the community and provides culturally and linguistically competent and appropriate services.”
State CHW Governance
Delaware does not have a dedicated state office of CHWs. The Division of Public Health within the Department of Health and Social Services supports CHW work in the state.
Certification and Training
The state is considering a voluntary certification program.
Medicaid Reimbursement
Delaware does not reimburse for CHW services through its state Medicaid program.
Other Funding or Financing Mechanisms
Christiana Care’s Health Ambassador program, which includes CHWs, is funded through the federal Maternal, Infant and Early Childhood Home Visiting program. Other Federally Qualified Health Centers (FQHC) in the state fund CHW positions through the FQHC’s operational budget. FQHCs also receive funding through the Delaware Department of Public Health.
The State Department of Health is leveraging funding through the Centers for Disease Control and Prevention’s Community Health Workers for COVID Response and Resilient Communities initiative to survey CHW partners to find ways to better understand the workforce as they work to develop a statewide certification.
Key Partnerships
A CHW subcommittee, guided by the Delaware Center for Health Innovation and Division of Public Health, released recommendations in 2017 about integrating CHWs into Delaware’s health professions’ workforce in a systemic and sustainable way.
Delaware Thrives, a partnership between the Department of Public Health and the Delaware Healthy Mother and Infant Consortium, provides resources to promote healthy communities with a focus on reproductive, maternal, and family health. This organization connects women ages 15 and older living in Western Sussex, Wilmington, and Southern Kent counties with CHWs to help build and maintain healthy lifestyles.
The Community Health Workers Association of Delaware supports CHWs in the state.
State CHW Legislation
Information is unavailable.
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.
