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
Illinois uses the APHA definition of CHWs, referencing it at the top of the state’s Department of Public Health CHW webpage and quoting it in statute (HB158).
Certification and Training
Legislation passed in April 2021 created a board within the Department of Public Health to develop and oversee CHW certification. Certification is required for CHWs to submit claims to the state Medicaid program but is not required when services are paid for through MCO administrative dollars.
Medicaid Reimbursement
Illinois does not currently reimburse for CHW services through its Medicaid program.
The state is in the process of implementing Public Act 102-0004 (HB0158), which adds CHW services as a covered benefit.
Other Funding or Financing Mechanisms
The Department of Healthcare and Family Services (HFS, Illinois’ Medicaid program) is providing grant funding to Healthcare Transformation Collaboratives across the state to support the work of CHWs in many of these collaboratives.
Key Partnerships
The Department of Health and Family Services (HFS) is currently collaborating with the Illinois Department of Public Health, the Illinois Community Health Workers Association, and a variety of providers (hospitals, health departments, etc.) and community-based organizations on implementing CHWs within the Medicaid program.
State CHW Legislation
The state passed Public Act 5412 in 2014, establishing the Community Health Worker Advisory Board, which considers CHW core competencies and develops recommendations for state leaders.
Public Act 102-0004 (HB0158) was signed by the governor on April 27, 2021. The public act creates a board within the Department of Public Health to develop and oversee CHW certification and directs the state to add CHW services as a covered benefit under the state’s Medicaid program. The state is in the process of implementing this new law. When implemented, CHW services will be reimbursed both through the Medicaid state plan.
State Resources
State Overviews
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.
