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
Information is unavailable.
Certification and Training
In September 2022, Iowa Department of Health and Human Services (Iowa HHS) was awarded HRSA-22-124 funding for CHW training programs that will build on existing CHW training at an Iowa-based nonprofit, Iowa Chronic Care Consortium (ICCC). Using funds provided by Iowa HHS, ICCC offers live training and created an asynchronous (on-demand) online training that will be used to train CHWs under the HRSA grant (including 288 CHWs in a comprehensive skills and competency-based training and 75 CHWs in a Department of Labor-approved CHW registered apprenticeship program). A public health training for CHWs will be developed to train 120 current CHWs and other health support workers. Participants completing the online skills training will receive a certificate from ICCC and the community college of their choice. Those that participate in the registered apprenticeship will receive a nationally recognized credential from the Department of Labor and those who finish the public health training will receive a certificate from Iowa HHS.
Through funding provided by the Iowa HHS, ICCC is creating a CHW supervisor training to be offered to employers across the state.
Medicaid Reimbursement
Iowa does not reimburse for CHW services through its Medicaid program.
Other Funding or Financing Mechanisms
In September 2022, Iowa HHS was awarded the HRSA-22-124 funding for CHW training programs that will build on existing CHW training through an Iowa-based nonprofit, ICCC. Additional key partners for this grant include Des Moines Community College (DMACC), Iowa Workforce Development, and the University of Iowa. The grant will allow the training to be offered at no cost to participants and offer a financial stipend for many to offset potential costs that participants may incur while taking the training.
Key Partnerships
Key partners for the HRSA CHW Training Grant include Iowa Chronic Care Consortium (ICCC), Des Moines Community College (DMACC), Iowa Workforce Development, and the University of Iowa.
The Iowa CHW Alliance is a network of over 50 partner organizations interested in growing the CHW workforce. The Alliance has been in existence since 2016, and through the HRSA grant, the Alliance will take a more active role in making recommendations for development of a CHW infrastructure in Iowa.
State CHW Legislation
Information is unavailable.
State Resources
- Iowa HHS contracted with University of Iowa and ICCC to complete an environmental scan for CHWs in Iowa. They currently have a contract to plan for a return-on-investment study for CHWs.
- Iowa CHW Alliance
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.
