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
Maryland Department of Health (MDH) uses a modified version of the American Public Health Association definition of CHWs, adding the phrase “the provision of information to support individuals in the community.”
State CHW Governance
Maryland does not have a dedicated state office of CHWs. The Maryland Community Health Workers program is housed in the Office of Population Health Improvement at the Maryland Department of Health.
Certification and Training
The Maryland 2018 Community Health Worker Act established the State Community Health Worker Advisory Committee and required regulations be adopted for the certification of CHWs and the accreditation of CHW certification training programs.
The Code of Maryland Administrative Regulations sets the requirements for CHW certification by Maryland Department of Health (MDH), along with the requirements for CHW certification training programs to be accredited by MDH. The certification of CHWs in Maryland is based on the successful completion of an accredited CHW certification training program.
The MDH CHW program is currently working with partners on the development of specialty training modules for CHWs in specific health care areas.
Medicaid Reimbursement
As part of Maryland’s Section 1115(a) Demonstration waiver, HealthChoice Medicaid, CHWs may be reimbursed for case management services for eligible individuals beginning 90 days pre-release, during transition, and post-release from incarceration. CHWs may also be part of a participant’s assigned care team as part of Maternal Opioid Misuse Model Pilot Program.
Other Funding or Financing Mechanisms
The Maryland Department of Health (MDH) CHW program leverages Preventive Health and Health Services Block Grantfunds to provide administrative support to the CHW certification and training program accreditation processes (including language access supports). The program also aims to engage broad partners in all decision-making processes, which includes approximately 50 percent CHW representation on committees and workgroups.
MDH received a Centers for Disease Control and Prevention 2103 and CDC 2109 grant funding to increase the number of accredited CHW certification training programs; develop specialty training modules for CHWs in specific health care areas; train underserved students at no cost to the student; and train, deploy, and engage CHWs in high-need jurisdictions. The MDH CHW program, in collaboration with the MDH Prevention and Health Promotion Administration, leveraged Substance Abuse and Mental Health Services Administration block grant funds for the development and implementation of specialty training modules for CHWs in HIV, sexually transmitted infections, viral hepatitis, and drug user health.
Key Partnerships
The Maryland State CHW Advisory Committee (established in Health-General Article, Title 13, Subtitle 37-Maryland Community Health Worker Act) advises the Maryland Department of Health on various issues relating to the certification of CHWs in the state and the accreditation of CHW certification training programs. Maryland has an active Maryland CHW association.
State CHW Legislation
The Maryland 2018 Community Health Worker Act (Health-General §§ 13-3701-3709 ) establishes the State Community Health Worker Advisory Committee and requires regulations be adopted for CHW certification process and to accredit CHW certification training programs.
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.
