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
State statute defines “Community health worker” as “an individual who meets qualification criteria adopted by the authority under ORS 414.665 and who: (a) Has expertise or experience in public health; (b) Works in an urban or rural community, either for pay or as a volunteer in association with a local health care system; (c) To the extent practicable, shares ethnicity, language, socioeconomic status and life experiences with the residents of the community the worker serves; (d) Assists members of the community to improve their health and increases the capacity of the community to meet the health care needs of its residents and achieve wellness; (e) Provides health education and information that is culturally appropriate to the individuals being served; (f) Assists community residents in receiving the care they need; (g) May give peer counseling and guidance on health behaviors; and (h) May provide direct services such as first aid or blood pressure screening.”
State CHW Governance
Oregon does not have a dedicated state office of CHWs. The state’s Traditional Health Worker (THW) program, which encompasses CHWs, sits within the Oregon Health Authority’s Equity and Inclusion Division.
Certification and Training
Certification is encouraged but not required for employment. CHWs can apply for certification through the Health Workforce Registry Portal after completing a state-approved training program and state-approved oral health training. All applicants are required to pass a background check. Training Programs are certified through the Training Evaluation Metrics Program Scoring (TEMPS) Subcommittee of the Traditional Health Worker Commission. Core competencies include outreach and mobilization; community liaising; care management, care coordination, and system navigation; and health promotion and coaching.
Medicaid Reimbursement
Oregon’s Medicaid program, the Oregon Health Plan, reimburses for CHW services under the State Plan. Coordinated Care Organizations (CCOs) are required to include Traditional Health Workers, such as CHWs, on their care teams. The Oregon Health Authority will reimburse providers for CHW services rendered to fee-for-service (FFS) members. CHWs must be certified and supervised by a health professional to qualify for Medicaid reimbursement.
As part of Oregon’s section 1115 demonstration waiver, “Oregon Health Plan,” CHWs are eligible to provide pre-release services to qualified incarcerated individuals within 90 days prior to release. CHWs are also eligible to apply for and receive HRSN infrastructure funding and may serve as HRSN connectors with a pathway to identify individuals in need of HRSN services.
Other Funding or Financing Mechanisms
Effective January 1, 2025, the Oregon Health Authority (OHA) implemented enhanced payments for Traditional Health Worker (THW) Culturally and Linguistically Specific Services (CLSS) provided to members of the Oregon Health Plan (OHP). For services rendered to coordinated care organization (CCO) members, CCOs will reimburse eligible providers through a CCO Behavioral Health Directed Payment.
Key Partnerships
- The THW Commission advises and makes recommendations to the Oregon Health Authority on the development, implementation, and sustainability of THWs and ensures that the program remains responsive to consumer and community health needs.
- The Oregon Community Health Workers Association is a key partner in supporting the workforce and advancing training and financing infrastructure.
State CHW Legislation
HB 3650 (2011) Requires the state to establish criteria, descriptions, and education/training requirements for community health workers, peer wellness specialists, personal health navigators, and other providers not regulated by the state.
SB 1580 (2012) Requires utilization of CHWs in Health Systems Transformation.
HB 3407 (2013) established the Traditional Health Worker Commission, which oversees CHWs, peer support and peer wellness specialists, personal health navigators, and doulas.
HB 2024 (2015) requires Oregon Health Authority to adopt rules and procedures for the training and certification of health workers to provide oral disease prevention services.
HB 2088 (2021) Created a Tribal Traditional Health Worker category in statute to facilitate delivery of culturally responsive care to tribal communities that experience significant and persistent health inequities and disparities
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.
