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DHHS proposes new community health worker certification chapter with three certification pathways
Summary
DHHS presented proposed rules creating a certification framework for community health workers, including a 200‑hour internship pathway, a 1,000‑hour experiential pathway, and reciprocity/Indian Health Service certification paths.
The Department of Health and Human Services proposed new administrative rules to create a certification program for community health workers (CHWs) this week, establishing required competencies, certification and recertification procedures, and multiple pathways for initial certification.
Chris Price of DHHS told the Administrative Rules Committee the rules were developed pursuant to 2023 House Bill 1028 and the work of a community health worker task force. He said the proposed chapter (NDAC chapter 33‑03‑380) defines CHW scope of practice, required competencies and certification requirements and includes provisions for supervision, reciprocity and discipline.
The rules specify three primary pathways to certification: a training‑plus‑internship pathway that requires a supervised internship of 200 hours or more; a community health representative pathway for individuals certified under Indian Health Service programs; and an experiential pathway based on 1,000 hours of qualifying work experience. Price said internships ‘‘may include supervised work or be exclusively supervised work’’ and clarified that supervised time can occur as part of existing employment if a qualified supervisor can attest to the applicant’s competencies. He also said reciprocity is available when an outside program or credential is ‘‘substantially the same.’’
Price told the committee the task force selected a 200‑hour internship requirement after reviewing surrounding states and that the department lacks statutory authority to regulate training institutes directly; to date there are no state‑approved CHW training programs, and DHHS anticipates roughly 100 workers are likely to pursue certification initially via the experiential pathway.
The department held a public hearing June 17, 2025; four people attended and three written comments were received and summarized in the report. DHHS reported non‑staff costs of $2,568.04 and said the expected fiscal impact is minimal.
Why it matters: the rules create a state certification process where none existed, establish clear competency and supervision standards and create multiple pathways for current workers and training‑program graduates to become certified, which could affect workforce development and service delivery across the state.
Price said the task force included representatives from tribes, community health workers and DHHS, and that the 200‑hour internship requirement reflects the group’s consensus.
