HCAI pauses statewide CHW certificate; redirects $12–13 million to training, immigrant outreach and CBO capacity
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Summary
Libby Abbott, deputy director of the Department of Health Care Access and Information’s Office of Health Care Workforce Development, told stakeholders that HCAI will not implement a statewide certificate program for community health workers, promotores and representatives and will instead allocate roughly $12–13 million in one‑time funds to a four‑pillar framework focused on immigrant outreach, organizational capacity, training resources and planning for future accreditation.
Libby Abbott, deputy director of the Department of Health Care Access and Information’s Office of Health Care Workforce Development, told attendees that HCAI will not implement a statewide certificate program for community health workers, promotores and representatives (CHWPRs). Abbott said the agency will instead move remaining one‑time funds—"we were left with about 12 to $13,000,000 onetime funding"—into a four‑pillar framework aimed at training, immigrant community support, organizational capacity building and planning for future accreditation.
The decision follows a multi‑year engagement process and a mid‑2024 reduction in scheduled funding. HCAI and partner agencies were first tasked on 06/30/2022 to develop statewide certificate program requirements and to work with the Department of Health Care Services (DHCS) on making CHWPR services billable in Medi‑Cal. HCAI issued a guidance letter on 07/01/2023, paused implementation in November 2023 after community feedback, and conducted a second round of stakeholder engagement from February through November 2024 that included 23 dialogues hosted by 20 organizations and more than 680 participants.
Those dialogues produced mixed views on an individual statewide certificate: some participants said a certificate could support career growth and recognition, while others worried it could exclude experienced workers who lack access to formal training environments. Abbott summarized the agency’s read of the input and the funding reality: "we will not be implementing a statewide certificate program." Instead, HCAI and its advisory groups designed four pillars for how to use the remaining one‑time funds.
Pillar 1, described as the immigrant community health and resilience pillar, directs resources toward CHWPR work that helps immigrant communities maintain access to health care, addresses mental‑health needs tied to immigration stress, and supports cross‑sector referrals (health, social services and legal or education supports).
Pillar 2 focuses on organizational sustainability and capacity building for community‑based organizations (CBOs) that employ CHWPRs. Abbott said HCAI will channel funds to help organizations build billing infrastructure, tap the Medi‑Cal CHW benefit and develop workforce supports that flow into dollars for CHWPRs (stipends, internships or childcare assistance). HCAI plans to route some funding through an existing program, the Amplifying Impact Initiative, to expand applicants and award amounts; Abbott said the initiative was originally funded by the California Health Care Foundation.
HCAI noted that Pillars 3 and 4 will receive no direct HCAI funds from the remaining $12–13 million. Pillar 3 is a technical effort to develop statewide training program resources and guidance CBOs can use to align training with Medi‑Cal billing and good practice. Pillar 4 is a road map and implementation plan for a future program‑accreditation or certification function should sustainable funding become available; HCAI said it will prepare that blueprint so the state will not need a third round of engagement before standing up accreditation.
Abbott said that funding opportunities for Pillars 1 and 2 are expected to launch in the second quarter or early third quarter of the coming year, with awards around the third quarter. She said pillar 3 work is already underway and expected to continue through the end of the year, and pillar 4 planning would begin early next calendar year. HCAI will continue iterating materials with its formal advisory work group and community consultants and will share updates via an email inbox and listserve provided to meeting participants.
The presentation recapped the timeline and community engagement that shaped the decision: the original 2022 statutory tasking, the 07/01/2023 guidance letter, a pause in November 2023 for deeper community engagement, the 2024 budget act reduction that left the one‑time funds, the ad hoc advisory group and a formal advisory work group convened to finalize the framework. The agency emphasized accessibility, community‑rooted training, support for worker well‑being and organizational sustainability as recurring themes from participants.
HCAI’s next steps include issuing the Pillar 1 and 2 funding opportunities, developing the training guidance under Pillar 3 in collaboration with DHCS and community consultants, and completing a program accreditation roadmap under Pillar 4 for future implementation.
Participants were invited to join the HCAI listserve for updates and to continue feedback through the advisory work group. "We are excited about what we're able to do with our remaining funds," Abbott said, while reiterating continued engagement with community stakeholders.
