HCAI says it will not launch statewide CHW certificate now, reallocates $12–$13 million to training and capacity building

The Department of Health Care Access and Information told community health worker, promotor(a) and representative (CHWPR) stakeholders that it will not implement a statewide individual certificate program and will instead use roughly $12 million to $13 million in remaining one‑time funds for a four‑pillar funding framework that emphasizes immigrant community support and organizational capacity building.

Libby Abbott, deputy director of HCAI’s Office of Healthcare Workforce Development, summarized the agency’s course of action during a stakeholder briefing, saying, “we will not be implementing a statewide certificate program.” Abbott added that the remaining funds are “not enough money to stand up a comprehensive, accreditation or certification function and maintain it over time.”

The decision follows a multi‑year process. HCAI said it was charged on 06/30/2022 with developing statewide certificate program requirements for the CHWPR workforce and issued a guidance letter on 07/01/2023 proposing a statewide certificate. After community feedback, HCAI paused implementation in November 2023 and conducted a second round of stakeholder engagement from February through November 2024. The Budget Act of 2024 substantially reduced state funding for the initiative, leaving HCAI with about $12–$13 million in one‑time funds, Abbott said.

Why it matters: CHWPRs provide outreach, navigation and direct support to populations that the health system struggles to reach. Abbott told attendees that HCAI and its partners at the Department of Health Care Services (DHCS) and the California Health and Human Services Agency sought to balance workforce recognition with protecting community access and inclusion. HCAI reported conducting 23 dialogues hosted by 20 organizations, with over 680 participants, to gather feedback on what the workforce needs to succeed.

What HCAI heard: Abbott summarized three principal themes from the dialogues: (1) CHWPRs want training in leadership, client communication, digital navigation and specialty content (behavioral health, disability services, street medicine and climate impacts); (2) there is no consensus on an individual statewide certificate — some stakeholders favored a certificate to professionalize the role while others argued it could exclude long‑time community workers; and (3) many organizations employ CHWPRs on short grants and need support to build sustainable operations.

Advisory groups and DHCS role: HCAI said it worked with an ad hoc advisory group during the second engagement round and later formed a formal advisory work group to refine priorities. Abbott said DHCS is providing technical assistance to organizations to help them tap the Medi‑Cal CHW benefit, a key element of sustainability that stakeholders raised repeatedly.

Four‑pillar framework and how funds will be used: Facing limited one‑time funds, HCAI said it will apportion the remaining $12–$13 million primarily to pillars 1 and 2, and pursue pillars 3 and 4 through non‑direct funding or technical work. Abbott described the pillars as:

• Pillar 1 — Immigrant community health and resilience: support CHWPRs who serve immigrant communities to maintain access to health care, address heightened behavioral‑health needs, and improve cross‑sector referrals (for example, connecting clients to legal and education services). Abbott said this pillar was prioritized in part because of increased immigration‑related needs identified during 2024.

• Pillar 2 — Organizational sustainability and Medi‑Cal readiness: capacity building for community‑based organizations (CBOs) so they can bill Medi‑Cal and partner with managed care plans; HCAI said it will channel funds through an existing program, the Amplifying Impact Initiative, and encourage grantees to use portions of awards for direct workforce supports such as stipends, internships, childcare and other material supports.

• Pillar 3 — Training program resources (no direct HCAI funding): creation of statewide training guidance and resources, developed collaboratively with DHCS and community‑rooted consultants, to help CBOs align training with Medi‑Cal billing and workforce needs.

• Pillar 4 — Road map for future accreditation (no direct HCAI funding): development of an implementation roadmap for a program accreditation function so HCAI and stakeholders would not need a third round of broad engagement if funding becomes available in the future.

Timing and next steps: Abbott said HCAI expects funding opportunities for pillars 1 and 2 to launch in the second quarter or early third quarter of the year, with awards around third quarter. She said HCAI has already begun work on pillar 3 and plans to start pillar 4 early next calendar year. Abbott also noted that Amplifying Impact was initially funded by the California Health Care Foundation and will expand to allow new applicants and additional funds to existing awardees.

Stakeholder priorities retained: HCAI said it will emphasize community‑rooted, accessible training (multiple languages and formats), prioritize program models that do not exclude people with lived experience, and require that any future certificate or accreditation function be inclusive, low‑cost or free, and informed by CHWPR practitioners.

What HCAI did not do: The agency said it will not roll out an individual state certificate at this time because the retained one‑time funds are insufficient to create and sustain either an individual certification or a program accreditation function.

Context and unanswered questions: HCAI described the guidance letter issued in July 2023 and the subsequent pause in November 2023 but did not specify a legislative citation for the June 2022 charge. Abbott said DHCS will continue technical assistance to organizations seeking to use the Medi‑Cal CHW benefit. Specific award amounts, the exact distribution of the $12–$13 million between pillars 1 and 2, and final solicitation documents were not specified in the briefing; Abbott said those details will be provided in forthcoming funding opportunity announcements and on the initiative’s listserv.