California Community Health Worker Certification Requirements

California’s community health worker certification requirements sit in an unusual place right now: there is no active state-issued certificate to apply for, but you can still qualify to work as a CHW and bill Medi-Cal by meeting the Department of Health Care Services (DHCS) requirements. Those requirements come down to three things: lived experience that connects you to the community you serve, either a qualifying training or 2,000 hours of CHW work, and a supervising provider enrolled in Medi-Cal who verifies your qualifications and submits your claims.1Department of Health Care Services. Frequently Asked Questions for Medi-Cal Community Health Worker Services – Provider Requirements

Where the State Certificate Program Stands

In 2022, the Legislature passed Welfare and Institutions Code Section 18998, directing the Department of Health Care Access and Information (HCAI) to build a statewide CHW certificate program.2California Legislative Information. California Welfare and Institutions Code 18998.2 HCAI issued a proposed framework in July 2023, stakeholders objected in November 2023, and the guidance was paused indefinitely. The 2024 Budget Act cut the funding needed to run a statewide certificate function, leaving HCAI with roughly $12 million in one-time funds redirected toward training and community-based organization capacity.3California Department of Health Care Access and Information. Community Health Workers, Promotores and Representatives An advisory workgroup is expected to provide input through June 2026, but there is no state-issued certificate to apply for right now.

What does exist, and has since July 2022, is a Medi-Cal benefit for CHW services with its own qualification rules run by DHCS. That is the credential that matters if you want to work and get paid.

The Two Pathways to Qualify Under Medi-Cal

DHCS lets you qualify through either training or experience. Every CHW also has to meet the lived experience requirement described further down, regardless of pathway.

Training Pathway

The training pathway requires completing a CHW program that issues a certificate of completion. Per Medi-Cal policy, the program must provide at least 80 hours of instruction, including a minimum of 10 hours of supervised field experience, and the curriculum must cover all the core competencies listed below.1Department of Health Care Services. Frequently Asked Questions for Medi-Cal Community Health Worker Services – Provider Requirements

One point that trips people up: the certificate does not have to come from a program approved by DHCS, HCAI, or any other state agency. It can be issued by any organization, in California, out of state, or internationally, as long as the training covers the required content. Program formats and prices vary widely, with tuition running from free community-based offerings up to around $1,900. Community colleges, community-based organizations, and health departments are common sources. Whichever program you pick, compare its syllabus against the core competency list before enrolling.

Experience Pathway

If you’re already doing CHW work, you can qualify through experience instead. This route requires at least 2,000 hours of paid or volunteer CHW work. There is a deadline attached: a CHW entering Medi-Cal billing through the experience pathway must earn a CHW certificate within 18 months of their first service provided to a Medi-Cal member.1Department of Health Care Services. Frequently Asked Questions for Medi-Cal Community Health Worker Services – Provider Requirements Missing that window can jeopardize your billing eligibility, so track dates from the first Medi-Cal encounter forward.

Documentation of the 2,000 hours should come from the employers or organizations where you did the work. Keep records as you go. Your supervising provider is the one who ultimately verifies that your experience satisfies Medi-Cal requirements.

The Lived Experience Requirement

Both pathways require lived experience that aligns with and connects you to the community or population you serve.1Department of Health Care Services. Frequently Asked Questions for Medi-Cal Community Health Worker Services – Provider Requirements Lived experience means firsthand knowledge of a health condition, social circumstance, or cultural identity shared with the community. Examples include experience with homelessness, managing a chronic illness, navigating the foster care system, immigration, or belonging to the same cultural or linguistic community as your clients.

This is currently a self-attestation. There’s no formal test, but the connection should be genuine, and your supervising provider has to be satisfied that you meet the requirement.

Core Competencies Your Training Must Cover

Whether you go through the training pathway upfront or earn your certificate later under the experience pathway, the curriculum has to address every competency area listed in the Medi-Cal state plan.4Medicaid.gov. California State Plan Amendment 25-0023 These are:

  • Communication
  • Interpersonal and relationship building
  • Service coordination and navigation
  • Capacity building
  • Advocacy
  • Education and facilitation
  • Individual and community assessment
  • Outreach
  • Professional skills and conduct
  • Evaluation and research
  • Knowledge base, including public health principles and social factors that drive health outcomes

A program that skips any of these areas may not satisfy Medi-Cal requirements even if it otherwise looks solid. Ask for the syllabus and check.

The Supervising Provider Piece

CHWs cannot bill Medi-Cal independently. You have to work under a supervising provider who is enrolled in Medi-Cal and takes responsibility for claims submission and qualification verification.1Department of Health Care Services. Frequently Asked Questions for Medi-Cal Community Health Worker Services – Provider Requirements Eligible supervisors include:

  • Licensed health care providers
  • Hospitals
  • Outpatient clinics, including tribal health centers and Federally Qualified Health Centers
  • Local health jurisdictions, including county First 5 agencies
  • Nonprofit community-based organizations
  • Pharmacies

Community-based organizations and local health jurisdictions can supervise CHWs even without a licensed provider on staff.1Department of Health Care Services. Frequently Asked Questions for Medi-Cal Community Health Worker Services – Provider Requirements The supervising provider has to maintain documentation showing each CHW they oversee has met all qualification and annual training requirements, and produce that documentation for DHCS on request or during an audit. In practice, this is where verification actually happens. Without a state portal, your relationship with your supervising provider is the credential.

Annual Continuing Education

Once qualified, you have to complete at least six hours of additional training each year to keep your Medi-Cal billing eligibility.1Department of Health Care Services. Frequently Asked Questions for Medi-Cal Community Health Worker Services – Provider Requirements Training can focus on any of the core competencies or on a special-focus area relevant to your community. Medi-Cal policy updates, trauma-informed care, and chronic disease management all count. Your supervising provider tracks these hours, but keep your own copies of certificates in case you change employers.

Certificates From Other States

CHW credentialing is run state by state, and there is no national standard or formal reciprocity. A California-earned certificate satisfies California’s Medi-Cal requirements, but if you move, expect to meet the new state’s rules from scratch. Going the other direction, a certificate from another state can count in California as long as the training covers the required competencies and field experience, because DHCS doesn’t require state agency approval of the training program.1Department of Health Care Services. Frequently Asked Questions for Medi-Cal Community Health Worker Services – Provider Requirements

Practical Steps To Get Started

  • Identify your lived experience connection to the community you plan to serve. This is a threshold requirement and cannot be replaced with additional training.
  • Pick a pathway. If you’re new, find a training program that covers all eleven core competencies and includes at least 10 hours of supervised field experience within its 80-plus hours. If you have 2,000 or more hours of CHW work, you can start under the experience pathway and earn your certificate within 18 months of your first Medi-Cal service.
  • Find a supervising provider willing to enroll your work. A Medi-Cal-enrolled clinic, community-based organization, local health jurisdiction, hospital, licensed provider, or pharmacy can fill this role.
  • Keep your own records. Certificate of completion, hour logs, field experience documentation, employer verification of experience hours, and annual training certificates all belong in a file you control.
  • Plan for six hours of continuing education every year.

Because there’s no state application to file or approval letter to wait for, your qualification lives at the employer and supervising provider level. That makes the choice of training program and the quality of your documentation more consequential than they’d be in a system with a central credentialing body.