Best Practices to Support High-Quality CHW/P/R Training Across California
Community health workers, promotores, and representatives (CHW/P/Rs) are trusted bridges between California’s most underserved communities and the health care system. They draw on lived experience, cultural knowledge, and deep community ties to help people navigate care, address social drivers of health, and improve health outcomes.
To support this essential workforce, the California Department of Health Care Access and Information (HCAI), in partnership with the California Department of Health Care Services (DHCS), has released a new Best Practices Framework for CHW/P/R Training Programs. The framework was developed with funding from the California Health Care Foundation (CHCF) and shaped by close to 40 stakeholder interviews, guidance from a dedicated project workgroup, and feedback from HCAI’s CHW/P/R Initiative Advisory Workgroup, the majority of whom are active CHW/P/Rs.
About the Framework
This Best Practices Framework is intended to be a set of helpful, voluntary recommendations that preserve the core values of the field, provide guidance without over-professionalizing the field, make training accessible for everyone, and build a shared framework grounded in community knowledge and experience and in research. It is not a certification or accreditation framework. HCAI and DHCS hope these best practices can provide many benefits, including clear expectations of what CHW/P/R programs should provide and a common training framework to help programs across the state align in approach and quality.
12 Categories of Best Practice
The framework recognizes that CHW/P/R training programs across California take many different approaches based on the participants they serve, the communities they are rooted in, and the roles graduates play. All these approaches hold value. The 12 categories below summarize the shared best practices that emerged across programs:
- Training philosophy and methodology. Meet participants where they are; honor lived experience; ground training in cultural humility; prioritize interactive, peer-based learning.
- Core competencies. Align curriculum to the 11 Core Skills in the National C3 Council’s competencies, taught in cultural, regional, and context-specific ways.
- Training structure. Provide a minimum of 80 hours of training for a certificate of completion, plus at least six hours of ongoing professional development annually.
- Training program transparency. Clearly communicate the roles, settings, content, and career pathways the training prepares graduates for.
- Training instructor qualifications. Ensure training is led or co-led by experienced CHW/P/Rs with relevant lived experience.
- Training format. Use a thoughtful mix of in-person and virtual learning, prioritizing synchronous instruction and ensuring rural accessibility.
- Training participant assessment. Use performance-based assessments that are culturally relevant, trauma-informed, and strengths-based.
- Training enrollment requirements. Keep requirements minimal to ensure access, avoiding barriers like GED requirements, English proficiency, or digital literacy.
- Training fees and costs. Keep training free or close to free; pay regular wages or stipends where possible.
- Training program evaluation. Conduct ongoing evaluation and act on results to continuously improve.
- Training organization credibility and qualifications. Be rooted in the communities served.
- Other good practices. Create alumni networks and provide wraparound supports such as childcare and transportation where feasible.
Read the Full Report
The full Community Health Worker/Promotores/Representative Training Program Best Practices report includes detailed guidance for each of the 12 categories, examples from training programs across California, and appendixes documenting how stakeholder feedback shaped the framework.
This project was developed by HCAI in partnership with DHCS, with funding from CHCF. Independent consultant Lalitha Vaidyanathan authored the final report.
