- • system, and the process of developing it, should respect the role and needs of • system, and the process of developing it, should respect the role and needs of volunteer CHWs; at the very least, the system should not undermine their status or their ability to practice freely.

## Key decision points for design of a certification system

Beyond the inclusion of basic features and the qualities of responsiveness just described, the design of a system for certification of individual CHWs should consider certain crucial issues such as the following:

- • core competencies: should be reflective of the actual experience of CHWs – • core competencies: should be reflective of the actual experience of CHWs – and should consider standards adopted by other states, in part for discussion of reciprocity – including the variations in skills between practicing exclusively in a community setting vs. in a clinical setting. We recommend reference to the CHW Core Project6 Consensus for defining CHW core roles and skills.
- • experience requirements: may be in addition to required training and/or in lieu of • experience requirements: may be in addition to required training and/or in lieu of training
- o providing for “grand-parenting” based on experience – will this option be o providing for “grand-parenting” based on experience – will this option be available permanently (as in Texas) or for a limited introductory period (as in most other states)?
- o back” period for required experience – how long? Experience suggests it o back” period for required experience – how long? Experience suggests it should not be open-ended;
- • requirements (some states have decided they are not necessary, or may specify • requirements (some states have decided they are not necessary, or may specify a high school diploma/GED; unnecessary educational credentials may create unintended barriers to entry for otherwise highly qualified CHWs);
- • of proficiency in core skills • of proficiency in core skills
- o will the process evaluate ability to use CHW core competencies (references o will the process evaluate ability to use CHW core competencies (references may be used, as in Massachusetts, absent administrative resources to support direct observation)?
- o will the process validate the “3 Cs” of community connectedness, o will the process validate the “3 Cs” of community connectedness, credibility, and commitment as a qualification (experience suggests this is difficult to specify in policy as a requirement)?
- o assessing work experience, who may serve as reference to attest to the o assessing work experience, who may serve as reference to attest to the applicant’s proficiency in core competencies?
- • with other states: this is expected to become increasingly salient as more • with other states: this is expected to become increasingly salient as more states adopt CHW certification programs;
- • checks: may be a general requirement in any state occupational regulations, • checks: may be a general requirement in any state occupational regulations, but employers generally do their own, and not all violations are relevant to CHW practice – indeed, CHWs who have been incarcerated for non-violent drug related offenses, for instance, may be especially effective with other formerly incarcerated individuals, or with families of the currently incarcerated;

Since most states regulate the provision of training to CHWs in some fashion, here are some considerations for decisions in this area:

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