HB 588

HB588 INTRODUCED
1 HB588
2 SL9D188-1
3 By Representative Hassell
4 RFD: Health
5 First Read: 10-Mar-26
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SL9D188-1 02/24/2026 KMS (L)cr 2026-312
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4 SYNOPSIS:
5This bill would create the Community Health
6Worker Certification Act.
7This bill would create the Community Health
8Worker Certification Board and provide for the
9membership, powers, and duties of the board.
10This bill would specify the minimum core
11competency skills framework for community health
12workers.
13This bill would provide for training programs
14offered through public K-12 career technical schools,
15public two-year and four-year institutions of higher
16education, and other board-approved competency-based
17providers.
18This bill would provide for requirements for
19certification of community health workers.
20This bill would create the Community Health
21Worker Certification Board Fund in the State Treasury.
22This bill would specify when certification is
23necessary, the proper use of the title of certified
24community health worker, and would provide for the
25denial, suspension, and discipline of the certification
26of a certified community health worker.
27This bill would provide for the adoption of
28rules by the board.
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29This bill would also require the Alabama
30Medicaid Agency to seek required federal approvals to
31support reimbursement for certain services provided by
32certified community health workers.
33
34
35A BILL
36TO BE ENTITLED
37AN ACT
38
39Relating to community health workers; to add Chapter 44
40 to Title 34, Code of Alabama 1975, to create the Community
41 Health Worker Certification Act; to create the Community
42 Health Worker Certification Board and provide for the
43 membership, powers, and duties of the board; to specify the
44 minimum core competency skills framework for community health
45 workers; to provide for training programs offered through
46 public K-12 career technical schools, public two-year and
47 four-year institutions of higher education, and other approved
48 competency-based providers; to provide for the certification
49 of community health workers; to create the Community Health
50 Worker Certification Board Fund in the State Treasury; to
51 specify when certification is necessary and provide for the
52 proper use of the title of certified community health worker;
53 to provide for the denial, suspension, and discipline of
54 certification of a certified community health worker; to
55 provide for the adoption of rules; and to also require the
56 Alabama Medicaid Agency to seek required federal approvals to
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57 support reimbursement for certain services provided by
58 certified community health workers.
59 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
60Section 1. Chapter 44 is added to Title 34 of the Code
61 of Alabama 1975, to read as follows:
62§34-44-1 Short title.
63This chapter shall be known and may be cited as the
64 Community Health Worker Certification Act.
65§34-44-2 Definitions.
66For the purposes of this chapter, the following terms
67 have the following meanings:
68(1) BOARD. The Community Health Worker Certification
69 Board.
70(2) CERTIFICATION. Recognition by the board that an
71 individual has met eligibility requirements and demonstrated
72 competency standards established by this chapter and rules
73 adopted pursuant to this chapter.
74(3) CERTIFIED COMMUNITY HEALTH WORKER. A community
75 health worker who holds certification issued under this
76 chapter.
77(4) COMMUNITY HEALTH WORKER. A front line public health
78 worker who serves as a liaison, link, and intermediary between
79 health and social services and the community and facilitates
80 access to services and service delivery. A community health
81 worker may also provide outreach, community education,
82 informal counseling, social support, and advocacy.
83§34-44-3 Community Health Worker Certification Board.
84(a) There is created the Community Health Worker
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85 Certification Board.
86(b)(1) The board shall be co-chaired by a
87 representative of the State Department of Education, appointed
88 by the State Superintendent of Education, and a representative
89 of the Alabama Community Health Worker Coalition appointed by
90 the Governor from a list of three names nominated by the
91 board. Each co-chair shall be familiar with the community
92 health worker model and may be a practicing community health
93 worker. The co-chairs shall be voting members of the board.
94(2) Additional voting members of the board, who shall
95 each be familiar with the community health worker model and
96 may be a practicing community health worker, shall include one
97 member appointed by each of the following:
98a. The Lieutenant Governor.
99b. The President Pro Tempore of the Senate.
100c. The Speaker of the House of Representatives.
101d. The Speaker Pro Tempore of the House of
102 Representatives.
103e. The Senate Majority Leader.
104f. The House Majority Leader.
105g. The Senate Minority Leader.
106h. The House Minority Leader.
107(3) The leadership of the Alabama Community Health
108 Worker Coalition shall appoint the following voting members:
109a. Two practicing community health workers;
110b. One individual with extensive experience and
111 training in public health policy; and
112c. One practicing community health worker or researcher
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113 who has used the community health worker model in his or her
114 work.
115d. One community member familiar with community health
116 worker services.
117(4) The State Superintendent of Education shall appoint
118 two voting members.
119(5) The Board of Trustees of the Alabama Community
120 College System shall appoint one voting member and one
121 nonvoting member.
122(6) Additional nonvoting members may be appointed to
123 the board as deemed necessary by the board to ensure balanced
124 representation of practitioners, educators, employers, public
125 agencies, payers, and community voices aligned with the
126 community health worker model and consistent with this chapter
127 and rules adopted pursuant to this chapter.
128(7) The appointing authorities shall coordinate board
129 appointments to ensure the membership of the board is
130 inclusive and reflects the racial, gender, geographic, urban,
131 rural, and economic diversity of the state.
132(c) Members of the board shall serve for terms of four
133 years. No member of the board shall serve for more than two
134 consecutive full terms. Vacancies on the board for any reason
135 shall be filled by the original appointing authority for the
136 unexpired term of office. A member originally appointed for
137 less than a full term may serve two consecutive full terms
138 thereafter. A former member may be reappointed after a lapse
139 of one year.
140(d)(1) The board shall establish and hold regular
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141 quarterly and additional special meetings for the purpose of
142 transacting business as provided by rules adopted by the
143 board. Notice of board meetings and the conduct of meetings
144 shall comply with the Alabama Open Meetings Act.
145(2) A majority of the membership of the board shall
146 constitute a quorum at any meeting of the board.
147(3) The State Department of Education, upon notice
148 satisfactory to the department, shall provide adequate space
149 for the board to meet.
150(e) The board may select and employ an executive
151 director who shall serve at the pleasure of the board and who
152 shall be responsible for the administration of board rules and
153 policies. The executive director shall be responsible for
154 employing and supervising other support personnel as directed
155 by the board. The executive director shall be designated as
156 the agent for the board for service of legal process upon the
157 board, act as its recording and corresponding secretary, have
158 custody of and safeguard and keep in good order all property
159 and records of the board, sign all instruments and matters
160 that require approval of the board, and perform all duties as
161 the board may assign or delegate.
162(f) Members shall serve without compensation but may be
163 reimbursed for travel and other expenses actually incurred in
164 the performance of their duties in the same manner as state
165 employees, subject to the availability of funds.
166(g) The Governor may remove any member of the board for
167 misconduct, incompetency, neglect of duty, or for any other
168 sufficient cause.
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169§34-44-4 Core competency skills framework.
170(a) The board shall adopt the following core competency
171 skills as the minimum competency framework:
172(1) Communication.
173(2) Interpersonal skills and relationship building
174 skills.
175(3) Service coordination and navigation.
176(4) Capacity building.
177(5) Advocacy.
178(6) Presentation and facilitation.
179(7) Organizational and cultural competency.
180(8) Public health knowledge.
181(9) Understanding of health systems and basic diseases.
182(10) Behavioral health issues and knowledge.
183(11) Field experience.
184(b) In adopting, interpreting, and implementing the
185 core competency skills framework, the board shall align
186 competency standards, training program requirements, approved
187 pathways, and assessment criteria with the nationally
188 recognized community health worker competency standards and
189 shall incorporate updates to those standards as they are
190 revised or replaced, through board policy and administrative
191 rule.
192(c) Nothing in this chapter or the core competency
193 skills framework shall be construed to authorize a community
194 health worker to provide direct care or treatment to any
195 individual or to perform any act or service for which a
196 license issued by a professional licensing board is required.
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197§34-44-5 Training.
198(a) Community health workers shall be provided with
199 academic-based and community-based training opportunities that
200 lead to the mastery of the community health worker core
201 competency skills framework. Training may be delivered by
202 educational institutions including, but not limited to, public
203 K-12 career technical schools and two-year or four-year
204 institutions of higher education, or through other
205 competency-based, academic-based, community-based
206 organizations, employers, providers, and instructors approved
207 by the board.
208(b) The board shall establish minimum requirements for
209 community health worker training programs that mirror the
210 nationally adopted curriculum adopted by the Alabama Community
211 Health Worker Coalition and require demonstration of
212 competency through instruction, applied learning, and
213 supervised practice, including field experience.
214(c) At a minimum, approved training programs shall
215 incorporate the community health worker core competencies
216 national standards as recommended by the Community Health
217 Worker Core Consensus (C3) Project, the National Association
218 of Community Health Workers (NACHW), the Foundations for
219 Community Health Workers, 3rd edition, and other nationally
220 recognized community health workers competency frameworks, and
221 any updated versions or modules published after October 1,
222 2026, as determined by the board.
223(d) The board shall collaborate with the State
224 Department of Education, the Alabama Community College System,
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225 and the Alabama Commission on Higher Education to establish
226 procedures for awarding college course credit or recognition
227 of prior learning for training, mentorship, and continuing
228 education completed under a board-approved program.
229(e) Training, mentorship, and continuing education
230 approved by the board may be offered through two-year and
231 four-year public institutions of higher education on a
232 flexible, non-credit or credit basis and shall not be
233 restricted to traditional semester schedules or credit hour
234 requirements. These offerings should be accessible throughout
235 the year, allowing individuals to enroll and complete training
236 at various times as needed.
237§34-44-6 Certification.
238(a) Certification is not required to perform services
239 within the core competency skills of a community health worker
240 pursuant to this chapter. An individual who is not certified
241 may continue to work as a community health worker, subject
242 only to the requirements of his or her hiring organization,
243 employer, contractor, payer, or other entity.
244(b) An employer requiring certification as a condition
245 of employment may verify certification with the board. Proof
246 of certification may be provided in a form and manner
247 established by board rule.
248(c) The board shall establish and administer a
249 community health worker certification program. Certification
250 is voluntary unless otherwise required by a hiring
251 organization or payer as a condition of employment or
252 reimbursement. The certification program shall require the
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253 applicant to demonstrate knowledge of the requirements of this
254 chapter, rules adopted pursuant to this chapter, and the
255 community health worker core competency skills framework.
256(d) The board, by rule, shall provide for all of the
257 following:
258(1) Eligibility standards for initial certification,
259 renewal, and recertification. Standards shall include, but not
260 be limited to, minimum age requirements, training or education
261 requirements, competency requirements, and ethical standards.
262(2) Multiple pathways to certification including, but
263 not limited to, grandfathering, which may include any of the
264 following:
265a. Completion of an approved training program;
266b. Demonstration of relevant work experience;
267c. Successful completion of an examination or
268 assessment; and
269d. Other competency-based criteria and verification
270 requirements.
271(e)(1) The board shall establish a process for granting
272 certification to individuals who hold a current, valid
273 community health worker certification from another state,
274 provided that the certification requirements of the other
275 state are substantially equivalent to those provided by this
276 chapter and board rules. Applicants seeking certification by
277 reciprocity shall submit proof to the board of current
278 certification and evidence that the applicant satisfies or
279 exceeds Alabama's core competency and training standards.
280(2) The board may require a reciprocity applicant to
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281 complete additional training or bridging requirements and, if
282 necessary, to demonstrate competency or to successfully
283 complete a certification examination or assessment, or both.
284(3) The board may enter into reciprocity agreements
285 with other states to facilitate certification across state
286 lines, provided those agreements uphold the standards
287 established by this chapter. All reciprocity applicants,
288 including those with national certification, shall also obtain
289 certification pursuant to this chapter to be recognized as
290 certified.
291§34-44-7 Community Health Worker Certification Board
292 Fund.
293(a) There is created a separate special revenue trust
294 fund in the State Treasury known as the Community Health
295 Worker Certification Board Fund. All receipts collected by the
296 board under this chapter shall be deposited in this fund and
297 used only to carry out the purposes of this chapter. Receipts
298 shall be disbursed only by warrant of the Comptroller. No
299 funds shall be withdrawn except as budgeted and allotted
300 according to Article 4 of Chapter 4 of Title 41 and Chapter 19
301 of Title 41, and only in amounts as stipulated in the general
302 appropriations bill or other appropriations bills.
303(b) The board may also accept all gifts, bequests, and
304 donations from any source whatsoever, and the gifts, bequests,
305 and donations shall be used or expended in accordance with
306 their terms or stipulations. In the absence of any terms or
307 stipulations, the gifts, bequests, or donations may be used or
308 expended for such purposes as the board may determine.
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309§34-44-8 Use of title.
310(a) An individual may use the title "certified
311 community health worker" or "CCHW" only if the individual
312 holds a valid certification credential issued by the board
313 pursuant to this chapter.
314(b) An individual who does not hold a valid
315 certification credential issued by the board may use the title
316 "community health worker" or "CHW."
317§34-44-9 Discipline.
318The board may deny, suspend, revoke, or otherwise
319 discipline a certified community health worker for cause
320 established by rule, including fraud or material
321 misrepresentation in an application for initial or renewal of
322 certification. Any hearing relating to an action of the board
323 under this chapter shall be conducted pursuant to the Alabama
324 Administrative Procedure Act, Chapter 22 of Title 41.
325§34-44-10 Rules.
326The board shall adopt rules as necessary to implement
327 this chapter pursuant to the Alabama Administrative Procedure
328 Act. In addition to any other rule specifically authorized by
329 this chapter, board rules may do all of the following:
330(1) Establish reasonable uniform fees and fee
331 structures for applications, renewals, and training program
332 approval.
333(2) Establish uniform application forms and standards
334 for certification pathways including, but not limited to,
335 grandfathering and reciprocity, and time frames for each
336 pathway.
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337(3) Provide additional requirements for initial and
338 renewal of certification including, but not limited to,
339 minimum age requirements and acceptable documentation for
340 proof of training which may include certificates of
341 completion, transcripts, or official letters from recognized
342 training providers or certifying bodies and procedures for
343 verifying submitted documentation.
344(4) Provide continuing education requirements,
345 including ethics.
346(5) Develop a procedure and establish criteria for
347 approving training program providers and instructors.
348(6) Develop procedures for complaint intake and
349 investigations.
350(7) Establish disciplinary guidelines.
351(8) Establish procedures for conducting audits.
352§34-44-11 Coordination of federal approvals for
353 Medicaid reimbursement.
354The Alabama Medicaid Agency, in coordination with the
355 board, shall seek any required federal approvals for
356 reimbursement mechanisms, including a State Plan Amendment,
357 waiver, or alternative payment model, to support reimbursement
358 for certain services provided by certified community health
359 workers, as permitted by state and federal law.
360Section 2. This act shall become effective on October
361 1, 2026.
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