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HB588 INTRODUCED
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HB588
SL9D188-1
By Representative Hassell
RFD: Health
First Read: 10-Mar-26
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SL9D188-1 02/24/2026 KMS (L)cr 2026-312
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First Read: 10-Mar-26
SYNOPSIS:
This bill would create the Community Health
Worker Certification Act.
This bill would create the Community Health
Worker Certification Board and provide for the
membership, powers, and duties of the board.
This bill would specify the minimum core
competency skills framework for community health
workers.
This bill would provide for training programs
offered through public K-12 career technical schools,
public two-year and four-year institutions of higher
education, and other board-approved competency-based
providers.
This bill would provide for requirements for
certification of community health workers.
This bill would create the Community Health
Worker Certification Board Fund in the State Treasury.
This bill would specify when certification is
necessary, the proper use of the title of certified
community health worker, and would provide for the
denial, suspension, and discipline of the certification
of a certified community health worker.
This bill would provide for the adoption of
rules by the board.
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rules by the board.
This bill would also require the Alabama
Medicaid Agency to seek required federal approvals to
support reimbursement for certain services provided by
certified community health workers.
A BILL
TO BE ENTITLED
AN ACT
Relating to community health workers; to add Chapter 44
to Title 34, Code of Alabama 1975, to create the Community
Health Worker Certification Act; to create the Community
Health Worker Certification Board and provide for the
membership, powers, and duties of the board; to specify the
minimum core competency skills framework for community health
workers; to provide for training programs offered through
public K-12 career technical schools, public two-year and
four-year institutions of higher education, and other approved
competency-based providers; to provide for the certification
of community health workers; to create the Community Health
Worker Certification Board Fund in the State Treasury; to
specify when certification is necessary and provide for the
proper use of the title of certified community health worker;
to provide for the denial, suspension, and discipline of
certification of a certified community health worker; to
provide for the adoption of rules; and to also require the
Alabama Medicaid Agency to seek required federal approvals to
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Alabama Medicaid Agency to seek required federal approvals to
support reimbursement for certain services provided by
certified community health workers.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. Chapter 44 is added to Title 34 of the Code
of Alabama 1975, to read as follows:
§34-44-1 Short title.
This chapter shall be known and may be cited as the
Community Health Worker Certification Act.
§34-44-2 Definitions.
For the purposes of this chapter, the following terms
have the following meanings:
(1) BOARD. The Community Health Worker Certification
Board.
(2) CERTIFICATION. Recognition by the board that an
individual has met eligibility requirements and demonstrated
competency standards established by this chapter and rules
adopted pursuant to this chapter.
(3) CERTIFIED COMMUNITY HEALTH WORKER. A community
health worker who holds certification issued under this
chapter.
(4) COMMUNITY HEALTH WORKER. A front line public health
worker who serves as a liaison, link, and intermediary between
health and social services and the community and facilitates
access to services and service delivery. A community health
worker may also provide outreach, community education,
informal counseling, social support, and advocacy.
§34-44-3 Community Health Worker Certification Board.
(a) There is created the Community Health Worker
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(a) There is created the Community Health Worker
Certification Board.
(b)(1) The board shall be co-chaired by a
representative of the State Department of Education, appointed
by the State Superintendent of Education, and a representative
of the Alabama Community Health Worker Coalition appointed by
the Governor from a list of three names nominated by the
board. Each co-chair shall be familiar with the community
health worker model and may be a practicing community health
worker. The co-chairs shall be voting members of the board.
(2) Additional voting members of the board, who shall
each be familiar with the community health worker model and
may be a practicing community health worker, shall include one
member appointed by each of the following:
a. The Lieutenant Governor.
b. The President Pro Tempore of the Senate.
c. The Speaker of the House of Representatives.
d. The Speaker Pro Tempore of the House of
Representatives.
e. The Senate Majority Leader.
f. The House Majority Leader.
g. The Senate Minority Leader.
h. The House Minority Leader.
(3) The leadership of the Alabama Community Health
Worker Coalition shall appoint the following voting members:
a. Two practicing community health workers;
b. One individual with extensive experience and
training in public health policy; and
c. One practicing community health worker or researcher
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c. One practicing community health worker or researcher
who has used the community health worker model in his or her
work.
d. One community member familiar with community health
worker services.
(4) The State Superintendent of Education shall appoint
two voting members.
(5) The Board of Trustees of the Alabama Community
College System shall appoint one voting member and one
nonvoting member.
(6) Additional nonvoting members may be appointed to
the board as deemed necessary by the board to ensure balanced
representation of practitioners, educators, employers, public
agencies, payers, and community voices aligned with the
community health worker model and consistent with this chapter
and rules adopted pursuant to this chapter.
(7) The appointing authorities shall coordinate board
appointments to ensure the membership of the board is
inclusive and reflects the racial, gender, geographic, urban,
rural, and economic diversity of the state.
(c) Members of the board shall serve for terms of four
years. No member of the board shall serve for more than two
consecutive full terms. Vacancies on the board for any reason
shall be filled by the original appointing authority for the
unexpired term of office. A member originally appointed for
less than a full term may serve two consecutive full terms
thereafter. A former member may be reappointed after a lapse
of one year.
(d)(1) The board shall establish and hold regular
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(d)(1) The board shall establish and hold regular
quarterly and additional special meetings for the purpose of
transacting business as provided by rules adopted by the
board. Notice of board meetings and the conduct of meetings
shall comply with the Alabama Open Meetings Act.
(2) A majority of the membership of the board shall
constitute a quorum at any meeting of the board.
(3) The State Department of Education, upon notice
satisfactory to the department, shall provide adequate space
for the board to meet.
(e) The board may select and employ an executive
director who shall serve at the pleasure of the board and who
shall be responsible for the administration of board rules and
policies. The executive director shall be responsible for
employing and supervising other support personnel as directed
by the board. The executive director shall be designated as
the agent for the board for service of legal process upon the
board, act as its recording and corresponding secretary, have
custody of and safeguard and keep in good order all property
and records of the board, sign all instruments and matters
that require approval of the board, and perform all duties as
the board may assign or delegate.
(f) Members shall serve without compensation but may be
reimbursed for travel and other expenses actually incurred in
the performance of their duties in the same manner as state
employees, subject to the availability of funds.
(g) The Governor may remove any member of the board for
misconduct, incompetency, neglect of duty, or for any other
sufficient cause.
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sufficient cause.
§34-44-4 Core competency skills framework.
(a) The board shall adopt the following core competency
skills as the minimum competency framework:
(1) Communication.
(2) Interpersonal skills and relationship building
skills.
(3) Service coordination and navigation.
(4) Capacity building.
(5) Advocacy.
(6) Presentation and facilitation.
(7) Organizational and cultural competency.
(8) Public health knowledge.
(9) Understanding of health systems and basic diseases.
(10) Behavioral health issues and knowledge.
(11) Field experience.
(b) In adopting, interpreting, and implementing the
core competency skills framework, the board shall align
competency standards, training program requirements, approved
pathways, and assessment criteria with the nationally
recognized community health worker competency standards and
shall incorporate updates to those standards as they are
revised or replaced, through board policy and administrative
rule.
(c) Nothing in this chapter or the core competency
skills framework shall be construed to authorize a community
health worker to provide direct care or treatment to any
individual or to perform any act or service for which a
license issued by a professional licensing board is required.
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license issued by a professional licensing board is required.
§34-44-5 Training.
(a) Community health workers shall be provided with
academic-based and community-based training opportunities that
lead to the mastery of the community health worker core
competency skills framework. Training may be delivered by
educational institutions including, but not limited to, public
K-12 career technical schools and two-year or four-year
institutions of higher education, or through other
competency-based, academic-based, community-based
organizations, employers, providers, and instructors approved
by the board.
(b) The board shall establish minimum requirements for
community health worker training programs that mirror the
nationally adopted curriculum adopted by the Alabama Community
Health Worker Coalition and require demonstration of
competency through instruction, applied learning, and
supervised practice, including field experience.
(c) At a minimum, approved training programs shall
incorporate the community health worker core competencies
national standards as recommended by the Community Health
Worker Core Consensus (C3) Project, the National Association
of Community Health Workers (NACHW), the Foundations for
Community Health Workers, 3rd edition, and other nationally
recognized community health workers competency frameworks, and
any updated versions or modules published after October 1,
2026, as determined by the board.
(d) The board shall collaborate with the State
Department of Education, the Alabama Community College System,
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Department of Education, the Alabama Community College System,
and the Alabama Commission on Higher Education to establish
procedures for awarding college course credit or recognition
of prior learning for training, mentorship, and continuing
education completed under a board-approved program.
(e) Training, mentorship, and continuing education
approved by the board may be offered through two-year and
four-year public institutions of higher education on a
flexible, non-credit or credit basis and shall not be
restricted to traditional semester schedules or credit hour
requirements. These offerings should be accessible throughout
the year, allowing individuals to enroll and complete training
at various times as needed.
§34-44-6 Certification.
(a) Certification is not required to perform services
within the core competency skills of a community health worker
pursuant to this chapter. An individual who is not certified
may continue to work as a community health worker, subject
only to the requirements of his or her hiring organization,
employer, contractor, payer, or other entity.
(b) An employer requiring certification as a condition
of employment may verify certification with the board. Proof
of certification may be provided in a form and manner
established by board rule.
(c) The board shall establish and administer a
community health worker certification program. Certification
is voluntary unless otherwise required by a hiring
organization or payer as a condition of employment or
reimbursement. The certification program shall require the
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reimbursement. The certification program shall require the
applicant to demonstrate knowledge of the requirements of this
chapter, rules adopted pursuant to this chapter, and the
community health worker core competency skills framework.
(d) The board, by rule, shall provide for all of the
following:
(1) Eligibility standards for initial certification,
renewal, and recertification. Standards shall include, but not
be limited to, minimum age requirements, training or education
requirements, competency requirements, and ethical standards.
(2) Multiple pathways to certification including, but
not limited to, grandfathering, which may include any of the
following:
a. Completion of an approved training program;
b. Demonstration of relevant work experience;
c. Successful completion of an examination or
assessment; and
d. Other competency-based criteria and verification
requirements.
(e)(1) The board shall establish a process for granting
certification to individuals who hold a current, valid
community health worker certification from another state,
provided that the certification requirements of the other
state are substantially equivalent to those provided by this
chapter and board rules. Applicants seeking certification by
reciprocity shall submit proof to the board of current
certification and evidence that the applicant satisfies or
exceeds Alabama's core competency and training standards.
(2) The board may require a reciprocity applicant to
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(2) The board may require a reciprocity applicant to
complete additional training or bridging requirements and, if
necessary, to demonstrate competency or to successfully
complete a certification examination or assessment, or both.
(3) The board may enter into reciprocity agreements
with other states to facilitate certification across state
lines, provided those agreements uphold the standards
established by this chapter. All reciprocity applicants,
including those with national certification, shall also obtain
certification pursuant to this chapter to be recognized as
certified.
§34-44-7 Community Health Worker Certification Board
Fund.
(a) There is created a separate special revenue trust
fund in the State Treasury known as the Community Health
Worker Certification Board Fund. All receipts collected by the
board under this chapter shall be deposited in this fund and
used only to carry out the purposes of this chapter. Receipts
shall be disbursed only by warrant of the Comptroller. No
funds shall be withdrawn except as budgeted and allotted
according to Article 4 of Chapter 4 of Title 41 and Chapter 19
of Title 41, and only in amounts as stipulated in the general
appropriations bill or other appropriations bills.
(b) The board may also accept all gifts, bequests, and
donations from any source whatsoever, and the gifts, bequests,
and donations shall be used or expended in accordance with
their terms or stipulations. In the absence of any terms or
stipulations, the gifts, bequests, or donations may be used or
expended for such purposes as the board may determine.
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expended for such purposes as the board may determine.
§34-44-8 Use of title.
(a) An individual may use the title "certified
community health worker" or "CCHW" only if the individual
holds a valid certification credential issued by the board
pursuant to this chapter.
(b) An individual who does not hold a valid
certification credential issued by the board may use the title
"community health worker" or "CHW."
§34-44-9 Discipline.
The board may deny, suspend, revoke, or otherwise
discipline a certified community health worker for cause
established by rule, including fraud or material
misrepresentation in an application for initial or renewal of
certification. Any hearing relating to an action of the board
under this chapter shall be conducted pursuant to the Alabama
Administrative Procedure Act, Chapter 22 of Title 41.
§34-44-10 Rules.
The board shall adopt rules as necessary to implement
this chapter pursuant to the Alabama Administrative Procedure
Act. In addition to any other rule specifically authorized by
this chapter, board rules may do all of the following:
(1) Establish reasonable uniform fees and fee
structures for applications, renewals, and training program
approval.
(2) Establish uniform application forms and standards
for certification pathways including, but not limited to,
grandfathering and reciprocity, and time frames for each
pathway.
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pathway.
(3) Provide additional requirements for initial and
renewal of certification including, but not limited to,
minimum age requirements and acceptable documentation for
proof of training which may include certificates of
completion, transcripts, or official letters from recognized
training providers or certifying bodies and procedures for
verifying submitted documentation.
(4) Provide continuing education requirements,
including ethics.
(5) Develop a procedure and establish criteria for
approving training program providers and instructors.
(6) Develop procedures for complaint intake and
investigations.
(7) Establish disciplinary guidelines.
(8) Establish procedures for conducting audits.
§34-44-11 Coordination of federal approvals for
Medicaid reimbursement.
The Alabama Medicaid Agency, in coordination with the
board, shall seek any required federal approvals for
reimbursement mechanisms, including a State Plan Amendment,
waiver, or alternative payment model, to support reimbursement
for certain services provided by certified community health
workers, as permitted by state and federal law.
Section 2. This act shall become effective on October
1, 2026.
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