National Reports and Toolkits
Community Health Workers and Community Health Representatives are an established workforce across the United States, and CHWs programs are implemented across the globe. There are many resources available to support CHW/CHR implementation in Montana. See below for a selection of national resources on CHWs. The World Health Organization has resources for international CHW program implementation.
To the left is a map of the 20 states that use a State Plan Amendment to fund CHW work as of March 2025 via Medicaid. Other states use a Medicaid 1115 waiver or a Managed Care Organization to fund CHW services.
More than 50% of states have a CHW certification or licensure process recognized by their state government.
Montana is the only state that has a licensure process for Doula’s, Behavioral Health Peers and Family Peers, but not Community Health Workers.
Community Health Workers + Medicaid
According to a recent MTCHWA survey, over 60% of CHWs have a personal experience of using a state program like Medicaid, but only 14% of CHWs are funded via a payer like Medicaid or Medicare. In Montana, as of 2026, there is very limited Medicaid funding opportunities for CHWs. Below are three toolkits that look at how State Plan Amendments can support CHW and CHR programs, and how other states utilize Medicaid to sustain CHW programs.
Community Health Worker ROI Studies
Decades of research have demonstrated that Community Health Workers are cost saving. They are considered a CDC best practice based on their effectiveness and impact in clinical and community care teams to prevent cardiovascular health, and are recommended by the Community Preventative Services Task Force (CPSTF) (first image/link). As described by the American Medical Association, ‘adding CHWs to the care team also reduced costs, with the hospital saving $2.30 for every $1 it invested in a CHW’ (second image/link). CHWs also bring cost-savings to patient centered medical homes by reducing unnecessary care such as ED utilization and providing better care coordination (third image/link)
Community Health Worker Program Implementation
Community Health Worker programs exist in local public health, community-based organization, traditional health care organizations and tribal health. Below is a sampling of toolkits developed by other states to support CHW program implementation: Rural Health Information Hub; American Hospital Association; National Association of County and City Health Officials.
Community Health Workforce Standards
Community Health Worker professional standards are fairly consistent across the United States because of the work of the National Council. The National Council worked in partnership with CHWs, state governments and stakeholders across the US to define a common set of CHW roles and competencies, which are now used by 20 states. These standards were also used by MTCHWA and have been adopted by the Association through the MTCHWA policy manual. See the resources below for more information.
