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101.1 Who We Are: The Community Health Worker
History, roles, Ohio certification and scope of practice
Your materials
Slides (PowerPoint) Handout (Word)
For instructors
Facilitator guide Printable pre and post tests Quiz (LMS import)
What you will learn
- Define a community health worker in your own words
- Name the ten roles CHWs play across the country
- Explain what Ohio requires for the CHW certificate
- Tell the difference between CHW tasks and nursing tasks
Start here
Think of the person on your block that everyone goes to for help. What makes people trust them?
Lesson
A trusted member of the community
The American Public Health Association describes CHWs this way:
- Trusted: A frontline public health worker who is a trusted member of the community, or knows it unusually well.
- A bridge: Links people to health and social services and helps services reach people better.
- Builds capacity: Helps people and communities gain the knowledge and power to improve their own health.
Many names, one kind of work
- Promotoras: Spanish-speaking health promoters, common in Latino communities.
- Faith health workers: Parish nurses' partners, church health ministers and lay health advisors.
- Navigators: Patient navigators, care coordinators and outreach workers in clinics and hospitals.
- Credible messengers: Outreach workers and violence interrupters who use lived experience to reach people.
The ten CHW roles
| Role | What it looks like |
|---|---|
| Cultural mediation; outreach | Bridging people and systems; meeting people where they are |
| Health education; coaching and support | Teaching in plain words; cheering people on |
| Care coordination and navigation | Helping people get to the right service and follow up |
| Advocacy; capacity building | Speaking up for people; helping groups lead |
| Direct service; assessment | Screenings, blood pressure checks, needs assessments |
| Evaluation and research | Helping collect data and share what works |
Why CHWs work upstream
- What we see: Ms. Davis keeps missing her blood pressure checks and her numbers are high.
- Why it happens (upstream): Her bus route was cut, she works two jobs, and the corner store has more chips than fresh food.
- What we can build on (assets): Her church van, a neighbor who drives, a mobile clinic stop, and the community garden two blocks over.
Getting the Ohio CHW certificate
The Ohio Board of Nursing certifies CHWs. You need to:
- Be 18 or older: And have a high school diploma or the equivalent.
- Finish an approved program: At least 100 classroom hours and 130 clinical hours.
- Apply to the Board: Send the application and the $35 fee.
- Pass a records check: Request a background check through the Ohio BCI.
- Renew every two years: Complete 15 hours of continuing education each renewal period.
What CHWs do and do not do
CHW tasks
- Health education in plain language
- Screenings and blood pressure checks, as trained
- Help with resources, benefits and appointments
- Home visits, follow-up calls and support
- Speak up for clients and communities
Not CHW tasks
- Diagnosing an illness
- Prescribing or changing medicine
- Giving or handing out medication doses
- Nursing tasks without RN delegation
- Medical advice beyond what you were taught
Situation: the medicine question
Situation: During a home visit, Mr. Johnson shows you his pill bottles. He says the water pill makes him go to the bathroom too much, so he wants to skip it. He asks what you think.
What do you say and do?
- Thank him for telling you and listen to his reasons
- Do not tell him to skip or keep the pill
- Offer to help him call his doctor or pharmacist today
- Write it in your notes and tell your supervisor
Talk it over
- Which of the ten roles do you already do, even without the title?
- Which role feels hardest for you right now, and why?
- Who in your neighborhood has been a CHW without being called one?
Study sheet
The big idea: CHWs are trusted community members who connect people to care and help communities build their own health.
Key points
- CHWs go by many names: promotoras, navigators, outreach workers, faith health workers and credible messengers.
- The C3 Project names ten CHW roles, from outreach and education to advocacy and research.
- CHWs look upstream for the causes of health problems and look around for community assets.
- In Ohio, the Board of Nursing approves training programs and certifies CHWs.
- CHWs do not diagnose, prescribe or give medication; they educate, connect, support and refer.
- Nursing tasks need delegation and supervision by a registered nurse.
Remember
- Certificate: age 18, diploma or equivalent, approved program, application, $35 fee, BCI check
- Training minimum: 100 classroom hours and 130 clinical hours
- Renewal: every two years, with 15 hours of continuing education
- Medication administration can never be delegated to a CHW
Ask yourself
- Which CHW roles match the strengths I already have?
- Who taught me how to help people in my community?
Vocabulary
| Word | What it means |
|---|---|
| Community health worker (CHW) | A trusted frontline public health worker who links people to services and helps communities improve their health. |
| Ohio Board of Nursing | The state agency that approves CHW training programs and certifies CHWs in Ohio. |
| Certificate | Official state recognition that you met Ohio's requirements to work as a certified CHW. |
| Scope of practice | The tasks a worker is trained and allowed to do in their role. |
| Delegation | When a registered nurse assigns a nursing task to a trained CHW and supervises it. |
| Continuing education | Classes taken after certification to keep skills current; Ohio requires 15 hours each renewal period. |
| C3 Project | A national effort that defined ten CHW roles and eleven CHW skills. |
| Upstream | The root causes of health problems, such as housing, income, transportation and policy. |
| Asset | Something a community already has that can help, such as people, places, groups or skills. |
| Referral | Connecting a person to another service or professional who can help them. |
Real-life situations
The neighbor who already does the work
Ms. Brenda in Glenville has helped neighbors sign up for utility help and find food pantries for ten years. She asks if she can get certified without taking a class.
What to do
- Thank her for her years of service
- Ask if she worked as a CHW before February 1, 2005, or holds a CHW certificate from another state
- If not, explain that Ohio requires an approved program, and that our working CHW pathway lets her practicum happen at her own work
- Help her fill out the program interest form
Why: Ohio allows only two routes around the training program: work as a CHW before 2005, or certification by endorsement from another state.
The question you cannot answer
At a health fair, a man asks you whether his chest tightness is just stress. He says it comes and goes.
What to do
- Do not guess or say it is probably nothing
- If he has chest pain or tightness right now, call 911
- If not, urge him to call his doctor today, and help him find one if he has none
- Note the contact on your outreach log
Why: Diagnosing is outside CHW scope, and chest symptoms can be an emergency. Connecting him fast is the right CHW action.
The worried applicant
A student tells you privately that she has a record from eight years ago and worries she cannot get certified.
What to do
- Thank her for trusting you and keep it private
- Explain that Ohio law limits which past records can stop a certificate
- Connect her with the program administrator for a private eligibility talk
- Encourage her not to give up before getting real answers
Why: Since 2025, Ohio can deny a CHW certificate for a conviction only for certain offenses, and many offenses stop counting after five years.
Activity: My CHW roles map
About 20 minutes.
- List three times you helped someone in your community get something they needed.
- For each one, find the matching CHW role from the ten roles.
- Circle the role you want to grow most in this program.
- Share one story with a partner or post it in the course discussion.
Post-test
Ten questions. You need 75% to pass, with one retake. Your result is saved in this browser.
Sources
- American Public Health Association, Community Health Workers
- C3 Project, CHW Roles and Competencies
- Ohio Revised Code 4723.84
- Ohio Administrative Code 4723-26-02, CHW certification
- Ohio Administrative Code 4723-26-05, Continuing education
- Ohio Administrative Code 4723-26-13, Standard curriculum
- Ohio Revised Code 9.79, Criminal records and licensing