North Carolina community health workers can pursue certification through the North Carolina Community Health Worker Association (NCCHWA). Standardized Core Competency Training is offered through community colleges. Program leaders should track workforce credentials separately from Medicaid contracts and Healthy Opportunities Pilot participation, because certification alone does not establish payment eligibility. [1, 2]
North Carolina CHW quick facts
| Topic | North Carolina guidance |
|---|---|
| Certification administrator | North Carolina Community Health Worker Association (NCCHWA). [1, 2] |
| Training pathway | Standardized Core Competency Training (SCCT), covering nine competencies. [1] |
| CHW I application | SCCT completed with at least 80%, within the year before application, or the association’s qualifying legacy pathway. [2] |
| Application fee | $50 nonrefundable certification application fee. [2] |
| Renewal | Three years. Contact hours vary by certification level, starting at 24 for CHW I. [3] |
| Funding watch | SFY27 funding has been approved to restart HOP services. Implementation details and eligible participation require current confirmation. [5] |
| Last reviewed | November 6, 2026 |
For program leaders
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What does a CHW do in North Carolina?
CHWs connect people with health information, services and community resources through relationships rooted in the communities they serve. North Carolina’s workforce resources emphasize core competencies, professional development and integration into local programs. An organization’s CHW role may include outreach, health education, navigation and support addressing barriers to care. Define the actual responsibilities in a job description and explain where a supervisor or clinical partner takes over. [1]
A program serving rural families may organize work around travel and follow-up across several counties. A clinic-based team may prioritize visits, referrals and coordination with existing care managers. Both need a consistent participant history, but their staffing model, deliverables and funding conditions can differ.
Is CHW certification available in North Carolina?
Yes. NCCHWA administers certification and describes training, legacy and advanced pathways. NCDHHS directs workers to the association for certification information. Association certification should not be described as a state professional license or confused with North Carolina’s separate certified peer support specialist credential. [1, 2]
Check the pathway and level shown on each worker’s approval rather than assigning a level based on job title. NCCHWA explains that workers do not have to progress through every level sequentially. For an advanced application, use the current level-specific instructions and obtain clarification about evidence before paying or submitting. [2]
How to apply through the SCCT pathway
For CHW I, the current certification page lists SCCT completion with a grade of 80% or higher within the year before the application. It also identifies knowledge and understanding of at least one population served. A training completion record is evidence for the application; it is not the same as certification approval. [2]
- Find a current SCCT course through the training resources linked by NCDHHS and NCCHWA.
- Confirm admission, schedule, delivery format, cost and the completion record directly with the college.
- Keep the course completion date and grade so the application timing can be checked.
- Submit the association’s current application and required supporting materials.
- Record the approved level and certification dates after the association issues its decision.
The application fee is $50 and nonrefundable. The association advises applicants who need financial assistance to contact it before applying. Its published processing estimate is six to eight weeks; that estimate should not become a promised employment start date. [2]
What is the legacy certification pathway?
NCCHWA lists a legacy pathway based on 2,000 hours of qualifying CHW experience demonstrating the nine core competencies. Use the association’s current evidence requirements to determine whether a particular worker qualifies. A résumé that says “community outreach” may not by itself show how the experience meets each competency. [2]
For an experienced employee, prepare a clear description of the work, dates, hours and the person who can verify it. Keep factual experience evidence separate from a supervisor’s assessment of readiness for a specific assignment. If the worker also holds another credential, ask NCCHWA how it applies rather than assuming automatic reciprocity.
What evidence supports an advanced-level application?
NCCHWA allows applicants to select the level for which they meet the criteria. Its published table distinguishes individual and interpersonal work from organizational, community and policy experience. Levels II and III list 2,000 to 4,000 hours plus a résumé, with different population and practice contexts; level IV lists at least 4,000 hours and broader policy context. Use the actual level criteria rather than selecting solely by years employed. These are the association’s credential standards. NCCHWA certification levels.
Paid and unpaid CHW roles can form professional-experience evidence under the association’s definition. The application requests experience-verification forms except for the SCCT route. Ask a verifier to describe actual competencies, duties and hours rather than copy a generic job description. Spanish- and Hmong-speaking application support is available, and other languages or an interview submission can be requested. NCCHWA application instructions.
Where can workers find training?
The NCDHHS workforce page identifies SCCT delivered through North Carolina community colleges and links to NCCHWA’s course information. It also points to North Carolina AHEC specialty training for continued professional development. Course availability and specialty training serve different purposes. A short workshop should not be presented as completion of the full SCCT pathway. [1, 4]
Before selecting a cohort, ask the college which credential pathway its course supports, how attendance and assessments work, and how completion will be documented. For employed workers, budget for participation time and coverage of current responsibilities as well as tuition.
North Carolina CHW renewal requirements
NCCHWA certification remains active for three years. Its current recertification page lists 24 contact hours for CHW I, 32 for CHW II, 40 for CHW III and 48 for CHW IV. It also requires at least five contact hours in each of three categories: traditional education; lived experience and on-the-job training; and participation in CHW workforce activities. [3]
A CHW I needs 24 total hours as well as at least five in each category. Completing 24 hours of webinars alone therefore does not satisfy the published category mix. For a fictional CHW I, a planning worksheet might allocate ten hours of approved traditional education, eight of approved hands-on learning and six of workforce participation. The association must still accept the actual activities and evidence. NCCHWA recertification framework.
Track activity title, date, category, actual contact time and completion evidence during the cycle. Ordinary job hours should not automatically become approved renewal hours. The association’s deadline wording refers to submission within 60 days of expiration. Confirm the applicable submission window directly; do not treat that wording as permission to practice under an expired credential. [3]
Does North Carolina Medicaid pay for CHW services?
There is no basis for treating NCCHWA certification as a universal Medicaid billing authorization. NC Medicaid’s CHW integration guidance describes ways organizations can incorporate the workforce into care delivery. The actual payment arrangement depends on the program, organization, contract and service involved. [6]
Before projecting revenue, obtain written confirmation of the funding mechanism, eligible population, organization responsibilities, required documentation and how payment is requested. A care management arrangement, a grant and a Healthy Opportunities service contract are distinct arrangements. Keep their reporting and payment rules identifiable.
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How can a CHW work as a Tailored Care Management extender?
Care-manager extender is a defined team role with separate eligibility, training and direction requirements. The current provider resources include a revised October 2026 TCM manual and an implementation memo. The memo sets December 8, 2026 as the revised requirements’ effective date, permits earlier adoption by plans and directs providers to their assigned plan’s implementation schedule. Check that schedule before treating the new manual as already operative for every team. NC Medicaid provider hub, October 2026 implementation memo.
The revised manual’s extender framework requires age 18, diploma or equivalent and one of its specified experience routes. Those include relevant lived experience with Medicaid-system knowledge, specified certified peer-support experience, a qualifying parent or guardian’s experience, or two paid years performing extender functions with at least one year directly serving the TCM population. A parent or guardian cannot act as their own family member’s extender. Association CHW certification alone should not be treated as automatic satisfaction of every extender condition. October 2026 manual, pages 20 to 21.
The care manager directs the extender’s functions and the team coordinates delegated work. The revised manual also prohibits extenders from working for the same organization where they receive services. Keep the team assignment and actual role separate from a worker’s general outreach job. October 2026 manual, pages 20 to 21.
Does association renewal learning replace TCM training?
No. NC Medicaid’s December 2025 bulletin established six hours of annual refresher training for care managers, extenders and supervisors beginning January 5, 2026. It gives plans and employers flexibility in timing within the year tied to deployment or hire. That program requirement is separate from NCCHWA’s three-year certification cycle. The revised October 2026 manual also describes required pre-deployment modules and remaining modules within six months of deployment, subject to its implementation schedule. NC Medicaid training update, October 2026 manual, pages 65 to 66.
What is happening with Healthy Opportunities Pilots?
The current NCDHHS HOP page reports that the General Assembly approved $9 million in SFY27 state funding to restart services. The department says it is determining how to use those resources, together with federal match, for a subset of eligible Medicaid members and will communicate next steps to partners. [5]
That update matters because older sections of the same page describe the suspension caused by the lack of funding after July 1, 2025. As of this review, a guide should report the new restart funding while avoiding a claim that every former service, provider or participant has already resumed. Confirm current instructions with the relevant partners before scheduling a funded service. [5]
The published pilot model assigns different responsibilities to administrators, care managers, Network Leads and Human Service Organizations. Administrators determine eligibility and authorize services; contracted HSOs deliver specified interventions and maintain tracking, reporting and invoicing capabilities. A CHW helping someone connect with a care manager does not by itself establish that the employer is a contracted HSO or that a service has been authorized. NCDHHS pilot roles.
The restart announcement does not settle the new operating footprint or guarantee resumption of every former intervention. Confirm the current geography, authorized service, participant eligibility, agreement and start date with the relevant partners. Keep an informational referral identifiable while that decision is pending.
A practical launch checklist for North Carolina programs
- Define the population, service area, CHW responsibilities and escalation contacts.
- Match each employee to the appropriate certification or training pathway.
- Record credential status, expiration, renewal category totals and supporting evidence.
- Confirm the current contract or grant requirements for each funded service.
- Establish a participant intake, consent and referral follow-up process.
- Review a sample record and funder report before expanding the caseload.
Treat this as an implementation checklist. It does not replace a payer contract or the association’s certification instructions.
What should CHW documentation capture?
A useful contact record identifies the participant, worker, date, purpose, activity, participant response, referral status and next step. For program management, distinguish attempted contact, completed education, referral made, appointment scheduled and confirmed connection to a service. Those stages answer different questions.
For a housing referral, record the barrier the participant identified, the resource offered, the agreed follow-up and what happened. Do not label the need resolved simply because a referral was sent. Where a funding arrangement requires additional fields or approval, configure those fields around its actual instructions.
How to choose CHW software in North Carolina
Start with the information your team needs to act on today: open follow-ups, unresolved referrals, upcoming credential renewals and reporting obligations. Ask a vendor to show those workflows using a realistic participant example. A general task list may be insufficient if the team cannot connect activities with the participant’s goals and referral history.
Ask how certification levels, training evidence and expiration dates can be kept distinct from service authorization. Ask how managers can review notes, restrict access and export reports. Confirm supported functions directly rather than assuming that a software platform connects to an HOP administrator, payer or external referral network.
Explore community health workflows to see how Smores Health approaches work across community-based teams.
Questions to bring to a software demonstration
- Can a supervisor find participants whose referral follow-up is overdue?
- Can the team distinguish credential renewal activities by category and level?
- Can reports separate grants, care management work and authorized social-needs services?
- Can staff document outcomes without marking a referral complete prematurely?
- Can the organization review access, exports and implementation responsibilities before launch?
Bring a sample report and a de-identified referral example. See the Smores Health platform, then use the walkthrough to assess the actual fit for your program.
See it in your program
Build your program around a connected workflow.
Bring your forms and reporting needs. See how Smores Health connects service notes, supervisor review, and program reporting in a walkthrough focused on your team.
A 20-minute walkthrough for your program.
Frequently asked questions
Is NCCHWA certification a state license?
NCCHWA administers the CHW certification described by the state workforce resources. Do not describe it as a state professional license or use it interchangeably with peer support certification. [1, 2]
Can experienced CHWs apply without taking SCCT again?
NCCHWA lists a legacy pathway based on qualifying experience and demonstrated competencies. The association determines whether the submitted evidence meets its current requirements. [2]
How often do North Carolina CHWs renew certification?
Every three years. Required contact hours vary by level, and the association specifies category minimums and supporting requirements. [3]
Has Healthy Opportunities restarted for everyone?
The current announcement reports funding to restart services, with details being finalized for a subset of eligible members. It does not establish universal resumption for all former participants or services. [5]
What should program leads look for in CHW case management software?
Look for a clear participant history, dependable follow-up, reviewable documentation, useful reports and a way to keep workforce status separate from funding eligibility. Test the actual workflows your organization uses.
Build a clearer workflow for your North Carolina CHW team
Bring your referral process, renewal tracker and funder report to Smores Health. Book a program walkthrough to evaluate how the platform fits your team’s work, or request pricing for your organization.
Sources
[1] NCDHHS, Community Health Workers workforce resources. https://www.ncdhhs.gov/divisions/office-rural-health/office-rural-health-programs/rural-health-operations/community-health-workers
[2] NCCHWA, Certification. https://ncchwa.org/services/certification/
[3] NCCHWA, Recertification. https://ncchwa.org/recertification/
[4] NCCHWA, Training. https://ncchwa.org/services/training/
[5] NCDHHS, Healthy Opportunities Pilots, current funding update. https://www.ncdhhs.gov/about/department-initiatives/healthy-opportunities/healthy-opportunities-pilots
[6] NC Medicaid, Integrating Community Health Workers in NC Medicaid. https://medicaid.ncdhhs.gov/integrating-community-health-workers-nc-medicaid
NC Medicaid TCM provider resources, including the October 2026 manual and implementation memo. Annual TCM training update, December 5, 2025.