Table 1.

CHW voluntary certification timeline

Year	Major events
2013	• CHW Workforce Coalition (convened in 2012) approves CHW definition, core competencies, and scope of practice. • Coalition recommends 10 action steps to ADHS including establishing CHW Program.
2014	• ADHS establishes CHW Program Manager position. • Coalition establishes workforce development and sustainability committees. • Coalition members developed advocacy fact sheets on CHWs.
2015	• Partners meet with Democratic Senator to discuss CHW sustainability; he subsequently hosts a forum to with Medicaid health care plans and insurance companies. • AzCHOW builds consensus among CHWs on certification through state wide survey, focus groups and annual meeting. • Coalition conducts a provider survey on benefits of CHWs. • Partners reach out to AACIHC and ADHS Tribal liaison to discuss CHR workforce. • Coalition develops a Sunrise application for a change in a health care profession scope of practice but decides not to submit it. • Partners hold listening sessions with CHR programs, Tribal Health Department Directors, and American Indian health policy experts. • CHR organize CHR Movement and host first annual CHR Policy Summi with 10 CHR Programs to discuss CHW certification efforts occuring in Arizona and New Mexico.
2016	• Democratic Senator hosts 2nd forum with stakeholders who recommend moving forward with Sunrise application and legislation. • Arizona Alliance of Community Health Centers and Arizona Public Health Association sign policy declarations in favor of certification giving boost to effort. • AzCHOW submits Sunrise application to Health Committee of Reference where it passes, but with opposition. • Hualapai Tribe adopts a tribal resolution to support the CHR workforce. • AzCHOW and CHR Movement discuss certification at annual events. • Coalition develops CHW Core Competency Training Approval Process. • CHR movement hosts second annual CHR Policy Summit with 18 CHR Programs for continual vetting of certification with members.
2017	• AzCHOW holds emergency meeting and decides to pursue legislation. • Democratic Representative sponsors CHW Voluntary Certification Bill. • CHW Bill passes out of the House of Representatives. • Senate Speaker assigns bill to Committee on Trade and Commerce where Chair declines to hear the bill. • AzCHOW receives foundation funding to support voluntary certification efforts. • Coalition members meet with opposition in the Senate to discuss bill. • AzCHOW approves the first CHW core competency training. • CHR Movement hosts third annual CHR Policy Summit with 100+ attendees and Tribal CHR Programs from 7 states.
2018	• Partners meet with Republican Representative and Chair of the Health Committee, who agrees to sponsor the bill. • CHR partners point out the need for reciprocity to be stated in the legislation • Coalition members galvanize broad support for the bill. • CHW/CHR workforce and stakeholder testify in Senate and House committees. • Bill passes the Senate and the House. • May 16, Governor Ducey signs the bill into law. • CHR Movement formalizes a CHR Coaltion meeting monthly on workforce policy issue and annual CHR Policy Summit planning.
2019	• ADHS forms the CHW Advisory Council for guidance on rules. • Advisory Council begins crafting recommendations for CHW definition, core competencies, and training and renewal requirements. • AACIHC commissions academic Coaltion partners to conduct a broad based CHR workforce assessment.