Resources and Sample Application Forms for Community Health Workers
On this page, you will find the resources and information you need to become certified in the state of Ohio. To become certified in Ohio, you must complete an approved training program, submit an online application to the Board, and meet all requirements to obtain a certificate. CHWs play an important role in facilitating access to quality health services. CHWs serve as liaisons between health/social services and the community.
The 2018 Ohio Community Health Worker Statewide Assessment
In September 2018, the Ohio Department of Health (ODH) and the Ohio Colleges of Medicine Government Resource Center (GRC) completed “Key Findings from the 2018 Ohio Community Health Worker Statewide Assessment (Assessment)” which identifies how CHWs are currently trained, certified, employed, and reimbursed. The summary report and fact sheets are below.
Community Health Worker Certification and Applicant Information
The links below will provide you sample applications for Community Health Worker certification, and each application has instructions about applying for certification, fees, etc.
- Fee Schedule for Licenses and Certificates
- CHW Application
- CHW Renewal Application
- CHW Reinstatement/Reactivation Application
- Attestation of Community Health Worker Training Program Completion – Form A
Criminal records checks are required for certification. Click on the links below for information.
- Criminal Records Checks Required for Licensure or Certification
- Request for Exemption from Electronic Fingerprint Submission
- List of Potentially Disqualifying Crimes
- Potentially Disqualifying Offense Determination Request
Below is a link for Chapter 4723-26, Ohio Administrative Code, to view the regulations that specify certification requirements.
The Board of Nursing regulates training programs in Ohio that prepare students for certification as a CHW. For a list of training programs approved by the Board click the link below.