CHRs Seek to Enhance Public Health Across the Country
The Indian Health Service’s (IHS) National Community Health Representative (CHR) Program recognizes community health projects highlighting the important work communities do to improve public health.
With more than 1,600 CHRs serving over 250 tribes, we recognize Community Health Improvement Week, June 1 – 7, as a powerful reminder that local efforts lead to lasting change.
Check out what Montana is working on!
The IHS CHR Program is eagerly watching Montana as it works to take steps towards passing legislation that will make CHW services eligible for billing and reimbursement.
Since January 2023, a group of community health workers (CHWs) has met twice monthly to discuss and build a scope of practice for Montana’s House Bill 850. This bill aims to address the state’s CHW workforce shortage through changes to Medicaid reimbursement.
“As the Montana CHR Programs appreciate the evolving partnerships with the Community Health Worker (CHW) Workforce, it is exciting to see the progression of CHW efforts across the state,” said Nurse Executive for the Billings Area Indian Health Service, Tara Peterson.
What will this bill do?
If passed, the bill would authorize the Montana Department of Labor to create a structure for CHW licensure. This would make CHW services eligible for Medicaid reimbursement, creating a new funding source to pay for the workforce.
The bill defines a CHW as a “licensed community health worker who is a frontline public health worker who lives in or is trusted by the community.” It also states they provide “outreach, maternity support, service navigation, coaching and social support, direct services, cultural mediation, capacity building, education, advocacy, and informal counseling.”
Mackenzie Petersen, director of Community-Based Public Health Projects at the University of Montana, is assisting with the bill’s legislative language.
“The scope includes CHW training requirements, a code of ethics, and certification requirements that will allow the Montana Department of Public Health and Human Services (DPHHS) to implement Medicaid services,” said Petersen.
“Ideally, what community health workers are doing is getting out of the clinic walls, meeting people where they are, and addressing the client's priorities to get to the root cause of their health conditions and health needs,” Petersen said in a Montana Free Press article earlier this year.
Where is the House Bill Now?
As of April 2025, the bill has passed the House and the Senate. However, it must return to the House to approve a language amendment. The entire legislation can be viewed on the Montana Legislature website.
Photo Credit: The National Academy for State Health Policy shares a map showing states using a variety of approaches to pay for CHW services.
