URAC Community Health Worker Program Accreditation — Frequently Asked Questions

What is URAC Community Health Worker Program Accreditation?

URAC Community Health Worker Program Accreditation is an organizational-level recognition that a CHW program meets nationally validated standards for program design, workforce development, scope of practice, quality management, and health equity integration.

Launched in 2024, it is the first accreditation in the United States developed specifically for organizations that employ or contract with community health workers. The accreditation evaluates the organization — not individual CHWs — and is valid for three years.

Who developed the URAC CHW accreditation standards?

URAC developed the standards through a multi-stakeholder advisory committee with representatives from Federally Qualified Health Centers, community-based organizations, nonprofits, educational institutions, and payers. The committee was constituted to reflect how CHW programs actually operate across diverse settings — not a single sector's perspective.

Diversity, equity, and inclusion (DEI) and social determinants of health (SDOH) are embedded throughout the standards — not treated as supplemental criteria tacked on at the end.

What types of organizations are eligible?

Any organization that employs or contracts directly with community health workers is eligible. This includes:

• Hospitals and health systems
• Federally Qualified Health Centers (FQHCs)
• Health plans and managed care organizations
• State and local public health departments
• Community-based organizations and nonprofits
• Faith-based health programs
• Academic medical centers
• For-profit CHW service organizations
• Integrated care networks and ACOs

What are the ten standard domains?

URAC evaluates CHW programs across ten domains:

1. Diversity, Equity & Inclusion — client and employee DEI, culturally responsive service delivery
2. Workforce Development — equitable compensation, career pathways, supervision, reporting structures
3. Learning & Development — onboarding, training requirements, competency assessment
4. Scope of Practice — defined CHW roles and boundaries aligned with state frameworks
5. Peer Support Integration — referral pathways and co-deployment protocols
6. Quality Management — performance measurement, outcome tracking, QI infrastructure
7. Care Team Integration — clinical workflow embedding and cross-team coordination
8. Leadership Engagement — governance, program sponsorship, executive accountability
9. Community & SDOH Alignment — community needs assessment and SDOH data integration
10. Program Sustainability — funding strategy, billing infrastructure, long-term viability

How long does the accreditation process take?

URAC states the review process takes approximately six months. Organizations should plan for six to twelve months from initial gap analysis through accreditation decision to allow time for policy development, evidence collection, and survey preparation.

Timeline depends on program maturity. Organizations with established quality management infrastructure move faster. Programs building CHW structure from the ground up take longer.

Does URAC evaluate individual community health workers?

No. The accreditation evaluates the organization and its program infrastructure — not individual CHWs. Standards assess how the organization recruits, trains, supervises, compensates, and supports its CHW workforce; how CHWs are integrated into care teams; and how the program measures outcomes.

Individual CHW qualifications may be addressed within workforce development standards, but individual CHWs are not themselves the subject of accreditation.

How does URAC CHW accreditation relate to state CHW certification?

They operate at different levels. State CHW certification programs recognize individual CHWs who meet state-defined training and competency requirements. URAC CHW Program Accreditation recognizes the organization that employs or deploys those CHWs.

The two are complementary. State-certified CHWs working within a URAC-accredited program represents the strongest quality signal to payers, regulators, and community partners. Neither substitutes for the other.

Does this accreditation affect Medicaid CHW billing eligibility?

Directly, no — Medicaid CHW billing eligibility is determined by individual state Medicaid programs. However, accreditation provides the quality documentation infrastructure that state Medicaid programs, managed care organizations, and value-based payers increasingly reference as a condition of CHW service reimbursement.

States are beginning to incorporate quality standards into CHW billing policy, and accreditation positions programs favorably as billing rules continue to develop. Organizations should also review state-specific CHW billing code requirements separately.

What evidence does URAC require?

URAC's review is documentation-based, supplemented by staff interviews. Organizations submit:

• Policies and procedures across all ten standard domains
• Job descriptions and organizational charts
• Training curricula and competency assessment tools
• Quality management reports and outcome data
• Evidence of leadership oversight and governance
• SDOH and community needs assessment documentation

A critical principle: documentation must reflect actual operations — not aspirational policies written for accreditation. Reviewers are experienced at identifying gaps between written policy and practice, and that gap is the most common source of deficiency findings.

How much does URAC CHW Program Accreditation cost?

URAC application and accreditation fees are not publicly published and vary by organization. Contact URAC directly at urac.org for current fee information.

IHS consulting fees are scoped per engagement based on program maturity, organizational complexity, and support scope. Schedule a discovery session for a tailored proposal.

What are the most common reasons CHW programs are not ready for accreditation?

The most common readiness gaps:

• Undefined scope of practice — CHWs doing different things in different settings without documented role clarity
• No quality management infrastructure — no outcome tracking, no QI process, no performance metrics tied to CHW activities
• Inadequate workforce documentation — no formal training curricula, no competency assessment, no supervision records
• Weak DEI operationalization — DEI stated as a value but not embedded in hiring, training, or service delivery protocols
• No leadership engagement evidence — program operates without formal governance or executive accountability structure
• Unstable funding model — reliance on a single grant with no billing or sustainability strategy documented

Who was the first organization to earn this accreditation?

Jefferson Health became the first organization to earn URAC Community Health Worker Program Accreditation in 2025. Jefferson's program expanded from fewer than a dozen CHWs to nearly 40 individuals embedded across hospital and community settings. Results include reduced emergency department utilization and readmissions, improved blood pressure control, and increased primary care engagement.

How does the accreditation process work from application to decision?

1. Application submission — organizational information and program documentation
2. Desktop review — URAC reviewers evaluate documentation against each standard domain
3. Staff interviews — structured interviews to validate that written policies reflect actual operations
4. Findings and response — organizations may respond to deficiency findings with additional evidence or corrective action plans
5. Accreditation committee decision — committee determines accreditation status based on the complete record

Accreditation is granted for three years, after which re-accreditation is required.

What is the difference between URAC accreditation and URAC certification?

URAC uses both terms across its 50+ program portfolio. Accreditation typically applies to a comprehensive evaluation of an organization or program across multiple operational domains. Certification typically applies to a more focused evaluation of a specific function or capability.

URAC Community Health Worker Program Accreditation is a full organizational program evaluation — it is accreditation in the substantive sense: a comprehensive assessment of how the organization builds, operates, and governs its CHW program.

How can IHS help our organization prepare?

IHS provides end-to-end accreditation preparation led by Thomas G. Goddard, JD, PhD, the former Chief Operating Officer and General Counsel of URAC. Services include gap analysis, policy development, quality management infrastructure design, evidence organization, staff interview coaching, application support, and deficiency response.

The discovery session is the right starting point — we assess your program's current state and identify the highest-priority gaps before any engagement begins.