A BILL TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING CHAPTER 49 TO TITLE 43 SO AS TO REQUIRE THE CERTIFICATION OF COMMUNITY HEALTH WORKERS IN THE STATE OF SOUTH CAROLINA; TO ESTABLISH CERTIFICATION REQUIREMENTS AND AUTHORIZED SERVICES; TO REQUIRE THE DEPARTMENT OF PUBLIC HEALTH TO PROMULGATE CERTAIN REGULATIONS, INCLUDING CONTINUING EDUCATION REQUIREMENTS; TO PROVIDE FOR MEDICAID REIMBURSEMENT OF AUTHORIZED SERVICES; AND FOR OTHER PURPOSES; AND BY ADDING SECTION 44-6-75 SO AS TO REQUIRE THE STATE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO SEEK FEDERAL APPROVAL FOR A STATE MEDICAID PLAN AMENDMENT OR WAIVER INCLUDING SERVICES PROVIDED BY CERTIFIED COMMUNITY HEALTH WORKERS IN CERTAIN CIRCUMSTANCES.
H5002 would create a new certification framework for community health workers in South Carolina by adding Chapter 49 to Title 43 of the state code. Beginning January 1, 2027, individuals could not hold themselves out as community health workers unless certified by the South Carolina Department of Public Health. To qualify, applicants must meet residency or employment requirements, be at least 18, and complete an approved competency-based training and mentorship program or satisfy alternative experience-based criteria set by regulation. Certifications would be renewed annually, with continuing education required for recertification, including instruction related to oral health, maternal and infant health, and geriatric care. The bill also allows training, mentorship, and continuing education to count toward college course credit.
The bill defines a scope of practice for certified community health workers and authorizes them to provide preventive services, chronic disease support, health education, care navigation across cultural and language barriers, and diagnosis-related self-management education. It directs the Department of Public Health to adopt regulations governing core competencies, training approvals, renewal procedures, fees, discipline, and scope of practice, and it requires the South Carolina Technical College System to be included among approved training providers. The department must also work with higher education agencies to facilitate college credit for approved training and education.
H5002 would also affect Medicaid policy by directing the Department of Health and Human Services to seek federal approval for reimbursement of certified community health worker services through a state plan amendment, waiver, or alternative payment model. Reimbursement would be tied to certified workers employed and supervised by Medicaid-participating providers such as hospitals, FQHCs, community mental health centers, behavioral health organizations, local public health departments, and similar entities. The bill expressly says certified community health workers may not enroll as independent Medicaid providers, but their services would not be treated as duplicative when delivered through a Medicaid managed care organization. It also contemplates a children’s preventive health coverage option under CHIP with no cost-sharing for these services, if allowed by federal law.
The general sentiment reflected by the bill text is supportive of expanding and formalizing the community health worker workforce, improving access to preventive and culturally responsive care, and creating a pathway to reimbursement. Because there are no committee transcripts or recorded votes provided, there is no documented public debate in the supplied materials. The bill appears designed to professionalize the field while integrating community health workers into the state’s health and Medicaid systems.
The main points of potential contention are likely to involve certification standards, regulatory authority, and Medicaid reimbursement structure. Questions may arise about whether the training and experience requirements are too restrictive or too permissive, how broad the authorized services should be, and whether limiting Medicaid enrollment to workers employed and supervised by certain providers could constrain access or workforce flexibility. The requirement that DPH and DHHS adopt regulations and seek federal approval also means implementation depends on agency rulemaking and CMS approval, which could affect timing and scope.
The bill would add a new chapter to Title 43 establishing state certification requirements for community health workers and a new section to Title 44 requiring DHHS to pursue federal approval for Medicaid reimbursement of certified community health worker services. It would also require DPH to regulate training, continuing education, discipline, fees, and scope of practice, and would create a pathway for approved training to count toward college credit. Affected parties include community health workers, training providers, Medicaid managed care organizations, Medicaid-participating providers, DPH, DHHS, and potentially CHIP-covered children if federal approval is obtained.
The available materials suggest a generally favorable, workforce-expansion approach to community health workers, with the bill framed as a way to improve access to preventive care, care coordination, and chronic disease support. No committee testimony or vote history is provided, so there is no recorded opposition or amendment debate in the supplied context. Overall, the bill appears policy-driven and implementation-focused rather than controversial on its face.
Likely areas of contention include whether certification should be mandatory for anyone using the title community health worker, what alternative experience-based pathways should be allowed, and how much discretion DPH should have in setting core competencies and continuing education. Stakeholders may also differ on the Medicaid reimbursement model, especially the restriction that certified community health workers cannot enroll as independent Medicaid providers and must be employed and supervised by specified provider types. Additional debate could arise over the scope of reimbursable services and whether the bill’s federal approval and rulemaking requirements could delay implementation.