1. Matt Richardson, MPH Lee Lane April 22, 2010
Accreditation: Why are we swimming in it—and, is a life raft on the way??
Matt Richardson, MPH
Lee Lane
April 22, 2010

2. In the Beginning, there was Snow…
Broad Street pump
Report of the Sanitary Commission of Massachusetts: Lemuel Shattuck and “markers” of community health
Discussion of LOCAL Public Health and the need for communities to protect it

3. Early 1900s… Charles Chapin, a physician, with the first survey!
1914 American Medical Association and the Council of Health and Public Instruction
Surveyed activities for local health departments to define roles more clearly

4. Evolution is always controversial, even for “public health standards”…
Haven Emerson and the Committee on Administrative Practice Report on Local Public Health Units
Six core public health activities in 1945:
Vital statistics
Sanitation
Communicable Disease Control
Maternal and child health
Health Education
Laboratory Services

5. 1988: Game Changer Assessment Policy Development Assurance
Barriers to Effective Action listed:
Lack of consensus on mission
Inadequate capacity
Disjointed decision-making without data
Inequity
Organizational Fragmentation
Inadequate knowledge

6. “Turning Points” to MAPP, and another Report? 2003—Now
Turning Point effort
MAPP framework
10 Essential Services for Public Health
NPHPS
Future of Public Health in the 21st Century
First call for national accreditation!
State efforts begin in earnest…

7. Let’s go “Exploring…” Final recommendations on a voluntary system
National effort with many partners: NACCHO, ASTHO, NALBOH, CDC, RWJF
The true genesis of national PH accreditation

8. Texas Accreditation Discussions
Texas Association of Local Health Officials (TALHO) agreed to convene an “Accreditation Committee” to examine the feasibility and interest in pursuing local public health accreditation
The Texas Association of Local Health Officials accreditation committee determined that there was a need for a neutral party and developed the Public Health Accreditation Council of Texas (PHACT) to carry out their plan.

9. Public Health Accreditation Council of Texas (PHACT)
Developed in June of 2007
Voting Members include:
School of Public Health
6 LHDs (2 small, 2 medium, 2 large)
State Association of County/City Health Officials (SACCHO)
2 DSHS (1 Central office, 1 HSR)
TPHA
THI
TMA
Ex- Officio Members

10. PHACT Mission
“To assure and enhance the quality of public health in Texas by identifying and promoting the voluntary implementation of public health standards and evaluation of voluntary accreditation of local health departments on their ability to meet these standards.”

11. Activities of the PHACT
2008 – Standards Development Workgroup - Reviewed and commented on the National Public Health Performance Standards Program, NACCHO Operational Definition and ASTHO’s State Public Health Survey
Recommended standards best suited for assessing compliance with Domain measurements

12. Activities of the PHACT
PHAB made recommended changes to national standards.
PHACT agreed to and adopted the PHAB standards for Texas
PHAB called for national Beta site applications
1 Texas site awarded (ATCHHS)
2010 – PHAB contracts with TALHO on behalf of PHACT to conduct Think Tank Meetings to review Beta accreditation materials

13. Role of PHACT in National Accreditation Process
Responsible for assisting LHDs in preparation for accreditation by:
Providing technical assistance
Recruiting reviewers
Advocating for capacity building
Using the PHAB standards and processes to review and recommend accreditation (outside reviewers)

14. Initial Steps by PHACT
Review leadership and membership for revised role
Research and produce document of minimal LPH capacity levels for a well-functioning public health system
Assess current state of LPH system
Collect resources to assist LHDs in meeting accreditation standards

15. DSHS Regions? What exactly are they in this process?
State Health Department accreditation assumed to be similar, yet distinct
Not sure of PHACT role for Regions

16. Questions or comments?
Thanks for listening!