1. Public Health Department Accreditation: An Overview
County Health Executives Association of California
Public Health Department Accreditation: An Overview
Robin Wilcox
Chief Program Officer
Public Health Accreditation Board
August 1, 2012

2. Public Health Accreditation

3. National Public Health Department Accreditation
The measurement of health department performance against a set of nationally recognized, practice-focused, and evidenced-based standards.
The issuance of recognition of achievement of accreditation within a specified time frame by a nationally recognized entity.
A platform for continuous quality improvement.
The continual development, refinement, and distribution of standards and measures.

4. High Performing Health Departments Leading to a Healthier Nation
PHAB’s Vision
High Performing Health Departments Leading to a Healthier Nation
not about a paper exercise.
The vision is TRANSFORMATIONAL CHANGE IN PUBLIC HEALTH

5. Goal of Public Health Department Accreditation
The goal of the national public health department accreditation is to improve and protect the health of the public by advancing the continuous quality and performance improvement of state, local, tribal and territorial public health departments.

6. Public Health Accreditation Board (PHAB)

7. Public Health Accreditation Board (PHAB)
PHAB is the non-profit public health department accreditation organization founded in 2007.
PHAB is funded by the Robert Wood Johnson Foundation (RWJF) and by the Centers for Disease Control and Prevention (CDC) but also has accreditation fees associated with the application..
PHAB’s governance structure is a board of directors composed of public health leaders from Tribal, state and local health departments and academia.

8. PHAB Accreditation Themes
Quality Improvement
Planning
Partnerships
Community Engagement
Leadership and Governance
Customer / Community Focus

9. Standards and Measures Version 1.0

10. Principles of Standards and Measures
Advance the collective public health practice
Moderate level: not minimum, not maximum
Be simple, reduce redundancy, minimize burden
Apply to all sizes of HDs and all forms of governance structure
Establish same standards for Tribal, state and local health departments
Build quality improvement into standards

11. PHAB Domains of Standards Standards Grouped by the Core Functions of Public Health & Ten Essential Public Health Services

12. Twelve Domains
Conduct assessments focused on population health status and health issues facing the community
Investigate health problems and environmental public health hazards to protect the community
Inform and educate about public health issues and functions
Engage with the community to identify and solve health problems
Develop public health policies and plans
Enforce public health laws and regulations
Promote strategies to improve access to healthcare services
Maintain a competent public health workforce
Evaluate and continuously improve processes, programs, and interventions
Contribute to and apply the evidence base of public health
Maintain administrative and management capacity
Build a strong and effective relationship with governing entity

13. Domains Cross All Programs
Sample Domains
Family Planning Program
# 8 Public Health Workforce
Programs
Immunization Program
MCH Program
# 3 Educate the Public
# 4 Community Engagement
# 5 Policy & Plans
# 9 Quality Improvement
Environmental PH Program
STD Programs

14. Structural Framework
 Domain
  Standard
Measure  
Documentation
Guidance

16. The PHAB Accreditation Process

17. . PHAB’s Electronic Information System Multiple users, different views
Tracks transactions in process
HD SOI and applications
Health departments upload documentation
Site visitors review documentation
Site visitors develop Site Visit Report
Accreditation Committee reviews SVR
Accreditation Committee records decision

18. Health Department Appoint an Accreditation Coordinator
Establish an Accreditation Team
Establish a process to select the best documentation for each of PHAB’s measures and requirements for documentation
Outreach and involve staff department-wide and partners

19. Seven Steps 1. Pre-application 4. Site Visit
Applicant prepares and assesses readiness, informs PHAB of its intent to apply (SOI)
2. Application
Applicant submits application and pre-requisites and receives training
3. Documentation Selection and Submission
Applicant gathers and submits documentation
4. Site Visit
Documentation review, site visit and site visit report
5. Accreditation Decisions
PHAB Accreditation Committee determines accreditation status:
Accredited (5 years)
or Not Accredited
6. Reports
Annual progress reports
7. Reaccreditation

20. 1. Pre-app: Statement of Intent
Submit prior to application
Online
Designate Accreditation Coordinator
Does not commit the health department to applying
Submit anytime after
online orientation is
completed

21. 2. Application Completed online Three prerequisites Letter of support
Electronic signature
Eligibility to apply
Completeness review
Forward invoice
Applicant training

22. Three Prerequisites Community Health Assessment
Community Health Improvement Plan
Health Department Strategic Plan

23. 2. Applicant Training
Required for each applicant health department Accreditation Coordinator
Another representative at the health department’s cost
Must be completed prior to
upload of documentation

24. Accreditation Specialists
Each health department is assigned a PHAB Accreditation Specialist
Support HD as they upload documentation
Completeness Review
Communication link between HDs and SVs prior to site visit
Questions on documentation
Agenda
Attend site visit
Receives the Site Visit Report

25. 3. Documentation Selection and Submission
12 months to complete the upload
When finished, PHAB will conduct a completeness review
Checks that documentation is complete
Does not check for conformity with the Standards and Measures
PHAB staff will follow-up for missing documentation

26. 3. Documentation Selection
Consider variety of options and programs:
Best reflects health department operation
Meets specifics of the Required Documentation
Demonstrates conformity with measure (Context and intent of M & S)
Changes may be made until final submission

27. 4. Site Visit After pre-site visit review of documentation
Usually 2 day visit
Interview staff; verify documentation implementation
Meet with community partners and governance
May ask for additional documentation
Visual observations

28. 4. Site Visitors Peer reviewers Matched to HD Trained by PHAB
3 or 4 team members
Conflicts of interest determined

29. 4. Site Visit Report Submitted online
Due 2 weeks after completion of site visit
Health department will review and may submit any information to correct a factual error

30. Final Process Steps
Accreditation Decision is by the Board’s Accreditation Committee
Annual Reports must be provided each year during your accreditation
Reaccreditation will occur after 5 years and advanced notice will be sent by PHAB

31. Multijurisdictional Applications
Apply as a single entity
Two or more HDs
PHAB will accredit each HD
All HDs or none accredited
PHAB can limit number of HDs
One lead HD
One lead AC
Geographically contiguous preferred
Shared documentation assessed once

32. Multijurisdictional Applications
Established & defined working relationship
MOU
Deliver services/perform functions over combined jurisdiction
High degree of interdependence
Each HD could not fulfill role
Half of Domains, majority of Measures

33. What can you do NOW to begin to prepare?

34. Readiness Checklists
Assists with health department preparation for accreditation
Optional, but recommended prior to submitting a Statement of Intent
The checklists are not submitted to PHAB

35. Three Prerequisites Community Health Assessment
Standard 1.1
Community Health Improvement Plan
Standard 5.2
Health Department Strategic Plan
Standard 5.3
Submitted with the application for accreditation
Criteria included in Domains 1 and 5
One page “tip sheet” on prerequisites available

36. Health Department Appoint an Accreditation Coordinator
Establish an Accreditation Team
Review your documentation for each of PHAB’s measures and requirements for documentation
Outreach and involve staff department-wide and partners

37. Dates and Signatures For - Review your HD’s: Policies Procedures Plans
Directives
Public Information
Etc.
Dates:
Created date
Revised date
Reviewed date
Amended date
Effective period
Signatures:
(Evidence of “authenticity”)
HD logo
HD Director signature
HD Abbreviation
For -

38. Online Orientation 4 Modules Introduction Process
Accreditation Coordinator
Standards and Measures
2 hours
About 30 minutes each

40. Fees

41. Fees:

42. Fees: .

43. Fees Support Assigned Accreditation Specialist
In-person training for the HD’s AC
Subscription to e-PHAB
Easier & cost effective to participate
Peer review and Site Visit
Site Visit Report with identified opportunities for improvement and areas of excellence
Annual QI guidance

44. Costs of Seeking Accreditation
The cost of doing business
The cost of CQI – doing better things better
The cost of planning and prioritizing
The cost of team building and strategic alignment of staff
The cost of building partnerships and sharing responsibilities with others in the public health system & community
The cost of maintaining a good working relationship with governing entity.

45. Benefits of Accreditation
Recognition and credibility
Identifies successes and opportunities for improvement
Access to public health experts
Platform for culture of continuous quality improvement
Means for accountability
Energizes the staff
Increases the understanding of public health
Improves communication with governance
Initiates and advances partnerships and community involvement
Encourages linkages among levels of health departments

46. Beta Test Feedback
“ . . .had a positive effect on those staff involved by providing opportunities to learn about the department in-depth and how much we do for the people who live and visit our state.”
Beta Test Health Department
Team building

47. Beta Test Feedback
“The standards and measures can be viewed as an operating manual on how to run a good health department. The basics and fundamentals in management are there, so as new leaders come in they don’t have to reinvent the wheel—the standards and measures can provide a consistent roadmap.”
Beta Test Health Department

48. Technical Assistance PHAB NACCHO, PHF, PH Institutes, each other
Accreditation Process,
Standards and Measures Interpretation,
e-PHAB,
fees, and
accreditation requirements
NACCHO, PHF, PH Institutes, each other
Preparation of processes, programs, interventions, materials, and documents

49. PHAB Accreditation Support Materialsx

50. Public Health Accreditation Board www.phaboard.org
1600 Duke St Suite 440
Alexandria VA
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