PUBLIC HEALTH DEPARTMENT ACCREDITATION AND THE U.S. AFFILIATED PACIFIC ISLANDS Carol Moehrle, Immediate Past Chair Public Health Accreditation Board Kaye Bender, President/ CEO, Public Health Accreditation Board (by phone) Liza Corso, Senior Advisor, CDC Office for State, Tribal, Local and Territorial Support (OSTLTS)

Hello from the phone Kaye Bender, PHAB President/CEO

Public Health Accreditation Board PHAB is national accrediting organization for public health departments: State health departments Local (city, county, regional) health departments Tribal health departments Territorial (and FAS) health departments

Public Health Accreditation Board (PHAB) The goal of the voluntary national accreditation program is to improve and protect the health of the public by advancing the quality and performance of state,local, tribal and territorial public health departments.

What is Public Health 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. The continual development, revision, and distribution of public health standards.

PHAB Accreditation: Key Elements Standards and measures across 12 domains: 10 Essential Services, administrative capacity, governance Strong foundation for all public health programs Three pre-requisites Community health assessment Community health improvement plan Strategic plan Accreditation assessment process External validation through peer review and site visits Annual reporting throughout five-year accreditation status

44 Health Departments Accredited: Why Were They Interested in Accreditation? Transparency and Accountability Most other governmental and health related services are accredited: hospitals, schools, child care centers, police departments, fire departments, etc. Provides a priority setting framework Commitment to improving their services Increased public engagement and support Increased staff morale Risk Management Potential for increased funding in the future; already using their accreditation certificate in grant proposals

Early Evaluation Results 97% of health departments that have had their PHAB site visit strongly agree that “Going through the accreditation process has improved the performance of our health department.”^ According to HDs that have had their site visit, accreditation: –Identifies strengths and areas for improvement –Strengthens internal and external partnerships –Encourages HDs to prioritize and address long-standing concerns –Acts as a “stimulus…for continuous quality improvement and performance management in our daily practice” ^ From PHAB evaluation of 33 health departments.

Early Evaluation Results Among health departments applying for accreditation, 95% or more believe that accreditation will:* –Stimulate quality and performance improvement opportunities –Allow HD to better identify strengths and weaknesses –Improve management processes –Stimulate greater accountability and transparency within HD * From NORC at the University of Chicago evaluation survey of 62 health departments that have applied for accreditation.

Early Evaluation Results Health departments also reported the following motivators for applying for accreditation^ –Accountability to external stakeholders –Documentation of HD’s capacity to deliver the 3 core functions and 10 Essential Public Health Services –Credibility of HD within community –Relationships with community stakeholders –Competiveness for funding opportunities –Communication with governing entity ^From NORC at the University of Chicago evaluation survey of 62 health departments that have applied for accreditation.

CDC’s Role in Accreditation Support Public Health Accreditation Board National partner organizations Technical assistance, educational resources, and trainings National Public Health Improvement Initiative and Performance Improvement Managers Network Establishing incentives—for preparing and for accreditation status Building connections to CDC-supported areas

Accelerates public health accreditation readiness; supports performance management and quality improvement practices Establishes a national network of Performance Improvement Managers (PIM Network) State, tribal, local, and territorial grantees Supported through the Prevention and Public Health Fund of the Affordable Care Act Funding for 2010 ‒ 2013 — $142 million total awarded National Public Health Improvement Initiative (NPHII)

NPHII Awardees

Accreditation—Making Programmatic and Strategic Connections How are programs and services reflected in PHAB standards? How can funded programmatic activities aid in meeting PHAB standards? How can PHAB standards provide the right foundation for strong programmatic work? Programs and Activities PHAB Standards and Measures

Examples of Programmatic and Strategic Connections Preparedness* Chronic disease programs Maternal and child health Environmental public health* Laboratories Infectious disease Immunizations* Occupational safety and health Informatics *Crosswalk(s) available or in progress Community health assessment/planning Healthcare-associated infections* Food safety* Health literacy Guide to Community Preventive Services* Healthy People 2020 National Prevention Strategy HHS quality aims and characteristics

PHAB Accreditation and US Affiliated Pacific Islands: Questions and Opportunities Building on momentum gained through NPHII Organizational self-assessment Quality improvement activities Continuing the conversation Feedback on standards and measures for PI setting? (i.e., clarifications, better examples, wording changes) How can we advance awareness and interest? Support and materials PHAB support – materials, webinars, speakers CDC support – OSTLTS support, connections to other work

Accreditation Website Resources PHAB CDC accreditation webpage Partner accreditation pages State: Local: Tribal: and Journal of Public Health Management and Practice—January/February 2014 Issue on Accreditation (open access)

Questions, Dialogue and Contact Information The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention Public Health Accreditation Board Kaye Bender Carol Moehrle CDC Office for State, Tribal, Local and Territorial Support, Division of Public Health Performance Improvement Liza Corso Vicky Rayle