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Greetings from PHAB,

The month of March has been a busy one as we continue to prepare for the launch of public health accreditation this coming fall. PHAB has reviewed the results of the beta test evaluation and other feedback and has revised the standards, measures, and documentation guidance, as well as the accreditation process. All of those revisions have been submitted to the respective workgroups for their review and consideration. We will focus on that body of work in more detail in next month's e-newsletter.

 

The PHAB Board of Directors met in March and made some initial decisions about accreditation that are described in this issue of the newsletter. We also welcomed two new public health leaders to our board. Dr. Terry Cline and Mr. Joe Finkbonner have been appointed to a three year term of office. In keeping with the outstanding scope of leadership that our Board of Directors brings to bear on accreditation guidance, Dr. Hugh Tilson received the prestigious Ronald Davis Special Recognition Award from the American College of Preventive Medicine.

 

CDC issued a press release about the importance of public health accreditation that you will want to read about in more detail. The link to that important document is included in this e-newsletter.

 

As we have attended meetings and conferences around the country, PHAB has identified some new questions for Word on the Street. We hope that these are helpful as you make your plans for your health department to be accredited soon!

 

The momentum around accreditation is increasing as we continue to develop a strong, credible national public health accreditation recognition of which your health department can be proud to be a part. Fall 2011 will be an exciting, historically significant time for public health!

 

Kaye Bender, PhD, RN, FAAN

President and CEO

Issue #31

March 2011

In This Issue
PHAB Welcomes New Board Members
PHAB Board Member Receives Award
March 2011 Board Meeting Highlights
Tribal Standards Workgroup Update
Environmental Public Health Think Tank Update
Final MLC Meeting Update
Great Basin Public Health Leadership Institute Update
RWJF Call for Proposals
Word on the Street

Kaye Bender (April 2011)

PHAWelcomes Two New Members to the Board of Directors

Two new members of the PHAB Board of Directors were appointed in March 2011 and have begun their three-year terms of office.

 

Terry ClineTerry L. Cline, PhD., began his tenure as Oklahoma's Commissioner of Health on June 30, 2009. Dr. Cline previously completed a post as Health Attach� at the U.S. Embassy in Baghdad, Iraq, where he advised the US Ambassador, the Iraqi Minister of Health, and the US Department of Health and Human Services on health-related challenges in Iraq. Dr. Cline served in this capacity under the Administrations of both President George W. Bush and President Barack Obama. Prior to that position, Dr. Cline served as Administrator for the federal Substance Abuse and Mental Health Services Administration (SAMHSA) from 2006-2008. Dr. Cline has extensive experience in overseeing health and human services at the state level as well. In 2004, he was appointed by Gov. Brad Henry as Oklahoma's Secretary of Health. At the same time, he served as Oklahoma's Commissioner of the Department of Mental Health and Substance Abuse Services, a position he had held since January 2001.

 

Joe FinkbonnerJoe Finkbonner is the Executive Director of Northwest Portland Area Indian Health Board (NPAIHB). Prior to that appointment, he was the Director of the Northwest Tribal Epidemiology Center (The EpiCenter) at the NPAIHB. The EpiCenter is one of 12 epidemiology centers nationally that focus specifically on American Indian/Alaska Native (AI/AN) health status. He began his work in Indian health for the Lummi Tribe as the Health Director/CEO, where he was very active at state and federal levels in his efforts to heighten the awareness of disparities of the AI/AN population, and to assist with focusing action toward improving the health status through policy development. In earlier years, he was a pharmacist at Providence Medical Center in Seattle and Overlake Medical Center in Bellevue.

 

PHAB welcomes these new Board members to their role and looks forward to working with them!

PHAB Board Member Dr. High Tilson Receives Prestigious Award

The American College of Preventive Medicine (ACPM) honored PHAB Board Member Hugh Tilson, MD, at Preventive Medicine 2011 in San Antonio, TX, with the prestigious Ronald Davis Special Recognition Award, named for former ACPM Fellow and President of the American Medical Association, Dr. Ronald Davis. Dr. Tilson received the award on February 19, 2011, for his long-standing dedication to ACPM and numerous accomplishments in the field of preventive medicine. Dr. Tilson is a past-president of ACPM and currently serves on the adjunct faculty of the University of North Carolina and Duke University, as well as the county health officer for Sagadahoc County, ME. For more information, please visit the ACPM's website.

  

Dr. Hugh Tilson 

Dr. Hugh Tilson receiving the Ronald Davis Special Recognition Award

Highlights of the March 2011 Board of Directors Meeting   
The PHAB Board of Directors held their quarterly meeting on March 1-3, 2011, in San Antonio, TX. Highlights of the Board meeting included: 
  • A formula for developing the final accreditation fee schedule was approved. More work has to be done to address the fee schedule for special application situations such as centralized states applicants, multi-jurisdictional applicants, and tribal applicants.
  • PHAB expects to publish the 2011/2012 fee schedule after the May 2011 Board of Directors meeting.
  • The Information Systems Development Committee approved the release of an RFP for the Information System development. See the PHAB website for more details on that RFP.
  • Work on the development of the strategic plan for 2012-2014 (beyond the launch) was initiated.
  • The Board heard a presentation on the recently released Institute of Medicine report, For the Public's Health: The Role of Measurement and Accountability and discussed potential implications for the recommendations on PHAB's accreditation scope of work in the future.
  • The Board received the final presentation on the beta test evaluation results. Recognizing that the beta test evaluation results are useful in revising PHAB's accreditation tools and processes, a summary report will be developed and distributed. The Board thanked NORC at the University of Chicago for completing an outstanding job throughout the process of the beta test evaluation. The Board emphasizes that results of the beta test evaluation sample cannot be used for describing or predicting health department performance in any of the domain areas.
  • The Board reaffirmed its commitment to working with its federal partners on varied approaches to incentivizing and otherwise supporting accreditation.
  • An interim progress report on the standards development was discussed. The version of the standards that will be used for the launch is expected to be approved at the May 2011 Board meeting.
  • The Board held a discussion with leadership from the National Association of Local Boards of Health (NALBOH) regarding the ongoing engagement of governance in accreditation.
  • The Board accepted the report of the Centralized States Think Tank, which included a definition of centralized state for accreditation purposes, as well as the categories of applicants under that definition. Accreditation policies and procedures will be developed accordingly.
  • Accreditation items expected to be released in early summer in anticipation of the fall launch are: Standards and Measures, Version 1.0; Accreditation Process, Version 1.0 (includes application information); Fee Schedule for 2011/2012; and Education Services to be Provided by PHAB.
Tribal Standards Workgroup Submits Final Recommendations  

PHAB appreciates the tremendous contribution from the volunteer members of the PHAB Tribal Standards Workgroup, who successfully completed their mission of providing recommendations to PHAB for inclusion of Tribal health departments in the PHAB standards and measures. One workgroup member commented, "[Using the PHAB standards and measures] provided a better understanding of the strengths and weaknesses of the public health department."

   

Tribal Standards WorkgroupMembers of the PHAB Tribal Standards Workgroup at their last meeting in San Francisco, CA


Others have been involved in providing Tribal feedback to the PHAB standards and measures, including the National Indian Health Board's (NIHB) Tribal Public Health Accreditation Advisory Board and members of the Tribal community at large through feedback provided during the National Call for Tribal Input. One Tribal Standards Workgroup member commented, "PHAB has encouraged Tribal input, listened to Tribal discussions, and incorporated indigenous knowledge and wisdom in the development of the standards. They should be commended for their commitment to improving the health of all Americans." PHAB has already incorporated many of the recommendations into the revised standards and measures for Tribal, State, Local, and Territorial Health Departments. The revised PHAB standards and measures will go through one more major review by the Standards Development Workgroup, the original group that created the set of standards and measures used during the beta test, before submission to the PHAB Board of Directors for approval in May.

Environmental Public Health Think Tank  
The second meeting of the PHAB Environmental Public Health (EPH) Think Tank was held in Atlanta, GA, on March 22, 2011. Participants reviewed results of the beta test and discussed progress on the recommendations provided by the interim EPH Think Tank report. Additional recommendations were developed to guide the work in the future as PHAB continues to connect its accreditation efforts with other quality and performance improvement efforts underway in environmental public health. PHAB thanks the members of the EPH Think Tank planning committee (Rob Blake, John Sarisky, Justin Gerding, Liza Corso, Sharunda Buchanan, and Pat Libbey) for guiding these efforts. PHAB also thanks the participants of the EPH Think Tank for giving thoughtful, deliberate discussion time to this important body of work. The final report will be available soon.
PHAB Participates in Celebrating the Final MLC Meeting 
PHAB was pleased to be a part of the celebration of the final year of the Multi-State Learning Collaborative (MLC) in New Orleans, LA, on March 16-18, 2011. This project has met its objectives of linking the work on public health accreditation with quality improvement for health departments. PHAB has appreciated the leadership exercised by the National Network of Public Health Institutes (NNPHI) in administering this program. We also applaud the work of the states that were a part of this very important effort. We have learned a lot from them, and we look forward to the next iteration of this most important work.
Great Basin Public Health Leadership Institute Learns About Accreditation 
Participants in the Great Basin Public Health Leadership Institute (GBPHLI) learned more about accreditation at their recent meeting on March 28-30, 2011, in Springdale, UT. PHAB staff, as well as representatives from beta test sites at Tooele County Health Department in Utah and Carson City Health and Human Services in Nevada, provided information about public health accreditation from their various perspectives. PHAB was also able to get some great feedback from the participants about accreditation planning in Utah and Nevada. We appreciate the participation of Joyce Gaufin, Executive Director of the GBPHLI; Myron Bateman and Jeff Combs from Tooele County Health Department; and Marena Works from Carson City Health and Human Services for incorporating accreditation into their program agenda for this year. Leadership is an important factor in accreditation readiness.
CDC Releases Press Release in Support of Accreditation
March 24, 2011, was an historic day for accreditation in the country as the Centers for Disease Control and Prevention (CDC) issued a press released describing the importance of PHAB's national voluntary accreditation program for public health departments. The press release includes quotes from CDC Director, Dr. Thomas Frieden; new PHAB Board member and Oklahoma State Health Commissioner, Dr. Terry Cline; PHAB Board member and Arkansas State Health Officer, Dr. Paul Halverson; and CDC Deputy Director and Director of the Office for State, Tribal, Local, and Territorial Support (OSTLTS), Dr. Judith Monroe, on the importance of accreditation and performance/quality improvement. The press release can be read on the CDC's website.

The connection between the National Public Health Improvement Initiative (NPHII) is also described in the press release. Dr. Kaye Bender (PHAB), Liza Corso (CDC), Jessica Solomon Fisher (NACCHO), and Jim Pearsol (ASTHO) held a joint session on the link between accreditation and the work of these important infrastructure improvement grants at the first in-person meeting of the grantees March 30-April 1, 2011.
The Robert Wood Johnson Foundation Issues a Call for Proposals
On April 14th, the Robert Wood Johnson Foundation (RWJF) will release a Call for Proposals for Public Health Services and Systems Research (PHSSR), a field of study that examines the organization, financing, and delivery of public health services at local, state, and national levels, and the impact of these activities on public health. Approximately $2.7 million will be awarded to up to 14 applicants through this solicitation. Awards will fund projects in the priority areas of Public Health Structure and Organization; Performance Management and Quality Improvement; Accreditation; and Public Health Workforce. The National Network of Public Health Institutes (NNPHI) will serve as the Administrative Service Organization and facilitate this Call for Proposals.

Practitioners, policymakers, and researchers from law, public policy, economics, business administration, organizational behavior, sociology, finance, urban planning, public administration, information and library science, and industrial and systems engineering are especially encouraged to apply. Junior investigators (less than seven years since doctorate) and first-time applicants to this solicitation are encouraged and will be given strong consideration. A web conference will be held for interested applicants on April 27, 2011. Brief proposals are due May 24, 2011. Additional information about the project can be found on the NNPHI website. Please direct any questions to Erica Johnson at [email protected] or 504.301.9854.
Word on the Street  


1. Why is PHAB preparing a fee schedule for accreditation when the organization receives funding from both the Robert Wood Johnson Foundation (RWJF) and the Centers for Disease Control and Prevention (CDC)? 
 
PHAB has been fortunate to have received grant funding for the development of the national accreditation program from both the RWJF and the CDC. However, as with any accrediting body, the establishment of a fee schedule to partially support the actual conduct of the accreditation review is common. PHAB won't always be supported by grants. It has to be a viable, sustained organization over time if the accreditation efforts are going to last. Having said that, both the RWJF and the CDC are supportive of PHAB's efforts to pass along only part of the cost of running PHAB in the new fee structure so that fees won't be a barrier for health departments to be accredited.
   

2. I work in a small health department and we know that we can't meet the PHAB standards alone. We are working closely with another health department in our state to share services so that we can meet the standards together. Will PHAB have procedures to address this type of arrangement?

Yes, PHAB already has a category for a multi-jurisdictional application. Sometime over the summer before the program launches, PHAB will hold a Multi-Jurisdictional Think Tank to explore this concept further and develop recommendations for the specific procedures for processing these types of applications. PHAB would encourage your health departments to continue to work together to share those services that are appropriate and that would strengthen your ability to provide essential public health services.


3. I am confused about the types of training that PHAB will offer in the future. Can you please clarify? 

PHAB will offer online orientation to accreditation for anyone interested in learning about the PHAB accreditation process. The online orientation will be specifically developed for public health departments and will encourage serious potential applicants to submit a Statement of Intent once the program is open for applications. That online orientation will be formatted so that the Accreditation Coordinator and Department Director can review it in addition to any staff who will be involved in the department's accreditation process. PHAB will also host training conferences for applicants on how to be successful through the accreditation process. The in-person conference will be designed to walk the applicant through each step, with tips for success along the way. PHAB will also train the applicants on the use of PHAB's information system, which is crucial to every step of the accreditation process, including where the health department's supporting documentation and materials will be uploaded. Another component of PHAB's training plan includes training for site visitors on the revised standards and measures and on successful review of the materials provided by the health department. Finally, PHAB will be working closely with its national partners who are providing technical assistance to health departments as they prepare for accreditation so that we are giving consistent advice all along the way. 


4. I work with a lot of program staff in my health department and they have asked how programs fit into the accreditation process. 

Public health programs are the means by which health departments achieve their mission to improve the health of the population they serve. Programs are central to the health department and therefore are central to public health accreditation. PHAB accreditation does not include program specific standards and measures. Instead, many of PHAB standards and measures should be reflected in how all programs function. In the revised standards and measures, there is a clear call for documentation from a variety of selected program areas that will help the health department show that they meet the measures. In addition, many programs have data that can effectively contribute to the required health assessment. They also have partners that are vital to include in the health improvement planning process and to show conformity with measures that require community engagement.
  At the national level, PHAB and its partners are working with various program leadership representatives to develop incentives for accreditation in the future. Through the program-focused Think Tanks, PHAB is able to work with its program partners to ensure that our standards are consistent with the more detailed program standards. This effort will assist health departments in using some of the same documentation for program compliance and for meeting PHAB standards.   

5. My health department wants to apply for accreditation, but we are somewhat daunted by the emphasis on documentation. Can you provide some comment on that? 

Any accreditation organization has to base its decisions on evidence. Documentation provided to PHAB is designed to do just that: provide evidence that the health department has met the measures associated with the standards. While it seems like a lot of paperwork, PHAB has learned from the beta test that health departments actually have much of the documentation in reports, plans, and other materials that they have developed. The additional documentation that health departments may have to develop should assist them in passing along valuable information about procedures that may have been primarily shared verbally in the past. A high performing organization will want to have its most important information documented to assist in continuity when there is staff turnover. So, it should be a win-win. PHAB 
 encourages health departments to identify and/or develop its pertinent documentation for accreditation as part of their regular work so that it won't be quite so daunting in the future.

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