PHAB Board of Directors Meeting Highlights

The PHAB Board of Directors held its annual meeting on December 6-8, 2011. Highlights from the meeting include the following:

1. Honoring outgoing Board member, Ken Kerik from Ohio, and thanking him for his service to PHAB.

2. Honoring outgoing Chair, Dr. Bill Riley, and thanking him for his service as Chair for the past two years. Dr. Riley will continue to serve on the PHAB Board of Directors as Immediate Past Chair.

3. Reappointing Dr. Paul Halverson, Dr. Leah Devlin, and Dr. F. Douglas Scutchfield to another three year term on the Board of Directors.

4. Appointing the first Accreditation Committee. The Accreditation Committee will make accreditation decisions on behalf of the PHAB Board of Directors. The Committee is composed of both Board members and non-Board members. Members of the Accreditation Committee include: 

PHAB Board Members

• Dr. F. Douglas Scutchfield, Chair of the Accreditation Committee; Peter M.  Bosomworth Professor of Health Sciences, Research, and Policy at the University of Kentucky
• Dr. Paul Halverson, Vice Chair of the Accreditation Committee; Director and State Health Officer of the Arkansas Department of Health
• Dr. Hugh Tilson, County Health Officer of the Sagadahoc County Board of Health (ME); University of North Carolina at Chapel Hill, North Carolina
• Joe Finkbonner, Executive Director of the Northwest Portland Area Indian Health Board (OR)
• Dr. Alonzo Plough, Director of the County of Los Angeles Public Health Emergency Preparedness and Response Program (CA)
• Dr. Rex Archer, Director of the Kansas City Missouri Health Department (MO) 

Non-PHAB Board Members 

• Dr. Christopher Atchison, Director of the Iowa State Hygenic Laboratory; Associate Dean and Clinical Professor at the University of Iowa College of Public Health
• Dr. Bruce Dart, Health Director of the Tulsa City-County Health Department (OK)
• Mary C. Selecky, Secretary of Health of the Washington State Department of Health
• Dr. Burton Wilcke, Chair of the Department of Medical Laboratory and Radiation Sciences at the University of Vermont
• Stephen Williams, Director of the Houston Department of Health and Human Services (TX) 

PHAB Primary Staff for the Accreditation Committee 

• Robin Wilcox, PHAB Chief Program Officer 

5. PHAB is also pleased to announce the appointment of a new member to the PHAB Board of Directors, Dr. Wilma Wooten, Public Health Officer for the County of San Diego Health and Human Services (CA). Dr. Wooten is board-certified in Family Medicine and has a Master's degree in Public Health. She received both professional degrees from the University of North Carolina, Chapel Hill, followed by residency training at the Georgetown/Providence Hospital Family Practice Residency Program in Washington, DC. Dr. Wooten has been in San Diego for the past 16 years and practiced medicine as a faculty member in the University of California San Diego (UCSD) Department of Family and Preventive Medicine for the first 11 years. She remains a volunteer Associate Clinical Professor in the department and is an Adjunct Professor at San Diego State University, Graduate School of Public Health. Since March 2001, Dr. Wooten has been the Public Health Officer for the County of San Diego Health and Human Services Agency. Her current responsibilities include quality assurance, special projects, media spokesperson, and health disparity activities. She functions as the medical director for the county's HIV, STD, and Hepatitis Branch, and serves as a county appointee to the HIV Community Planning Prevention Board. She is a member of the State Office of AIDS California African-American HIV/AIDS Coalition and works closely with the local regional constituent to this organization. Dr. Wooten will begin her three year term on the PHAB Board of Directors in 2012.

6. PHAB's Board of Directors also received the report of the Centralized States Expert Panel, led by PHAB consultant Kathy Vincent. The Board made decisions about how the accreditation process will be implemented in states where the local health departments are operated by the state health department and therefore are all in one governmental system. The PHAB Standards and Measures Version 1.0 will still apply, as will the review process, but some acknowledgement of shared documentation, as well as state health department directed policies and services, has to be considered. The Board also determined that the population of the jurisdiction served will still guide the fee structure for the local health departments in centralized states. 

7. The PHAB Board of Directors received the report from the Multi-jurisdictional Applications (MJD) Expert Panel and appreciates the work that they did to provide that report. While the application category of MJD described in the Guide to National Public Health Department Accreditation Version 1.0 remains intact, the Board requires additional time to consider all of the accreditation process and fee implications before those can be published. PHAB encourages health departments who are considering submitting an MJD application to wait until those procedures have been approved. They are on the agenda for the April 2012 Board meeting. PHAB consultant Shirley Orr has led the development of those recommendations.

8. The PHAB Board of Directors approved the 2013 Accreditation Fee Schedule as the same schedule that is in place for the 2011-2012 accreditation cycle. The Board determined that additional time and experience is needed before changes in the fee structure are approved. Applicants planning to apply for accreditation in 2013 may plan their budgets using the 2011-2012 fee structure.

PHAB Standards and Measures Version 1.0 Errata

National Partner Updates and Announcements

ASTHO Funding Opportunity: National Demonstration Initiative on QI Practices in State Public Health Programs

With funding from the Robert Wood Johnson Foundation, the Association of State and Territorial Health Officials (ASTHO) is pleased to announce the launch of a National Demonstration Initiative on Quality Improvement Practices in State Public Health Programs. The purpose of the National Demonstration Project is to increase state readiness for accreditation, demonstrate the value of accreditation/QI, improve integration of services among state public health programs, and use standard methodology to manage budgets in difficult times. The deadline for applications is 11:59 PM ET on January 9, 2012. Download the full RFA and contact Denise Pavletic at dpavletic@astho.org for more information. 

ASTHO Profile Report Provides Comprehensive Look at State Public Health

If you want a better understanding of the governmental public health enterprise and the contributions state and territorial health agencies make to public health, the recently released ASTHO Profile of State Public Health, Volume Two is your best resource. This publication gives critical insight into how governmental public health is structured and organized at the state and territorial level, and is an unparalleled data source on state and territorial health agency responsibilities, resources, planning and quality improvement activities, and information exchange methods.    

Strengthening the Community of Practice for Public Health Improvement (COPPHI)

PHAB was pleased to be included in the outstanding array of speakers for the COPPHI Open Forum, coordinated by the National Network of Public Health Institutes (NNPHI) on December 12-13, 2011, in Alexandria, VA. More than 185 participants engaged in conversation about various strategies to improve public health. It was a very well planned and productive conference aimed at continuing to connect the dots between accreditation and quality improvement. Hats off to the NNPHI staff for another successful open forum! For more information, visit the NNPHI website. 

Word on the Street

1. Does it matter who develops documentation that the health department submits to PHAB? Who are the acceptable parties for developing documentation?

Documents that are submitted to PHAB to provide evidence that the health department is in conformity with a measure may come from a variety of sources. Documentation may have been developed, for example, by a contractor, another health department, an academic institution, community partners, other governmental departments, etc. If the applicant is a local health department, the documentation may have been developed by the state health department; if the applicant is a state health department, the documentation may have been developed by a local health department. The documents must however, have been adopted by the health department and must be in use by the health department at the time that they are submitted to PHAB. The author or originator of a document is less important than the adoption and use of the documentation by the applicant health department. Please refer to page 7 of the PHAB National Public Health Department Accreditation Documentation Guidance Version 1.0.  It states that "the purpose of documentation review is to confirm that materials exist and are in use in the health department being reviewed regardless of who originated the material." In other words, PHAB is concerned with the "what," not the "how." 

2. Can you explain what is meant by the requirement for documentation to be signed? Is this requirement for an actual signature?

The requirement for signed documents does not necessarily require an actual person's signature. Each piece of documentation must include evidence that it has been adopted by the health department. In some cases, documentation will be a written policy and will include the signature of a governor, mayor, or health department director. In other cases, documentation may be an email; the "To" and "From" and the email addresses will serve as evidence that the document is "official" health department business. In other cases, a department logo will provide the evidence that the document is an official health department document. For example, a brochure will not have the health department or program director's signature, but it will include the department's logo. A health department logo will be acceptable. Further, a document developed by a partnership or coalition of which the health department is a member, may or may not include the health department's logo. In this case, evidence of the health department's membership or participation in the partnership or coalition will suffice. 

3. Can you also explain what is meant by the requirement for documentation to include a date? How exact must that date be?

The date on the documentation serves two purposes: (1) it allows the PHAB site visit team to ascertain if the documentation is in conformity with the timeframe requirements in the PHAB Standards and Measures Version 1.0, and (2) it provides information to the health department concerning how current the document is and if there is a need for review and/or revision. The specificity of the date depends on the document: a memo or an email will have a specific day; a report may indicate a month and year; and a brochure may show only a year. 

4. The health department may depend on another unit for certain documentation, like a human resources policy. Such a policy might be the responsibility of the state health department or a mayor's human resources department, for example. What if it is outdated based on the PHAB requirements? It's out of our control; what should we do?

The health department can provide evidence that it has reviewed the document (that is developed by others) and updated its own policies and procedures for implementation of the policy. Each document must have been adopted by the health department and must be in use by the health department at the time that it is submitted to PHAB. The health department can provide evidence that it reviewed and considered the implementation of policies in order to meet the timeframes outlined in the PHAB Standards and Measures Version 1.0.

PHAB is not seeking volunteer site visitors at this time. The PHAB Research and Evaluation Committee advised us that we should endeavor to use current volunteers who were site visitors during PHAB's beta test of the program. Using individuals who have had the beta test experience with the PHAB process and the standards and measures will increase inter-rater reliability. PHAB will be seeking new volunteers sometime in the future and will announce a call for volunteers through PHAB's newsletter. Watch for that call later in 2012!

6. We have been asked by our Board of Health if we become PHAB accredited, can we drop our other accreditation statuses for our health services?

PHAB's national accreditation program was designed specifically for population focused public health services as described by the Ten Essential Public Health Services framework. We deliberately did not design our accreditation program to take the place of or compete with credible existing health services accreditation programs. A health department that operates accredited health services will certainly have to decide the accreditation opportunities that best meet their needs, but PHAB was designed to address a gap in accreditation rather than to take the place of existing accreditation programs.

7. When will the 2013 Accreditation Fee Schedule be published?

The 2013 Accreditation Fee Schedule was approved by the PHAB Board of Directors at its December 2011 Board meeting. That fee schedule will remain the same as the 2011-2012 Accreditation Fee Schedule. 

You may contact: 

Mark Paepcke, Chief Administrative Officer, to talk about fees and contractual information. He may be reached at mpaepcke@phaboard.org or 703-778-4549 ext. 104.

Robin Wilcox, Chief Program Officer, to talk about interpretation and meaning of the PHAB Standards and Measures as well as the accreditation process. She may be reached at rwilcox@phaboard.org or 703-778-4549 ext. 106.

Rachel Margolis or Marita Chilton, Accreditation Specialists, to talk about the accreditation process for health departments. Rachel may be reached at rmargolis@phaboard.org or 703-778-4549 ext. 108, and Marita may be reached at mchilton@phaboard.org or 703-778-4549 ext. 114.

David Stone, Accreditation Education Specialist, to talk about PHAB's education services, including orientations and trainings. He may be reached at dstone@phaboard.org or 703-778-4549 ext. 105.

Travis Parker Lee, Program Specialist, to talk about meetings, events, and requests for speakers.  He may be reached at tlee@phaboard.org or 703-778-4549 ext. 102.

Kaye Bender, President/CEO, to talk about accreditation related strategies, partnerships, long-range planning at PHAB, PHAB Board of Directors, committees, and think tanks. She may be reached at kbender@phaboard.org or 703-778-4549, ext. 103.

If you have a suggestion for future segments of Word on the Street, please send them to Travis Parker Lee, PHAB Program Specialist, at tlee@phaboard.org.