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Greetings from PHAB,
Care to guess what is the number one question asked of PHAB these days? It is "when will the first health departments be accredited?" If you have been wondering about that as well, then we want to share our thoughts about that. There are health departments that are ready to schedule a site visit and we have site visitors that have been trained and are ready to go. So, over the next several weeks, we expect to begin to make site visit team assignments. We will follow the timelines in the process described in the Guide to National Public Health Department Accreditation Version 1.0. When those steps have been completed and site visit reports have been forwarded to the Accreditation Committee, then accreditation decisions can be made. PHAB has not set a time frame for the process since we believe strongly that the process needs to be done well and in the spirit of encouraging quality improvement. One thing is clear though, PHAB continues to receive Statements of Intent regularly so we will have a solid number of health departments somewhere in the accreditation process by the end of 2012! Not bad for one year post-launch. Thanks for all of your help in making that happen.
In this e-newsletter, we continue to spotlight a national partner. PHAB acknowledges the very important roles of our national partner organizations in providing technical assistance to health departments preparing for accreditation. This issue features the Association of State and Territorial Health Officials (ASTHO) and their role in assisting state health departments prepare for accreditation through the provision of technical assistance and other projects related to quality improvement. You will also read about the decisions made at the June 2012 PHAB Board of Directors meeting. Our educational services are expanding to offer a series of webinars for Tribal public health departments considering accreditation. As PHAB grows, we continue to add new staff. Our latest team member is Genny Lush, Office Manager. Please read more about her in this e-newsletter -- she will likely be the voice you hear when you call PHAB on the phone.
The PHAB family lost a wonderful founding Board member and first Board chair as we mourned the untimely passing of Dr. Marie Fallon. She was a great inspiration to us in the early years of PHAB's development, and she continued to provide us with outstanding leadership as we grew. We will miss her terribly, and we are pleased to continue the work that she helped to start.
All of us at PHAB hope you are having a great summer and that your plans include restful vacations, cool air, healthy food choices, and pleasant thoughts about accreditation!
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Kaye Bender, PhD, RN, FAAN
President and CEO
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PROGRAM NOTES: Accreditation Program Updates
Public Health Accreditation Board of Directors Quarterly Meeting
The Public Health Accreditation Board of Directors held its quarterly meeting in Seattle, WA, on June 6-7, 2012. Regular organizational business was handled, and program highlights from the Board meeting include:
- Decision to extend the use of the PHAB Standards and Measures Version 1.0 through 2013. This decision matches an earlier decision by the Board to use the existing fee schedule through 2013 as well.
- Final decisions about the multi-jurisdictional application category (see below for more detail).
- Approval of an analysis of PHAB's development and operation of performance standards in compliance with the OMB Circular A119, Revised.
- Approval of revisions to the Accreditation Decision Policy and Procedures Manual. This is an internal manual developed for the Accreditation Committee's use in guiding their work.
- Approval of the concept of an Accreditation Reserve Corps, intended to provide PHAB with support to handle accreditation applications should we need "surge capacity".
- Presentation about the newly released Institute of Medicine report Investing in a Healthier Future by Dr. David Fleming, Director and Health Officer for the Seattle/King County Health Department and member of the IOM committee.
- Interim reports from the recent think tank focused on Maternal-Child Health and plans for upcoming think tanks on Emergency Preparedness (held June 12-13, 2012, in partnership with the CDC); and Public Health Informatics (scheduled for July 17-18, 2012, in partnership with the Joint Public Health Informatics Task Force and the CDC). PHAB uses the think tank process to inform our future program development and quality improvement activities. When final recommendations are completed from each think tank, and the Board has approved them, findings will be shared in future issues of this e-newsletter.
- PHAB is working with NORC at the University of Chicago in the development of a long-range evaluation plan for PHAB. The Board held discussion about the elements of an effective evaluation plan. When it has been completed, PHAB will post the full plan on our website.
Multi-Jurisdictional Accreditation Application Category
During the development of PHAB's accreditation application categories, a multi-jurisdictional was created. This category was approved in an attempt to address some of the current work occurring among small local health departments where sharing of public health services is the operational norm. Along with the category, the PHAB Board of Directors approved the following definition:
For multi-jurisdictional applications, the partnering health departments, which could be two or more health departments, will apply as a single entity. The partnering health departments must select one lead health department to apply on behalf of all the partners. The partnering health departments must submit a memorandum of understanding (MOU) or similar documentation describing in detail the multi-department relationship. The relationship must be that of the health departments working together to deliver services and/or perform functions over the combined jurisdiction. It cannot be simply an 'of convenience' or paper-only relationship to apply for accreditation. The business and working relationship of multi-jurisdictional applicants must be well established and well defined (Guide to National Public Health Department Accreditation Version 1.0).
At the June 2012 Board meeting, the following decisions were made related to the implementation of the accreditation process for multi-jurisdictional applications:
- PHAB accredits health departments -- not consortia or informal organizational arrangements. Therefore, PHAB will accredit each health department in the multi-jurisdictional application arrangement.
- Health departments applying for accreditation under a multi-jurisdictional application must demonstrate a high degree of interdependence in the provision of their public health services.
- Shared documentation submitted in a multi-jurisdictional application would be reviewed only once.
- PHAB will exercise the right to limit the number of health departments included in a multi-jurisdictional application if that number is too large to ensure a high quality review.
- All other aspects of the accreditation process will be implemented exactly as it would be with any other local health department.
Now that these policies have been approved by the Board, specific guidance will be developed and made available to jurisdictions considering submitting a multi-jurisdictional application. The Fee Development Committee will also consider any implications to the fee structure and will publish that information as soon as the work is done.
Accreditation Web Conference Series for Tribal Health Departments
In an effort to involve Tribal public health departments in national public health department accreditation efforts, PHAB and the National Indian Health Board (NIHB), one of our partners, are sponsoring a three-part web conference series designed for our Tribal health departments. The series will help Tribal public health leaders and Accreditation Coordinators as they prepare for the accreditation process. The first conference is titled Getting Started with PHAB Accreditation and will be held on June 20th. This presentation will focus on the beginning elements, including the three pre-requisites, which must be considered by a department that plans to undergo accreditation.
The second conference will be held on July 2nd and is titled Understanding the Accreditation Process. The focus will be on each of the seven steps of accreditation. The final presentation, Building Toward Success in Accreditation, will be held on July 18th and discusses challenges and successes from going through the accreditation process. Tribal representatives will add their own experiences during the presentations.
We hope that Tribal leaders and Tribal health department representatives will join us for this series of web conferences. We invite and welcome your participation. For more information about the series and how to access the presentations, please contact David Stone at PHAB (dstone@phaboard.org or 703.778.4549 ext. 105) or Blake Harper at NIHB (bharper@nihb.org or 202.507.4070).
Partnership with the Centers for Disease Control and Prevention
PHAB continues to appreciate its partnership with the Centers for Disease Control and Prevention (CDC). During the past couple of months, PHAB has partnered with CDC in the following specific activities:
- Presentation of a CDC-wide seminar on public health department accreditation on April 3, 2012. More than 300 CDC employees attended the seminar, which was led by Dr. Judy Monroe, Carol Moehrle, Dr. Terry Cline, and Dr. Kaye Bender. PHAB engaged in meaningful discussions about the potential impact that accreditation can have on strengthening the nation's public health infrastructure.
- Engagement with CDC program leadership as PHAB holds its think tanks. CDC leadership from various program areas actively participated in the Workforce, Maternal and Child Health. and Emergency Preparedness Think Tanks, as well as in the planning of the upcoming Informatics Think Tank.
- PHAB staff and Board members actively participated in recent conferences: the Agency, Systems, and Community Health Improvement Conference and the National Public Health Improvement Initiative (NPHII) Conference. Additionally, health departments presented their work on accreditation and quality improvement through the NPHII grants. NPHII has assisted many health departments in their accreditation journey.
PHAB Hires Its First Office Manager
PHAB welcomes Geneviece "Genny" Lush as the new Office Manager. Prior to joining PHAB, Ms. Lush served, for five years, as the Office Manager for the Alexandria Economic Development Partnership, focusing her attention on all aspects of office administration, meetings and events, and bookkeeping. Ms. Lush is currently enrolled at George Mason University working to obtain her Bachelors in Sociology.
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PARTNER SPOTLIGHT: The Association of State and Territorial Health Officials (ASTHO)
ASTHO is the national nonprofit organization representing state health officials in the United States, the U.S. Territories, and the District of Columbia, and over 100,000 public health professionals who work in state health agencies. Through its performance portfolio projects, ASTHO provides technical assistance to support a culture of quality improvement (QI) in state health agencies and systems. ASTHO is a partner with PHAB and regularly provides custom technical assistance to states preparing for voluntary national accreditation. Below is a highlight of a few of the many resources and services available from ASTHO.
QI Demonstration Initiative: In March 2012, ASTHO kicked-off a National Demonstration Initiative on QI Practices in State Public Health Programs through funding from the Robert Wood Johnson Foundation. After a competitive application process, five state health agencies (Arizona, Connecticut, Maryland, Minnesota, and Oregon) were selected to receive $100,000 in funding as well as QI and subject-matter consultation over the next 18 months. Throughout this project the state health agencies will increase state health agency readiness for accreditation, demonstrate the value of accreditation/QI, and improve integration of services among state public health programs, specifically in maternal and child health, chronic disease, and environmental health programs. For further information, please contact Denise Pavletic at dpavletic@astho.org.
SHIP Guidance & Resource: A state health improvement plan (SHIP) serves as a system-wide planning guide for states and is one of the three prerequisites for PHAB accreditation. While there is no one way to conduct a SHIP, through research and a survey of the field, ASTHO has developed an Online SHIP Guidance and Resource which provides a suggested framework for state health improvement planning, including a comprehensive collection of resources and state examples. This guidance will be updated on a regular basis.
NPHII Technical Assistance: With funding from the CDC, ASTHO provides comprehensive capacity building assistance to NPHII grantees to improve infrastructure investments and positively impact health improvements and health equity for residents of states, local communities, Tribes, and territories. ASTHO's technical assistance focuses on systems development and reengineering and comprehensive accreditation readiness. Over the last several months, ASTHO has provided tailored on-site trainings to eleven states, territories, and Tribes in the form of workshops, evaluation tools, guidance documents, and webinars, and made numerous presentations to grantees in national meetings and webinars. Areas covered have included comprehensive accreditation readiness, E-health tools and strategies, return on investment (ROI) and customer satisfaction, business process redesign, SHIP planning, and agency realignment and workforce redeployment strategies. If your state, Tribal, or territorial health agency is interested in receiving technical assistance from ASTHO, please contact Donna Marshall at dmarshall@astho.org.
ASTHO's Accreditation Coordinator Learning Community: In April 2012, ASTHO convened an Accreditation Coordinator Learning Community via conference call. This developing group serves as a peer network where members can exchange accreditation related resources and engage with colleagues in other state health agencies for the purpose of supporting accreditation coordinators leading up to the national accreditation application process. For more information on how you can participate in future calls and join the online learning community please contact Joya Coffman at jcoffman@astho.org.
Please visit the ASTHO Performance Team website to learn more about opportunities available from ASTHO!
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ACCREDITATION ROUND UP: News Related to Accreditation and Quality Improvement
Public Health Foundation Announces 2012 Future of Public Health Awardees
The Public Health Foundation (PHF) is pleased to announce the recipients of the 2012 Future of Public Health Award. Visit the PHF website for more information on this year's recipients.
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WORD ON THE STREET
1. How does the accreditation process work for health departments who do not directly manage environmental public health programs?
Health departments do not have to directly operate environmental public health programs in order to be accredited. But, serving as the backbone of the public health system in their community, the health department should have a strong partnership with the agency that does provide environmental public health services. Whether that agency is the state health department or another governmental agency entirely, that relationship should be described, and the documentation provided should reflect those organizational structures. Leadership from those agencies should be included in the site visit interviews.
2. We still have a question about the services that PHAB accreditation covers and from which program areas we can submit documentation. Some programs are excluded from the PHAB accreditation review process. Can you please explain this?
PHAB accredits public health departments under the framework of the three Core Functions of public health and ten Essential Public Health Services. We do not accredit individual or personal health care services (such as home health, primary care, or mental health services) or services that might reside under the public health department organizational umbrella, but which have existing accreditation or oversight bodies. For example, we do not accredit the regulation of long-term care or Medicaid because CMS oversees those aspects of public health. Primary care has an existing accreditation process available through the Joint Commission. PHAB recognizes that often the administration of these programs and services consumes a lot of the health department's time and leadership talent, but we simply cannot overstep the boundaries that exist in other accreditation or oversight areas. For example, we would accept documentation from a public health education program that informs the public of the need for dental hygiene; we would not accept documentation from a dental clinic that provides individual dental services. Other examples of program areas from which PHAB will accept documentation and those from which documentation would not be appropriate are listed on page 6 of the PHAB Standards and Measures Version 1.0. If you have specific questions about your organizational structure and what to include in your PHAB accreditation documentation, please contact Robin Wilcox at rwilcox@phaboard.org. We are happy to provide you with any clarification that you might need.
3. Now that the Accreditation Specialists have done some completeness reviews, what advice would they give a health department working on their documentation?
Some useful tips based on their early reviews include the following:
- Remember to look at the "Acceptable File Formats" document. A lot of users are uploading .pub and .msg files; neither are accepted file formats.
- Screenshots of websites need a date. The date can either be visible within the screenshot, or the Accreditation Coordinator can type the date the screenshot was taken in the document with the screenshot.
- Showcase a variety of public health programs. In some cases PHAB has seen the majority of documentation come from a limited number of programs.
- Provide specific instructions to the site visit team about the documentation. Many health departments have submitted documents that are very lengthy or multiple documents that are combined into one PDF. Often, there are no directions identifying where the site visitor should look. Our advice is to make sure the documentation is targeted and to make it easy for the site visit team members to see how the documentation demonstrates conformity.
4. Who at PHAB should we contact for specific questions and technical assistance?
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.
Genny Lush, Office Manager, to talk about general office inquiries. She may be reached at glush@phaboard.org or 703-778-4549 ext 100.
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.
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