PHAB SPECIAL REPORT: First Accreditations Herald New Era for Public Health    

Eleven Public Health Departments First to Achieve National Accreditation

The public health community celebrated a milestone in February when PHAB announced it had awarded the status of five-year accreditation to 11 public health departments.

 

"This is a truly historic moment in public health," PHAB President and CEO Kaye Bender stated in a March 4 national press release. "These are the first of many health departments that we look forward to being able to recognize for achieving national standards that foster efficiency and effectiveness, and promote continuous quality improvement."

 

 

Comanche County Health Department employees celebrate the agency's five-year national accreditation.

 

Accreditation was awarded on February 27 to:

* Comanche County Health Department, Lawton, Okla.

* Franklin County Health Department, Frankfort, Ky.

* Livingston County Department of Health, Mt. Morris, N.Y.

* Northern Kentucky Independent District Health Department, Edgewood, Ky.

* Oklahoma City-County Health Department, Oklahoma City, Okla.

* Oklahoma State Department of Health, Oklahoma City, Okla.

* Spokane Regional Health District, Spokane, Wash.

* The Public Health Authority of Cabarrus County, Inc. d/b/a Cabarrus Health
   Alliance, Kannapolis, N.C.

* Three Rivers District Health Department, Owenton, Ky.

* Washington State Department of Health, Olympia, Wash.

* West Allis Health Department, West Allis, Wis.

 

News of the first accreditations traveled swiftly across the public health landscape. A national press release disseminated on March 4 garnered nearly 31,000 headline impressions over a two-week period and was delivered to more than 10,000 media outlets around the world. Among other highlights, Kentucky's House of Representatives adopted House Resolution No. 148 on March 7, recognizing the national accreditation of the three Kentucky health departments. To the north, in Wisconsin, Governor Scott Walker issued a proclamation honoring the accreditation of the West Allis Health Department and declaring April 2 "West Allis Public Health Day" throughout the state.

 

Oklahoma State Department of Health staff demonstrate their enthusiasm for accreditation at a March 8 celebration.

 

The Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation also helped spread the good news about the first accreditations. CDC's internal agency-wide newsletter, "CDC Connects," spotlighted the milestone event in its April 16 online edition. And on March 4, the Robert Wood Johnson Foundation's home page showcased the accreditations in an article bearing the bold headline "A Big First for Public Health."

 

'It was like the gold medal for the Olympics'

Pride and jubilation filled the air on February 28 as 11 public health departments received emails from PHAB informing them of their accreditations. At the Livingston County Department of Health in Mt. Morris, N.Y., February 28 dawned bright for then-Director Joan Ellison. Aware that PHAB would be informing her health department of its accreditation status that day, Ellison rushed to her computer at 8 a.m. to check her email. For Ellison, the day held dual significance. In addition to awaiting the accreditation decision, Ellison was marking the final day of her four-decade career in public health.

 

"I checked my email probably every 15 minutes," Ellison recalled. "We wanted to have a celebration in the afternoon, if we were accredited."

 

Work went on as usual, but Ellison continued to check her computer every 15 minutes. At 11:20 a.m., the email from PHAB finally arrived.  

 

"I held my breath and opened it," Ellison said. Her health department had been awarded national accreditation.  

 

"I was so excited," she said. "This meant so much to us. I have been in public health over 40 years, and it absolutely was one of the highlights of my career. It said to me, and it said to the staff, that we have met the national standards. We are accredited at the national level. It was just a wonderful way to end my career as a public health director. I couldn't have asked for it to happen in any better way. And I say this from the depths of my heart: It is not what I did; it was what everybody did together."

 

At the celebration that afternoon, "staff were crying tears of joy," Ellison said. "It was just a sense of accomplishment. It was like the gold medal for the Olympics."

 

At a March 5 meeting of the State Health Leadership Initiative in Washington, D.C., CDC Director Dr. Tom Frieden, center, took time out to personally congratulate Oklahoma Commissioner of Health Dr. Terry Cline, left, and former Washington State Secretary of Health Mary Selecky, on their health departments' accreditations.

Similar scenarios played out across the nation that day as employees at the 11 newly accredited public health departments learned that their agencies were among the top-performing public health departments in the land.

 

In Edgewood, Ky., staff at the Northern Kentucky Independent District Health Department reacted to the news with cheers and a sense of "relief to know we had actually made it," said Accreditation Coordinator Alan Kalos. Health Department Director Dr. Lynne Saddler later commented, "So many people here had worked so hard for so long to get to the point of the decision that when the email message finally came, I cried tears of joy and relief. It felt like we had reached the top of Mount Everest. Being conferred accreditation made us realize that in spite of budget cuts and other challenges, we can still provide quality services that bring value to the people whose health we work to promote and protect."

 

Meanwhile, at the Oklahoma State Department of Health in Oklahoma City, staff were high-fiving each other in hallways, corridors and offices.

 

"Congratulatory messages were sent from near and far," said Accreditation Coordinator Joyce Marshall. "Our employees had taken to heart the gaps that were addressed when first reviewing the standards, and had worked very hard to assure we had processes and documentation in place to meet or exceed PHAB Standards and Measures."

 

Looking back on the celebrations and events that followed their accomplishment, Marshall added, "It's so much more than the piece of paper, the absolutely beautiful plaque, or even the accreditation itself. It is the opportunity it presented us to continually improve to be the best organization possible, leading to our ultimate goal of better health and services for all Oklahomans."  

 

 

At West Allis Health Department in West Allis, Wis., employees toss their mittens skyward to express their excitement upon learning of their accreditation. The agency was among 11 public health departments to be awarded national accreditation on February 27, 2013.

PHAB SPECIAL REPORT: Eleven Public Health Departments Achieve National Accreditation   

Health Department Leaders Cite Benefits of National Accreditation: 'Accreditation is our future' 

 

Public health in the United States marked a milestone in February when PHAB awarded national accreditation to the first 11 public health departments. Benefits of the accomplishment are already being seen at the newly accredited health departments, including improved quality and performance, increased public support and awareness, and increased credibility and accountability. 

 

  
"Accreditation is about quality improvement, and the work we have done to achieve accreditation has resulted in many efficiencies. It has led us to truly challenge ourselves about the way we do our work, and to ask the question: 'Is this as good as we can do it?' And the answer, more times than not, is 'No, there are better ways that we can do that.'  It is continuous quality improvement. As we investigate our shortcomings, we discover ways to do things better. We are here to serve our public, and we need to do that with the highest regard to the use of public resources and with the highest quality services we can provide." -- Torney Smith, MS, Administrator, Spokane Regional Health District, Spokane, Wash.

 

 

 "The whole accreditation process changed the culture of the department. Accreditation has us looking at our performance and managing our public health activities differently. The path has been developed by PHAB and its partners for the direction that health departments must go. Having met those standards and having been accredited now, it gives the staff not only the morale boost, but it says, 'We are on the right track, and we are moving in the direction the national leaders see public health going.'" -- Joan Ellison, former Public Health Director, Livingston County Department of Health, Mt. Morris, N.Y.

   

 

 

  "Everybody is feeling very proud. There has been an increase in visibility for

us across the state. We are putting all the emails and cards we have gotten together so staff can see all the people congratulating us and sending comments. We have a binder in our staff lounge where I have been putting copies of all the emails and letters from various agencies and the community. The binder moves around. Every time I go into the lounge, it is in a different location, so I know people are looking at it."  -- Sally Nusslock, RN, Health Commissioner, West Allis Health Department, West Allis, Wis.

 

 

 

 "Going through the process of gathering documentation and making corrective plans of action has been the biggest benefit of accreditation thus far. We have been receiving numerous phone calls and emails from other health departments around the nation that are also interested in pursuing accreditation, and we are excited and eager to provide any assistance we can. The accreditation preparation process has led to numerous quality improvement initiatives within our health department that have helped to break down silos, streamline operations, improve staff satisfaction and almost double our grant funding." -- Judy Mattingly, MA, Franklin County Health Department, Frankfort, Ky.

 

   

"I'm as proud as I could possibly be for our agency [as well as] the Spokane Regional Health District, and our entire public health network in Washington. This is a major accomplishment for all of us, and more important, for the people of our state. It shows that we have the programs and measures in place so that we can meet our community's needs as effectively as possible."  -- Mary C. Selecky, former Secretary, Washington State Department of Health, Olympia, Wash.

 

 

 "At a time when financial hardship has limited the health department's ability to reward excellence, staff morale has suffered. The news of achieving accreditation has served as a bright acknowledgement of all our staff's efforts to achieve excellence. There is a renewed excitement about working in public health, not only in our health department, but across the Commonwealth. Northern Kentucky has actively encouraged other health departments to apply for accreditation as a means for improving the delivery of public health across the country, but cautions other health departments to apply only if they have thoroughly explored the requirements and are prepared to meet the challenges presented by the standards and measures." -- Alan V. Kalos, Health Planning Administrator, Northern Kentucky Independent District Health Department, Edgewood, Ky.

 

   

 "Just do it! Your staff will appreciate it; your community will appreciate it; your leadership will appreciate it. We now consider the accreditation process the most effective workforce development project we've implemented to date. Staff truly rose to the occasion. They are more aware of the ten essential services; they understand better where they fit in the big picture and how everyone's job is important to accomplishing our overall goal of improving and maintaining the health of our communities. Finally, staff has learned to accept and appreciate

the challenge of meeting national standards." -- Brandie O'Connor, MPH, Administrator, Comanche County Health Department, Lawton, Okla.

  

 

 

  "In addition to giving us heightened visibility and credibility,

becoming accredited has given us more opportunities to get our

messages out on what matters most -- improving and protecting the health of

Oklahomans! We believe the benefits far outweigh the costs, and that the

return on investment will be proven many times over." -- Joyce Marshall, MPH,

Director, Office of Performance Management, Oklahoma State Department of

Health, Oklahoma City, Okla.  

 

 

 

 

"We've had many opportunities, such as this one, to speak to others about

our experience with the entire accreditation process and how our health

department is stronger as a result. Get off the fence!  Accreditation is not a

project or program -- its standards and measures make up a 'playbook' for how

to operate a health department. Accreditation is our future." -- Georgia Heise,

DrPH, District Director, Three Rivers District Health Department, Owenton, Ky.

 

 

 

 

  "To be one of only eleven in the country is quite an accomplishment. It has brought a sense of pride to the staff. We have received congratulations from other health departments. Apply, but do so only if you are willing to make the commitment in time and energy to do a thorough job of self-assessment, and then be willing to make the changes necessary to comply with the standards." -- Cindy Walker, MPH, RD, LDN, Program Coordinator/Accreditation Coordinator, The Public Health Authority of Cabarrus County, Inc. d/b/a Cabarrus Health Alliance, Kannapolis, N.C.

 

 

 

 

  "Reach out to those of us who have been through the process, to learn about our challenges and successes, and to benefit from the peer network. I think that the process is an eye-opening one; in preparing for accreditation it helped us to identify gaps and opportunities for our agency to become better. Accreditation truly requires an environment of continuous quality improvement, and we have found that by embracing a culture of change and quality improvement, our agency is prepared for the changing face of local public health. -- Gary Cox, JD, Executive Director, Oklahoma City-County Health Department, Oklahoma City, Okla.

  

 

 

In Frankfort, Ky., Franklin County Health Department staff find a creative way to celebrate their accreditation status.

 

 

Spokane Regional Health District's Torney Smith, center (standing), leads staff in a cheer following the announcement of the agency's acccreditation.

PHAB IN ACTION 

PHAB Hosts Public Health Ethics Expert Panel and Informatics Think Tank

To stay abreast of the changing public health landscape, PHAB recently hosted a Think Tank and Expert Panel meeting. The Public Health Ethics Expert Panel met February 22 in Atlanta to discuss the relationship between the PHAB Standards and Measures and best practices in public health ethics. The panel also met to identify concepts, activities, and tools that would strengthen PHAB's guidance for health department documentation related to public health ethics, and to identify strategies to ensure that PHAB has communicated the emphasis on public health ethics in its accreditation materials. Assisting PHAB with this work are Expert Panel members Ruth Gaare Bernheim, Kathy Kinlaw, Alma Harris, Alan Melnick, Matt Stefanak, Leslie Wolf, Drue Barrett, Liza Corso, Craig Thomas, Lisa Lee, Subha Chandar, Barbara Ellis, Leonard Ortmann, and Hugh Tilson. PHAB appreciates the work of the CDC Ethics Subcommittee of the Advisory Committee to the Director in informing this body of work.    

Atlanta was also the setting for PHAB's Public Health Informatics Think Tank on April 3-4. The Think Tank aimed to discuss the relationship between PHAB accreditation standards and other informatics performance standards or other program performance indicators. The Think Tank also sought to identify strategies to strengthen the PHAB accreditation Standards and Measures in those areas where informatics is key; develop common language and definitions related to informatics to use in accreditation-related work; and identify and discuss strategies to ensure informatics community input into the accreditation process.  

Participants in this body of work include Tim Callahan, Marcus Cheatham, Kathy Cook, Seth Foldy, Kelly Friar, Joe Gibson, Shaun Grannis, Bill Hacker, Geraldine Johnson, Mary Beth Kurilo, Phred Pilkington, Joann Schaefer, Torney Smith, Mary Grace Stobierski, Debra Bara, John Besser, Bill Brand, David Callahan, Michael Coletta, Laura Conn, Liza Corso, Kimberly Gadsen Knowles, Kate Glynn, Denise Koo, Jim Mootrey, Melody Parker, John Ridderhof, David Ross, Anita Samuel, Paula Soper, Patrick Wall, Ronique Watkins, Mark White, Warren Williams, Paula Yoon, and Herman Tolentino. Given the complexities associated with informatics in public health, this group will work on both short-term and long-term strategies for PHAB's consideration. PHAB appreciates the partnership with the Public Health Informatics Institute in hosting this Think Tank.

Bulbul Bhattacharya Joins PHAB Team

 March 4 was a busy day at PHAB headquarters. In addition to releasing a national press release announcing the first accreditations, PHAB welcomed Data Analyst Bulbul Bhattacharya, MPH, to its growing team. Bulbul previously worked as a Research Associate at Drexel School of Public Health in Philadelphia, where she was involved in research related to women's health. Among other research duties, she used data from the original Women's Health Initiative to explore how hip fractures among post-menopausal women are related to lifetime occupational exposures. Formerly, Bulbul worked as a family medicine practitioner in India. There, her job duties included working with UNICEF to set up immunization camps for needy people in urban communities, as well as engaging in family planning counseling and conducting related surgical procedures. Bulbul holds a master's degree in public health from Drexel School of Public Health, with a special focus on epidemiology and biostatistics. Welcome Bulbul!

New Site Visitors Attend Training

More than 20 new Site Visitors attended a PHAB-sponsored in-person training in Alexandria, Va., on April 16-17. These public health professionals learned about their roles as Site Visitors, worked through several case studies related to documentation review, and became acquainted with the Site Visitor portion of e-PHAB. PHAB's David Stone and Jeff Lake organized the training event, while Travis Parker Lee handled the logistics. The accreditation process would not work without the dedication of these volunteer peer Site Visitors. PHAB appreciates their commitment to making public health better.

New PHAB Site Visitors gathered for a group photo during a recent two-day training in Alexandria,Va.

SITE VISITOR SPOTLIGHT

Q&A With Site Visitor Oliver Delk: 'I wanted to give back to my profession'  

PHAB's volunteer Site Visitors perform a central role in the national accreditation process. From reviewing documentation submitted by health department applicants to conducting key on-site interviews and writing the Site Visit Reports, Site Visitors are critical to PHAB's mission and goals. With this edition of the e-newsletter, PHAB launches a new feature that will spotlight these important peer reviewers. Recently, Site Visitor Oliver R. Delk, Grants and Contracts Administrator at the Fulton County Department of Health and Wellness in Atlanta, shared some thoughts about his Site Visit experience.

Why did you volunteer to be a PHAB Site Visitor?

Beyond the obvious -- being a part of history -- I wanted to give back to my profession, by helping to establish the standard(s) which our constituents should expect from a first-class operation. For far too long, public health has had to provide services for numerous unfunded mandates, so the least that I could do for a profession that I love is to volunteer.

What did you gain from the experience?

I learned in great detail about why public health works. I was able to see the passion and commitment that the local health department employees exhibited when they carried out their responsibilities. I have a better appreciation for the real dedication to providing a quality product/service to everyone that requests it. If there is a back story, it is the unsung heroes that, despite limited funding, seem to always find a way to help those most in need.

Would you consider doing it again?

Yes, I would do it again if asked, in a heartbeat. First, I was part of a team that shared the same passion and interest that I do about our profession. Being part of a team of content experts has allowed me to expand my knowledge of public health.  

What would you say to colleagues who are considering volunteering to be a PHAB Site Visitor?

I would tell them that the experience you will have is unparalleled to any training or internship you could have in public health. You will have an opportunity to gain insights on the various ways local health departments respond to public health needs in different regions of the country. You will have a better understanding of the problems and possible solutions facing public health, and the programs that have been implemented for their constituents. It is a win, win.

PHAB PROGRAM NOTES  

Highlights from the March 20-21 PHAB Board of Directors Meeting

PHAB's Board of Directors held its quarterly meeting in San Diego, Calif., March 20-21. Highlights of the meeting included:

• Appointment of PHAB's newly created Evaluation and Quality Improvement Committee. This committee will assist PHAB with its internal and external evaluation work and will also guide the development of the requirements for the annual accredited health department quality improvement reports. The committee will be co-chaired by Board members Les Beitsch and Bill Riley. Additional members appointed for three-year terms include Mary Davis, North Carolina Institute for Public Health; Kim Gearin, Minnesota State Department of Health; Julia Heaney, Michigan Public Health Institute; Brenda Joly, Muskie School of Public Service, University of Southern Maine; Jack Moran, Public Health Foundation; Greg Randolph, Center for Public Health Quality; Susan Ramsey, Washington State Department of Health; Lillian Rivera, Miami-Dade Health Department; and Jennifer Smith, Texas Association of Local Health Officials.
• Discussion and planning for PHAB's internal and external evaluations. As a learning organization committed to quality improvement, PHAB takes a comprehensive approach to assessing how well the accreditation program is serving applicant health departments and volunteers, as well as monitoring the impact of accreditation on health departments that achieve accreditation. PHAB also plans to assess how well the accreditation measures are performing, including determining if they truly measure what they were designed to measure, are clear in wording, intent and interpretation, and are consistently applied by Site Visitors across all health department settings. The Board discussed the development of psychometrics for handling these and similar questions over time.
• Discussion of the work plan to revise the Standards and Measures. PHAB is already working to update Standards and Measures, Version 1.0, with the goal of making them more clear and applicable to health departments today. The Accreditation Improvement Committee will begin work in June to prepare the version that will be provided to the public this summer. The public vetting process will allow PHAB to benefit from your input prior to implementing the updated version of the Standards and Measures on July 1, 2014.
• Completion of annual conflict-of-interest disclosures. PHAB values transparency in its governance structures.
• Dr. Ron Chapman, Director of the California Department of Public Health and State Health Officer, served as the keynote speaker for the Board and partners' dinner.

WORD ON THE STREET: A Round Up of Accreditation Questions and Answers

1. Does PHAB batch health departments' applications, or does it process them as they are ready for the next step? How can we speed up the process? 

Generally, PHAB moves health departments through the accreditation process as the health departments are ready. For example, statements of intent and applications are processed by PHAB staff as soon as they are submitted. Completeness reviews of health departments' documentation are processed as quickly as possible. 

There are two occasions in which PHAB must "batch" health departments' applications. PHAB trains Accreditation Coordinators in groups. Once a health department's application is complete, the health department may need to wait a bit for the next scheduled (usually quarterly) training before they can move ahead and begin to upload documentation. But they should be preparing their documentation way ahead of time and can use that time to finalize their documentation selection. After the training, PHAB processes the health departments as they are ready. If a health department uploads the documentation in 3 months, PHAB will take it to the next step. If another health department uploads all of its documentation in 2 months, PHAB will not wait but will move that health department to the next step. 

The other time we need to "batch" health departments is for the Accreditation Committee to meet and review Site Visit Reports for an accreditation decision. The Committee will not act on Site Visit Reports for accreditation decisions as they come in, but will meet (at least quarterly) and review groups of Site Visit Reports. 

The accreditation process is long, but to a great extent health departments can determine if they speed ahead or take more time. For example, there are several times that the health department has 30 days to respond to PHAB. Some health departments take all 30 days, while others get back to us in a week or less. Health departments have one year to upload their documentation, but most complete this step in a few months. Thus, health departments have a good amount of control in regard to the speed of the process.

2. To be accredited, what percentage of the measures must a health department fully demonstrate? Is there a "cut off" number of measures that must be demonstrated? Is there a formula? 

The Accreditation Committee makes accreditation decisions based on descriptive information from the Site Visit Report as well as the measures' assessments. The Accreditation Committee carefully reviews the entire contents of the Site Visit Report: the measures' assessments, the strengths and opportunities for improvement identified by the Site Visitors, and the Site Visitors' overall impression of the department as a functioning health department. The Accreditation Committee does not use a formula or "cut off." There is no numerical formula by which accreditation decisions are made. There are no numerical thresholds of measures demonstrated to confer accreditation. No standards or measures are weighted. Accreditation decisions are based on quality rather than quantity.

 3. What if it seems that one of the members of my health department's Site Visit Team is a "tougher grader" than the other Site Visitors? How do we know that the Domains that have been assigned to that Site Visit Team member will not be assessed more strictly than the other Domains? 

Before they are assigned to health departments, all Site Visitors participate in PHAB's two-day training, during which they assess documentation and work through case studies with sample documentation. During trainings, all Site Visitors receive consistent guidance on what factors to consider when reviewing a health department's documentation. In addition, all Site Visit Teams are made up of at least three public health professionals. If one team member believes that a measure is not "fully demonstrated," the team is instructed to join together in a discussion of the documentation. As such, the team engages in a consensus process to ensure that the assessment reflects the professional opinion of all team members. The final assessments are not determined by one person. Additionally, if a measure is not assessed as "fully demonstrated," the team is required to provide a narrative that explains the reasons for their rating. Having to explain their rating guards against arbitrary assessments. PHAB believes that it is important for all Site Visit Teams to assess the documentation in a consistent fashion, and we will continue to provide training and resources to support an effective peer-review process.

4. Does PHAB recommend any particular source for samples of documentation, or document templates that we can use for accreditation documentation? 

PHAB strongly advises against any health department obtaining and using a template or copying a sample in an attempt to meet the required documentation. While PHAB hopes that best practices and evidence-based programs are shared among practitioners in the field, practices and programs must be adapted by the health department to be appropriate for their own community. The accreditation process is about documentation, not documents. That is, what a health department submits should provide evidence and serve to document what the health department actually does. The evidence that the health department submits should be a true and accurate illustration of how the health department actually operates. PHAB Site Visitors are trained to explore and ask questions about how policies, procedures, and practices are operationalized in the health department. Site Visitors are instructed to examine how the documentation reflects the reality of the health department. Submitting a template that has not been adapted, adopted, and implemented by the health department will not be assessed as meeting the measure.

5. 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 [email protected] 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 [email protected] or 703-778-4549 ext. 106.

Rachel Margolis, Jennifer Jimenez, Brittan Wood or Marita Chilton, Accreditation Specialists, to talk about the accreditation process for health departments. Rachel may be reached at [email protected] or 703-778-4549 ext. 108; Jennifer at [email protected] or 703-778-4549 ext. 107; Brittan at [email protected] or 703-778-4549 ext. 115; and Marita at [email protected] or 703-778-4549 ext. 114.

Jeff Lake, Volunteer Services Manager, to talk about the recruitment, selection, and assignment of Site Visitors and Teams as well as PHAB's Reserve Corps of Accreditation Specialists. He may be reached at [email protected] or 703-778-4549, ext. 110.

David Stone, Accreditation Education Specialist, to talk about PHAB's education services, including orientations and trainings. He may be reached at [email protected] 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 [email protected] or 703-778-4549 ext. 102.

Jessica Kronstadt, Director of Research and Evaluation, to talk about public health accreditation-related research and evaluation. She may be reached at [email protected] or 703-778-4549 ext. 117.

Teddi Nicolaus, Communications Manager, to talk about accreditation-related news, interview requests, and promotions. She may be reached at [email protected] or 703-778-4549 ext. 118.

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 [email protected] or 703-778-4549 ext. 103.

Genny Lush, Office Manager, to talk about general office inquiries. She may be reached at [email protected] or 703-778-4549 ext. 100.

If you have a suggestion for future segments of Word on the Street, please send them to Teddi Nicolaus.