PHAB is pleased to release proposed revisions to the Standards and Measures, Version 1.0 for review and comments. The proposed revision is Standards and Measures, 1.5. Comments will be accepted by PHAB for 30 days (July 8 to August 9).

PHAB is providing a survey instrument where you can submit your comments and indicate which Domain, Standard, and Measure each comment is about. You may comment on as many measures as you would like. There is also an opportunity to submit general comments.

In this special edition of PHAB's newsletter you will find information on:

•  Comment Guidelines
•  How to Submit Comments
•  Summary of Proposed Revisions
  • Content
  • Editorial
•  Note on the Affordable Care Act

Please confine your comments to the content of the proposed revisions. The formatting of the document is uneven and will be corrected before the next version of the Standards and Measures is released. Grammatical errors and other typographical errors will also be addressed prior to final publication.

Submit comments using the survey instrument.

Please do not submit comments via email, fax, letter, or other format.

PHAB is not proposing a complete revision of the Standards and Measures, Version 1.0. The proposed revisions are targeted to address (1) needed improvements that were identified through the first year of their use and (2) a limited number of topic areas that the field requested that PHAB consider adding or emphasizing. Because the proposed revisions do not represent a complete revision, the next version of the Standards and Measures will be titled Version 1.5.

The final Standards and Measures, Version 1.5 will be released in January 2014 and become effective on July 1, 2014. Version 1.5 will be applicable to health departments whose applications for accreditation are completed on or after July 1, 2014. PHAB will provide a series of webinars on the changes once the final version has been approved by the board. These webinars will assist health departments in preparing their documentation to address the revisions.

The basic format of the Standards and Measures, as used in Version 1.0, will not change (Domains, Standards, Measures, Purpose, Significance, Required Documentation, and Guidance). The format has been expanded to include two new columns for each Required Documentation in which the number of examples required and the time frame within which the documentation must be dated will be specified.

There are two major types of proposed revisions: content and editorial.

1. Content Revisions

Detail changes to address a number of issues were integrated throughout the proposed Standards and Measures, Version 1.5. Any one topic may be addressed in several places in the proposed Standards and Measures. No new Standards are proposed, eight new Measures are proposed, and a number of new Required Documentation are proposed throughout the Standards and Measures. Specific topics addressed are:

1. There are a number of proposed revisions that relate to public health communication science. Revisions address the need for a planned approach to guide the development and implementation of health promotion programs. The importance of branding the health department, relationships with the media and communities, and the appropriate use of digital media are addressed in the proposed revisions.
2. Strategies and actions for the identification and resolution of public health ethical issues are proposed in the revisions.
3. There is an increased focus on the fact that health departments work with many data bases and sources of information and need the capability to manage information and bring data together to support decision-making. There is a need to manage information assets (data and systems) and to guide systems development to plan for the future.
4. The workforce development plan is proposed to be strategic and address competencies and barriers. The importance of a work environment that supports employees was added. The proposed revisions include moving most of the human resources function from Domain 11 (Management and Administration) to Domain 8 (Workforce). Therefore, changes in these two Domains look more substantial than they actually are.
5. The proposed revisions include a view that a deliberate, purposeful effort to address health inequities is required. The critical nature of community engagement as the primary and central tool for addressing populations with higher health risks or poorer health outcomes was emphasized. There is a proposed increased emphasis on looking at broad and non-public health specific data and issues such as economic (e.g., unemployment and poverty rates), societal (e.g., educational levels, crime rates, and access to healthy foods), environmental (e.g., housing stock and green space), and various types of qualitative data (e.g., the population's perceptions of health or the neighborhood's contributing factors to poor health).

1. Editorial Revisions

The Standards and Measures have received extensive editing. These changes were made without track-changes, as they are too numerous to follow. Changes included the following:

1. Standards and Measures, Version 1.0 includes a series of definitions of time frames (page 5). The proposed revision deletes these definitions and replaces them with specific time frames. For example, the Standards and Measures, Version 1.0 defines "current" as "within the previous 24 months." The new version of the Standards and Measures will say "24 months" and not use the term "current."
2. The Required Documentation is reworded to finish the phrase "Documentation of." Rewording the Required Documentation in this way will more clearly define what is to be documented or evidenced.
3. The Guidance for each measure is being edited so that it will always start with either "The health department must provide," (for documents) or "The health department must document," (for processes).

General edits were made to ensure logic flow and to increase clarity.

The Affordable Care Act (ACA) will affect the future of public health at all levels. While many of the issues for public health departments have been identified, the implications of how those issues will be defined, how they will be addressed, and the implications for the services and activities of health departments are not yet fully understood. While PHAB is aware that many changes will be felt by both the health care system and the public health system, it is premature to predict how the PHAB Standards and Measures should address this changing landscape. Therefore, the proposed Standards and Measures, Version 1.5, does not address the ACA through proposed revisions in Domain 7 (Promote strategies to improve access to health care services) or any other Domain. PHAB plans to conduct Think Tanks and other information-gathering activities specific to the implications of the ACA to public health departments. Revisions to the Standards and Measures concerning this topic will be addressed in future versions of the Standards and Measures.