Nearly 121 Million U.S. Residents Now Experiencing the Benefits of PHAB Accreditation
In keeping with their mission to improve the conditions in which their communities can be healthy, four health departments were recently awarded five-year accreditation by the Public Health Accreditation Board. The decisions bring another 6.5 million U.S. residents into an expanding national network of communities served by health departments that meet national standards for delivering quality programs and services.

National accreditation status was awarded August 4, 2015 to Central Valley Health District in Jamestown, North Dakota; Thomas Jefferson Health District in Charlottesville, Virginia; the Illinois Department of Public Health in Chicago; and Washtenaw County Public Health in Ypsilanti, Michigan.

Since the launch of the national accreditation program in 2011, 79 governmental public health departments have achieved accreditation through PHAB. With the August decisions, the benefits of national accreditation now reach 39 percent of the U.S. population, or nearly 121 million people. In all, 28 states plus the District of Columbia now have a PHAB-accredited health department within their borders.

"Four more U.S. communities are now experiencing the benefits of their health departments being nationally accredited," said PHAB President and CEO Kaye Bender, PhD, RN, FAAN. "These four health departments represent a wide variety of size and organizational structures -- all working with their communities to improve the health status of their jurisdictions."

Read the full press release here.

In August, the Illinois Department of Public Health (IDPH) became the eighth state health department to achieve PHAB accreditation. Above, IDPH Director Nirav D. Shah, MD, JD, left, and Nicole L. Griffith, MHA, LSSGB, Deputy Director in the Office of Performance Management at IDPH, pose with the department's official accreditation recognition plaque.

PHAB Announces Changes to the Accreditation Process
A new Guide to National Public Health Department Initial Accreditation was adopted by the Board of Directors of PHAB during their June 2015 meeting. The Guide contains a number of policy and process revisions. Health departments considering or working toward accreditation should carefully review the new Guide to National Public Health Department Initial Accreditation. An advance PDF copy of the Guide is available here. Printed copies are available for purchase in PHAB's online store. A table of effective dates of various policy and process changes may be accessed here.

While the overall process for accreditation has not changed, a number of policies have been revised and others newly adopted. The previous Guide was adopted in 2011 and, based on evaluations and learning over the past few years, required revisions. The process for health departments to seek accreditation is significantly improved with the adoption of the new Guide. Implementation of most of the revisions of the process in the Guide require that changes be made in PHAB's information system, e-PHAB. The e-PHAB changes will be complete and ready for implementation on February 1, 2016. Other changes in policy will be effective September 1, 2015. See the table for effective dates of the various changes in the accreditation process.

The development of the new and revised policies was steered by PHAB's Accreditation Improvement Committee. The members of this Committee represent state, local, and Tribal public health departments. Proposed revisions were vetted with the public health community and comments were carefully considered by the Committee. A draft Guide was submitted to the PHAB Board of Directors for their consideration and adoption in June 2015. Please refer to Appendix 1 and 2 of the Guide for an overview of the revised process. Contact Robin Wilcox, Chief Program Officer, at rwilcox@phaboard.org with any questions.

Recent Evaluation Findings Highlight Benefits of Accreditation
According to one local health department, accreditation is "one of the best leverage points" to improve the public health system and success on health measures. That is one of the findings from a series of focus groups and interviews conducted by the social-science research organization NORC at the University of Chicago, as part of their three-year contract to evaluate the PHAB accreditation program.
 
NORC has also heard from other health departments that accreditation has improved their visibility, credibility, and reputation; led to a greater focus on identifying and using evidence-based programs and metrics; strengthened relationships with the governing entity and community partners; and given the health department an advantage when seeking grant funding. Several health departments have discussed how accreditation has strengthened their quality improvement (QI). One health department noted that accreditation "was a major opportunity to change our organizational culture to one where QI and performance management initiatives have become the norm."
 
In addition to the focus groups and interviews, NORC conducts a series of surveys, including one of health departments that have been accredited for one year. Among the 28 respondents to that survey, 96 percent indicated they have experienced the following benefits:

• Stimulated quality and performance improvement opportunities within the health department;
• Improved management processes used by leadership team;
• Stimulated greater accountability and transparency within the health department; and
• Allowed the health department to better identify strengths and weaknesses.

 
Site visitors also report benefits from their role. In a survey of 28 site visitors who had conducted two or more site visits, more than 85 percent reported each of the following benefits:

• Contributing to improvement of the public health field;
• Learning about new, innovative, and promising public health practices; and
• Gaining in-depth information about the accreditation process.

 
The evaluation findings from NORC and from surveys conducted by PHAB have also helped PHAB improve. We are incorporating what we are learning as we revise the accreditation process and as we develop new training modules and resources for health departments and site visitors. We would like to thank all who provide feedback. Your candid comments are critical for PHAB's continued improvement.

For information about evaluation activities, please contact Jessica Kronstadt, PHAB Director of Research and Evaluation, at 703-778-4549, ext. 117, or via email at jkronstadt@phaboard.org.


New PHAB Video Debuts Today: Benefits of Accreditation Spotlighted
Readers of the PHAB E-newsletter have front-row seats today as PHAB unveils a new video titled "Reaping the Benefits of Accreditation Across the Nation." The six-minute video showcases the benefits PHAB accreditation brings to health departments and the communities they serve.

Supported with a grant from the Robert Wood Johnson Foundation and developed in partnership with Washington, D.C.-based Dahlman-Cook Productions, the new video takes viewers behind the scenes at three health departments: the California Department of Public Health, the Chicago Department of Public Health, and Three Rivers District Health Department in Kentucky. Filmed on location in Sacramento, Calif., Chicago, Ill., and Owenton, Ky., the video drills deep to answer the question: "How has your health department changed as a result of going through the accreditation process?"

"The PHAB staff and Board of Directors are deeply grateful to the leadership of the three health departments for opening their doors to PHAB's camera crew in April and May and generously sharing their time and energy in order to bring the benefits of accreditation into the national spotlight," said PHAB President and CEO Kaye Bender.

PHAB's website with this new information will be updated in the next two weeks.

To view the video, click here.
 

PHAB's New Online Store is Up and Running
"We are very excited about our new online store," said PHAB President and CEO Kaye Bender. "The demand for PHAB's publications and other products -- such as printed copies of PHAB Standards and Measures Version 1.5 -- has increased, and the strong demand has outgrown our current ordering process. We think the online store will significantly improve the fulfillment process and place these important products into users' hands more quickly."

The store will grow over time to include new products, such as an accreditation "kick-off" kit for health departments that are just starting their accreditation journey and want to spark excitement among their staff. In addition, the store will eventually feature a special portal that will be available only to accredited health departments wishing to purchase additional copies of PHAB's official recognition plaque, customizable banners, apparel, and other products branded with PHAB's logo and seal of accreditation.

PHAB's new online store is open around the clock at https://phab.orderit247.com/login. PHAB's website with this new information will be updated in the next two weeks.


PHAB to Conduct Workshop at COPPHI Open Forum in October
Mark your calendars! PHAB will conduct both a plenary session and a pre-conference workshop during the Community of Practice for Public Health Improvement (COPPHI) Open Forum for Quality Improvement in Public Health. The Open Forum will be held at The Westin Seattle on October 15-16, 2015. Open Forum participants are invited to attend an October 15 plenary session during which PHAB President and CEO Kaye Bender will share important information about PHAB.

The Open Forum will be preceded by a day-long pre-conference workshop on Wednesday, October 14. PHAB Education Specialist David Stone will lead the workshop, assisted by Public Health Foundation President Ron Bialek, and performance improvement consultant Sonja Ambruster. The workshop will cover a range of topics, including the accreditation process, the PHAB Standards and Measures, the importance of accreditation, key plans that must be in place, and performance improvement. Workshop participants will gain the knowledge they need to get their preparation efforts underway.
 
"Being prepared to undertake the accreditation process is as important as going through the process itself, yet many health departments have no idea how to begin to prepare for the process or even what to do to get started," Stone said. "That's where this workshop comes in. If you are beginning to get familiar with the process or wondering how you should prepare, then this day will give you the fundamentals you need."

The workshop will also provide an excellent opportunity for newly appointed Accreditation Coordinators to get a solid foundation for their roles, Stone added.
 
The $125 fee includes all materials and meals/breaks for the workshop. The workshop will be limited to the first 40 participants and will be held on October 14 from 8 a.m. to 4 p.m. Click here to register. For more information, contact PHAB Education Specialist David Stone at dstone@phaboard.org or 703-778-4549, ext. 105.


In-Person Applicant Trainings Held Quarterly at PHAB
PHAB hosts required in-person applicant trainings for Accreditation Coordinators at the PHAB Office located in Alexandria, VA, on a quarterly basis. The two-day trainings consist of both didactic and discussion methods to provide a detailed description of what to expect in the remaining steps of the accreditation process, as well as critical factors for successful completion toward PHAB accreditation. Content includes training on how to use the Documentation Submission module in e-PHAB, tips for selecting documentation, preparation for and participation in the site visit, accreditation decisions, and annual reports.

The training is for groups of PHAB applicants and consists of no more than 24 participants at a time. The accreditation fee that the health department pays covers the travel and training costs for the health department's Accreditation Coordinator. Health departments may choose to send one additional person to the training to attend with the Accreditation Coordinator, but the additional person is responsible for arranging and paying for their travel to the training. Currently, the cost for an additional trainee is $850.00. This fee covers hotel lodging for two nights, meals provided during the training, and training materials.  

PHAB's current 2015 and 2016 applicant training schedule is below, but please note that PHAB does have the option to add extra trainings if numbers warrant:


2015 Quarter     Months                          Next Training Date
3rd Quarter        July-September              November 17-18, 2015
4th Quarter        October-December         February 9-10, 2016

2016 Quarter     Months                          Next Training Date
1st Quarter        January-March                May 10-11, 2016
2nd Quarter       April-June                        August 9-10, 2016
3rd Quarter       July-September                November 8-9, 2016
4th Quarter       October-December           Mid-February 2017


Trainings are held approximately six weeks after a quarter ends, and health departments are eligible to attend the closest training to the quarter in which they paid their accreditation fee. Travis Parker Lee, Program Specialist, provides training details after the end of each quarter, but he is available to answer questions and concerns at any time. Travis can be reached at tlee@phaboard.org or 703-778-4549 ext. 102.


PHAB Holds Think Tank for Health Departments Serving Populations Under 50,000
PHAB is exploring challenges and opportunities related to the accreditation of health departments that serve populations of fewer than 50,000 people. Although several health departments of this size have attained PHAB accreditation, PHAB has heard from other health departments that there is a need to hold some discussions about the barriers they face. Data from the NACCHO Profile and Forces of Change surveys reinforce this feedback and provide further detail about commonly-cited barriers. A group of health department representatives interested in advising PHAB on this topic have convened once for a think tank meeting and will continue to work with PHAB over the next year as PHAB's Advisory Committee. PHAB has also received great input already from public health departments attending the COPPHI Open Forums, as well as those who participated in the in-person think tank meeting and on a national conference call on June 9, 2015. PHAB is committed to exploring potential avenues to address these accreditation barriers.

PHAB will continue to also seek input through the project time line from other health departments as there are opportunities to do so. For purposes of this project, PHAB considers that not all of these health departments are rural, although many are rural or frontier. This work also has potential implications for territories and Tribes. PHAB sees this work as the exploration of a different, but related accreditation product (which means standards/measures and process) for health departments who wish to pursue quality improvement in their work but find the current approach too daunting as a first step. PHAB will use examples from other accrediting bodies as reference points to guide the basis for this project. Whatever model PHAB chooses, it will be connected to the current accreditation requirements so that health departments who wish to work through the entire process can readily do so. The current model of accreditation will continue to be available to any health department, regardless of size. PHAB encourages health departments who are already working on their accreditation journey to continue to do so. For more information, stay connected to PHAB through its e-newsletter.


DIS Subject Matter Experts Meet at PHAB in July
As part of its cooperative agreement with the Centers for Disease Control and Prevention (CDC), PHAB is coordinating a comprehensive, inclusive process for developing recommendations to strengthen and formalize the role of Disease Intervention Specialists (DIS) in areas such as STD/STI, HIV, TB, Ebola, and other communicable diseases, as well as emergency preparedness and response. PHAB is working with CDC, the National Association of County and City Health Officials (NACCHO) and the National Coalition of STD Directors (NCSD) to develop potential models for DIS certification; establish a national registry for DIS; articulate essential job tasks, knowledge, skills, and abilities of the DIS role; and provide a comprehensive framework for future DIS training. To advise PHAB's work, a DIS Expert Panel met at PHAB July 7-8, 2015.

In a few weeks, Disease Intervention Specialists in all public health work settings in the country will be invited to participate in an important job task analysis, which will form the basis for the rest of this work. PHAB has contracted with PSI, Inc., a non-profit credentialing organization, to conduct the job task analysis, which is an online survey developed by PSI in partnership with Disease Intervention Specialists from across the country. Please be on the lookout for the opportunity to participate in this very important work.

A Disease Intervention Specialists Expert Panel convened at PHAB July 7-8, 2015.

PHAB Participates in California Accreditation Readiness Conference
PHAB was pleased to be included in an accreditation readiness conference hosted by the California Department of Public Health and attended by most of the local health departments in California.

The August 26-27 conference, titled "Moving Forward Together: California's Journey to Public Health Accreditation," brought together national, state, and local health department speakers to discuss ways local health departments can support each other as each creates its own accreditation path. In spite of some ongoing environmental challenges posed by droughts and wildfires, health department staff were actively engaged with one other in making their accreditation plans. PHAB Board members Ron Chapman and Wilma Wooten were among the conference's faculty. PHAB applauds the California public health system for their commitment to excellence and to each other.

PHAB Exhibits at NACCHO, NACo, NALBOH
If you happened to be at one of several national conferences this summer, you probably stopped by PHAB's booth in the exhibit hall or attended an accreditation-related session. Between the annual meetings of the National Association of County and City Health Officials (NACCHO), the National Association of Counties (NACo), and the National Association of Local Boards of Health (NALBOH), PHAB visited with hundreds of conference-goers this summer and fielded myriad questions about public health department accreditation.

Accreditation was a popular topic at the NALBOH annual conference in Louisville, Ky., in August, where PHAB President and CEO Kaye Bender led a session devoted to the intersection between the function of governance and health department accreditation, identifying areas where the board of health can be even more engaged in health department performance management and quality improvement.

PHAB will also be on hand at the annual meeting of the American Public Health Association in Chicago later this fall. PHAB exhibits at a number of meetings and conferences each year to engage potential applicants, partners, and policy-makers, and to inform the public health community at large about public health department accreditation. Through presentations and exhibits, PHAB provides educational resources, shares materials, seeks feedback, and supports its national partners at recognition events for outstanding health department work.

New Rounds of CDC-Funded Accreditation Support Initiatives Underway
With funding from the Centers for Disease Control and Prevention's Office for State, Tribal, Local, & Territorial Support, the National Association of County and City Health Officials has announced two funding opportunities for local health departments (LHDs) and public health departments from U.S. territories and Freely Associated States (HDs) to engage in accreditation readiness activities. The 2015-2016 Accreditation Support Initiative (ASI) awards are intended to stimulate quality improvement and promote LHD and HD readiness to seek voluntary national accreditation through the Public Health Accreditation Board.  The LHD applications are due September 11th. The HD applications are due on September 29th and 30th. Click here to access the RFPs and application documents. Questions about this opportunity can be directed to asi@naccho.org.

The National Indian Health Board also announced an ASI funding opportunity for tribal health departments that recently closed on August 31. Click here for more information about the Tribal ASI, or contact Karrie Joseph at kjoseph@nihb.org.


Public Health Foundation Offers Aligning Accreditation Plans Workshop
The Public Health Foundation (PHF) recently unveiled "Aligning Accreditation Plans," a new service designed to help health departments ensure that the various plans required for health department accreditation are complementary and effectively tracked within the health department's performance management system.
 
The accreditation prerequisites: the health assessment, health improvement plan, and strategic plan, require significant time and effort. When the prerequisites are complete, and the focus turns to workforce development planning, quality planning, and performance management system planning, some agencies find their health improvement plans and strategic plans were not written with these other plans in mind.
 
PHF recommends taking steps early to align all the plans required for accreditation, consider how they can reinforce one another, and how performance management can be used to track performance across all the plans. This half-day workshop uses a framework for aligning the plans and documenting that alignment, taking into account quality improvement principles, the essential services of public health, and PHAB's Standards and Measures for accreditation.
 
To bring this workshop to your health department, contact Margie Beaudry at (202) 218-4415 or mbeaudry@phf.org.


CEPH to Hold Town Hall at APHA Annual Meeting
The Council on Education for Public Health is seeking feedback from employers of public health graduates and student preceptors on new proposed criteria. The proposed criteria will be discussed at a town hall meeting to be held during the annual meeting of the American Public Health Association.

The discussion will seek to answer such questions as:
*     Do the proposed criteria identify the right skills and knowledge?
*     Have they missed important skills or knowledge?
*     How can CEPH continue to support the development of a workforce that contributes to better public health outcomes?
*     Do the proposed standards support quality in student learning?
*     Do these standards reflect the dynamic, current discussions in public health and higher education?

The town hall will be held on Sunday, Nov. 1, from 4 p.m. to 5:30 p.m. at the Hyatt Regency McCormick Place, Room CC12B. Comments may also be submitted online through Friday, Sept. 18.

Though the discussion will focus on perspectives from individuals who supervise interns and employ graduates of public health degree programs, faculty and others from academic settings may observe the session on a space-available basis. Pre-registration is not required for faculty. Visit the CEPH website to read more about the process, review the proposed revisions and download the comment submission form. For more information, email Nicole Williams at nwilliams@ceph.org.


NACCHO Releases New Fact Sheet on Accreditation and Environmental Public Health
The National Association of County and City Health Officials (NACCHO) in August released a new fact sheet focusing on the role of environmental public health programs in public health department accreditation. Environmental public health is an important contributor to the accreditation process and many PHAB standards and measures specifically involve environmental public health. Developed in consultation with the Centers for Disease Control and Prevention, the fact sheet explores the types of environmental public health documentation local health departments have used in their accreditation.

Titled "Role of Environmental Health Programs in Public Health Accreditation," the two-page fact sheet includes important lessons learned, best practices and recommendations that health departments can implement. Click here to download a copy of the free fact sheet or visit www.naccho.org.

Welcome Eleanor Hope Hennig
The extended PHAB family continues to grow! In July, PHAB Senior Accounting Specialist Daniel Hennig and his wife Debs celebrated the birth of their first child, Eleanor Hope. Born shortly after 9 a.m. on July 25, 2015 in Alexandria, Va., Eleanor entered the world weighing 7 pounds, 6 ounces and measuring 20 inches in length.

"Eleanor is growing daily, Mom is recovering well and both of us are thrilled to become parents," proud papa Daniel says.

The entire PHAB family joyfully joins in congratulating the Hennig family on the birth of little Eleanor!

 

1. I am confused about what documentation should be used for measures that require "data," "data analysis," and "research."  Can you explain the difference?

Data is defined in the PHAB glossary as "factual information (as measurements or statistics) used as a basis for reasoning, discussion, or calculation." The term "data" is used hundreds of times throughout the Standards and Measures, Version 1.5. For example, Measure 1.2.3 requires the collection of data and Measure 1.2.4 requires the provision of data to others. Data can be analyzed in order to draw conclusions. Data include both quantitative information (the number of survey respondents who gave a particular response, for example) and qualitative information (opinions, for example, gathered through a focus group). Data can either be primary data (data collected from an original source) and secondary data (data collected in the past, by others).

Data analysis involves an examination of the data, their elements, and their relations, in order to draw conclusions that can be useful for decision-making. PHAB uses this term to indicate more than simply presenting data; that is, it is more than the presentation of numbers for descriptive purposes (for example, stating the median household income or the infant mortality rate). Analysis of data requires examining the associations between data to identify implications. For example, Measure 1.3.2 requires the distribution of data analysis and findings. The presentation of data without an examination of it, would not meet this measure. A simple comparison of one jurisdiction with other jurisdictions would not fit PHAB's definition of "data analysis;" it is the presentation of data. Analysis would provide some conclusions from the data (for example, looking at the relationship between median household income and infant mortality rate).

Research is defined in the PHAB Glossary as "a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalized knowledge." Measures in Domain 10 address research. For example, Measure 10.2.3 requires the "communication of research findings." The Guidance for this measure states that "Research referred to is research conducted and published by others, outside of the health department. The research must have been evaluated by experts to provide valid implications, for example, peer-reviewed for publication in journals." Research provides conclusions that contribute to the public health knowledge base and that can be used by others in the public health field. The simple reporting of compiled data would not fit this definition and would not be sufficient for use in Measure 10.2.3. Comparisons of jurisdictions would not fit this definition unless causal or correlations of factors were included and conclusions were presented.

2. 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, or e-PHAB. 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.
 
Marita Chilton, Jennifer Jimenez, Cathy Vogel, or Brittan Wood, to talk about the accreditation process for health departments. Marita may be reached at mchilton@phaboard.org or 703-778-4549, ext. 114; Jennifer may be reached at jjimenez@phaboard.org  or 703-778-4549, ext. 107; Cathy may be reached at cvogel@phaboard.org or 703-778-4549, ext. 108; and Brittan at bwood@phaboard.org or 703-778-4549, ext. 115.
 
Jeff Lake, Volunteer Services Manager, to talk about the recruitment, selection, and assignment of Site Visitors and Teams as well as PHAB's Accreditation Reserve Corps. He may be reached at jlake@phaboard.org 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 dstone@phaboard.org or 703-778-4549, ext. 105.
 
Travis Parker Lee, Program Specialist, to talk about meetings, trainings, Site Visitor travel logistics, and requests for speakers. He may be reached at tlee@phaboard.org or 703-778-4549, ext. 102.
 
Genny Lush, Program Specialist, to talk about statements of intent, applications, and accreditation process issues. She may be reached at glush@phaboard.org or 703-778-4549 ext. 113.
 
Jessica Kronstadt, Director of Research and Evaluation, to talk about public health accreditation-related research and evaluation. She may be reached at jkronstadt@phaboard.org or 703-778-4549, ext. 117.
 
Teddi Nicolaus, Communications Manager, to talk about news, media requests, marketing, and promotions. She may be reached at tnicolaus@phaboard.org 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/think tanks, and student opportunities. She may be reached at kbender@phaboard.org or 703-778-4549, ext. 103.
 

If you have a question for future segments of Word on the Street, please send them to PHAB e-newsletter editor Teddi Nicolaus.