The Tribe learned about and heard about public health accreditation from different sources over the course of 5 years.  According the Bonnie Culfa, RN, MSN, Sault Ste. Marie's Health Director, "We began hearing about public health accreditation at regional and national meetings."  Keweenaw Bay Indian Community, another Tribe in the Upper Peninsula of Michigan, was an original test site for early public health accreditation efforts, and presented on their experience at a quarterly Tribal Health Director's meeting that Ms. Culfa attended. Donna Norkoli, a Health Educator for the SSM Tribe, attended a grant meeting between the Michigan Public Health Institute and the Robert Wood Johnson Foundation where public health accreditation was a key agenda item.  She brought the possibility of public health accreditation to the Community Health Leadership Team.  During a CDC Tribal Consultation Meeting, public health accreditation was brought up by CDC staff.  There, the Health Director met a staff member from the National Indian Health Board (NIHB).  NIHB was in the initial planning stages of its Tribal Accreditation Support Initiative (Tribal ASI).  The program publically launched in November, 2014, and offered small competitive awards to Tribes working on public health accreditation.  According to Ms. Culfa, an elected SSM councilwoman and former NIHB Board of Directors Chairperson, Cathy Abramson, "encouraged us to apply for the NIHB grant."

With the buzz of public health accreditation all around and in the ears of Community Health staff, the Health Division Director and the Leadership Team, the next step was to make the decision whether to move forward with accreditation or not.  According to the Health Director, the Leadership Team was "already familiar with [healthcare] accreditation" and committed to quality improvement.  Pointing out that AAAHC does not clearly cover public health services, pursuing public health accreditation was a "natural next thing to do."   "When a good idea comes along, we tend to move on it," says Colleen Commons, Health Education Supervisor.  She describes SSM Tribe and the Tribal leadership as being "really progressive" on health and education.  Gaining support for the idea of accreditation was not as much of an issue as "finding the time and having enough people to do the work."  SSM received the Tribal ASI award from NIHB in February, 2015, and as Ms. Culfa describes, "this was where we initially got our feet wet." 

  

SSM is currently working on three documents, their community health assessment (CHA), community health improvement plan (CHIP), and strategic plan, otherwise known as the pre-requisites for applying for public health accreditation.  Given other projects starting around the same time and the short 4½ month grant period, "we were scrambling at the beginning.  Some of our processes are very slow and take a long time to get rolling," says Culfa.  A new staff member, Tyler LaPlaunt was hired to link several existing recent health assessments and annual Strategic Community Action plans into the CHA and CHIP.  The Michigan Public Health Institute was contracted to guide the division in updating their strategic plan, which was 15 years old.  The accreditation team very much appreciated the commitment of two Health Board members and the Tribal Chairman who participated in the strategic planning meeting.   Ms. Culfa described the strategic planning process as challenging, but rewarding.  "It was beneficial to see my staff in different roles and articulating opinions. Everybody was getting involved and speaking up."

 

Although still early on in the public health accreditation process, the SSM accreditation team has some words of advice for other Tribes who may just be beginning the conversation about public health accreditation in their own communities.  First, find the champion.  "Find someone who wants to champion and can get behind the benefits of accreditation," says Culfa, "and then approach leadership."  The level of excitement of that champion is also important.  Having learned the hard way, SSM also recommends forming a steering committee right away.  One invaluable member of their steering committee is their Operations Manager, Joel Lumsden, who has years of experience with coordinating their current AAAHC and CARF accreditation efforts.  Although the standards and measures are different for PHAB, "he sees through an accreditation lens," says Culfa.  Using both existing Tribal and local resources wisely, supporting key people as champions in the process, and making opportunities for leadership participation have all been essential elements of the Sault Ste. Marie Tribe's path to public health accreditation.