Accreditation program for health departments launches: Voluntary program to drive improvement ============================================================================================= * Teddi Dineley Johnson Marking a major milestone for public health, a national program to accredit the nation’s health departments launched in September. After years of planning, the much-anticipated accreditation program ushers in a new era for public health in the United States. With the goal of protecting and improving Americans’ health, accreditation is expected to advance the quality and performance of all of the nation’s health departments. The program — developed collaboratively by hundreds of public health practitioners, researchers and educators — sets measures and standards by which more than 3,000 state, local, territorial and tribal health departments can improve their services, value and accountability. “This is truly a transformational change in public health,” said APHA member William Riley, PhD, chair of the board of directors of the Public Health Accreditation Board, at a Sept. 14 news conference in Washington, D.C., launching the accreditation program. “It is time to initiate a process by which we can collectively educate others about what we do and to invite them to engage with us in various ways to make it better.” With health departments’ budgets shrinking and the challenges in front of them growing, the importance of having an operational “road map” has never been greater, public health leaders say. By bringing transparency and accountability to their stakeholders and the public, accreditation is expected to drive quality and performance improvement in all of the nation’s public health departments as they strive to not only meet the standards, but exceed them. According to public health leaders, the standards will set a new baseline of quality, allowing the public to have access to the same range and quality of health services no matter where they go in the country. “Accreditation is a landmark accomplishment for public health,” said APHA Executive Director Georges Benjamin, MD, FACP, FACEP (E). “The standards and measures will serve as a blueprint for what governmental public health departments should assure and stimulate innovation as they work to meet their communities’ health needs in the best and most efficient ways.” Accreditation standards and measures will help health departments establish a strategic direction that is consistent with national public health standards, giving them access to peer experts in the field who will review their work and give them recommendations about how to improve it, said APHA member Kaye Bender, PhD, RN, FAAN, president and CEO of the Public Health Accreditation Board, the nonprofit organization that oversees the voluntary accreditation program. ![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/41/9/1.3/F1.medium.gif) [Figure1](http://www.thenationshealth.org/content/41/9/1.3/F1) From left, ASTHO Executive Director Paul Jarris and APHA Executive Director Georges Benjamin at the program launch. Photo by Teddi Dineley Johnson “This is a process that is based on quality improvement, and the greatest benefit for health departments to be accredited is to tell their constituents — the people they serve — that ‘we want to serve you in the best way that we can,’” Bender said, noting that the board hopes to award its first health department accreditations as early as summer 2012. Within two weeks of the program’s launch, 17 health departments had submitted applications and were starting to move through the accreditation process, she told *The Nation’s Health*. “We are very excited to actually begin the work with each health department that will apply for accreditation,” Bender said. Upon applying for accreditation, health departments will have up to one year to submit their documentation, Bender said. Health departments that have assembled all of the necessary materials at the time of application will likely be able to go through the process in about 12 months, while others may take longer, Bender said, noting that health departments will have to reapply for accreditation every five years. By 2015, the Public Health Accreditation Board aims to have 60 percent of the U.S. population served by an accredited public health department. Public health departments that want to begin the journey toward accreditation are instructed to visit the Public Health Accreditation Board’s website and complete a mandatory online orientation module. To help health departments determine if they are ready to begin the application process, the site features accreditation readiness checklists that address eligibility, completion of prerequisites, internal processes and preparation tasks. Paul Jarris, MD, MBA, executive director of the Association of State and Territorial Health Officials, said his organization strongly recommends that state and territorial health agencies attain national accreditation and that he is “very pleased” with the initial response. “Our expectation is that over the next number of years, all state health agencies will go through the process,” Jarris told *The Nation’s Health*. Citing the 2010 ASTHO Profile Survey, Jarris said 72 percent of state health agencies indicated they intend to seek accreditation. Of those, nearly half plan to seek accreditation within the first two years of the program. The collaborative manner in which the accreditation program was developed has helped to create a sense of “ownership” of the program within the public health community, said Jarris, who is an APHA member. “By having such an inclusive process involving both the academic community, the funders and, most importantly, having such an extensive involvement of the practice community, there is this great ownership for public health accreditation among the practice community,” Jarris said. “So there is not a feeling of ‘this is being done to us by someone else.’ There is a feeling that ‘this represents the best work of public health, and we want to be part of it.’” In development for four years, the accreditation program is supported by a range of public health organizations, including APHA. Funded by the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, the accreditation program was tested by 30 health departments over a 15-month period that concluded in December. During the test, health department test sites evaluated themselves based on accreditation standards, measures and processes developed through a national vetting process that garnered nearly 4,000 comments from public health practitioners in 2009. California Department of Public Health Director Ron Chapman, MD, MPH, served on the Public Health Accreditation Board’s first beta test site team, visiting a health department in rural Oregon in 2009. “It made me a believer in public health accreditation,” Chapman said, noting that he is now mobilizing his own health department to create a plan that will position it for accreditation. “The strategic plan has quality improvement as a key element,” Chapman said. “I’m a big fan of quality improvement. I believe that quality improvement is going to strengthen our California Department of Public Health. I believe it is going to enhance our business operations and enhance the delivery of public health to the people of California.” Chapman said he sees accreditation as a road map to the future, “and when I look through the lens of accreditation, I see a very bright and promising future for California and the nation.” For more information, visit [www.phaboard.org](http://www.phaboard.org) or email info{at}phaboard.org. * Copyright The Nation’s Health, American Public Health Association