A national program to accredit the nation’s health departments, which is expected to transform the delivery of community health services, is on target to launch this fall.
The Public Health Accreditation Board, the nonprofit organization that is spearheading the voluntary accreditation program, recently completed a nationwide pilot test, putting it another step closer to its goal of accrediting all of the nation’s health departments.
In December, the board completed a 15-month “beta test” of the accreditation program. Thirty public health departments across the United States served as test sites, evaluating 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. Feedback from the test sites is now being used to refine and tailor the accreditation program, which is set to officially launch later this year.
“Accreditation is a major accomplishment for a health department,” Thomas Frieden, MD, MPH, director of the Centers for Disease Control and Prevention, said in a March statement. “It means that it is addressing key community health problems. Just as the public expects hospitals, law enforcement agencies and schools to be accredited, so should they come to expect public health departments.”
CDC and the Robert Wood Johnson Foundation are funding the accreditation effort, which has a goal of improving and protecting the health of every community by advancing the quality and performance of all public health departments. The effort is supported by APHA and many other organizations, including the Association of State and Territorial Health Officials and the National Association of County and City Health Officials.
To prepare health departments for the voluntary program’s anticipated fall launch, the Public Health Accreditation Board expects to release a range of materials in early summer that will help health departments gear up for the accreditation process, including the first version of the standards and measures, application information and a fee schedule for 2011–2012.
The preparation of health departments for accreditation remains vital to the success of the national program, said APHA member Kaye Bender, PhD, RN, FAAN, president and CEO of the Public Health Accreditation Board.
“Health departments vary significantly in the services they provide and the way they carry out the services, and that has been exacerbated by the economic issues facing health departments today,” Bender told The Nation’s Health. “The accreditation program, through its standards and measures, describes what a governmental public health department should assure.”
Health departments may not directly provide all the services described in the standards, Bender said. But they need to know who does provide the services, as some health departments contract the work out, or partner with other organizations to ensure that the services are provided.
“So these standards and measures become like an operations manual or a road map for what a health department should do,” Bender said. “And it is even more important during these tough economic times, because health departments are struggling to keep their identity and also to educate the public about what they do.”
The 30 agencies that tested the accreditation process — 19 local, eight state and three tribal health departments — “overwhelmingly said that most of the tools and the process that had been developed were about right,” Bender said.
“We believe that the beta test for the most part taught us we were pretty well on track,” she said.
Pilot test work pays off for participants
Though the test sites did not receive accreditation, they are already benefiting from the results, Bender said. For example, serving as a test site opened Oklahoma State Department of Health leaders’ eyes to new opportunities in the areas of collaborative planning and community engagement.
Participants at a vaccination event held by the Comanche County Health Department in Oklahoma pose for a photo. The health department was one of 30 agencies that helped test a forthcoming program that will accredit health departments.
Photo courtesy Comanche County Health Department
“The standards and process overall were set up very well,” said Joyce Marshall, MPH, performance management director for the Oklahoma State Department of Health. “Additionally, based on the identification of areas where improvement could be made when compared to the Public Health Accreditation Board standards, in just a few months several of our county health departments initiated efforts that produced significant increases in community partners attending health planning meetings as well as improvements in the effectiveness of those meetings as rated by the coalition partners.”
Marshall said she will encourage health departments to look seriously and critically at accreditation, and to apply when the opportunity presents itself, “as it is a unique opportunity to evaluate the effectiveness and efficiency of our services to a national standard while meeting agency strategic priorities and goals.”
Another test site in Oklahoma, the Comanche County Health Department, learned from the self-assessment that it needed to take a critical look at how it was executing public health on the local level.
“I’m excited for the opportunity to be able to really say that we can meet national standards,” said Keith Reed, MPH, CPH, administrative director at the Comanche County Health Department. “We haven’t been able to provide evidence to our community partners that we can meet national standards, and with accreditation, we will be able to.”
Most of Oklahoma’s health departments are centralized — or state-run — agencies, Reed said.
“In a centralized state, it was kind of easy for us to assume we were meeting all of our local responsibilities, but the self-assessment really forced us to re-evaluate that and to ensure that we were indeed meeting our local responsibilities.”
In early March, the National Opinion Research Center at the University of Chicago completed its formal evaluation of the “beta test.” Findings from the 256-page report will be synthesized and released in a future report.
“We want to finish the story, not only tell what we learned from the ‘beta test’ but what changes in the program resulted from that,” Bender said.
By 2015, the Public Health Accreditation Board aims to have 60 percent of the U.S. population served by an accredited public health department. Health departments will have to reapply for accreditation every five years.
For more on accreditation, visit www.phaboard.org.
- Copyright The Nation’s Health, American Public Health Association
