Category Archives: Accreditation
Over 100 health departments have engaged with the Public Health Accreditation Board on their accreditation journey, according to PHAB CEO Kaye Bender in an email exchange with NewPublicHealth, and more health departments enter the system each week. “One year post launch of voluntary national public health department accreditation, PHAB is excited about the progression of health departments through the process,” Bender wrote. “The first site visits began last month, and more are scheduled. We expect to announce the first accredited health departments in early 2013!”
At the recent APHA 2012 conference, representatives from California’s state and local health departments led a session offering their peers a first look at the accreditation process underway in California. As PHAB states, “the goal of national public health accreditation program is to improve and protect the health of the public by advancing the quality and performance of all health departments in the country – state, local, territorial and tribal.” All of the California representatives made a case for why accreditation is a priority for their respective departments.
“Accreditation equals opportunity,” said Dr. Ron Chapman, California Department of Public Health director. “Quality improvement is about problem solving. Infuse quality into what you do every day and you will see transformation.”
>>Watch a VIDEO with Ron Chapman about new opportunities to transform public health by making quality improvement a way of life.
Dr. Alonzo Plough, Emergency Preparedness and Response Program director for the Los Angeles County Public Health Department, said accreditation’s quality improvement standards align well with the “triple aim” goals of: improving patients’ experience of care, improving the health of populations and reducing the cost of health care.
Plumas County Public Health Agency director, Mimi Hall, talked about how building relationships with local hospitals and community and business leaders can help meet public health goals.
“We have to redefine the role of public health and work with outside organizations to get the best benefit for the community,” said Hall. “Accreditation pulls it all together.”
Several sessions at this year’s American Public Health Association meeting include brass-tacks guidelines for initiating and furthering partnerships between public health and hospitals to improve community health. In a session yesterday, Michael Bilton, who co-founded and leads the Association for Community Health Improvement of the American Hospital Association, spoke about the value of partnerships between public health and hospitals, since both have requirements to complete similar community needs assessments.
Health departments seeking public health accreditation must complete a community needs assessment, and non-profit hospitals must complete community benefits reports every three years under the Affordable Care Act.
Bilton pointed out that for many communities, the collaboration won’t be one that starts from scratch. San Francisco has had a community benefit requirement for non-profit hospitals since 1994, “which promoted a sense of collaboration in many communities,” Bilton told the audience at the APHA session.
Bilton says the collaboration also aligns with the National Prevention Strategy, released by the Surgeon General last year, which is promoting partnerships across federal agencies to improve community health.
>>Read an interview series on the National Prevention Strategy on NewPublicHealth.
Bilton says the Strategy specifically points to community needs assessments as a way to identify and begin working on many of the priorities in the Strategy. “And those priorities have already been identified by many hospitals,” says Bilton. The joined forces of hospitals and public health departments also help achieve the “triple aim” of additional goals stressed in the Affordable Care Act including improving improving care, improving health care quality and reducing costs. These collaborations underscore the notion that helping to manage population health is the role of hospitals as well, said Bilton.
Bilton advised public health officials anxious to collaborate with hospitals on community benefit requirements to do several things including:
- Become acquainted with hospital regulations
- Approach hospitals as early as possible in your process
- Find out who is leading the assessment
- Ask hospitals about their assessment process and goals
- Offer to help hospitals with with data, communications, facilitation or staff expertise, as appropriate
- Balance short term needs such as fulfilling IRS or accreditation requirements with longer term opportunities—sustained health improvement collaboration.
>>Bonus Link: Read a NewPublicHealth interview with Laurie Cammisa from Children's Hospital Boston on community benefit collaboration.
The Office for State, Tribal, Local and Territorial Support (OSTLTS) at the Centers for Disease Control and Prevention (CDC), was launched in 2009 as a central office dedicated to advancing public health at the state and local levels and identifying both gaps and opportunities for collaboration. Judith Monroe, the office's director, spoke to us last year about challenges facing health departments in a tough time. Recently, at the ASTHO Annual Meeting, we had a chance to catch up with Dr. Monroe to hear what she and her office have been up to since we last spoke in the summer of 2011.
>>Read our earlier Q&A with Dr. Monroe.
NewPublicHealth: The focus of the ASTHO annual meeting this year is on the intersection of health care and public health. What efforts is CDC engaged in right now in that intersection?
Dr. Monroe: We’ve been involved in a number of areas. The IOM report on the integration of primary care and public health, was co-funded by the Health Resources and Services Administration and CDC. And CDC had a seat at the table when ASTHO and the IOM came together to develop the strategic map for the integration. We’re excited about that and we continue to be on those calls.
We have an office here at CDC recently created called the Office of Prevention Through Healthcare that is looking at this intersection and where the gains might be, working with the Centers for Medicare and Medicaid Services very closely. And, in addition, our office—the Office of State, Tribal, Local and Territorial Support—has forged a relationship with all of the primary care residency programs across the nation. That’s dear to my heart because I was a residency program director in family medicine for a number of years. We’ve had a number of educational venues taking the science from CDC and packaging it in a way that the residency programs can use. We’re looking toward some quality improvement projects with the residency programs as well as “playing matchmaker” in many ways, between health departments and residency programs. And, I am the point person here at CDC for our relationships between the American Academy of Family Physicians and the American College of Physicians so we have a lot going on. Those are the biggies, but there are many daily activities taking place as well.
NPH: Thank you for that overview. Since you’ve been at OSTLTS, what are some successes that you’d point to?
This summer, Paul Kuehnert, MS, RN, joined the Robert Wood Johnson Foundation (RWJF) as senior program officer and director of the Foundation’s Public Health Team. For nearly 20 years, Kuehnert has provided executive leadership to private and governmental organizations to build and improve systems to address complex health and human services needs. As the county health officer and executive director for health for Kane County, Ill, he led public-private partnerships, integrated planning with transportation, land use, parks and recreation and other diverse sectors, and a comprehensive wellness program for government workers that resulted in demonstrable improvements to the health of employees – as well as marked cost savings [watch an RWJF Public Health in Action video profile of Kuehnert].
NewPublicHealth caught up with Paul Kuehnert during the National Association of County and City Health Officials Annual Meeting this week to talk about the future of public health, and what his decades of leadership in government and private organizations to improve health has taught him.
NewPublicHealth: You were a health director at a time of great change in public health, and that includes massive budget cuts and incredibly rising rates of chronic disease, all creating a very challenging environment. How did that shape your approach to leadership at Kane County and how do you think it will inform what you’ll now be doing in your position?
Paul Kuehnert: I think we’re living through a time that there’s this incredible convergence of the recession, the epidemic of chronic diseases and other situations that all present challenges for public health. As a local public health leader, the key thing was to really develop a strategic focus and to find ways to engage policymakers and other community leaders and partners. That was and is so critical because I think what we have to do in these times is really sort out what it is that public health, and in particular, governmental public health really has to do in order to meet these challenges. And, what is it that other partners can do or, in fact, may do better than governmental public health, which has to be an excellent steward of the public resources. Governmental public health has to be really well versed in what the evidence is for the kinds of things that we’re doing, and be mindful of being very accountable and very transparent in the community as relatively scarce dollars are used to provide services to the community.
Those are the issues that were key for me when I was a local health director, and I think what that does for me in my new position at the Robert Wood Johnson Foundation is that it has really grounded me in the reality that these are very different and very difficult times for public health. So, I would say the same things that were true for me as a local health director really have to be true for Robert Wood Johnson Foundation as well. We need to be strategic, we need to be focused, we need to engage policymakers and stakeholders in our work and we need to be very transparent about what we’re doing. So, I feel like my recent experience, in the trenches really provides a grounding for me in this new position.
NPH: Partnerships are critical to the future of public health and health departments. What partnerships did you develop or advance that were most critical to the success of public health endeavors in Kane County?
National Public Health Accreditation launched last fall, and since then 64 local health departments, three tribal health departments and one state department have submitted applications to the National Public Health Accreditation Board (PHAB). Carol Moehrle, chair of PHAB and director of public health for the Idaho North Central District, spoke about the accreditation process and benefits during a keynote speech at the Keeneland Conference. NewPublicHealth caught up with Carol Moehrle during the meeting.
NewPublicHealth: Are you pleased with the number of applicants you’ve seen so far?
Carol Moehrle: We are pleased. We knew we’d have some early adopters. And to have 68 complete their applications with the last seven months, that’s a great start. We’ve got a long way ahead, but we also know we have many applicants in the queue waiting to apply. We’re hearing lots of good energy, and departments beginning the process now can look to the earlier applicants for best practices, so applying will be easier as time goes on.
NPH: What is the process and timetable for accreditation application review?
This year’s APHA meeting is the first one since the launch of the Public Health Accreditation Board’s (PHAB) national, voluntary accreditation program for state, local and tribal health departments. At past APHA meetings, attendees have gotten previews on the accreditation standards and rollout plans. This year, it’s finally time to learn how health departments are starting to get organized and ready to apply for accreditation—and what PHAB has been hearing as the program gets underway. Several state health department representatives shared their accreditation plans and activities to date at a session here this morning.
Jack Wilson, from the New York State Department of Health, told attendees that his department is using a strategic planning tool traditionally used in the private sector to align its specific strategies (enforce public health laws, maintain a competent workforce, promote tools to improve health, etc.) to PHAB’s domains. The health department recognizes that it has many disparate programs and initiatives that would benefit from being aligned with larger strategic goals. Despite progress, though, Wilson said that the strategic planning process is time-intensive and can be derailed by unexpected events like this summer’s Hurricane Irene damage in upstate New York.
“The Kentucky accreditation train has departed!” said Rona Stapleton from the Kentucky Department of Public Health(KDPH), sharing that her department plans to apply in 2014. In spring 2010, with help from ASTHO staff and an ASTHO grant, KDPH began developing a plan to sell the idea of accreditation internally; pull together a readiness team; and design a logic model for meeting accreditation goals. Stapelton said she and her colleagues reached out to ASTHO, NNPHI and others who could share best practices so that the department could take advantage of work that had already been done.
Today the Public Health Accreditation Board (PHAB) launched the first national accreditation program for local, tribal and state public health departments with a press conference at the National Press Club in Washington, D.C. The goal of the accreditation program, which was initiated and supported by the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention (CDC), is to protect and improve Americans’ health by advancing the quality and performance of all of the nation’s public health departments.
“PHAB’s vision for accreditation is to create a reliable national standard for public health,” said Kaye Bender, R.N. , Ph.D, FAAN, President and CEO of PHAB. “PHAB supports health departments in achieving this standard by recognizing the important work they do and by providing support to improve their services.”
National public health accreditation, says Bender, will provide consistent standards so that people in different states and towns have access to the same range and quality of services. Watch an interview with Kaye Bender on the launch of national public health department accreditation:
“With shrinking budgets and a growing number of health challenges to address, there has never been a more important time for public health departments to focus on the best and most efficient ways to keep people healthy,” said James Marks, M.D., MPH, Senior Vice President and Director of the Robert Wood Johnson Foundation’s Health Group. “We believe that accreditation can ensure a strong, transparent public health system and therefore a healthy nation." Watch an interview with James S. Marks on the importance of national public health accreditation to communities:
James Marks, Kaye Bender and Judith Monroe, M.D., F.A.A.F.P., Director of the Office for State, Tribal, Local and Territorial Support at CDC were among the presenters at the accreditation launch to be held at the National Press Club in Washington, D.C., today. Other speakers included health department officers who have already completed many of the steps needed to apply for public health accreditation within the next few months. Their comments include:
- “We are going to use our accreditation credential to show our community that we’re worthy,” said Torney Smith, M.S., Administrator, Spokane Regional Health District, Spokane, Washington.
- "We strive to have a healthy and happy Cherokee nation and a major component of that is advancing the quality and performance of our public health activities," said JT Petherick, J.D., M.B.H., Health Legislative Officer, Cherokee Nation Health Services, Tahlequah, OK.
- "Accreditation is an important tool to use to help build across jurisdictions. Success of public health will be if we use the [accreditation] process to drive performance improvement and along with that are transparent and accountable to others. The potential for future impact from public health accreditation is tremendous," said Paul Jarris, M.D., Executive Director, Association of State and Territorial Health Officers.
- “It’s my hope accreditation will never become an end in itself and that we all will improve the process over time… because the circumstances of protecting us and keeping us safe change over time,” said Bobby Pestronk, M.P.H, Executive Director, National Association of County and City Health Officials. “And I hope accreditation will help others in the community recognize the importance of health departments.”
Watch a Public Health in Action video showcasing health departments working toward health department accreditation:
Since 2004, North Carolina has been the only state in the U.S. to have mandatory public health department accreditation, requiring local departments to meet standards set by the North Carolina Division of Public Health. Recently, staff members of the North Carolina Institute For Public Health published an article in the American Journal of Public Health about the process and value of local public health department accreditation.
For the study, 48 accredited health departments were surveyed on the impact of accreditation and the benefits and barriers related to the process. Half of the public health departments surveyed reported that they acted on suggestions for improvement received during the accreditation process, and 67 percent conducted quality improvement activities, according to the report. The authors say study results can benefit other states now considering national accreditation through the Public Health Accreditation Board.