Greetings from PHAB,
 
As I write this message, I am in Seattle, Washington, for the 50th anniversary of the Special Olympics Games. What a special time for the more than 3,000 athletes and 1,000 coaches from 51 delegations! And what an important reminder of the work that takes years to accomplish. Of course, I can't help but think about public health accreditation and how much work the accredited health departments have done, how far we have come with the community health assessments and improvement plans, and how much accreditation has improved the image of health departments. You may not feel it, but I see and hear about it every day. Just like the Special Olympics athletes, it's a hard journey for many health departments. But being willing to do that work in pursuit of excellence in practice is important!
 
In this newsletter you will read about PHAB's newest Accreditation Works! stories that just went live on our website this morning. Please check those out, especially if you are working with or for a health department that happens to be wondering whether accreditation matters. You will also read about PHAB's ongoing work in updating our accreditation Standards and Measures (Version 2.0) and how you can stay up-to-date on the topics being considered. Also in this newsletter, we are pleased to unveil a newly published Accreditation Coordinator Handbook.
 
Thanks to all the accredited health departments and to those who are in the process of being reviewed. I am confident that just like these athletes, you will find the work was well worth it in the end.

Kaye Bender, PhD, RN, FAAN,
PHAB President & CEO
Issue #71
July-August 2018 
In This Issue

Kaye Bender, PhD, RN, FAAN

 President and CEO
PHAB
                

PHAB BOARD OF DIRECTORS:  News & Notes 

The PHAB Board of Directors met June 27-28, 2018 in Alexandria, Virginia. PHAB is fortunate to have a dedicated and committed Board that is knowledgeable about public health in general and works hard to ensure that accreditation keeps up with the changing public health landscape.
A highlight of the meeting was the appointment of Bruce Dart, PhD, and Rahul Gupta, MD, MPH, to three-year terms on PHAB's Board of Directors.
 
Dr. Dart 
Dr. Dart has served five local health departments in three states during his 34-year career in public health. Currently, he is the executive director of the Tulsa City/County Health Department, a local public health agency of 340 team members serving a county of over 600,000 people in Oklahoma. Dr. Dart also serves on several National Association of County and City Health Officials work committees and is a NACCHO past-president and former board member. He also serves on PHAB's Accreditation Committee. He is a registered environmental health specialist and former Nebraska Environmental Health Administrator of the Year. He is a "Year 15" graduate of the National Public Health Leadership Institute and his team was co-winner of the Martha Katz award for best project. He has received an appointment as a Visiting Associate Professor in the Oklahoma University College of Public Health and serves on the CASA, MyHealth, and Campaign to Prevent Teen Pregnancy boards of directors in Tulsa. He also chairs the Oklahoma State Health Department's Obesity Prevention Committee as part of the Oklahoma Health Improvement Plan. He holds both a Doctoral Degree and a Master's Degree in health services, as well as a Bachelor's Degree in biology.
 
 
 
Dr. Gupta 
Dr. Gupta serves as commissioner and state health officer at the West Virginia Bureau for Public Health. A practicing internist, he also serves as an adjunct professor in the Department of Health Policy, Management, and Leadership at the West Virginia University School of Public Health and as an adjunct associate professor at the University of Charleston School of Pharmacy. Dr. Gupta earned a Doctorate of Medicine, with subspecialty training in pulmonary medicine, from the University of Delhi and completed his internship and residency training at St. Joseph Hospital/Northwestern University in Chicago. Additionally, he earned a Master of Public Health degree in healthcare organization and policy from the University of Alabama-Birmingham. Dr. Gupta has authored more than 100 scientific publications in medicine and public health and served as a principal investigator for numerous clinical trials. He presently serves as the secretary and ex-officio member at the West Virginia Board of Medicine and as president-elect of the West Virginia State Medical Association. He has also served on several national boards, including the National Association of County and City Health Officials. He also served as a steering committee member at the National Quality Forum on Population Health as well as at the Institute for Health Metrics Evaluation.
 
Outgoing  PHAB Board Chair Bud Nicola, left, passes the gavel to incoming Chair Joe Finkbonner.
 
Also during the meeting, the Board thanked outgoing Board Chair Bud Nicola for his service. Dr. Nicola then  passed the gavel to incoming Board Chair Joe Finkbonner. The Board elected Rex Archer to the role of Vice Chair of the Board, while Paul Halverson was re-elected as Secretary/Treasurer.
 
In addition, the Board heard presentations from Marie Flake (Washington State Department of Health); Charlie Fautin (Benton County Health Department, Corvallis, Oregon); Terry Allan (Cuyahoga County Board of Health, Parma, Ohio); and Lance Himes (Ohio Department of Health) on their multi-year work to test and implement transformation of their public health systems through implementation of the foundational public health services (FPHS) framework. With funding from the Robert Wood Johnson Foundation, PHAB's Public Health National Center for Innovations ( PHNCI) convened the three states in 2015 to form the 21st Century (21C) Learning Community, and helped to advance new phases of their public health systems transformation work.
 
PHNCI Chief Innovations Officer Jessica Fisher, back row, left, pauses for a photo with 21C Learning Community honorees, from left, Marie Flake, Charlie Fautin, and Terry Allan. 
 
The FPHS framework defines a "minimum package of services" that must be available in health departments everywhere for the health system to work anywhere. Later in the summer, PHNCI will host a think tank to further discuss the outcomes from this work, with plans to update the model and its potential uses in fall 2018. Stay tuned to the PHNCI website for further details. The 21C states' work to define FPHS for their individual states and tailored implementation based on their specific needs and contexts are detailed in newly released case studies.  
 
 
 
 
Existing Accreditation Fee Structure to Remain in Place 
During its June 27-28 meeting, the PHAB Board of Directors voted to maintain the existing accreditation fee structure. As such, there will be no increase in accreditation fees for another year (through June 30, 2019). PHAB reviews the accreditation fee structure annually for potential changes that may be required.
 
PHAB NEWS, NOTES & UPDATES 
 
Three More Health Departments Achieve Accreditation in May
PHAB recently awarded five-year accreditation status to Fulton County General Health District in Wauseon, Ohio; Monterey County Health Department in Salinas, California; and Washington County Health Department in Bartlesville, Oklahoma. As of May 15, 2018, a total of 223 health departments (31 state, 191 local, and one Tribal) as well as one statewide integrated local public health department system, have achieved five-year accreditation through the Public Health Accreditation Board.
 
"By putting their work out for peer review, these health departments are bringing new levels of transparency, credibility, and recognition to their mission," said PHAB President and CEO Kaye Bender, PhD, RN, FAAN. "The peer-review process provides valuable feedback to inform health departments of their strengths and areas for improvement so that they can better protect and promote the health of the people in the communities they serve."
 
 

Monterey County Health Department's Planning, Evaluation, and Policy Unit presents the department's official PHAB accreditation plaque to its Board of Supervisors on June 12, 2018, at a ceremony in Salinas, California. The object in the center is the California Endowment's Arnold X. Perkin's Health Equity Award.
 
 
PHAB Continues Work on Version 2.0 of Initial Accreditation Standards and Measures
As PHAB has reported in several prior newsletters, we are working to update the initial accreditation standards and measures to reflect the changing public health practice world. PHAB has set a target date of early 2020 to publish these standards and measures. PHAB will conduct its usual public vetting of those new requirements prior to that time. As we work on the various topics under consideration for updating, we will share (via the PHAB website) various documents such as commissioned papers and summaries of think tanks and expert panels. In recent months, PHAB held the first three Version 2.0 think tanks (see photos below) related to health equity, behavioral health, and performance management/quality improvement.
 
New Graphic: Version 2.0: Work in Progress
Over the coming summer months, a new tab and associated graphic will appear on PHAB's website titled "Version 2.0: Work in Progress." Be on the lookout for this graphic on PHAB's website. The graphic will be used whenever PHAB shares materials related to the development of Version 2.0 of the PHAB Standards and Measures. We will keep the Version 2.0 section separate from the current official accreditation materials so as not to confuse readers. Please keep in mind that just because the materials posted here will contain recommendations for changes to the initial accreditation requirements, it doesn't mean that the recommendations will be included. PHAB just wants to be as transparent as possible about the topics that are being discussed.
 
PHAB appreciates the representatives from the public health field and our various national partners for their help in thinking through these topics during our Health Equity, Behavioral Health, and Quality Improvement/Performance Management think tanks held at PHAB's Alexandria, Virginia office over the past several months.
 
 
 
Health Equity Think Tank, June 19, 2018 
 
 
Behavioral Health Think Tank, May 30, 2018 
     
Performance Management/Quality Improvement Think Tank, April 17, 2018 
 
 
 
Standards and Measures Documentation: Tips for Success
Editor's Note: This is the first in a series of columns in which PHAB staff share tips for successfully demonstrating conformity with various PHAB Standards and Measures. In this inaugural installment, PHAB Chief Program Officer Robin Wilcox discusses measures related to cultural competence and cultural barriers.  
 
A number of measures in the PHAB Standards and Measures address cultural competence and cultural barriers among the population: i.e., cultural competence of the health department's messages for Measure 3.1.1; cultural sensitivity and linguistically appropriate information in Measure 3.2.6; efforts to address cultural and language barriers to care in Measure 7.2.3; and the provision of socially, culturally and linguistically appropriate policies, processes, programs, and interventions in Measure 11.1.4.
 
On the surface, some populations may seem to be homogeneous, and the health department may feel challenged to demonstrate conformity with these measures. However, when multiple aspects of the community are considered, communities are never homogeneous. PHAB recommends thinking "diversity" instead of thinking "homogeneous versus heterogeneous."  Diversity goes beyond race and language to include age (for example, teens and the elderly), educational attainment, income levels, disability, and faith. It can include the geography of neighborhoods, roles in the community, sexual and gender orientation, income levels, levels of social capital, and literacy and health literacy.
 
The more the community appears to be homogeneous, the more challenges the health department may face in reaching out, establishing trust, and developing lines of communication with those that have different social, family, or religious customs or have other barriers to health equity and to the receipt of public health services. There are always opportunities to reach out to diverse groups of individuals in the community. Interacting with diverse groups of individuals is a central responsibility of public health in its work to produce health in communities.
 
If health departments dig a little deeper into their communities, they will find that not everyone is the same. For PHAB measures that address barriers, inequity, and cultural sensitivity and competence, the health department should describe the group(s) that they are reaching out to, partnering with, and addressing with public health efforts.
 

Hot off the Press! New Accreditation Coordinator Handbook Now Available 
A new Accreditation Coordinator Handbook is now available for free download on PHAB's website, and will be available for purchase through PHAB's online store later this week. The Handbook describes the accreditation process and the roles and responsibilities of the Accreditation Coordinator for each step of the process. It includes information about departments' internal processes and tips for preparing accreditation documentation.
 
The Accreditation Coordinator is the health department's staff member who is responsible for coordinating the accreditation process within the department. PHAB requires every health department to have a designated Accreditation Coordinator. Health departments rely heavily on their Accreditation Coordinator to lead the health department's accreditation efforts. The Accreditation Coordinator's effectiveness is critical to the health department's success in achieving accreditation.
 
The Handbook is a companion document to the Guide to National Public Health Department Initial Accreditation  and the PHAB Standards and Measures. The health department must refer to the Guide to National Public Health Department Initial Accreditation for information about the official initial accreditation process, and must refer to the PHAB Standards and Measures for information about the official requirements for receipt of initial accreditation.
 
  
PHAB Receives Inclusive Health Champion Recognition at Special Olympics Inclusive Health Summit 2018
PHAB President and CEO Kaye Bender, left, pauses for a photo with Special Olympics CEO Mary Davis at the Special Olympics Inclusive Health Summit in Seattle on June 30, 2018.
On June 30, 2018 in Seattle, Washington, PHAB was among several organizations to receive recognition from Special Olympics International for being an Inclusive Health Champion. After attending the Special Olympics Inclusive Health Forum in May 2017, PHAB committed to using its national platform to advance an effort to encourage health departments to think about including individuals with intellectual disabilities as they prepare for accreditation. To that end, PHAB has developed a tip sheet for health departments to use as they work to include individuals with intellectual disabilities in their various programs and initiatives. PHAB encourages health departments to consider using examples of population health activities that include people with intellectual disabilities for their documentation, where the accreditation standards and measures lend themselves to doing so.
PHAB is now working with a small number of accredited health departments to showcase their work through case studies. The case studies will be available in fall 2018.
  
 
Public Health Innovation Playbook Launches 
In partnership with the Alliance for Innovation, the Public Health National Center for Innovations (PHNCI) has launched the Public Health Innovation Playbook, an interactive website designed to help teams and individuals undertake and succeed at their own and their health departments' innovation activities. It is intended to be a companion resource to support innovation journeys and to maximize the success of innovation projects. The Playbook is divided into sections reflecting critical elements of the Innovation Framework, with helpful tools and exercises for use. Read the press release for more information, and visit The Playbook today.
PARTNER SPOTLIGHT 


NACCHO Presents 2018 PPHR-PHAB Crosswalk: Connecting Standards-Based Programs  
 
By Emily Blau and Melissa Mayer
   
The National Association of County and City Health Officials (NACCHO) works with the nearly 3,000 local and Tribal health departments across the United States to build public health capacity and capability. NACCHO's capacity-building work covers many subject areas, including performance improvement and public health preparedness. One program that intersects both public health preparedness and performance improvement is Project Public Health Ready (PPHR). PPHR is a criteria-based training and recognition program for local health departments focused on all-hazards preparedness.  
 
Each year, with a team of preparedness experts, NACCHO revises the PPHR criteria to align with other national and federal standards. While PPHR and PHAB are separate standards-based programs with distinct requirements, they share some of the same content, aim to meet similar goals, and are both grounded in continuous quality improvement. NACCHO's Performance Improvement and PPHR teams work closely to best support local health departments pursuing both programs, and to infuse performance improvement principles into all capacity-building activities related to these two programs. In areas including epidemiology, legal and administrative preparedness, and medical countermeasure dispensing, the crosswalk shows where both programs overlap in required documentation. If, for example, an agency effectively responded to PPHR Criteria Element V  "Surge Capacity," they could use similar documentation to meet PHAB Measure 2.3.3 A, "Access to laboratory and other support personnel and infrastructure capable of providing surge capacity." In addition to alignment for specific measures, the crosswalk also notes areas of broad alignment, such as the required workforce development plan, and recommends strategies for developing this documentation in tandem for both programs to reduce duplication of effort. In a recent webinar, NACCHO also provided several coordination and content tips to agencies considering or already pursuing both PPHR and PHAB.
 
Aligning PHAB and PPHR efforts is a great opportunity to reduce documentation burden, strengthen interdisciplinary collaboration, and strengthen your agency's culture of quality improvement. To learn more:
  • Listen to a recent webinar in which NACCHO and PHAB presenters describe each program and identify opportunities for alignment. 
  • Download the crosswalk.
  • Read stories from the field from local health departments that have pursued both programs.
About the authors: Emily Blau is a CDC Public Health Associate stationed at NACCHO and working on emergency preparedness and program evaluation. Melissa Mayer is a Performance Improvement Program Analyst at NACCHO.
 
 
NIHB Recognizes Tribal Health ASI Awardees as Leaders in Public Health Accreditation 
The National Indian Health Board (NIHB) recognized 20 Tribal health departments for their work in public health accreditation during the closing plenary held May 24 at the 2018 National Tribal Public Health Summit in Prior Lake, Minnesota. Engaging in quality improvement activities in preparation for accreditation has helped Tribes identify gaps in their public health services, improve the quality of their services, and improve relationships with states and counties.  
 
With support from the Centers for Disease Control and Prevention, NIHB provides mini-grants to Tribal health departments working on public health accreditation through the Tribal Public Health Accreditation Support Initiative (ASI). For this fourth cohort of Tribal ASI awards, NIHB is providing funding support to assist the Tribes as they work to prepare and apply for voluntary public health accreditation through PHAB.

 
The National Indian Health Board (NIHB) recognized 20 Tribal health departments for their work in public health accreditation during the closing plenary on May 24 at the 2018 National Tribal Public Health Summit in Prior Lake, Minnesota.
 
 

Give Your Feedback on the Health Equity Guide!
Human Impact Partners (HIP) is evaluating its Health Equity Guide to assess how people are using the resource and what they can do to improve it. The Health Equity Guide website is a great resource for health departments seeking to advance health equity, and includes many case studies and resources. If you have visited the website, please take 15 minutes to give your feedback! (If the link doesn't work for you, you can copy/paste the URL to your browser: https://www.surveymonkey.com/r/WFGDHW5.
 
Everyone who uses the Guide is encouraged to take the survey, although HIP is particularly looking for feedback from health department staff. Everyone who completes the survey before August 31 will be eligible for HIP's raffle of 5 hours of free TA on health equity organizational development. Click here to complete your survey now!
PHAB STAFF CORNER

Chelsey Saari Joins PHAB as an Accreditation Specialist 
 
PHAB is pleased to welcome Chelsey K. Saari to the PHAB staff. In her new role as an Accreditation Specialist, Chelsey will work collaboratively with PHAB's staff of skilled Accreditation Specialists in handling the technical, review, and logistical aspects of PHAB's national accreditation process.  
 
Chelsey brings a wealth of public health department and accreditation experience to her new role. Prior to joining PHAB, she spent six years at the Kent County Health Department in Grand Rapids, Michigan, serving as a Public Health Program Supervisor, Accreditation Coordinator, and Academic Health Department Liaison. Prior to that, she spent two years as a CDC Public Health Associate at the Cuyahoga County Board of Health in Parma, Ohio.  
 
"During my time at Kent County I had the privilege of meeting and working with many of the PHAB staff as an Accreditation Coordinator and as a Site Visitor, so it was a no-brainer to join this team when the opportunity presented itself," Chelsey says.
 
A native of New Lothrop, Michigan, Chelsey holds a Master of Public Health degree from Des Moines University. She earned her undergraduate degree from Saginaw Valley State University, where she studied psychology and health sciences. She is presently working toward a doctorate degree in Public Health Leadership from the University of Illinois at Chicago.
 
In January, Chelsey and husband Kyle welcomed a son, Marek, into the world. The couple also has two "fur kids," Chelsey notes, referring to an 8-year-old Goldendoodle named Henry and a 6-year-old Cavalier King Charles Spaniel named Dexter. 
WORD ON THE STREET: A Round-Up of Accreditation Questions & Answers
 

1. I was surprised to see the names of two health departments listed on the PHAB website as "Health Departments Reviewed: Not Accredited."  When did PHAB begin to list "Not Accredited" health departments on its website?
 
As an accrediting body, PHAB must list the names of health departments whose documentation has been submitted and reviewed and has not achieved accreditation, as part of our accreditation decisions. PHAB began listing "Not Accredited" health departments when the first health department decision of "Not Accredited" was made by the Accreditation Committee. The Accreditation Committee can designate a health department as "Not Accredited" for one of several reasons: not completing the required steps to achieve accreditation (after documentation is reviewed by site visitors); completing an Action Plan unsatisfactorily; or not demonstrating implementation of an Action Plan. Also, failure to go through the reaccreditation process and maintain accreditation status can cause a health department to be listed as "Not Accredited."
 
 
2. I am confused about some of the health departments that PHAB has accredited. It seems to me that PHAB isn't looking deep enough into a health department's work when it makes its accreditation decisions.
 
PHAB's accreditation decisions are based on peer review of the documentation submitted by the health department against the PHAB Standards and Measures and the observations and discussions conducted during the site visit. Every attempt is made during the site visit to obtain responses to any questions the reviewers may have; to validate the documentation provided; and to get an overall picture of the operations of a health department. The Accreditation Committee cannot legally consider any other information in their deliberations. If you feel that PHAB needs to consider changes to its accreditation Standards and Measures to be more robust, please follow our work as we develop Version 2.0.  PHAB will consider revisions during that time frame.
 
3. Who at PHAB may 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, Triona Gateley, Jennifer Jimenez, Chelsey Saari, or Brittan Williams, Accreditation Specialists, to talk about the accreditation process for health departments. Marita may be reached at mchilton@phaboard.org or 703-778-4549, ext. 114; Triona may be reached at tgateley@phaboard.org or 703-778-4549, ext. 124; Jennifer may be reached at jjimenez@phaboard.org or 703-778-4549, ext. 107; Chelsey may be reached at csaari@phaboard.org or 703-778-4549, ext. 130; and Brittan at bwilliams@phaboard.org or 703-778-4549, ext. 115.
 
April Harris, Accreditation Specialist, to talk with accredited health departments about maintaining accreditation and to assist accredited health departments as they prepare for reaccreditation. She may be reached at aharris@phaboard.org or 703-778-4549, ext.125.
 
Catrina Kerrison, Executive Assistant, Office Coordinator, to talk about general office inquiries and questions related to PHAB's governance. She may be reached at ckerrison@phaboard.org or 703-778-4549, ext. 100.
 
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, Education Services Manager, 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.
 
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, PHAB's E-Newsletter, website issues, PHAB's online store, marketing, and promotions. She may be reached at tnicolaus@phaboard.org or 703-778-4549, ext. 118.
 
Jessica Solomon Fisher, Chief Innovations Officer, Public Health National Center for Innovations at the Public Health Accreditation Board, to talk about all matters related to the Center. She may be reached at jfisher@phnci.org or 703-778-4549, ext. 116.
 
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 suggestion for a future segment of Word on the Street, please send it to PHAB E-Newsletter editor Teddi Nicolaus. The PHAB E-Newsletter is published on a periodic basis. Click here to subscribe. Learn more about PHAB at www.phaboard.org


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