Greetings from PHAB,

The summer of 2017 ended with some significant damage in several parts of our country due to hurricane-related activity. PHAB has been impressed, but not surprised, at the outstanding response the public health community has amassed. There are no better times than these to recognize the importance of strong health departments in protecting the health of their communities, even when they are also dealing with loss or damage to their own homes, families, and the overall infrastructure. PHAB extends its warmest congratulations on a job well done to those who have already met many challenges and our thoughts of encouragement to those who are still working to restore healthy living conditions in their jurisdictions.
These situations serve as reminders to us that public health constantly faces challenges and barriers to ensuring the conditions in which people can be healthy. Whether the issues are environmental, behavioral, political, financial, or all of the above, health departments are called upon on a regular basis to find innovative and creative ways to accomplish their goals. PHAB has been asked recently if we plan to keep the accreditation standards and measures fresh and updated as public health experiences changes. You will read more about those plans in this newsletter, as well as about current initiatives to customize our accreditation products for a varied array of potential applicants.
PHAB continues to strive to be a strong, credible national accrediting body that recognizes strong, nimble health departments that work every day to create optimal public health for all!

Kaye Bender, PhD, RN, FAAN
President & CEO, PHAB
Issue #69
October/November 2017
In This Issue
Kaye Bender, PhD, RN, FAAN
President & CEO, PHAB
Dr. Scutchfield
PHAB Honors Dr. F. Douglas Scutchfield
PHAB's Accreditation Committee is a pivotal part of the accreditation process. Composed of both PHAB Board of Directors members and non-board members, this committee has worked hard since 2012 reviewing site visit reports and making accreditation decisions. One individual has chaired this important work since its inception. F. Douglas Scutchfield, MD, a member of the PHAB Board of Directors and Professor of Health Services Research and Policy at the University of Kentucky Colleges of Public Health and Medicine in Lexington, served as the inaugural chair of this committee from 2012 until now. Dr. Scutchfield will rotate off the PHAB Board and the Accreditation Committee at the end of this calendar year. When the Accreditation Committee met in September 2017, they presented "Scutch" with a crystal replica of the health department accreditation plaque to commemorate his service to PHAB and to health departments going through the accreditation process. Thank you, Dr. Scutchfield, for your leadership and guidance in establishing this most important body of work!
PHAB Board Presents Resolution at ASTHO Annual Meeting
At the 2017 annual meeting of the Association of State and Territorial Health Officials (ASTHO) in September, PHAB Board of Directors members Dr. Terry Cline and Dr. Paul Halverson, and PHAB Accreditation Committee member Mary Selecky, presented a resolution commending ASTHO for its commitment to public health and accreditation. PHAB appreciates ASTHO's work in establishing PHAB and national accreditation and in providing technical assistance to the 39 state health departments active in the PHAB system. To date, 28 state health departments have achieved PHAB accreditation, and 11 state health departments are in the process.
Also during ASTHO's Annual Meeting, PHAB Board of Directors ex-officio member Georges Benjamin, MD, Executive Director of the American Public Health Association, received ASTHO's Ed Thompson 2017 Lifetime Achievement Medal for his important legacy in the advancement of public health for the nation; and PHAB Board of Directors ex-officio member Paul Jarris, MD, March of Dimes Chief Medical Officer and former Executive Director of ASTHO, received ASTHO's 2017 Alumni Award for his continued commitment to public health. PHAB congratulates Dr. Benjamin and Dr. Jarris on receiving these awards.

Benefits of PHAB Accreditation Now Reaching 66 Percent of U.S. Population
Demonstrating a consistent and continued commitment to improving public health in their communities, nine governmental public health departments in September were awarded five-year accreditation status through the Public Health Accreditation Board (PHAB). These accreditation decisions mean that the benefits of being served by a PHAB-accredited health department now extend to more than 203 million people, or 66 percent of the U.S. population.
National accreditation status was awarded September 13, 2017 to:
*          Allegheny County Health Department, Pittsburgh, Pennsylvania
*          Arizona Department of Health Services, Phoenix, Arizona
*          Benton County Health Department, Corvallis, Oregon
*          Butte County Public Health Department, Oroville, California
*          Camden County Health Department, Blackwood, New Jersey
*          Lincoln County Health Department, Merrill, Wisconsin
*          Mississippi State Department of Health, Jackson, Mississippi
*          Nassau County Department of Health, Mineola, New York
*          North Central Public Health District, The Dalles, Oregon

The Mississippi State Department of Health in Jackson, Miss., was among nine health departments awarded five-year accreditation status in September. Pictured above, the health department's Office of Performance Improvement team poses with the new banner they created to announce their achievement.

Preparations Underway for Version 2.0 of the Standards and Measures
PHAB is continually working to ensure that the accreditation requirements are current with state-of-the-art public health practice, as public health evolves in our science base and best-practice identification. The process for doing that will result in Version 2.0 of the accreditation standards and measures. We want to ensure Version 2.0 takes into account what we've learned from PHAB's first 10 years as well as from the broader research and practice community.
Here is a brief summary of the steps PHAB plans to take during the next two years:
  • A review of the published and gray literature is being conducted to identify potential topic areas in the accreditation standards and measures where the science base has changed or the best practices have evolved.
  • Now that PHAB has a large and varied number of accredited health departments, we have also initiated tracking the psychometrics of the measures to see how health departments perform, as well as how well the measures actually measure what they were intended to measure. We will also review questions and feedback PHAB has received about specific measures. PHAB will use these analyses as indicators of measures that may need to be reviewed for revision.
  • PHAB is identifying topic areas for which additional information or conversation is needed in order to consider revisions. Depending on the topic area, PHAB will either commission papers on the topics and/or will convene think tanks or expert panels to explore potential revisions.
  • When all of the above work has been completed, PHAB will prepare a draft of Version 2.0 of the accreditation standards and measures for public vetting. The estimated time frame for this part of the work is late 2019/early 2020.
Stay tuned to future PHAB newsletters for additional reports, requests for feedback and input as the work progresses. PHAB continues to value and seek input from the field as we work to ensure that the accreditation requirements are relevant to contemporary public health practice.

Update on Customized Accreditation Support Materials and Documents
The standards and measures for accreditation are applicable to all types of health departments. However, PHAB has learned that additional and customized accreditation support materials are often needed to assist the accreditation work of specific types and sizes of health departments, in the context of their environment. To that end, PHAB has several customized products that will be made available to the field over the next few weeks:

*       Supplemental Documentation Guidance for Army Preventive Medicine/Public Health Departments that wish to pursue accreditation using the local health department standards. The PHAB Board of Directors approved this document on September 8, 2017. The documentation guidance is a companion document to Version 1.5 of the PHAB Standards and Measures. In addition, a companion Acronyms and Glossary of Terms is available for use with this supplemental documentation guidance.
*       A draft Supplemental Process and Documentation Guidance for Tribal Public Health Departments pursuing accreditation has been developed in partnership with the National Indian Health Board's Tribal Public Health Accreditation Advisory Board. This guide is intended to provide additional assistance to Tribal health departments in applying the PHAB standards and measures in a Tribal setting. The document can be found here, and the vetting document for providing PHAB with comments is located here. PHAB will be taking public comments on this document until December 31. 2017.
*     PHAB has been working for a while now on how to best support smaller health departments that wish to achieve national public health department accreditation. Over a two-year period PHAB has held several open forums, interactive webinars, town halls, and other discussions to obtain input from health departments that are interested in accreditation but feel there are insurmountable barriers to their achieving accreditation. PHAB has also convened a group of health department thought leaders to serve on a think tank to discuss which of the standards and measures pose the most barriers for small health departments. PHAB has explored a variety of potential options for meeting the accreditation needs of these health departments. As of the date of this newsletter, PHAB has 62 health departments that serve a population of 50,000 or fewer in the e-PHAB system, including 19 that are accredited. PHAB understands that these smaller health departments may need some additional or different technical assistance to achieve accreditation. In that regard, PHAB will be working with the National Association of County and City Health Officials over the next several months to explore in more detail what that technical assistance might entail and how it might best be provided. Stay tuned to the PHAB newsletter for additional details as this body of work progresses.
*      PHAB and the National Association of Public Health Statistics and Information Systems (NAPHSIS) have been working together for more than two years to customize the NAPHSIS standards for statewide vital records/health statistics (VRHS) work so that they can be used for accreditation purposes. In 2016, PHAB and five jurisdictions conducted an alpha test on the standards and measures. With funding from CDC and the National Center for Health Statistics, PHAB will soon begin a beta test of the VRHS standards and measures and process in six sites across the country. Stay tuned to the PHAB newsletter for updates as this initiative progresses.
*      PHAB has a new stakeholder relationship with Special Olympics International to clarify where accreditation fits in with health departments' work with community members who have intellectual disabilities. That clarification has been provided in a new tip sheet titled Inclusive Health and PHAB Health Department Accreditation.

PHAB Issues Call for Commissioned Paper on Health Equity
In preparing for the development of Version 2.0 of the standards and measures, PHAB is interested in understanding what health departments are currently doing to address health equity (best and promising practices), learning what guidelines and tools are now available to assist health departments' work in health equity, and capturing model practices that could lead to changes in the accreditation standards and measures. To that end, PHAB has issued a call for a commissioned paper. The commissioned paper will describe health equity efforts where public health departments are either the leader or a strong, key partner; provide descriptions of technical assistance resources, models, or tools that are available to public health departments; and make recommendations concerning the types of activities that health departments should be expected to do to address health equity in the population they serve. This information will be used by PHAB for further discussion and consideration for future accreditation standards. If you are interested in developing this commissioned paper, a letter of interest must be received by PHAB no later than 5:00 p.m., Eastern time, October 25, 2017. The letter may be submitted by email to Robin Wilcox at . PHAB will respond no later than November 8, 2017, to all individuals who submit a letter of interest. The final paper is due to PHAB by close of business, January 31, 2018.

News from PHNCI: Design Thinking for Analytic Tools in Public Health: City Sprint Chicago
Researchers at the University of Chicago's Center for Spatial Data Science and School of Social Service Administration apply design thinking to public health by analyzing data to identify where government funding for health services is spent in relation to need, and where it could be spent. Read more about the project and results on the PHNCI website .
Tell PHNCI About Your Innovation!
Help PHNCI light the spark in public health innovation by submitting yours today on the PHNCI website .
JPHMP Direct Highlights the Work of PHAB and PHNCI
JPHMP Direct , the multimedia companion site of the Journal of Public Health Management & Practice, is partnering with PHAB and the Public Health National Center for Innovations (PHNCI) -- a division of PHAB -- to engage in a deeper conversation with public health thought leaders, researchers, practitioners, students and other readers. In the current column, PHNCI Program Specialist Travis Parker Lee shares details about PHNCI's Innovation Grant Program and the variety of challenges being addressed by the nine grantees, from promoting nutrition to engaging at-risk communities.   

National Conferences Fill Summer Agenda
From coast to coast, it's been a busy summer for PHAB's outreach team. From June to August, PHAB staff members were on hand at the annual conferences of several partner organizations, including the National Indian Health Board (NIHB), the National Association of County and City Health Officials (NACCHO), and the National Association of Local Boards of Health (NALBOH). We hope you had an opportunity to participate and attend one of the numerous presentations from PHAB staff, as well as stop by PHAB's booth in the exhibit halls.
NALBOH members whose work is associated with a PHAB-accredited health department joined for a group photo at the conclusion of NALBOH's 2017 Annual Conference on August 4, 2017, in Cleveland, Ohio.
Update on PH WINS and PHAB Accreditation
The 2017 Public Health Workforce Interests and Needs Survey (PH WINS) was launched in late September. A collaboration between the Association of State and Territorial Health Officials (ASTHO) and the de Beaumont Foundation, this nationally representative survey of governmental health agency workers at state and local public health agencies was first fielded in 2014 and is an online survey capturing individual worker perspectives related to their workplace environment, training needs, and trends impacting public health. Currently, PH WINS is the only nationally representative data source of the governmental public health workforce. The findings from the first fielding of PH WINS have been used by participating health agencies to better understand and address workforce development, as well as by partners to help inform future investments in public health workforce development. This survey will help identify the current workforce needs of health departments and inform and guide workforce research, development, and training.
To learn more about the survey, including its goals, benefits, and results from 2014, please click here. If you have any questions about the 2017 Public Health Workforce Interests and Needs Survey, please contact the PH WINS team at
PHAB has received questions about whether participation in the PH WINS survey would count for accreditation. PHAB is a strong supporter of the PH WINS survey as a means to collect data on the interests and needs of the public health workforce. There are two places in Domain 8: Measure 8.2.1 and Measure 8.2.3, where PH WINS data/reports might apply. Also, for Measure 8.2.1 (Workforce Development Plan), it is sufficient to use aggregate data about the needs, gaps, etc., as the basis for the plan, as long as the data are specific to the health department. So, for those state health departments that participate in PH WINS and get their state-specific report back, it most definitely can be used to inform the development of their workforce development plan. PHAB doesn't dictate how a health department gets the information (needs assessment/gap analyses) from their staff, so they certainly can use their own surveys. However, with PH WINS already done for them, it seems like a win-win for them to use it to inform their plan. State health departments that don't participate in PH WINS should be aware that regional reports are not specific enough and therefore cannot be used for their workforce development plan.
Regarding Measure 8.2.3: Individuals who participate in the PH WINS survey may print their responses to the training needs assessment portion of the survey and share that information with their supervisor when mapping out personal training needs. If the supervisor or health department uses it for their professional/career development, then it can be used as an example for this measure.
National Board of Public Health Examiners Announces Program Updates
Since 2008, more than 6,000 public health professionals have become Certified in Public Health (CPH). The National Board of Public Health Examiners (NBPHE), which oversees the CPH credential, recently announced a number of changes to ensure the CPH evolves with the changing needs of the public health workforce.
New eligibility: In 2015, the NBPHE responded to the growing demand to certify individuals who did not hold a graduate degree accredited by the Council on Education for Public Health (CEPH). Previously, only students and alumni of CEPH-accredited schools and programs of public health could sit for the CPH exam. A pilot was conducted in 2015 to determine whether candidates who had at least five years of work experience in public health and at least a bachelor's degree could pass the CPH exam. The pilot had nearly 500 candidates and the NBPHE board determined their pass rate justified a new criteria for eligibility. Since fall 2015, all public health professionals with at least five years of public health work experience and at least a bachelor's degree in any field are eligibile to sit for the CPH exam.
Flexible testing options: Starting in 2017, candidates taking the CPH exam began receiving their results immediately after testing. Prior to this, candidates had to wait four-to-six weeks to find out if they had passed or failed the exam. Also in 2017, the CPH exam moved away from discreet testing cycles. It is now administered twelve months a year at computer-based testing centers around the country.
New content outline:
The NBPHE recently completed the analysis of the results of a job task analysis, a survey process which resulted in an in-depth look at the duties and responsibilities of nearly 5,000 public health professionals. After a preliminary period of analysis, members of the NBPHE board of directors shared the results of the Job Task Analysis with a great number of organizations representing public health. Using the feedback gathered through this presentation process, the NBPHE recently announced the CPH exam will follow a new content outline starting in 2019. The 2019 content outline is available on the NBPHE website and study materials are under development.
For more information about the Certified in Public Health credential, visit . Questions may be directed to

PHAB STAFF CORNER              
Brittan Williams Selected for Emerging Leaders Program
PHAB Accreditation Specialist Brittan Williams, MPH, CHES, has been selected to participate in the inaugural class of the North Carolina Public Health Associations' (NCPHA) Emerging Leaders Program. NCPHA created the program based on a recommendation made by its 2016-17 Executive Board that a program be developed to enhance participants' individual leadership skills and equip them with the tools to become better prepared to take on leadership roles in their organizations and communities.
The training is provided in partnership with the Kanof Institute for Physician Leadership (KIPL) of the North Carolina Medical Society.

WORD ON THE STREET: A Roundup of Accreditation Questions & Answers
1. I have talked to a health department that has a community health improvement plan (CHIP) that addresses only one priority health issue. I thought that a CHIP is a plan that addresses a number of the most serious health issues in the population, not just one health issue. Am I wrong?
No, you are not wrong. The purpose statement for Measure 5.2.2, the measure that requires a CHIP (page 138 of the Standards and Measures, Version 1.5), states that "While some or many programs in the local health department may have program specific plans, they do not fulfill the purpose of the community health improvement plan, which looks at population health across programs and across the community." The Significance statement further states that "Partners can use a community health improvement plan to prioritize existing activities and set new priorities." So, the CHIP is a plan to address multiple health issues of the population and involve many community partners and community sectors in efforts to improve the health status of the population. Public health departments are responsible for a wide array of health issues and, when they partner with other sectors of the community, they can greatly expand the issues that are being addressed to improve the health of the community. The CHIP should help direct the community to use its various resources and assets to broadly improve the health of the population. There is no magic number of priorities identified in a CHIP; that depends on the community assets and resources. However, a community is able to address more than one issue at a time.
2. Measure 7.1.1, Required Documentation 3, states that the collaborative process to assess the availability of health care services must consider emerging issues. Can that include an increase in the incidence of a disease or the identification of a new disease (Zika, for example)?
The focus of Measure 7.1.1 is on the health care system. Other measures address the identification and mitigation of diseases. The examples of emerging system issues include "changes in the structure of the health care system; types and numbers of health care professions being trained; changes in reimbursement structure, rates, or payment mechanisms such as accountable care organizations; developing care models, for example, coordinated care organizations or convenient care clinics; electronic medical records," as stated in the Guidance (page 180 of the Standards and Measures, version 1.5). So, examples of changing health needs do not address the intent of Measure 7.1.1. This measure is not about a Zika case, a flu epidemic, a hep outbreak, antibiotic resistant TB, etc. This measure is about the structure and design of the health care system, especially preventive primary care and chronic disease management capacity (see the statement of Significance for this measure). A fictional example could be that there is an increase of doctors who adopt a concierge model of care that increases access for a few patients who can afford it, but decreases access for those with few financial resources. That would be a systems issue that could be emerging.

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 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 or 703-778-4549, ext. 106.
Marita Chilton, Triona Gateley, Jennifer Jimenez, or Brittan Williams, Accreditation Specialists, to talk about the accreditation process for health departments. Marita may be reached at or 703-778-4549, ext. 114; Triona may be reached at or 703-778-4549, ext. 124; Jennifer may be reached at or 703-778-4549, ext. 107; and Brittan at 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 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 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 or 703-778-4549, ext. 110.
David Stone, Accreditation Education Specialist, to talk about PHAB's education services, including orientations and trainings. He may be reached at 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 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 or 703-778-4549, ext. 117.
Teddi Nicolaus, Communications Manager, to talk about news, media requests, marketing, and promotions. She may be reached at 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 new Center. She may be reached at 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 or 703-778-4549, ext. 103.
If you have a question for a future segment of Word on the Street, please send it to PHAB e-newsletter editor Teddi Nicolaus. Click here to sign up for the PHAB E-Newsletter. Learn more about PHAB at

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