Greetings from PHAB,
In reading more about accountability and transparency in government, I am reminded of a quote by Brian Tracy, "Excellence is not a destination; it is a continuous journey that never ends." Health departments that have achieved accreditation understand that accreditation is a tool to use when that health department wants to turn things around; to indicate that they intend to be excellent; to strive to use national performance standards and measures and peer review to hold themselves accountable for that journey toward excellence.
These are progressive, futuristic health departments who understand that the accreditation process is a journey that is continuous, and the use of the results of the peer review is unique to their health department. PHAB is pleased to partner with these progressive health departments as they continue their excellence journey.
In this newsletter you will read about PHAB's latest accreditation decisions, as well as the vetting of PHAB's newest accreditation program for Vital Records and Health Statistics. PHAB has been reporting in the newsletters on this project for about three years, and we are excited that it is coming to fruition. You will also read about the transition of the Public Health Quality Improvement Exchange (PHQIX) to PHAB, another resource that PHAB intends to advance in support of quality improvement. In that regard, PHAB is pleased to unveil a new section in our newsletter focused on quality improvement and performance management. In every newsletter going forward, this new section will provide updated information, tips for success, and available resources for health departments to use along their excellence journey.
Happy fall from the PHAB Team!
Kaye Bender, PhD, RN, FAAN,
PHAB President & CEO
Issue #72
October-November 2018 
In This Issue

Kaye Bender, PhD, RN, FAAN

 President and CEO


Dr. Gupta 
Rahul Gupta Joins March of Dimes as Chief Medical and Health Officer
PHAB Board of Directors member Rahul Gupta, MD, MPH, MBA, FACP, in September was named Senior Vice President and Chief Medical and Health Officer for March of Dimes, the nation's leader in mom and baby health. In his new role, Dr. Gupta will provide strategic oversight for March of Dimes' medical and public health efforts to improve the health of all moms and babies. Prior to joining March of Dimes, he served as Commissioner and State Health Officer in West Virginia since 2015. We look forward to continuing our work with Dr. Gupta in his new role. Read the full announcement here. 

In other Board of Directors news, the PHAB Board will meet in November 2018 to conduct its usual business and to consider the final standards and measures for Vital Records/Health Statistics Accreditation. (See related story in the next section.)
More Than 235 Health Departments Now Accredited Through PHAB
The number of health departments demonstrating their desire to be transparent and accountable to their communities continues to grow larger. Across the United States, the population now served by a health department that has achieved PHAB's rigorous national standards now surpasses 70 percent, with more health departments seeking the credential each day.
National accreditation status was awarded August 21, 2018 to:
  • Cambridge Public Health Department, Cambridge, Massachusetts
  • Department of Health Services, Division of Public Health, Madison, Wisconsin
  • Knox County Health Department, Mount Vernon, Ohio
  • Lincoln County Health and Human Services, Newport, Oregon
  • Livingston County Health Department, Howell, Michigan
  • Logan County Health District, Bellefontaine, Ohio
  • Marion Public Health, Marion, Ohio
  • Onondaga County Health Department, Syracuse, New York
  • Plumas County Public Health Agency, Quincy, California
  • Saint Louis County Department of Health, St. Louis, Missouri
  • Springfield-Greene County Health Department, Springfield, Missouri
  • Williams County Combined Health District, Montpelier, Ohio

Former Saint Louis County Department of Health Director  Dr. Faisal Khan announces the department's national accreditation in August 2018.

Vital Records/Health Statistics Accreditation Module Available for Public Comment Through November 2, 2018
P rogress has been made on the development of accreditation standards and measures for Vital Records/Health Statistics (VRHS) Units in the 57 jurisdictional areas identified by the National Center for Health Statistics (NCHS) within the National Vital Statistics Collaborative Program (VSCP). This includes the jurisdictions where statewide vital records are collected from the 50 states, District of Columbia, New York City, American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and Virgin Islands. PHAB has partnered with the National Association for Public Health Statistics and Information Systems   (NAPHSIS), CDC's Center for State, Tribal, Local, and Territorial Support (CSTLTS), NCHS, and several states to develop the standards and measures and complete both an alpha and a beta test to ascertain their applicability in the field. The revised version of the Standards and Measures for National Accreditation of State/Territorial Vital Records/Health Statistics Units is now open for public comment until November 2, 2018.   Please click here to view the draft for public vetting . If you are interested in providing comments to PHAB, you may do so by   clicking here . PHAB anticipates launching the program in early 2019.

Interested in Serving as a Volunteer Site Visitor for PHAB?
Site visitors play an important role in PHAB's accreditation process. Their work includes reviewing the documentation submitted by health departments and tribes, participating in site visits, and writing the site visit report used by the Accreditation Committee to make the accreditation determination.
If you are interested in becoming a site visitor for PHAB and want to learn more about the roles and responsibilities of a PHAB site visitor, please read PHAB's Site Visitor Tip Sheet 
or contact PHAB Volunteer Services Manager Jeff Lake: , or (703) 778-4549, ext. 10. Click here to apply to be a PHAB site visitor.

Eighteen public health professionals attended PHAB's two-day Site Visitor Learning Event Sept. 25-26, 2018, at PHAB's office in Alexandria, Virginia. 

PHQIX Transitions to a New, Online Learning Platform Supported by PHAB
RTI International created the Public Health Quality Improvement Exchange (PHQIX) in September 2012 with funding from the Robert Wood Johnson Foundation. The goal has been to sustain national QI efforts by providing public health practitioners with a means for obtaining knowledge from the experiences of their colleagues. This community engagement component was designed to ensure that lessons learned are not limited solely to the individuals who executed a specific QI initiative. PHQIX has served public health practitioners well in the dissemination of QI models and practices, in the development of an online database of QI efforts conducted by governmental public health departments across the country, in providing search and query functions to enable users to find interventions and tools relevant to their own health department and community needs, and in creating a forum for dialogue and learning among the site's users.
PHQIX has achieved its initial goals of providing an online platform for connecting public health practitioners, academicians, and researchers who work on quality improvement. It's now time for PHQIX to move to the next phase of supporting the public health field in continuing to work on quality improvement. In fulfilling that next phase, PHQIX will transition to a new, online learning platform supported by PHAB. It will take a few months to achieve the full transition. In the meantime, here is what PHQIX users can expect:
  • The PHQIX website will remain open to current users for information retrieval.
  • Quality improvement tips, best practices, and so on, will be covered in a special section of the PHAB e-newsletter.
  • Submissions to PHQIX will be suspended during this transition time.
  • If a user has questions about quality improvement in public health during this transition, there are multiple resources for quality improvement tools, tips, and models on PHAB's national partner websites:
The future PHQIX functions and resources, although administered by PHAB, will not require a health department to be accredited to access them.
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.
As we work on the various topics under consideration for updating, the information is posted on the PHAB website. Since the last newsletter, PHAB has held an expert panel meeting on Public Health Laboratories (see photo below) and has added that information to the website.
In partnership with the Association of Public Health Laboratories, PHAB held an Expert Panel meeting on September 6, 2018, in Alexandria, Virginia.
Standards and Measures Documentation: Tips for Success
Editor's Note: This is the second in a series of columns in which PHAB staff share tips for successfully demonstrating conformity with various PHAB Standards and Measures. Here, PHAB Chief Program Officer Robin Wilcox discusses measures related to Domain 7: Strategies to Improve Access to Health Care. 
Domain 7 addresses access  to needed health care services. The intent of the PHAB Standards and Measures in Domain 7 is to address improved access from a community systems perspective. This Domain and its standards and measures are not about clinical services that the health department provides directly or how, when, or where those services are provided.

The PHAB Acronyms and Glossary of Terms says that access is "the potential for or actual entry of a population into the health system. Entry is dependent upon the wants, resources, and needs that individuals bring to the care-seeking process. The ability to obtain wanted or needed services may be influenced by many factors, including travel distance, waiting time, available financial resources, and availability of a regular source of care."

Populations who often lack access to health care include the elderly, children, veterans, people with physical or intellectual disabilities, the homeless, people who lack financial resources, migrants, immigrants, immuno-compromised individuals, the uninsured and underinsured, people who live in rural/frontier locations, non-English speaking people, and the LGBTQ community.

Characteristics of communities promote or impede these populations' ability to obtain the health services they need. Community characteristics that influence access to health care include social, cultural, economic, infrastructure, and geographic factors.

Domain 7 is also about the structure and design of the health care system and its relationship with the community. Issues include the availability of primary care and other providers, the community's trust of the health care system, the location of services related to public transportation routes, service hours, urgent care availability, continuity of care, convenience of health care locations, insurance reimbursement structures, and electronic medical records.

The assessment and promotion of the population's access to care requires that community partners evaluate and address factors such as prevalence of disabilities; insurance status; economic status; racial and ethnic minority status; limited English proficiency; poor mobility; lack of transportation; lack of health literacy; sexual orientation and gender identity; socioeconomic status; and residential location.

The promotion of access to care is not as simple as looking at where people live and where health care outlets are located. It is not as simple as increasing a clinic's hours. Efforts to increase access to care require multi-sectoral collaboration, in-depth analysis of the populations who lack access, creative systems-thinking, and community systems-level changes.

Going All In to Create Multisector Partnerships and Share Data
All In: Data for Community Health is a learning network of communities that are testing exciting new ways to systematically improve community health outcomes through multisector partnerships working to share data. The Public Health National Center for Innovations (PHNCI) joined All In to partner with other national program offices implementing similar initiatives to improve communities, as well as to include its learning communities of grantees in the diverse collaborative network that connects members with tools, resources, and expertise to help advance efforts. Click here to read a blog authored by PHNCI staff to learn more about this initiative. 

Be in the Know! Subscribe to PHAB's E-Newsletter!
Enjoying reading this newsletter but not yet a subscriber? It only takes a minute to sign up. PHAB's E-Newsletter is distributed on a periodic basis to more than 6,250 public health professionals. The PHAB E-Newsletter is the best way stay abreast of important news and updates related to PHAB's national accreditation program, to gain tips for success on your accreditation journey, as well as to learn about the activities, technical assistance and resources available through PHAB's partner organizations. Click here to subscribe.

Editor's Note: Welcome to the first installment of Quality Improvement Corner. Here, Jessica Kronstadt, PHAB Director of Research and Evaluation, shares what PHAB has learned from accredited health departments about their performance on the Domain 9 measures.

Quality improvement (QI) is a core component of public health accreditation. The promotion of QI practice and performance management are among the most common benefits of accreditation reported by evaluation respondents. One study found that health departments engaged in accreditation showed significantly larger gains in their quality improvement activities over time compared to those that have not begun the application process. (Click here to read more about research and evaluation findings related to QI.)  For this reason and because of PHQIX's transition to PHAB, this newsletter will begin a regular feature on quality improvement and performance management.
Today, we focus on what we have learned from accredited health departments about their performance on the Domain 9 measures . As performance management and quality improvement are relatively new to the field of public health, it is perhaps not surprising that health departments still have opportunities for improvement in this area. Three measures, in particular, more frequently pose challenges to health departments pursuing accreditation:

Measure 9.1.3: Implemented performance management system - Health departments that do not demonstrate this measure are often unable to provide two appropriate examples of all the required components, especially monitoring and analyzing progress towards goals and identifying next steps.
Measure 9.1.4: Implemented systematic process for assessing customer satisfaction with health department services - Several health departments are unable to demonstrate analysis of data related to customer satisfaction.
Measure 9.2.2: Implemented quality improvement activities - Challenges relate to using QI models and tools for projects tied to the QI plan.
In the spirit of continuous improvement, many health departments continue to strengthen these areas and document their progress on their QI journey through action plans and annual reports. Click here for more information on health department performance on Domain 9.

New! Tribal Public Health Accreditation Readiness Case Study: Chickasaw Nation
The National Indian Health Board (NIHB) recently released a new resource to help Tribes assess their accreditation readiness. Available as a free download on NIHB's website, the 12-page Tribal Public Health Accreditation Readiness Case Study: Chickasaw Nation, adapts the evidence-based Community Readiness Model (CRM) to an Accreditation Readiness Model (ARM) to fit the unique challenge of assessing readiness for public health accreditation in Tribal communities. This model was chosen for its known fit in Indian Country; it was also chosen because it accounts for the underlying dynamics of readiness for change, such as leadership support, community climate, and knowledge of the issue.
In partnership with CDC, NIHB created the Tribal Accreditation Support Initiative (ASI) in 2014 to increase the readiness of Tribal health departments to undertake or achieve public health accreditation through the provision of sub-awards to Tribes and targeted capacity-building assistance. Chickasaw Nation is one of 20 Tribes that have been supported by NIHB's Tribal ASI, and has used the ARM to help direct their public health improvement path.

NACCHO Announces New Performance Management Resource for Health Departments
The National Association of County and City Health Officials' (NACCHO) Performance Improvement team announces the release of its newest resource, Measuring What Matters in Public Health: A Health Department's Guide to Performance Management. Using a simple seven-step process, this resource walks health departments through a pragmatic approach to developing a formal, agency-wide performance management system. It also includes stories from the field that translate theory into practice, and each step is supplemented with editable worksheets, spreadsheets, and templates that can be tailored to meet agency-specific needs. To access the guide, visit NACCHO's  Performance Management web page . Questions? E-mail .

ASTHO Rolls Out PHAB Accreditation Infographic Series
The Association of State and Territorial Health Officials (ASTHO) recently rolled out a four-part impact of accreditation infographic series . Developed by ASTHO with support from CDC's Center for State, Tribal, Local, and Territorial Support, the series illustrates how PHAB accreditation positively influenced six state health departments' agency processes, programs, and infrastructure. The infographics highlight how the PHAB accreditation process improved these agencies' partnerships and collaborations, strengthened relationships and governance, facilitated performance and quality, and enhanced capacity to conduct planning and assessment activities. All four are available for free download:

Accreditation Highlighted in Public Health Foundation Webinars
PHAB accreditation will be a key topic in two new webinars to be offered this fall by the Public Health Foundation (PHF):
  • Utilizing Academic Partnerships to Enhance Capacity in Small Health Departments: Join the Council on Linkages Between Academia and Public Health Practice and the Public Health Foundation on Wednesday, October 24, 2018 from 2-3 p.m. ET to hear how the Kent City Health Department in Ohio is utilizing an academic health department partnership with Kent State University to expand its capacity and support its journey toward PHAB accreditation. Learn more about this event and register today.
  • Competencies for Performance Improvement Professionals in Public HealthAre you actively engaged in supporting your organization's performance improvement (PI) efforts? Join PHF on Tuesday, November 6, 2018 from 1-2 p.m. ET for a webinar introducing a new competency set designed specifically for PI professionals working in public health. Learn more about this event and register today.
Also, learn how Springfield-Greene County Health Department in Springfield, Missouri, leveraged the public health accreditation process to spark creativity, innovation, and further staff involvement in performance improvement efforts organization-wide. Recorded earlier this year, this webinar shares how the health department revamped its Quality Council and took a multifaceted and comprehensive approach to systematic quality improvement. Watch the archive of this presentation and read the speakers' responses to practical questions from viewers about replicating this program in other communities.

Jessica Kronstadt
Jessica Kronstadt Appointed to ASTHO Committee
Jessica Kronstadt, MPP, PHAB's Director of Research and Evaluation, was recently appointed to serve on the Association of State and Territorial Health Officials' (ASTHO) Performance Improvement and Accreditation Policy Committee. This appointment will further strengthen PHAB and ASTHO's commitment to working together on these topics to better serve the public health field.

WORD ON THE STREET: Accreditation Questions & Answers

Who at PHAB may we contact for specific questions and technical assistance?
You may contact:
Mark Paepcke, Chief Administrative Officer, for information about fees and contractual information, or e-PHAB. He may be reached at or 703-778-4549, ext. 104.
Robin Wilcox, Chief Program Officer, for information 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, Chelsey Saari, Brittan Williams, Accreditation Specialists, for information 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; Chelsey may be reached at or 703-778-4549, ext. 130; 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, for 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, for information 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, Education Services Manager, for information about PHAB's education services, including orientations and learning events. He may be reached at or 703-778-4549, ext. 105.
Genny Lush, Program Specialist, for questions 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, for information about public health accreditation-related research and evaluation. She may be reached at or 703-778-4549, ext. 117.
Teddi Nicolaus, Communications Manager, for media requests and questions related to PHAB's E-Newsletter, website, online store, 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, for all matters related to the 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, the Board of Directors, committees/think tanks, and student opportunities. She may be reached at 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

PHAB's E-Newsletter is distributed on a periodic basis to more than 6,250 public health professionals. The PHAB E-Newsletter is the best way stay abreast of important news and updates related to PHAB's national accreditation program, as well as learn about the activities, technical assistance and resources available through its partner organizations.  Click here to subscribe.

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