Public Health Accreditation Board

Frequently Asked Questions

Beta Test

1. What is the beta test?

A beta test is a formative evaluation and quality improvement method used when launching a new product for obtaining the feedback of future users of the product. The PHAB beta test is a way to test the accreditation standards, measures, assessment process and written support documents by having a variety of public health departments implement them and report on their review and evaluation of the process. Through the test, PHAB will identify improvements that should be made in order to ensure that accreditation program is logical, practical, and promotes continuous quality improvement in health departments

PHAB has selected thirty health departments (eight state health departments, nineteen local health departments, and three tribal health departments) to be sites for the beta test. In order to ensure that the selected sites represent a diverse cross-section of the population, PHAB selected sites that vary in size, structure, population served, governance, geographic region, and degree of preparedness for accreditation.

The thirty health departments will work through the accreditation process and provide valuable feedback that will inform the voluntary accreditation program’s national launch in 2011. They will be working closely with, and providing information to, the beta test evaluator. The evaluator is responsible for collecting data from you, analyzing the data, and making recommendations to PHAB concerning ways to improve the accreditation program. They will engage in one-on-one interviews, surveys, and regular reporting.

2. What will a health department do as a beta test site?

The beta test process will run from October 2009 through December 2010. Selected sites have identified a staff member to be the “Accreditation Coordinator” who will serve as the point of contact for PHAB throughout the beta test and who will attend a two-day training session scheduled for early November . The selected site will be required to review and provide feedback on PHAB products, complete a self-assessment, gather and submit information electronically, schedule and host a 2-3 day site visit, review and provide feedback on the site visit, track staff time and costs of the process, participate in a quality improvement training and complete a quality improvement project. Beta test sites are entering into a contract with ASTHO or NACCHO in order to receive funding.

3. Which organizations are involved in the beta test?

PHAB is conducting the beta test and has partnered with various national organizations to assist public health departments in the process. PHAB’s beta test partners include the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), the National Association of Local Boards of Health (NALBOH), the National Indian Health Board (NIHB), the Robert Wood Johnson Foundation (RWJF), and the Centers for Disease Control and Prevention (CDC) among others. ASTHO will provide technical assistance to state and territorial health departments and NACCHO will provide technical assistance to local health departments. NIHB will work with tribal health departments in collaboration and in consultation with ASTHO. NALBOH will be working on governance issues.

4. What are the benefits of participating in the beta test?

The accreditation beta test offers a unique opportunity for public health departments to have a hand in shaping the future of public health. By participating in the beta test, your health department will provide valuable feedback to PHAB that will be used to revise and tailor the standards and process before the national launch in 2011. So your input will have a direct impact on how the national accreditation program is formed.

Accreditation provides a variety of benefits to public health departments; most notably it encourages them to engage in ongoing quality improvement. In addition, local public health departments who are participating in state accreditation programs have reported specific benefits such as receiving valuable performance feedback that enables them to identify their health department’s strengths and areas for improvement; opportunities for quality improvement efforts; increased accountability and credibility with elected officials, communities, and other key stakeholders; enhanced public visibility of the health department; and improved staff morale.

Participating in the beta test also provides important opportunities for public health departments. Participating health departments will receive:

  • Funding to offset the cost of participation in the beta test evaluation activities;
  • Hands-on technical assistance regarding meeting the standards and measures;
  • Technical assistance on identifying priority areas for improvement in your health department and implementing quality improvement efforts;
  • On-site training offering quality improvement skill-building and networking with other public health departments;
  • Access to a peer network that allows sites to share experiences, lessons learned, best practices, strategies and quality improvement techniques, among other things;
  • Travel support for a staff member to attend training meeting and closing meeting; and
  • Guidance materials to assist in selecting quality improvement consultants.

Importantly, when the accreditation program is operational, PHAB will provide beta test sites with:

  • Expedited review during the accreditation process and
  • Priority status in the queue when applying for accreditation.

5. As a beta test site, will I be expected to meet all of the measures and have a community health assessment, community health improvement plan, and organizational strategic plan?

Health departments that are working with PHAB as beta test sites will not be expected to meet all of the standards and will not need to have a community health assessment, community health improvement plan, or organizational strategic plan in order to participate in the beta test. The purpose of the beta test is to test the accreditation process and standards; it is not an evaluation of the health departments.

6. What if a beta test site has added duties due to an especially heavy flu season, particularly H1N1?

The PHAB Board and staff, as well as the ASTHO and NACCHO partners involved in the quality improvement component of the beta test, are all aware of the potential effect of a heavy flu season on the beta test. Should a department be faced with an unusually heavy flu season, we will all work with them to adjust the beta test schedule as required. If H1N1 becomes a national public health issue, PHAB will work with all of the beta site health departments to adjust the beta test schedule so that health departments can focus on handling H1N1 as a priority.

7. If health departments in the beta test successfully complete it, will they automatically receive national accreditation status?

No, health departments that complete the beta test will not receive accreditation. They will receive expedited review during the accreditation process and priority status in the queue when applying for accreditation, when the program is operational.

8. What is an appointing entity?

It refers to the person or group that hires the health department director. It might be an individual, a board, or another administrative individual authorized to approve the actions of the health department director.

9. If my department applied to be a beta test site and was not chosen, or if we chose not to apply, what can we do, while the beta test is being conducted, to prepare for accreditation?

Health departments can prepare for accreditation by:

  1. Developing community health assessments, community health improvement plans, and organizational strategic plans, or if you already have them, updating them (community health assessments, community health improvement plans, and organizational strategic plans will be required to apply for accreditation when the program is launched);
  2. Reviewing PHAB’s standards, measures and guidance for documentation, assessing your department’s ability to meet them, and engaging in improvement efforts, where indicated; and
  3. Incorporating and implementing quality improvement efforts in your department.

These activities will better position your department to apply for and be successful at attaining accreditation.

10. Will the beta test include state-based accreditation programs or multi-state regional accreditation programs as applicants?

No. A different process is being designed to assess how accreditation might work in these states or multi-state regions. This beta test will not address these issues.

11. Will PHAB be using volunteers for the members of the site visit teams during the beta test? I would like to volunteer to be a site visitor during the beta test. How do I apply?

Yes, PHAB will be asking volunteers to be members of the site visit teams during the beta test. PHAB will form site visit teams that provide a balance of types of public health experience and knowledge. In the near future, PHAB will develop a list of the characteristics and experience that teams will need to have. Please send your name and contact information to Robin Wilcox at to be included on a list of volunteer potential site visit team members.

12. How much does it cost to participate in the beta test?

There is no outright required cost to participate in the beta test. However, PHAB anticipates that health departments will need additional resources to provide feedback to evaluators about the accreditation process and to complete the quality improvement activities. Therefore, with funding from the Robert Wood Johnson Foundation, ASTHO and NACCHO will provide support to each beta-test site to offset the costs of the beta test evaluation activities and quality improvement activities.

13. What efforts can the funding support?

The grant is intended to support health departments’ beta test evaluation efforts –including, but not limited to data collection and periodic surveys to gather feedback on the accreditation process, standards, measures and technical assistance needs. These funds are not intended to support staff time for assessment and documentation activities related to the accreditation process.

The grant funds will also support quality improvement (QI) activities to address an area for improvement identified during the beta test assessment. The funds can be used to support QI training and technical assistance, travel to QI trainings and implementation of a QI initiative. Funds may not be used for capital costs or equipment (e.g., office furniture, software, computers).

For Beta Test Sites: Quality Improvement Project and ASTHO & NACCHO Contracts

1. I am a beta test site. Where do I go for more information or with questions about quality improvement (QI) project?

For local health departments, contact Penney Davis at NACCHO (202-507-4213 or For state health departments and tribal health departments, contact Joya Coffman at ASTHO (571-522-2302 or For general questions about the beta test itself, contact Robin Wilcox at PHAB (703-778-4555 or

2. Whom do I contact with questions about the contracts for the QI project funding?

Questions about the NACCHO contracting process should be directed to Penney Davis at NACCHO (202-507-4213 or and to Joya Coffman at ASTHO (571-522-2302 or

3. When are the QI projects due?

The QI projects and the reports are due to ASTHO OR NACCHO on December 3, 2010.

4. When must the contracts with ASTHO and NACCHO be final?

The contracts with ASTHO and NACCHO must be signed within 45 days of notification of the beta test decision.


1. What is the national voluntary accreditation program?

The goal of the national voluntary accreditation program is to improve and protect the health of the public by advancing the quality and performance of all public health departments across the country. With broad input and support, the accreditation program has developed standards that state, local, tribal and territorial health departments can implement to ensure they are providing the best services possible to keep their communities safe and healthy.

2. Which organizations are involved in the accreditation program?

The Public Health Accreditation Board (PHAB) is a non-profit organization that was created specifically to develop and implement the national voluntary accreditation program. It is jointly funded by the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation. The program is supported by the nation’s leading public health organizations, including APHA, APHL, ASTHO, NACCHO, NALBOH, NIHB, NNPHI, and PHF, as well as several state health departments.

3. What does it mean to have my public health department receive accreditation status?

Accreditation tells your community that you are providing the best possible services to keep them safe and healthy. Accreditation drives your health department to continuously improve the quality of services you deliver. With accreditation status, you will be able to demonstrate increased accountability and credibility to the public, funders, elected officials and other stakeholders. Also, the accreditation assessment process provides valuable, measurable feedback to your health department on your strengths and areas for improvement, so you can better protect, promote and preserve your community’s health.

4. Why is accreditation important?

National public health accreditation means that people across the country can expect the same quality of public health programs and services no matter where they live – in a Northeast city, a West coast suburb, or a Midwest town. The expectation is that accreditation will strengthen public health departments and the services they provide, which contributes to improved health outcomes in communities. Accreditation will allow all public health departments to demonstrate the value and importance of their work, and the critical impact that public health departments have on the public. Also, accreditation is a critical part of the future of public health, and as the national conversation around health reform progresses accreditation will be an integral part of that dialogue.

5. How were the accreditation standards created?

The standards were created thoughtfully and thoroughly to ensure their efficacy and flexibility to a variety of public health departments. PHAB convened a Standards Development Workgroup, comprised of representatives from state and local health departments, to develop the standards, measures and guidance for documentation. The Workgroup drafted these materials, and then PHAB released them publicly to solicit feedback from public health departments across the country. In response, PHAB received almost 4,000 individual comments, approximately 123 completed online surveys, 29 feedback forms, 35 paper surveys and more than a dozen narrative comments. After reviewing every one of these comments, the Workgroup revised the materials and is currently finalizing them for use in the beta test.

6. How does accreditation relate to the quality improvement activities my department is already doing?

Accreditation and quality improvement are intertwined and support each other.  Many health departments will need to implement quality improvement in order to meet the accreditation standards in some areas.  In particular, the quality improvement activities you are already doing will be critical to meeting standards that address evaluation and continuous improvement of processes, programs and interventions. Accreditation drives QI, and QI improves the performance of health departments.

7. How much does it cost to prepare for and apply for accreditation?

At this time we do not know the exact cost, because it varies greatly by health department. Preliminary data from state-based accreditation programs show that staff time is the major cost associated with accreditation, and that the cost of preparing the assessment materials varies depending on the size of the department. The beta test is designed to evaluate the cost of preparation across a broad range of health departments so that public health departments can plan accordingly. PHAB’s Fees and Incentives Workgroup is charged with developing a fee structure for public health accreditation. They have held one meeting and are just beginning the work of considering appropriate fees.