Public Health Accreditation Board

Draft National Voluntary Accreditation Standards for Public Health Accreditation

As of July 2009, PHAB has developed the following documents for the accreditation program:

Developing the Standards:

At their January 2009 Board meeting, the PHAB Board unanimously approved an initial draft set of standards and measures for vetting. The standards and measures were the products of months of development by a Standards Development Workgroup of state and local public health professionals, national and federal public health experts, public health researchers, and other technical experts. These initial standards and measures were subject to an “alpha” field test with a small group of local and state health agencies, resulting in multiple revisions.

PHAB also encouraged public feedback on the next draft of the documents, and a public comment period took place from February 7 to May 7, 2009. During that time, PHAB received over 4,000 individual comments, as well as other comments through online surveys and group feedback forms. The PHAB Standards Development Workgroup carefully reviewed each comment and, based on the feedback, proposed changes to the documents. The Workgroup's recommended changes were submitted to the PHAB Board of Directors, and in July 2009 they adopted the revised standards and measures for use in the beta test. The accreditation beta test is taking place from fall 2009 through the end of 2010, and will result in further refinement of the standards and processes. All of this feedback will help to shape the final national public health accreditation program, which will launch in 2011.

The development of draft standards and measures was guided by several principles.  The standards and measures should:

  • Advance the collective practice
  • Be simple and reduce redundancy
  • Minimize burden
  • Reinforce local and state health departments’ roles and demonstrate shared accountability
  • Apply to all sizes and all forms of governance structure
  • Be based on American National Standards Institute principles

About the Standards and Measures

There are two sets of standards and measures: one for Local Health Departments (also used by tribal health departments) and one for State and Territorial Health Agencies.

The two sets of standards and measures are very similar. Each is organized around eleven domains and has the same set of standards; however, in some cases the measures vary in order to properly reflect a local or state context. There are a total of 30 standards, and a total of 102 measures for local health departments and 111 for state and territorial health agencies. The standards and measures documents include a list of “conventions,” which relate to certain assumptions employed in the development of the standards and measures.

Another important aspect of the draft standards and measures is the “guidance for documentation” feature. Associated with each measure is a description of the kinds of documentation a health department might include to attest to their ability to meet a measure. Some listed document is required; others are suggested. The examples listed in these draft standards and measures are not the only possible examples. There are likely to be many more options identified through the beta test and through implementation of the program.

PHAB Glossary and Scoring Methodology

Along with the draft standards and measures, the Board also released two companion documents that will be revisited and revised throughout the beta test: a glossary and a scoring report. The glossary provides definitions of terms used in the draft standards and measures. The scoring report describes options for a scoring methodology for each measure and options for summing scores to determine a suitable total score for awarding accreditation status to an applicant. The document also reviews related assumptions about scoring reliability and validity. It is assumed that a site visit review team will ultimately use a scoring tool to rate an applicant on each measure.

What’s Next?

The standards, measures and additional documents are currently being tested in the PHAB beta test. All of the comments received to date, as well as the feedback that will be received during the beta test process, will be used to refine and enhance the final standards, measures and processes for the national accreditation program.