what’s new at the public health accreditation board? kaye bender, phd, rn, faan mlc grantee...
TRANSCRIPT
What’s New at the Public Health Accreditation Board?
Kaye Bender, PhD, RN, FAAN
MLC Grantee Meeting –Charlotte, NC
March 19, 2009
Presentation Overview
• Description of PHAB’s Current Work
• PHAB Board of Directors Strategic Plan
• Program Development and Timeline
• Introduction to the Standards
A Rising Tide…
CDC’s Future Initiatives
“Future of the Public’s Health” in the 21st Century (IOM)
Statewide Accreditation Programs
Exploring Accreditation
Accreditation “Fits” in 2008
Accreditation, as envisioned by the Public Health Accreditation Board, is in tune with heightened national movement
• The Healthiest Nation• Trust for America’s Health – Blueprint for a Healthier
America
Commitment of the PHAB Board of Directors and Staff
• Create demand and successfully deliver PHAB accreditation– Develop and establish PHAB accreditation– Market and manage the PHAB brand– Promote strategic partnerships ***– Establish sufficient funding– Strengthen PHAB organizational
effectiveness
Robert Wood Johnson Foundation Goal
60% of the population will be covered 60% of the population will be covered by accredited health departments by by accredited health departments by 2015.2015.
Credentialing and Accreditation
• Credentialing is a concept that applies to individuals who seek public health certification.
• Accreditation is a concept of validating performance improvement that applies to state, local, tribal, and territorial health departments.
The goal of a voluntary national accreditation program is to improve and protect the health of the public by advancing the quality and performance of state, local, territorial and tribal public health departments.
Voluntary Accreditation Goal
Public Health Accreditation Board
• Established May 2007 in Alexandria, VA• Governed by state, tribal and local public
health officials and board of health members
• Health department involvement:– Board of Directors representation– Workgroups oversee development– Volunteer opportunities
Executive Committee
• Chair: Paul K. Halverson
• Vice Chair: unfilled
• Secretary/Treasurer: Ed Harrison
• Immediate Past President: Marie Fallon
• Kaye Bender, President and CEO
• Rex Archer (MO)• Shepard Cohen (MA)• Leah Devlin (NC)• Marie Fallon (OH)• Fernando A. Guerra TX)• Paul K. Halverson (AR)• Edward Harrison (IL)
PHAB Board of Directors
•Kenneth Kerik (OH)•Carol Moehrle (ID)•Judy Monroe (IN)•Bud Nicola (WA)•Alonzo Plough (CA)•William Riley (MN)•F. Douglas Scutchfield (KY)•H. Sally Smith (AK)
Funding Partners
Eligible Applicants
All variations of state, local, tribal and territorial health departments can apply for national accreditation
Developmental Work
• Standards Workgroup
• Assessment Process Workgroup
• Beta test
• Equivalency Recognition Workgroup
• Research and Evaluation Committee
• Fees & Incentives Workgroup
• Marketing and Communication
PHAB Timeline2007 2008 2009 2010 2011
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Internal Operations
Standards and Measures
Assessment Process
18 Month Beta Test
Applications
Standards Development Workgroup
• Workgroup comprises state and local health department leaders and BOH members
• Collaborative, consensus, iterative process
• Facilitated by consultant with standards development expertise– MCPP Healthcare Consulting, Inc
Standards Development Workgroup• Leah Devlin (NC): Co-Chair• Carol Moehrle (ID): Co-Chair• Terry Allan (OH)• Rex Archer (MO)• Tim Callahan (CT)• Rick Danko (TX)• Robert Fulton (MN)• John Gwinn (OH)• Mary Kushion (MI)• Richard Morrissey( KS)• Rita Parris (NE)
• Sylvia Pirani (NY)• Joy Reed (NC)• Stephen Ronck (OK)• Jane Smilie (MT)• Torney Smith (WA)• Bonita Sorenson (CA)• Jeffrey Stoll (CO)• Susan Turner (FL)• Harvey Wallace (MI)• Christina Welter (IL)• Kathy Vincent (AL)• Barbara Worgess (AZ)
Standards and Measures Development
• Develop standards for all health departments
• Measures specific to local and state health departments
• Guidance for documentation and demonstration of department performance on meeting standards and measures
• Scoring and weighting methodology
Standards and Measures: Principles• Advance the collective practice
• Be simple, reduce redundancy
• Minimize burden
• Reinforce local and state health departments’ roles, demonstrate shared accountability
• Apply to all sizes and all forms of governance structure
• Based on American National Standards Institute principles
Principles continued Based on a body of existing work
Essential PH Services NACCHO Operational Definition National Public Health Performance Standards Program State Experiences ASTHO Survey Data
Essentially all of the concepts in the Operational Definition and NPHPSP have been addressed
Standards Development Timeline• Draft standards and measures
developed by workgroups
• Alpha test/desk review
• Public vetting
• Revised based on feedback
• PHAB Board approval
• Beta testing
Feb 08-Feb 09
Oct 08-Nov 08
Feb 09-April 09
May 09-June 09
July 09
Late summer 09-Nov 10
Standards Vetting
Why? Improve standards and measures
What? Standards, measures and documentation guidance
How? Through a variety of online and in-person opportunities
When? February-April 2009
We need to hear from YOU! And, we will, in just a few moments!
Equivalency Recognition Workgroup
• Bud Nicola (WA): Chair• Rex Archer (MO)• Janet Canavese (MO)• Shepard Cohen (MA)• Kathleen MacVarish (MA)• Joan Brewster (WA)• Pamela Butler (OH)
• Martha Gelhaus (IA)• Joe Kyle (SC)• Edd Rhoades (OK)• Rachel Stevens (NC)• Debra Tews (MI)• Lee Thielen (CO)
Equivalency Recognition Work Group
• To acknowledge states with existing programs that advised the national process
• Not a grandfathering process
• Recognize programs that conform to the national program
• Not “PHAB accreditation,” but eligible for same benefits
Equivalency Workgroup Products
•Definition
•Guiding Principles
•Eligibility Criteria
•Recognition Criteria
• Application Process (and Fees)
• PHAB SER Review Process
• Scoring Methodology
• Glossary
Accreditation System
A public health accreditation system is a network of public health agency accrediting bodies, led by PHAB and including state-based and regional accrediting programs that work together to improve the infrastructure of public health in the nation. This will be accomplished through PHAB leadership, a commitment to collaboration, innovation at the state and national levels, and by sharing common goals and objectives.
More Recent Work on State-Based Accreditation
Think Tank to further the discussion
More work to come…..
Assessment Process Workgroup
• Determine how to evaluate whether a health department has achieved accreditation status
• Determine how health departments can appeal decisions
• Professional Accreditation Consultant– Michael Hamm and Associates
• Bud Nicola (WA): Chair• Christine Abarca (FL)• Joan Ascheim (NH)• Janet Canavese (MO)• Alan Kalos (KY)• Jerald King (IN)
Assessment Process Workgroup
•Laura Rasar King (DC)•Richard Matheny (CT)•Bruce Pomer (CA)•Rita Schmidt (WA)•David Stone (NC)•Jeffrey J. Zayach (CO)
Assessment Process
Process to include:– Readiness Review– Application Form– Self-assessment– Site Visit– Findings and
Recommendations Report– Final Determination – Appeals Process– Maintenance of
Performance– Re-accreditation
Assessment Process: Principles
–The assessment process should reduce anxiety and increase comfort for the applicant
–PHAB will offer training, technical assistance, and informational materials on the accreditation process
–All applicants will be required to participate in PHAB training on the application process
31
Research and Evaluation Committee
• Develop a plan for evaluating the assessment processes and identifying research that would improve the standards-setting and accreditation program.
• Review standards and measures for validity and reliability.
• Provide consultation on data collection and interface with accreditation tracking and application online system.
Research and Evaluation Committee
• William Riley (MN): Chair• Christine Bean (NH)• Mary Davis (NC)• Seth Foldy (WI)• Les Beitsch (FL)
• Paul Erwin (TN)• Kerry Gateley (VA)• Brenda Joly (ME)• Laura Landrum (IL)• Glen Mays (AR)
Financing
• Workgroup on fees and incentives
• Affordability of fees critical to success
• Accreditation process should be designed with cost controls in mind
Benefits of AccreditationAccountability & credibilityAccountability & credibility
Tool for improvement
Tool for improvement
Greater collaboration
Greater collaboration
Recognition & validation
Recognition & validationBetter
understanding of public health
Better understanding of
public health
Team buildingTeam building
Highlights HD strengths
Highlights HD strengths
AccreditationAccreditation
Incentives
Uniformly positive
Participate in learning community
Informed by UNC research
Possible tangible incentives
Improved access to funding
Grants application requirements
Grants reporting requirements
Incentives Research
• What matters to State HDs?– Financial incentives
• Accredited agencies – 60%• Agencies applying for accreditation – 32%
– Infrastructure/quality improvement – 36%– Grants application and administration – 20%
Incentives Research
• What matters to Local HDs?– Financial incentives
• Agencies considering accreditation – 51%• Accredited agencies – 37%
– Infrastructure/quality improvement – 33%– Technical assistance and training – 27%
Incentives Underway
Areas for Further Exploration
• Incentives thresholds
• Incentives from States to Locals
• Providing incentives– Menu– Sequencing
• Incentives for Tribal Health Departments
Now, To The Standards
11 Domains
31 Standards
>100 Measures
Documentation
Draft Standards Framework
Eleven DomainsPart A
Administrative Capacity and Governance
Part B
1. Conduct assessment activities focused on population health status and health issues facing the community
2. Investigate health problems and environmental public health hazards to protect the community
3. Inform and educate about public health issues and functions
4. Engage with the community to identify and solve health problems
5. Develop public health policies and plans
6. Enforce public health laws and regulations
7. Promote strategies to improve access to healthcare services
8. Maintain a competent public health workforce
9. Evaluate and continuously improve processes, programs, and interventions
10. Contribute to and apply the evidence base of public health
Eleven Domains (cont.)
Domain 1: Conduct assessment activities focused on population health status and health issues facing the community
Standard 1.1 B: Collect and Maintain Population Health Data
Collect and maintain reliable, comparable, and valid data that provide information on conditions of public health importance and on the health status of the population.
Measure Documentation and Scoring GuidanceType of Measure
Type of Review
1.1.1 B: Assure a surveillance system is in place for receiving reports 24/7 and for identifying health problems, threats, and hazards
Documentation should address: Processes and protocols to maintain the
comprehensive collection, review, and analysis of data from multiple sources,
Processes and protocols to assure data are maintained in a secure and confidential manner
Current 24/7contact information, in the form of a designated telephone line or a designated contact person (which may be provided in rural areas via regional or state agreements)
Reports of testing 24/7 contact systems, such as, internet, fax, page phone line, etc.
Capacity HealthDepartmentLevel
1.1.2 B: Communicate with surveillance sites on at least an annual basis.
Documentation should address: List of providers and public health partners who
may be surveillance sites
Process HealthDepartmentLevel
As you review the standards…
• Consider the following questions:– Will this standard improve public health
department performance?
– Are the important components of this standard captured in its associated measures for the standard?
– Can this standard be documented?– Can health departments meet this standard
now?
Standards for Discussion• Which standards do you think are
particularly strong? – You would recommend that PHAB keep
these standards.
• Which standards do you think are Problematic? – You think PHAB should modify or possibly
delete these standards.
Opportunities to Provide Feedback There are multiple ways to offer feedback on the
standards and measures before April 30, 2009:
• Complete the online survey at www.phaboard.org
• Complete and submit the online or hard copy vetting forms
• Invite PHAB to lead a standards vetting discussion at your group meeting
• Lead a vetting session with your group
Your Feedback on the Standards
• Why did this standard catch your attention?
• If you think the standard is strong, why did you like it?
• If you think the standard is problematic, why? How would you modify it?
www.phaboard.org
Contact Kaye Benderor any Board Member
703.778.4549
www.phaboard.org
Contact Kaye Bender or any Board Member703.778.4549
For more information…..