Transcript Proposed Vetting Process Plan

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
by accredited health departments by
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.
Voluntary Accreditation Goal
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.
Public Health Accreditation Board
• Established May 2007 in Alexandria, VA
• Governed by state, tribal and local public
health officials and board of health
members
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Health department involvement:
– Board of Directors representation
– Workgroups oversee development
– Volunteer opportunities
Executive Committee
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Chair: Paul K. Halverson
Vice Chair: unfilled
Secretary/Treasurer: Ed Harrison
Immediate Past President: Marie Fallon
PHAB Board of Directors
• 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)
•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 Timeline
2008 2009 2010
2007
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2011
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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
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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)
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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
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Based on a body of existing work
 Essential PH Services
 NACCHO Operational Definition
 National Public Health Performance Standards Program
 State Experiences
 ASTHO Survey Data
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Essentially all of the concepts in the Operational Definition and
NPHPSP have been addressed
Standards Development Timeline
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Draft standards and measures
developed by workgroups
Feb 08-Feb 09
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Alpha test/desk review
Oct 08-Nov 08
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Public vetting
Feb 09-April 09
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Revised based on feedback
May 09-June 09
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PHAB Board approval
July 09
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Beta testing
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
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Bud Nicola (WA): Chair
Rex Archer (MO)
Janet Canavese (MO)
Shepard Cohen (MA)
Kathleen MacVarish (MA)
Joan Brewster (WA)
Pamela Butler (OH)
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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
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Not a grandfathering process
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Recognize programs that conform to the national
program
• Not “PHAB accreditation,” but eligible for same
benefits
Equivalency Workgroup Products
•Guiding Principles
• Application Process (and
Fees)
• PHAB SER Review Process
•Eligibility Criteria
• Scoring Methodology
•Definition
•Recognition Criteria • 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
Assessment Process Workgroup
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Bud Nicola (WA): Chair
Christine Abarca (FL)
Joan Ascheim (NH)
Janet Canavese (MO)
Alan Kalos (KY)
Jerald King (IN)
•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
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William Riley (MN): Chair
Christine Bean (NH)
Mary Davis (NC)
Seth Foldy (WI)
Les Beitsch (FL)
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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 Accreditation
Accountability
& credibility
Highlights
HD
strengths
Tool for
improvement
Accreditation
Greater
collaboration
Team building
Better
understanding
of public health
Recognition
& validation
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
Draft Standards Framework
11 Domains
31 Standards
>100 Measures
Documentation
Eleven Domains
Part 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
Eleven Domains (cont.)
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
Domain 1: Conduct assessment activities focused on population
health status and health issues facing the community
Collect and maintain reliable, comparable, and valid data that
Standard 1.1 B: Collect and
provide information on conditions of public health importance
Maintain Population Health Data
and on the health status of the population.
Measure
Documentation and Scoring Guidance
Type 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,
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Processes and protocols to assure data are
maintained in a secure and confidential manner
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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)
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Reports of testing 24/7 contact systems, such as,
internet, fax, page phone line, etc.
Capacity
Health
Department
Level
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
Health
Department
Level
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 Bender
or any Board Member
703.778.4549
For more information…..
www.phaboard.org
[email protected]
Contact Kaye Bender or any Board Member
703.778.4549