Scrutinize Me: Like Hospitals, Public Health Departments Now Face Expensive Accreditation Process

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Published on
June 7, 2012

department of public health, tammy worth, reporting on health, health journalism, public health accreditation boardLike hospitals and universities, local and state public health departments will soon be eligible for accreditation through a voluntary national program. The process is moving slowly, and the oversight group, the nonprofit Public Health Accreditation Board, has just begun receiving applications.

So why should John Q. Public – or you – care? Public health departments won't get any money for being accredited. But if accreditation works well, some speculate that it may become a prerequisite for things like government grants and other sources of funding. The process is also expensive at a time when many public health departments are facing severe budget cuts affecting services like lead poisoning prevention. Still, the consensus in the public health community seems to be that accreditation is a good thing. Here's why (and why you might want to check in with your public health department about accreditation).

The Public Health Accreditation Board is funded by the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation. Thirty health departments around the country have already taken part in a test to try out the process and work out kinks; it's worth checking out this list to see if any in your area participated:

PHAB has set requirements that must be met in 10 areas: monitoring community health status; diagnosing and investigating local health problems; informing and educating individuals; mobilizing the community to solve health problems; developing policies and plans for community health efforts; enforcing laws that protect public health; linking people to services; assuring a competent health workforce; evaluating health services and researching solutions to health problems. Three prerequisites for applying are creating a community assessment, improvement plan and strategic plan. 

Gianfranco Pezzino, a senior fellow at the Kansas Health Institute, said this shows an agency can meet national standards and provides good "PR material to use with the public and constituents." Accredited agencies will receive no extra personnel or money. Pezzino expects, however, that it could elicit funding down the road by providing eligibility for CDC or other grants that are offered only to accredited organizations.

Stephanie Branco, director of program planning and evaluation for the National Association of Local Boards of Health, said it will help agencies gain credibility, validate their strengths, create a framework for planning and instill a culture of quality. She said just performing a community health assessment will allow agencies to better understand the needs of their communities. An assessment requires the involvement of service providers and individuals in the community.

Accreditation, initially at least, should be easier for larger agencies, mostly because of cost. Fees for applying are based on the size of the population in the covered community and range from $12,270 from communities with fewer than 50,000 people to $95,400for those with more than 15 million people. That's a heavy chunk of change at a time when most public health agencies are facing budget cuts, but the accreditation board plans to use the fees to help train and improve the agencies' work.

In Florida, the state health department has to apply separately from its 67 community organizations. Both the state and the Miami-Dade County Health Department took part in the initial testing for accreditation. The handful of counties that have now submitted applications for accreditation in Florida are all some of its largest, said Laura Reeves, operations and management consultant manager for the department's Office of Performance Improvement.

"It does require an investment of personal and financial resources to do it,"" Reeves said.

Because the costs are high and budgets are tight, Pezzino said striving for accreditation may lead to cooperation and ingenuity in the public health sector. Smaller organizations that can't meet the standards alone will likely work with other agencies to share resources and personnel. Consolidation of services is already a movement in public health and accreditation may only prove to speed up the process.

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