Accreditation Readiness Resource Kit

Introduction to Accreditation

The Public Health Accreditation Board (PHAB) is a nonprofit organization dedicated to advancing the continuous quality improvement of Tribal, state, local, and territorial public health departments. PHAB developed, and now oversees, the Public Health Accreditation process.

PHAB’s public health department accreditation process seeks to advance quality and performance within public health departments. PHAB’s vision is “a high-performing governmental public health system that will make the United States a healthier nation”. For more about PHAB’s vision and mission, visit PHAB’s website. National public health department accreditation has been developed because of the desire to improve service, value, and accountability to stakeholders.

This section includes:

  • Overview of the Accreditation Process
  • Benefits of Accreditation
  • Public Health Accreditation Board Standards
  • Review of the Seven Steps of PHAB Accreditation

Overview of the Accreditation Process:

According to PHAB, Public Health Department Accreditation is:

  • The measurement of health department performance against a set of nationally recognized, practice-focused and evidenced-based standards.
  • The issuance of recognition of achievement of accreditation within a specified time frame by a nationally recognized entity.
  • The continual development, revision, and distribution of public health standards.

The goal of the national accreditation program is to improve and protect the health of the public by advancing the quality and performance of Tribal, state, local, and territorial public health departments.


    Benefits of Accreditation:

    Accreditation through PHAB provides a means for a health department to identify performance improvement opportunities, improve management, develop leadership, and improve relationships with the community.  The process is one that will challenge the health department to think about what business it does and how it does that business.  It will encourage and stimulate quality and performance improvement in the health department.  It will also stimulate greater accountability and transparency.  National public health department accreditation has been developed because of the desire to improve service, value, and accountability.

    The tangible benefits of working on accreditation will vary among health departments. Since accreditation is about performance and quality improvement, the actual benefits to a health department will depend on its identified needs. Accreditation provides a framework for a health department to identify performance improvement opportunities, to improve business operations, develop leadership and staff, and improve relationships with the community. The process is one that will challenge the health department to think about what business it does and how it does that business.

    PHAB has an ongoing commitment to documenting the impact of accreditation on the nation’s governmental public health departments, and by extension, the benefits to the communities they serve. PHAB’s website includes the early evaluation results of their accreditation efforts and will be updated regularly as results become available.


    Public Health Accreditation Board Standards

    Perhaps PHAB’s greatest influence has been the development of national standards and the accreditation process.  PHAB standards address services, programs, and operations essential to effective public health management.  Through accreditation, an agency is able to maintain a balance between protecting the public and providing an environment that safeguards the life, health, and safety of staff.  Standards set by PHAB reflect practical up-to-date policies and procedures and function as a management tool for public health departments in the United States.

    The standards development and approval process has involved participation from a wide range of organizations, and the current standards and measures were the products of months of development by the PHAB Standards Development Workgroup, which included state and local public health professionals, national and federal public health experts, public health researchers, and other technical experts. The 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. The standards and measures were then subject to a public vetting process, and a beta test where feedback was collected from 30 beta site health departments and 97 beta test site visitors. Version 1.0 of the Standards and Measures was adopted by the PHAB Board of Directors in May, 2011, after three years of development.

    The Standards and Measures are divided into 12 domains; domains 1-10 address the ten Essential Public Health Services. Domain 11 addresses management and administration, and Domain 12 addresses governance. Standards are the required level of achievement that a health department is expected to meet.  Measures provide a way of evaluating if the standard is met.  Required documentation is the documentation that is necessary to demonstrate that a health department conforms to a measure.

    Each Domain, Standard and Measure is numbered using a standardized taxonomy for clarity. Thus, the numbers 5.3.2 delineate Domain 5, Standard 3, and Measure 2. 

    The Standards and Measures document provides guidance to health departments as they work to select the best evidence to serve as documentation.  It includes a “Purpose” statement for each standard and measure, a “Significance” statement for each measure, and narrative guidance specific to each required documentation item.  PHAB strongly recommends that the health department pay close attention to this document when selecting the most appropriate documentation to meet a measure.

    PHAB released Version 1.5 of the Standards and Measures in December 2013. Version 1.5 of the Standards and Measures clarifies the wording of requirements, stipulates the number of examples that are required for each measure, and specifies the time frame for each measure. Additionally, a limited number of noteworthy public health issues that are emerging as important forces in the advancement of public health have been included. For a quick summary of the revisions and clarifications, see the Summary of Version 1.5 Revisions and Clarifications, March 2014.

    As of June 2, 2014, PHAB stopped accepting accreditation applications under the Standards and Measures Version 1.0. Health departments whose applications were currently in the system on June 2 will still be reviewed under Version 1.0, while all health departments that submit their applications from June 3, 2014 forward will be reviewed under the revised Standards and Measures Version 1.5.


    Seven Steps of PHAB Accreditation:

    The accreditation process is structured around seven steps to accreditation. For more information about each of the seven steps, visit PHAB’s website. This toolkit is intended to provide guidance and resources to help you prepare for accreditation, and is structured around each of the 7 steps outlined below:

      1. Pre-application:  Health department prepares and assesses readiness for application for accreditation, completes Online Orientation, and informs PHAB of its intent to apply.
      2. Application: Health department submits application and fee, and completes applicant training
      3. Documentation Selection & Submission: Applicant selects documentation for each measure, uploads it to e-PHAB, and submits it to PHAB
      4. Site Visit: Site visit of the health department is conducted by PHAB-trained site visitors and a site visit report is developed  
      5.  Accreditation Decision: PHAB’s Accreditation Committee will review the site visit report and determine accreditation status of the health department
      6. Reports: If accredited, the health department submits annual reports
      7. Reaccreditation: As accreditation status nears expiration, the health department applies for reaccreditation