PHAB Version 1.5: New Resources for Local Health Departments

By Lowrie Ward, Program Analyst, NACCHO

This summer, the Public Health Accreditation Board (PHAB) began accepting applications for its voluntary national accreditation program under Standards and Measures Version 1.5. According to PHAB, this updated version of its 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, PHAB included a limited number of noteworthy public health issues that are emerging as important forces in the advancement of public health. Information about these changes is available at www.phaboard.org.

The changes have received praise from many in the field, with many local health departments (LHDs) indicating that the clarifications, revisions, and additions are valuable. Laurie Dietsch, Accreditation Coordinator at Columbus Public Health (accredited March 2014), thinks the changes are “PHABulous” and notes that PHAB “listened to the feedback from health departments that have gone through the process and made changes to clear up confusing areas.” She thinks that these changes “make version 1.5 a true reflection of quality improvement, which is what accreditation is all about.”

April Harris, Accreditation Coordinator at the Three Rivers District Health Department in Kentucky (accredited February 2013), has similar feelings. As a representative of an accredited agency, she is “thrilled that PHAB is demonstrating a willingness to consistently improve.” Alan Kalos, Accreditation Coordinator at the Northern Kentucky Health Department (accredited February 2013), says that “aside from more clearly identifying the purpose and types of documents required, the most helpful aspect of [Version] 1.5 is the redesigned format. The new format clearly indicates the time frame and the number of examples required. This makes preparing to meet the requirement and developing a timeline for needed processes much easier.”

As a part of NACCHO’s ongoing efforts to support LHDs as they prepare for accreditation, NACCHO has updated several resources to reflect the changes to the standards and measures:

  • In NACCHO’s Example Documentation Library, which is a collection of documentation that LHDs plan to submit to PHAB, NACCHO has removed examples that no longer meet Version 1.5 Throughout the summer, more examples will be added that conform specifically to Version 1.5.
  • NACCHO also updated its Documentation Selection Tools. These are resources that help accreditation coordinators and teams collect and organize documentation in ways other than measure by measure. For example, one popular tool is the programmatic documentation matrix. This includes a list of all PHAB measures that can be met with documentation from a program area. Teams can use this matrix to select documentation and make sure that their submissions reflect the “breadth and depth of programming at the health department,” as PHAB requires. This tool and others have been redone so that they are in alignment with Version 1.5

    Both the Example Documentation Library and the Documentation Selection Tools can be accessed from www.naccho.org/documentation.

  • NACCHO has also updated the Developing a Local Health Department Strategic Plan: A How-To Guide. This guide provides a framework for LHDs to use as they conduct the process that creates an agency strategic plan, a PHAB prerequisite. While the entire guide hasn’t been recreated, it contains an addendum document that indicates where revisions and updates are necessary.

    This guide and other strategic plan resources are available at www.naccho.org/prerequisites.

  • The Accreditation Support Initiative (ASI) from NACCHO and the Centers for Disease Control and Prevention funds LHDs around the country as they prepare for national accreditation. The ASI website (www.naccho.org/asi), which includes documentation and other valuable resources, has been updated to reflect the recipients of last year’s awards—many of which are applying under Version 1.5.

You may still find some NACCHO resources that have not been adjusted to reflect the changes in Version 1.5. Please let us know at accreditprep@naccho.org if you find something that you believe should be updated.

NACCHO staff are available as a technical assistance resource for all areas of accreditation preparation. PHAB provides guidance related to the technical aspects of the accreditation process and interpretation of the standards and measures, while NACCHO and other partners can help organizations as they prepare to meet the requirements of the standards and measures. NACCHO staff can review documentation and provide feedback based on our interpretation of the PHAB requirements. Additionally, we are also happy to connect LHD staff with peers from around the country doing similar work in their communities. If you are interested in technical assistance, visit www.naccho.org/accreditation or e-mail accreditprep@naccho.org.

Stories from the Field: Using a Low-Powered Radio Station to Bolster Preparedness Efforts

The following story was submitted to NACCHO’s Stories from the Field website by Robert Cohen from Maine Township (IL) Regional Medical Reserve Corp on July 3. NACCHO’s Stories from the Field website provides a means for local health departments (LHDs) to share their experiences and demonstrate the value of public health. Stories from the Field can be used to support advocacy, peer learning, and collaboration with state and federal partners. Share your story at http://nacchostories.org.

Throughout the country, there are hundreds of small, low-powered radio stations that provide information about an area’s attractions, special road conditions, fire hazards, and so much more. These little gems can be of significant use during public health emergencies or area disasters.

During public health and safety emergencies, a low-powered portable emergency advisory radio station can directly reach citizens via standard radio receivers. It can be a lifesaver, allowing the broadcast of critical instructions and information regarding disasters/evacuations, medical emergencies (hospital surge, points-of-distribution field information, quarantine isolation, decontamination), terrorist/shooter incidents, HAZMAT and traffic information, and critical public safety instructions. Low-powered broadcasts may be received on standard vehicle radios or portable radios over a three- to five-mile range (25­–75 square miles). Systems today are so advanced that several can be linked together for greater coverage.

Low-powered AM radio stations can provide an additional tool during non-emergency times for broadcasting helpful public health information, developing community awareness for your programs, and also as a recruiting tool that does not have to be paid for each time it is utilized. The system we have can be run from a fixed location as we do most of the time or can be loaded into the back of a car and taken anywhere in our area and setup to broadcast pertinent information regarding a public health emergency or disaster related information. Portability also makes a low-powered radio station especially useful at large public gatherings for broadcasting key information, such as schedules, traffic, parking, safety, and critical instructions for patrons approaching or exiting.

Messaging can be controlled using flash drives [...] and may also be uploaded via ethernet from a network or a laptop computer. If you need to “break in” to your messaging, you may do so live with a microphone. When you lose power in your area due to storm damage, you can still broadcast by connecting your unit to a generator.

Getting the word out to hundreds or thousands of residents on an ongoing basis can be a costly venture. Having your own low-powered AM radio station and some strategically placed signage telling people how to access your station can accomplish community outreach by continuously broadcasting your message with all of the pertinent information. We broadcast information regarding West Nile Virus, whenever there is a food recall in our area, storm-related information, flooding information, location of mass care or shelter facilities, and general community events information. Just think about an available 24/7 recruiting drive for your medical reserve corps or other programs. Look at what you might accomplish if thousands of people knew about a blood drive. Consider all of the information you could get out regarding point-of-distribution sites.

Since the inception of our station, we have increased volunteer enrollment in three of our programs. When flooding was a potential threat, those in prone areas were grateful for the extra warning we were able to give them. Our community events have been better attended as well. Most importantly, when we had to shut down our radio to change our antenna location, we got phone calls wondering what happened and why was our station off the air. This told us that our residents have embraced the system.

We found that instead of solely relying on public resources of newsprint and general radio, we are able to communicate specifically what we need to in order to keep our residents officially informed. By utilizing your own radio station, you are not limited to [whatever] time space a local television station may have to give you to get a condensed message out. Further, by having your own low-powered station, you can keep your message out there 24/7 for as long as needed, for mere pennies of electricity use.

Read more LHD stories from the field at http://nacchostories.org.

Seasonal Influenza Vaccinations for Pregnant Women, Children with Special Healthcare Needs, and Adults with Disabilities: LHD Capacity and Recommendations for the Future

Vaccine shotBy Charlene Kemmerer, PMP, Program Analyst, NACCHO, and Lindsay Tiffany, Communications Specialist, NACCHO

While flu season might seem a long way off, NACCHO recently released a research brief summarizing individual key informant interviews it conducted earlier this year about the capacity of local health departments (LHDs) to promote and administer seasonal flu vaccine and track vaccination rates among children with special healthcare needs (CSHCN), pregnant women, and adults with disabilities.

NACCHO recruited LHD staff involved in vaccine surveillance, promotion, or administration through its infectious disease prevention and control, immunization, and disability electronic mailing lists, which consist of people who self-select to receive updates from NACCHO. NACCHO selected participants based on their region, position title, and number of years on the job. Nine individuals from a group of 24 candidates participated; these LHDs were located in eight states and oversaw jurisdictions ranging in population size from 19,000 to 1.5 million residents. NACCHO transcribed and analyzed recordings from the key informant interviews to identify common themes. Results of the interviews are summarized below.

Collecting Data on Seasonal Flu Vaccination Rates for Pregnant Women, CSHCN, and Adults with Disabilities

None of the LHDs interviewed collected community-wide data on seasonal flu vaccination rates for pregnant women, CSHCN, or adults with disabilities. LHDs reported that they did not have the infrastructure or staff capacity to track community-wide flu vaccination rates. Additionally, people can receive a flu vaccination in many locations (e.g., pharmacies and private physicians’ offices) and providers may not be required to report this information.

Administering Vaccinations

Several LHDs indicated that they vaccinated pregnant women, CSHCN, and adults with disabilities for flu as part of larger efforts to vaccinate the community through school-based clinics, health fairs, and public clinics.

LHDs identified reimbursement as one challenge to vaccinating pregnant women, CSHCN, and adults with disabilities. LHDs indicated that reimbursement issues (including reimbursement for staff time) compounded the management challenges of providing vaccinations.

Promoting Vaccinations

LHDs used various strategies to promote flu vaccinations among pregnant women, CSHCN, and adults with disabilities. LHDs reported posting fliers about flu clinic dates and times at local businesses. Others used a healthcare provider or school newsletter to promote flu vaccinations. LHDs also used newspaper, radio, and television advertisements to promote flu vaccinations. LHDs indicated that vaccine misconceptions often hindered their promotion efforts.

Many LHDs said that they used Facebook or Twitter to promote flu vaccinations, and two LHDs noted that texting services could provide effective flu vaccination reminders.

Partnerships

When asked to name the most valuable partner that LHDs could engage to increase the number of flu vaccinations for pregnant women, CSHCN, and adults with disabilities, participants consistently named physicians. LHDs also mentioned working with managed care providers, federally qualified health centers, pharmacists, and schools. Sometimes LHDs in different jurisdictions worked together to promote and administer flu vaccinations.

Recommendations

Based on the findings of this research, NACCHO recommends the following:

  • LHDs should collaborate with community-based organizations and community stakeholders (e.g., businesses, employers) to increase the coordination of resources and programs to improve the health of people with disabilities.
  • LHDs should leverage existing programs for pregnant women, CSHCN, and adults with disabilities to promote and provide flu vaccinations.
  • LHDs should ensure that any flu vaccination campaigns are accessible by people with sensory disabilities through the use of accommodations like Braille/large print, American Sign Language, and closed captioning.
  • The federal government should maintain funding to state and local health departments for immunization programs, including funding for the Vaccines for Children Program.
  • The federal government should support an interoperable system allowing for information exchange between state- and local-level immunization registries and between all pertinent local users.
  • The federal government should fund activities necessary for state and local health departments to establish third-party billing systems.

To read the full-length research brief, Capacity of Local Health Departments to Track, Administer, and Promote Seasonal Influenza Vaccinations for Pregnant Women, Children with Special Healthcare Needs, and Adults with Disabilities, visit the NACCHO Bookstore.

Need information on billing for clinical services? NACCHO’s Billing for Clinical Services Toolkit was designed to help make navigating the billing process easier for LHDs. It contains resources from state billing guides, the Centers for Medicare and Medicaid Services, state health departments, local health departments, insurance companies, and vendors of products such as electronic medical records and billing clearinghouses.

An LHD of the Year Award Winner Explains How to Implement a Tobacco-Free Policy

Interview by Ian Goldstein, Web and New Media Specialist, NACCHO

NACCHO honored the exceptional achievements of local health departments (LHDs) and local health officials at the 2014 NACCHO Annual Conference, held July 8–10 in Atlanta. NACCHO’s LHD of the Year Award recognizes and honors outstanding accomplishment of LHDs across the country for their innovation, creativity, and impact on communities. The following winners were categorized by size of jurisdiction and recognized for accomplishments in outstanding internal and external policy: Small Jurisdiction: Macon County Public Health Center (Franklin, NC); Medium Jurisdiction: Whatcom County Health Department (Bellingham, WA); and Large Jurisdiction: Chicago Department of Public Health (Chicago, IL).

The following is an excerpt from a recent NACCHO podcast featuring an interview with Macon County Public Health Center Health Director Jim Bruckner, who spoke about his health department’s winning tobacco control policy.

*

NACCHO: What made you decide to apply for this award?

Bruckner: Macon County has long advocated for strong tobacco control policies for our community. In partnership with our community partners—local youth groups—we set a goal in 2008 to try and get a tobacco-free parks and recreation policy established in the community. We met a bit of resistance at the time. Our county commissioners didn’t feel that they had the ability to set forth such a policy. Things changed for us in 2012 when the North Carolina legislature passed the Smoke-Free Restaurants and Bars law. Although that focused on exposure to second-hand smoke, it also gave authority to local governments to regulate smoking in public places.

NACCHO: How has this policy been implemented in Macon County?

Bruckner: Our timeline for the project was nine months initially and the process began with some legislative and policy research. We utilized folks from the state division of public health’s tobacco control branch and their online toolbox for implementation policies. They also had a model policy that was great to have available; it sped up the process in getting the policy through our county attorney and into the board of commissioners. We then transitioned into building public support and securing some necessary grant funding. Once we verified that we had public support, we set about building evidence-based feasibility and support from community leaders and elected officials. In this phase, we basically went to a lot of meetings.

Once the ordinance was successfully adopted by the commissioners, we transitioned to the implementation phase. This phase was about 90 days long. We did facilities surveys, which looked at where they needed signage and what other needs facilities had. That’s what we were trying to secure the grant funding for. We purchased signage for all the recreation facilities and all of the parks; we purchased rugs for the entryways of the buildings; we did a widespread media campaign with press releases; and we did signs at the movie theaters. We clarified with our parks and rec staff and our sheriff’s department what the enforcement procedures would be and helped them develop talking points and handouts that they could give to folks who had questions or if they met with any violations. The ordinance actually went into effect July 9, 2012. One of the good things about the fact that it’s an ordinance on the enforcement side is that it established penalties if you are caught smoking in a parks and rec area.

NACCHO: For those who don’t know, what is the population of Macon County and where in North Carolina are you located?

Bruckner: We are in far western North Carolina and have a population of about 34,000. We’re a small rural county; about 50 percent of the county is national forest.

NACCHO: North Carolina was traditionally part of tobacco country. Is that part of Macon County?

Bruckner: Not necessarily Macon County but it is part of the state.

NACCHO: What was the biggest challenge, from a governmental standpoint, when implementing this ordinance?

Bruckner: We had three challenges upon which our success was largely dependent. This first was the ability to develop and demonstrate strong community support for the cause. The second was the argument of tobacco-free versus smoke-free. The third was the cost of implementation to the county.

NACCHO: Tell us more about the issue of tobacco-free versus smoke-free.

Bruckner: What we had to do in the beginning was squelch the argument of tobacco-free versus smoke-free. We built support for the tobacco-free argument by showing photos at presentations showing kids running around at the park or under bleachers at the ball field and we made sure to highlight the fact that there were cigarette butts on the ground and tobacco pouches and tobacco plugs where the children were playing. Also, the youth who were involved in advocating for this did cigarette butt pick-ups in parks and actually presented those in 20-gallon trash bags in front of the board of commissioners as an example of what they picked up in just a few hours at the park.

*

Listen to the rest of the interview with Jim Bruckner about his community’s response to the ordinance and his advice to other LHDs that are looking to implement similar policies (start at the 5:30 mark) at http://bit.ly/1Ah1d8e.

Interested in listening to more of NACCHO’s podcasts? NACCHO’s podcast series is now available for subscription on iTunes. If you have iTunes or an iPhone, download the podcast app and search “NACCHO.” Once you subscribe, the latest NACCHO Podcasts will automatically download to your phone. You can also subscribe with the following link: http://bit.ly/1zd6xrI.

Chikungunya: Time to Prepare for a New Mosquito-Borne Virus in the United States

On July 17, the Centers for Disease Control and Prevention announced that the first locally acquired case of the chikungunya disease has surfaced in the continental United States. The post below shares how LHDs can prepare for chikungunya.

Screen Shot 2014-07-18 at 1.37.13 PM

The chikungunya (pronounced “chik-en-gun-ya”) virus has expanded its range into the Western Hemisphere as of late 2013. The virus, which has been known throughout Africa and Asia since the 1950s, causes a disease that has been compared to having a terrible case of the flu combined with an abrupt case of arthritis. It is most commonly characterized by fever and joint pain and could include headache, muscle pain, joint swelling, and/or a rash. The disease is spread via bites of two species of mosquitoes that are present and abundant in the United States: Aedes aegypti and Aedes albopictus, the latter is an alien species that has established itself in our country.

Chikungunya disease has been rapidly spreading since its introduction. It has spread in a matter of months throughout the Caribbean and Central America and into the eastern coast of the South American continent. More than 50,000 cases of human disease have been reported through the end of May 2014. Will it reach and become established in the United States? It is virtually certain that it will. We have already seen this happen with West Nile Virus, which entered the United States in 1999 and  spread throughout almost the entire country within five years. In fact, at least four cases of chikungunya in U.S. citizens who became ill with after returning from trips to Caribbean islands were recently documented in Florida and Tennessee. Local health departments should expect to see more of these cases as travel to the Caribbean for business and pleasure purposes increases over time. In addition, hundreds of thousands of soccer fans, many from the United States, are expected to travel to Brazil in July for the World Cup. The opportunities for introduction of the virus via infected fans returning from the games will be many.

Local health departments are on the front lines to prevent and control the expected introduction and spread of this virus and disease. This is the time for assuring that we as a profession and as a nation are prepared for this new disease. Treatments might only diminish the symptoms; there are no cures. There are also no vaccines to prevent infection. Local health departments will need to rely on traditional public health measures of surveillance, response, and education.

NACCHO recommends that local health departments take the following steps to prepare for chikungunya:

  1. Review mosquito surveillance capacities and ability to monitor the mosquito populations, measure for the presence and extent of the virus, and identify human cases.
  2. Review and update mosquito control plans and assure that all participants in that plan are capable of responding to findings that would be a trigger for use of control measures.
  3. Review vector control education plans for the public, medical providers, and laboratories serving the community. Awareness of the virus and disease, recognition of symptoms, personal measures for preventing mosquito bites, and community measures for eliminating Aedes mosquitoes and their breeding sites are all parts of a comprehensive vector disease prevention and control educational campaign.

This post originally ran on NACCHO’s Preparedness Brief blog. For more preparedness news and resources, visit http://www.nacchopreparedness.org.

Interview with Mo Mullet Award Winner Joan Ellison, RN, MPH

By Lindsay Tiffany, Communications Specialist, NACCHO

joan-ellison

NACCHO is pleased to recognize Joan Ellison, RN, MPH, as this year’s recipient of the Maurice “Mo” Mullet Lifetime of Service Award. This award honors current or former local health officials for noteworthy service to NACCHO that has reflected the commitment, vigor, and leadership exemplified by Mo’s distinguished career.

Ellison’s career in local public health spanned more than 43 years, including 34 years as Public Health Director of the Livingston County (NY) Department of Health. Throughout that time, she devoted herself to improving the health of the community and to working with colleagues at state and national levels to better the field of public health. Ellison exemplified continuous quality improvement, as evidenced by her work on APEX-PH, Mobilizing for Action through Planning and Partnerships (MAPP), and public health department accreditation.

NACCHO: How did you get involved with NACCHO?

Ellison: I joined NACCHO in 1990 when I read that NACCHO was accepting applications from LHDs to become demonstration sites for APEX-PH. I applied and had no idea what I committed the department to; however, we were accepted as a demonstration site. NACCHO broadened our public health world. Exposure to the broader scope of public health is difficult in a small health department; NACCHO brings the national level home. After APEX-PH, I volunteered to serve on the MAPP Committee and went on to serve on several other NACCHO committees, the NACCHO Board of Directors, and I chaired the Profile committee.  It has been very rewarding and exciting for me to work with NACCHO and NACCHO staff and my experience has brought depth to the department.

NACCHO: In your nomination, your colleague noted that you and your staff wore buttons with the words “That’s the way we’ve always done it” crossed out with a large red “x.” How important was innovation for you in your career in local public health?

Ellison: Innovation and creativity are extremely important in public health. We are a small-to-medium county health department in upstate New York. Exposure to what larger counties were doing and being on the cutting edge of public health was elusive to us. Thinking outside of the box was critical. Innovation was the turning point for us because it allowed us to implement APEX-PH, starting with an internal assessment. We were then able to identify priorities. We simply weren’t allowed to say “That’s how we’ve always done it.” We needed new ways to address public health concern and to improve our internal structure.

NACCHO: From advocating for funding for LHD bioterrorism efforts to battling the West Nile Virus, you’ve faced all kinds of challenges. What has been the most challenging issue you faced and how did you deal with it?

Ellison: There were a number of challenges. More than any issue, funding was and remains the number one challenge for local health departments. It was challenging to think of different ways to explain what public health is and how it benefits the community. It’s not something you can explain in a few words and expect that they will immediately understand. There are so many other priorities in the community that it is overwhelming to fight for public health funding. We found that we really had to educate people in a grassroots way–from community members and local policymakers to state and federal legislators.

Unfortunately, to this day public health funding continues to get cut. This comes at a time when you read the public health journals and see that more and more problems are being identified as public health issues. In my opinion, public health is the health of public. People are not putting funding where it needs to be to address such a wide range of issues. Funding has been and will be a challenge and we’ll need to continue to work on it forever. We’re really past the phrase “Do more with less.” We’ve already done that. If you don’t have resources to be able to provide the infrastructure that is needed, there is really no other avenue for addressing these critical public health issues.

NACCHO: You were a big champion for the Mobilizing Action through Planning and Partnerships (MAPP) process. How did MAPP strengthen your LHD?

Ellison: The department has implemented the MAPP process several times. It was fantastic because it put the role of the LHD in the community into focus. Through the MAPP process, we became identified by the community as change agent, as a leader, and as a facilitator. It made us a partner in the community. Our partners were also facing financial challenges, similar to us. MAPP encouraged all of us as partners to address the health of community through the community public health system and that was advantageous for everyone. I think community agencies sometimes struggle with turf—“that’s my program” or “that’s not our issue.” MAPP relinquishes that hold and brings partners together.

NACCHO: What are you most proud of in your long tenure in local public health?

Ellison: Two things come to mind. The first is initiating a local law to ban smoking in public places in our county. In the mid 1990’s when we began working on the smoking ban, two counties in New York state already had bans in place. Our county was the third and, more notably, we were the first small county and our local law was stronger than any in the state. We put public health first and our community took action. The hearing for the ban was largest public hearing that our county board had ever had. While there were opponents and proponents, the majority of those that came out were in favor of it.

Recently, I couldn’t be more proud of our department for achieving accreditation. We were first of 11 health departments recognized. It was many, many years of excellence that prepared us for accreditation. Through continuous quality improvement efforts, the department was able to meet the PHAB Standards and Measures. To realize that we met national standards is awesome. It takes a long time for public health to be able to show its successes. The things we address—be it promoting the use of car seats or diet and exercise interventions or reducing chronic disease mortality—it takes years to see the results and it’s rarely one intervention that makes a difference. The staff worked tirelessly through various strategies and interventions with partner agencies to improve the health of the community. Through their efforts, Livingston County has been named the healthiest county in New York State for two years! Staff deserve the credit for accreditation.

NACCHO: What advice would you give to young professionals just starting their careers in local health departments?

Ellison: First, they need to think of public health as the health of the public. Oftentimes when you talk to community partners about a problem, they think it’s the LHD’s problem. By framing public health as the health of the public, it makes community partners see that it’s not just the LHD’s responsibility, but is the work of entire public health system. Partnering with other organizations in your community is critical. Learn how to work with your community. Every community and agency is different. It’s important for public health leaders to understand the focus of programs and to develop community goal through a community health improvement plan.

Second, I would tell them that this is the best career you could have. It’s tireless work. You have to work long and hard but if you do, you will see changes. It’s incredibly rewarding.

Improving the Quality of Public Health Practice through PHAB’s Accreditation Program and the FDA Retail Program Standards

By Stephen Hughes, Consumer Safety Officer, Food and Drug Administration, and Amy Chang, Program Assistant, Environmental Health, NACCHO

For the past 15 years, the Voluntary National Retail Food Regulatory Program Standards (Retail Program Standards) have served as a model for the continuous improvement of retail food regulatory programs throughout the United States. Many of the retail food regulatory programs enrolled in the Retail Program Standards operate within a larger public health agency with a broad public health mission. As public health accreditation becomes more common for public health agencies, it is becoming more important for retail food regulatory programs to understand the relationships between the Retail Program Standards and the standards used for public health accreditation.

The Public Health Accreditation Board’s (PHAB’s) accreditation program defines the expectations for health departments that seek to become accredited and document the capacity of the health department to deliver the three core functions of public health and the Ten Essential Public Health Services. Similarly, the Retail Program Standards serve as a guide to regulatory retail food program managers in the design and administration of a retail food program and provide a means to recognize a program’s accomplishments.

Although each initiative targets different parts of a public health agency, they share many similarities, such as an emphasis on specific, measurable performance metrics and continuous quality improvement. Specific, measurable performance metrics, coupled with continuous quality improvement, will help public health agencies to improve the quality of public health practices.

To assist health departments in understanding that both initiatives complement each other and are not mutually exclusive processes, NACCHO and the Food and Drug Administration created the Crosswalk on Public Health Accreditation and Retail Program Standards. The document provides an overview of the two initiatives, areas of alignment, and examples of how specific documents generated during the Retail Program Standards process might be used to meet certain required documentation examples for the PHAB measures. The table below gives a broad overview of how PHAB’s accreditation program and the Retail Program Standards have many similarities. Access the full crosswalk in NACCHO’s Bookstore.

Broad Overview of Similarities between PHAB Standards and the Retail Program Standards

crosswalk-table