Illinois Accreditation Development Project

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Illinois Accreditation Development Project

• Multi-State Learning Collaborative
• November 17, 2005
• Elissa Bassler
• Laura Landrum
• Georgeen Polyak
• Jonathan Dopkeen

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Purpose of IADP

• Design an accreditation framework that would
  transition the IL local public health
  certification program into a more
  performance-based program
• Contribute to the knowledge base and participate
  in national dialogue through the MLC

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Illinois Local Health Department Certification
Program

• Illinois Project for Local Assessment of Needs
  (IPLAN)

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What led to Certification and IPLAN?

• 1990 - Project Health The Illinois Public Health
  Improvement Project

• Strategic planning by professionals from state
  and local health departments, public health
  academia, and public health associations
• Identified need to improve assessment function of
  public health statewide
• Catalyzed the development of progressive rules
  for certification of local health departments in
  Illinois

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Requirements for Certification of Illinois Local
Health Departments

• Before and After 1993

Before July 1993 To be recognized as a local
health department in Illinois, LHDs MUST DO
After July 1993 To be certified as a local health
department in Illinois, LHDs MUST

• Potable Water
• Food Sanitation
• Maternal Health/Family Planning
• Child Health
• Communicable Disease Control
• Private Sewage
• Solid Waste
• Nuisance Control
• Chronic Disease
• Administration

• Assess community health needs
• Investigate hazards within the community
• Analyze identified health needs for their
  determinants
• Advocate and build constituencies for public
  health
• Prioritize among identified community health
  needs
• Develop policies and plans to respond to priority
  needs
• Manage resources and organizational structures
• Implement programs and services to respond to
  priority needs
• Evaluate programs and services
• Inform and educate the community

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Illinois Administrative CodeTitle 77 Public
Health

• Chapter 1 Department of Public Health

Subchapter H Local Health Departments Part 600
Certified Local Health Department Code
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IL Certification Standards

• Organizational Practice Standards
• developed at UIC-SPH in 1991-92
• CDC funding
• Key question
• How can states determine whether local health
  units adequately address the core functions of
  public health?

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Organizational Practices vs. EPHS

• Assess
• Investigate
• Analyze
• Advocate
• Prioritize
• Plan
• Manage
• Implement
• Evaluate
• Inform

• Monitor
• Diagnose and investigate
• Inform
• Mobilize
• Plan
• Enforce
• Link
• Workforce
• Evaluate
• Research

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IL Certification Process

• LHD conducts IPLAN process
• IDPH reviews IPLAN submission for substantial
  compliance with Code
• LHD submits Certification Application
• If Certification Application provides
  self-affirmation of compliance with all practice
  standards, then IDPH director grants a 5-year
  certification to the LHD

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IL Project for Local Assessment of Needs (IPLAN)

• Underlying belief
• Public health services are most efficiently and
  effectively provided at the local level.
• Primary goals
• To establish a process for community involvement
  and
• participation in community health assessment and
• planning
• To make local health departments accountable to
  their
• communities rather than to the state

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IPLANs Essential Elements, a modified APEX-PH
model

• Organizational capacity assessment
• Community health needs assessment
• Community health plan, focusing on a minimum
  of three priority health problems

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IPLAN Requirements, every five years

• LHD or LPHS self-assessment
• Community participation
• Assess community health indicators
• Set at least 3 priority health needs
• Risk and contributing factor analysis
• Outcome and impact objectives and intervention
  strategies
• Local Board of Health adoption

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Community Health Committee

• ethnic racial groups
• medical hospital community
• mental health social service organizations
• cooperative extension service
• schools
• law enforcement organizations
• voluntary organizations
• faith community
• businesses and economic development
• unions
• youth, senior citizens, other target populations

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States role in IPLAN

• Established the framework (APEX-PH model)
• Develops, enhances and maintains IPLAN data
  system
• Conducts training and provides technical
  assistance
• Reviews submitted assessments and plans for
  substantial compliance with the administrative
  rules (every 5 years) and provides follow-up
  technical assistance

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IPLAN Products Health Priority Comparison
Chronic Disease Substance Abuse Access to Care
MCH Violence Mental Health
Infectious Disease Unintentional
Injury Environmental
Source Illinois Department of Public Health,
Division of Health Policy, Preliminary Results,
6/16/00
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Certification Program Financing and Incentives

• PHHS Block Grant for state program - - 250,000
  annually since 1993
• Local activities to maintain certification status
  
• Local sources of funding
• Local Health Protection Grant (recipients are
  certified local health departments)
• Estimated local IPLAN costs 10,000-15,000 in
  1994

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Initial Evaluation ResultsImproved Local
Effectiveness in IL
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Statewide IPLAN Forums, 2000 Six Major Themes

• Increase Collaboration and Communication Between
  Local Health Departments and the State Health
  Department
• Examine the Process to Enhance Flexibility
• Expand the IPLAN Data System Indicators and
  Increase Access and Skills
• Explore Funding Avenues
• Disseminate Plans Broadly
• Identify Best Practices

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SHARE - Applications

• Identifies jurisdictions with similar concerns,
  e.g., adolescent health, tobacco-related illness
• Identifies local participants to network and
  examine best practices for mutual priorities
• Vehicle for a stronger message to policymakers
  regarding local priorities

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Forces of Change in IL

• Split of a single SACCHO into three
• Northern IL Consortium bill to fund public health
  by consolidated regions
• IDPHs Enrich and Strengthen strategic planning
  process to revisit basic issues in governmental
  public health
• increased interest in use of standards
• increased interest in accountability,
  accreditation

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Evolution of IL Accreditation Components
1984 1993 1999 2005

• 1984 Roadmap Principles
• 1990 Project Health
• 1993 Standards established IPLAN begins
• 1994 Certifications granted
• 1999 2nd Round Certifications
• 2003 Enrich and Strengthen process initiated
• 2004 3rd Round Certifications begin
• 2005 IL Accreditation Project

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IL Accreditation Development Project Milestones

• Convene IL Accreditation Task Force
• Adopt a set of performance standards
• Develop enhanced measurement instrument for
  adopted standards
• Develop a governance structure/process
• Design an evaluation/QI plan
• Develop IL Accreditation Resource Plan
• Develop an implementation plan

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Major Issues for IADP

• Building a new consensus among 3 local public
  health organizations and IDPH
• Increasing state capacity to shepherd and sustain
  new program
• Revitalizing local and state capacity-building
  activities
• Creating a new culture of performance improvement
  and rigor
• Balancing capacity, process and outcomes in
  performance measures

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IADP EnhancementsFrom Certification to
Accreditation

• Descriptive metrics
• Minimal standards
• Assessment focus
• State administration
• Pass/fail criteria
• Compliance purpose

• Objective measures
• Optimal expectations
• All core functions
• Possible third party
• Range/tiered criteria
• Improvement purpose