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Issues in Public Health Accreditation: US and Illinois

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Title: Issues in Public Health Accreditation: US and Illinois


1
Issues in Public Health Accreditation US and
Illinois
  • Illinois Public Health Association
  • April 24, 2006
  • Laura B. Landrum
  • Illinois Public Health Institute

2
Exploring Accreditation for the Nation Why Are
We Doing This?
  • The Future of the Publics Health in the 21st
    Century (IOM)
  • CDCs Futures Initiative
  • Quality Improvement Efforts in Public Health
  • Key Stakeholder Meeting 2004
  • Do the benefits outweigh the costs?

3
Exploring
Accreditation (EA) Project Goal
Design a model voluntary national accreditation
system for state and local (governmental) public
health departments and determine whether it is
feasible and desirable to implement.
4
Draft EA Accreditation Model Under Construction
  • Governance structure
  • Process for implementing the governance structure
  • Principles for establishing standards
  • Principles for determining conformity with
    standards
  • Financial principles
  • Proposal for incentives to attract applicants for
    accreditation
  • Proposal for evaluating success

5
Purpose of IL Accreditation Development Project
  • 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 Multi-State
    Learning Collaborative

6
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

7
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

8
Certifications Essential Element IPLAN
  • Organizational capacity assessment
  • Community health needs assessment
  • Community health plan, focusing on a minimum
    of three priority health problems

9
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
10
Percent of Illinois LHDs Performing Selected
Practice Performance Measures 1992-1999
11
Forces of Change in IL
  • Split of a single SACCHO into three
  • Northern IL Consortium bill highlights
    disagreement on how best to fund public health
  • 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

12
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
  • 2004 3rd Round Certifications begin
  • 2005 IL Accreditation Project through IL Public
    Health Institute

13
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

14
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

15
IADP Enhancements From Our Current System into
the Future
  • Descriptive metrics
  • Assessment focus
  • State administration
  • Pass/fail criteria
  • Forgotten purpose
  • Objective measures
  • All core functions
  • Possible third party
  • Range/tiered criteria
  • Improvement purpose

16
Key IADP Decisions To Date
  • Retain current Illinois local public health
    performance standards
  • Use NACCHOs Operational Definition to develop
    performance measures
  • Criteria for analyzing structure options
  • Criteria for effective performance measures

17
Structural Elements of Enhanced
Certification/Accreditation in IL
  • New relationship between mandatory certification
    and voluntary accreditation?
  • Fix certification and enable lhds to choose
    beyond minimum mandatory measures
  • Administration of the program
  • Fair and equitable process
  • Peer learning
  • Training
  • Governance of the program
  • Decision-making process
  • Meaningful evaluation
  • Redevelop standards and measures over time

18
Comment Periods
  • Exploring Accreditation
  • Consensus report available May 2006
  • www.exploringaccreditation.org
  • IL Accreditation Development Project
  • LHD/BOH commentary process July-August 2006
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