Kentucky voices: health care

Ky. Voices: Ky. health departments set national standards

March 21, 2013 

There are many public-health historic events — the worldwide eradication of smallpox, the announcement of the success of the Salk polio vaccine and Surgeon General C. Everett Koop's mailing of the AIDS brochure to every American household.

Another less ballyhooed, but perhaps equally important, event occurred in early February, and Kentucky public health was in the lead.

After many years of preparation, the first health departments in the United States achieved national voluntary public health accreditation.

There were 11 accredited health departments in the first accreditation cohort; two state health departments, Washington and Oklahoma, and nine local health departments, of which three were from Kentucky.

These pioneering Kentucky health departments were Franklin County Health Department, Three Rivers District Health Department covering Carroll, Gallatin, Owen and Pendelton counties, and Northern Kentucky Independent District Health Department covering Boone, Campbell, Grant and Kenton counties.

Accreditation was granted by the Public Health Accreditation Board and its accreditation committee. The board has worked over several years, supported by the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, to establish itself, its processes and standards for allowing local, state and tribal health departments to achieve voluntary accreditation.

The board began accepting applications for accreditation in September 2011 and now hasover 150 health departments in various stages of the accreditation process.

The process of accreditation is long and involved. It requires, as a prerequisite, that a health department complete a strategic plan, a community health assessment and a community health improvement plan.

Once these are accepted, the health department completes a self-study to examine whether it meets and can provide documentation of compliance with rigorous standards that cover the 10 essential public health services.

These essential services include: diagnosing and investigating community health hazards, such as disease outbreaks; enforcing public health rules and regulations and the development of policy and plans to support community health efforts. Accredited health departments must also meet requirements in administration and governance.

The accreditation process is validated with a site visit by a team of public-health peers trained to assess compliance with public health standards. A report is then submitted by the site surveyors to the accreditation committee for review and decision.

If a health department achieves accreditation, annual reports must be submitted on continued compliance with the standards and a reaccreditation process completed in five years.

The accreditation process is done by health departments to show that they are accountable to the communities they serve. It also attests to their excellence in providing services. As a part of the standards the health department must have in place a functioning quality improvement plan to assure continued commitment to excellence, and demonstrate that they are continuing efforts to improve their services.

Public health departments would have benefited from passage of House Bill 360, which required health department accreditation and provided some support to assist them in the process. The bill, however, has been introduced on three occasions and languished each session.

Yet, Kentucky should be proud of its leadership in this effort. We are a state with numerous health problems — a high lung-cancer rate, diabetes and other chronic diseases.

For a small state, with our health problems, to lead in making sure we have effective health departments is a signficant indication that public-health leaders here are working to assure healthier communities.

The Kentucky Department of Public Health, having made the commitment to achieve this milestone, is also on its way to achieving accreditation.

So, congratulations to Kentucky's leaders in public health, their staff members and boards of health. These dedicated professionals have distinguished Kentucky as a leader in public health accreditation.

Dr. F. Douglas Scutchfield is a University of Kentucky professor and chair of the Public Health Accreditation Board's accreditation committee.

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