Frequently Asked Questions about Accreditation

Icon1. What is the purpose of the national accreditation program?

National public health accreditation aims to improve and protect the health of the public by advancing the quality and performance of state, tribal, and local health departments. Accreditation will drive public health departments to continuously improve the quality of the services they deliver to the community (Source: PHAB).

Icon2. Why now?

Public health departments play a critical, but often unrecognized role in promoting and preserving the health of people in communities across the country. Despite the important role health departments play in our communities, there has not been a national system for ensuring their accountability and quality—until now.

Other community services and organizations have seen the value of accreditation, such as schools, day care centers, police departments and hospitals. Now, there is an opportunity for public health departments to measure their performance, get recognition for their accomplishments and demonstrate accountability within their communities. Also, as the public health field faces increasing challenges from epidemics and disaster preparedness, it is more important than ever that systems are in place to ensure their effectiveness and quality of services (Source: PHAB).

Icon3. What benefits are anticipated from accreditation? Could accreditation impact funding?

The external validation and objective feedback from the PHAB accreditation process could have significant potential to accelerate performance improvement.

Health departments will position themselves to capitalize on anticipated funding preferences for accredited health departments. Going through the process will also highlight areas for improvement, and health departments may be able to better frame grant proposals to address those gaps.

The process will provide health departments with an opportunity to think about their mission, vision, and values, and how to do business given the challenging social and economic environment. Accreditation may raise the visibility of public health issues and provide a point of entry for decision-making discussions involving public health.

In addition, at MDH, accreditation will provide MDH an opportunity to think about what business it does and how it does that business given the challenging times. Accreditation may raise the visibility of public health issues and provide a point of entry for decision-making discussions involving public health.

Icon4. When will national accreditation start for health departments?

Icon5. How much will it cost to apply for accreditation?

Fees are based on the size of the jurisdictional population served by the health department. Jurisdictional population is used as a proxy for complexity of the review. You can find more information the cost of accreditation at PHAB: Fee Overview [Attn: Non-MDH link].

Icon6. How long does health department accreditation last?

PHAB has adopted a five-year accreditation cycle.

Icon7. Who developed the accreditation standards, measures, and processes?

The PHAB Board of Directors and the PHAB Standards Development Workgroup, along with significant feedback from public health leaders and practitioners, developed the standards, measures and processes that were formally adopted by the PHAB Board in August 2009.

PHAB held a public vetting process on the draft standards which resulted in a tremendous amount of feedback from the public health field. PHAB received 4,000 individual comments, online surveys and group feedback forms. The Standards Development Workgroup reviewed all public comments thoroughly and is grateful for the invaluable feedback provided by all who participated in the public vetting process.

In addition, PHAB administered a beta test of the accreditation process with 30 state, local and tribal health departments of various sizes. Pat Adams, MDH Director of Office of Statewide Health Improvement Initiatives, served as a site visitor during the beta test and actually reviewed one state health department's accreditation application and documentation. After going through this process, her site visitor group evaluated the experience and gave suggestions to PHAB for improvement of the standards and site visit processes (Source: PHAB).

Icon8. How does PHAB differ from JCAHO and AAAHC accreditation?

All three types of accreditation aim to promote quality of services and performance, based on a national set of standards, but differ in the types of entities eligible to apply and the types of services to be improved by standards. Each accrediting body is a unique entity that has different policies, procedures, standards, methodology for revising its standards, length of awarding accreditation, etc.


Questions Unique to Local Public Health Departments

Icon9. Minnesota is known for its great public health system. Why should Minnesota's local public health departments apply?

Accreditation is considered a "next step" in Minnesota's ongoing effort to improve the quality and performance of the public health system. Establishing consistent program performance expectations and related measurable indicators could promote consistent and improved public health practice in Minnesota. The Centers for Disease Control and Prevention (CDC), the Robert Wood Johnson Foundation (RWJF) and other national public health leadership organizations have been very supportive of national public health accreditation as a way to ensure quality and visibility of public health departments.

MDH has received a grant from through the CDC National Public Health Improvement Initiative to shepherd MDH's accreditation process and to support local and tribal public health departments which choose to seek accreditation. The Commissioner of Health is advised by the State Community Health Services Advisory Committee (SCHSAC). SCHSAC approved the recommendations of its Performance Improvement and Accreditation Workgroup, which included:

  • that local public health performance improvement system should be aligned with the national standards,
  • that MDH and Community Health Boards (CHBs) should work together so that all CHBs are prepared to apply for voluntary national accreditation by 2015, and
  • that CHBs and local health departments should review their governance and organizational structures, responsibilities, authorities and current legal agreements in relation to the national standards and the voluntary national accreditation program.

The workgroup's full recommendation is available online:

Icon National Public Health Standards and Voluntary Accreditation: Implications and Opportunities for Public Health Performance Improvement in Minnesota (PDF: 725KB / 56 pages)
SCHSAC Performance Improvement and Accreditation Workgroup
Dec. 2010

Minnesota's local public health departments will be joining many of peer health departments across the country who will also seek accreditation.

Icon10. How will the Minnesota Local Public Health Assessment and Planning process support CHBs and local health departments to meet accreditation standards?

The Local Public Health Assessment and Planning process was updated based on recommendations from the State Community Health Services Advisory Committee (SCHSAC), to align the process with the national accreditation standards.

The process aligns with the PHAB Standards and Measures by using PHAB definitions and criteria. Guidance and technical assistance from MDH will also be based on the PHAB Standards and Measures.

Completing the Minnesota Local Public Health Assessment and Planning Process will result in:

  • A thorough understanding of the standards and measures after conducting the organizational self-assessment
  • A completed prerequisite for accreditation, the Community Health Assessment, as defined in PHAB Standard 1.1
  • A completed prerequisite, the Community Health Improvement Plan, as defined in PHAB Standard 5.2
  • A completed prerequisite, the organizational Strategic Plan, as defined in PHAB Standard 5.3
  • A completed Quality Improvement Plan to submit as documentation for Standard 9.2

After completing the Local Public Health Assessment and Planning Process, the CHB will have the plans it needs to implement before pursuing accreditation. PHAB isn't just asking for plan documents. Accreditation requires implementing, monitoring, reporting, and revising these plans.

Icon11. Will a community health board or an individual local public health department apply for accreditation?

From the Public Health Accreditation Board (PHAB):

"A local health department is defined, for the purposes of PHAB accreditation, as the governmental body serving a jurisdiction or group of jurisdictions geographically smaller than a state and recognized as having the primary statutory authority to promote and protect the public's health and prevent disease in humans. This authority is defined by the state's constitution, statute, or regulations or established by local ordinance or through formal local cooperative agreement or mutual aid. The entity may be a locally governed health department, a local entity of a centralized state health department, or a city, city-county, county, district, or regional health department."

Please contact PHAB for further guidance.

Icon12. How will MDH work with CHBs so that they are prepared to apply for accreditation in 2015?

MDH can provide a variety of training, technical assistance and consulting. For more information, visit: Accreditation for Local Public Health


Questions Unique to Tribal Public Health Departments

Icon13. How were the tribal accreditation standards, measures and processes developed?

The PHAB Board of Directors and PHAB Standards Development Workgroup, along with significant feedback from public health leaders and practitioners, developed the standards, measures and processes that were formally adopted by PHAB's Board in August 2009 (Source: PHAB).

PHAB worked with the National Indian Health Board (NHIB) to ensure that accreditation standards for tribal health departments addressed the specific needs and challenges of the Tribal public health programs. As the national public health accrediting body, PHAB recognizes the unique and critical role that Tribal governments have in developing the accreditation program (Source: NIHB).

Icon14. How were tribes involved in the development of the national accreditation program?

In addition to participating in the development of the PHAB Standards and Measures, health departments from three tribal nations participated in a beta test of the accreditation standards and process (the Navajo Nation Division of Health, Window Rock, Arizona; Keweenaw Bay Indian Community, Department of Health & Human Services, Baraga, Michigan; and the Cherokee Nation Health Services, Tahlequah, Oklahoma). PHAB has an ongoing commitment to learn more about tribal public health.

PHAB convened a Tribal Standards Workgroup, on which Deb Smith of the Fond du Lac Band of Lake Superior Chippewa served. This workgroup reviewed accreditation standards and measures while considering unique issues like tribal sovereignty and culturally appropriate approaches to care. This workgroup suggested changes to the final tribal standards. More Information:

To learn more about the PHABTribal Standards Workgroup, visit the PHAB e-Newsletter for June/July 2011 [Attn: Non-MDH link].

Icon15. What kind of support/technical assistance can tribal public health departments expect from MDH?

MDH can provide a variety of training, technical assistance and consulting. For more information, visit: Accreditation for Tribal Public Health

Icon16. How does PHAB differ from other programs in which Indian Health Services participates?

Other types of accreditation aim to promote quality of services and performance, based on a national set of standards, but differ in the types of entities eligible to apply and the types of services to be improved by standards. Each accrediting body is a unique entity that has different policies, procedures, standards, methodology for revising its standards, length of awarding accreditation, etc.


Questions about the Minnesota Department of Health

Icon17. Minnesota is already are recognized nationally for its great work. Why has MDH applied for accreditation?

The Centers for Disease Control and Prevention (CDC), the Robert Wood Johnson Foundation, and other national public health leadership organizations have been very supportive of national public health accreditation as a way to ensure quality and visibility of public health departments. MDH has received an infrastructure grant from CDC that supports MDH to seek accreditation, and to increase organizational capacity and commitment for quality improvement projects.

The Commissioner of Health is advised by the State Community Health Services Advisory Committee (SCHSAC). SCHSAC approved the recommendations of its Performance Improvement and Accreditation Workgroup, which included:

  • that local public health performance improvement system should be aligned with the national standards, and
  • that MDH should lead the way by preparing for state-level accreditation, and seeking voluntary national accreditation at the earliest opportunity (no later than 2013).

For the full text of the Performance Improvement and Accreditation Workgroup Report, visit:

Icon National Public Health Standards and Voluntary Accreditation: Implications and Opportunities for Public Health Performance Improvement in Minnesota (PDF: 725KB / 56 pages)
SCHSAC Performance Improvement and Accreditation Workgroup
Dec. 2010


MDH joins many of its peer state health departments across the country in seeking accreditation.

Icon18. Who at MDH was involved with preparing MDH's accreditation application?

Pulling together the evidence and documentation needed for accreditation will be complex, but MDH has a plan to move things forward:

  • The MDH Health Steering Team provide leadership and guidance for the accreditation process.
  • 12 interdisciplinary Domain Teams include MDH management and staff from divisions and offices whose work is represented in the domain standards. These teams have collected evidence of MDH's activities that meet the accreditation standards in their assigned domains.
  • Staff from the MDH Office of Performance Improvement provide coordination and support throughout the entire accreditation process. This coordination team is working through the entire process including organizing the site visit, and facilitating an evaluation of the process once complete. This same team is also supporting local and tribal public health departments choosing to pursue accreditation.

Individual staff have been asked by their supervisor to: serve on a domain team, participate in a quality improvement project, collect documentation or other evidence of MDH activities, or be interviewed during the site visit.