Increase the number of tribal public health agencies that are accredited — PHI‑03 Data Methodology and Measurement

To be accredited, public health agencies must submit documentation to demonstrate conformity with approximately 100 consensus Standards and Measures, which are based on the 10 Essential Public Health Services, to the Public Health Accreditation Board (PHAB). That documentation is reviewed by a team of peers who also conduct a site visit. That team of peer site visitors develops a report describing the public health agency's conformity with the Standards and Measures. PHAB's Accreditation Committee reviews the report and makes a determination about accreditation status.

A PHAB-accredited public health department is accredited for five years. During those five years, health departments must submit annual reports describing how they are addressing priority areas for improvement. Additionally, these reports provide PHAB with a way to ensure the health department continues to be in conformity with the accreditation requirements outlined in the PHAB Standards and Measures. When initial accreditation expires, the health department must apply for, and successfully complete, the reaccreditation process in order to maintain accreditation status. The requirements and the process for reaccreditation have been designed to ensure that accredited health departments continue to evolve, improve, and advance, thereby becoming increasingly effective at improving the health of the population they serve. Reaccreditation utilizes a modified self-study model that requires health departments to use narratives to describe how the activities are being implemented, reviewed, and revised, as well as to note the health department's advancements towards achieving a culture of quality improvement. The domains are the same as those in initial accreditation, but the reaccreditation measures are fewer and different (105 in initial accreditation and 31 in reaccreditation). Reaccreditation also requires health departments to report on population health outcomes, which will help to inform and document the evidence for how accreditation contributes to changes in health outcomes.

The count reflects tribal health departments that have current accreditation status, as of the time of reporting. This includes public health agencies that have achieved initial accreditation and those that have maintained their accreditation through the reaccreditation process. Those that do not get reaccredited or have let accreditation status lapse will not be included within the count. As was done in Healthy People 2020, a count measure is proposed for this objective, rather than a percentage. CDC and PHAB have consulted with experts on Tribal public health, including the National Indian Health Board and representatives from Tribal Epidemiology Centers. While there are estimates about the number of Tribal public health agencies in this country, those estimates are less well established in the literature. For that reason, it is considered more reliable to use a count measure for this objective. There are two other Core Objectives that use this data source and track this same area of focus; this is the only objective that is a count.