1. DHSS/LPHA National Accreditation Exchange Meeting
August 16, 2012
MINUTES
ATTENDEES
DHSS Local Public Health Agencies Other
Nancy Hoffman Stephanie Browning Mahree Skala, MoALPHA
Ray Shell Sarah Rainey
Scott Clardy Jamie Opsal
Andy Hunter Karen Zeff
Les Hancock Evander Baker
Susan Thomas Frank Fick
Zula Ganbaatar Laura Klaysner
Craig Ward Gary Zaborac
Becca Mickels Jodee Frederick
Cherrie Baysinger Kathy Zimmerman
Jo Anderson Rex Archer
Valarie Seyfert Bert Malone
Yoli Carrillo
Matt Steiner
Jeanine Arrighi
Rhonda Bartow
Jaci McReynolds
Jim Berry
Jean Miller
TOPIC DISCUSSION ACTION
Welcome and Jo welcomed the group and facilitated introductions. She
Introductions provided background for the purpose of the group to provide
Jo Anderson, a forum for those preparing for National Accreditation to
Director, Center for share lessons learned and tools. The goal of the meeting was
Local Public Health to identify members’ needs, determine what we can learn
Services from each other, and plan how the work group wants to
proceed.
Discussion of Jo facilitated discussion. Items mentioned included:
specific facets of the How others have networked with other agencies and
national universities
accreditation How did you start with your groups? How did you select
preparation process individuals?
(prerequisites or How are you compiling and storing documentation and
standards) members what elements are you using? How is information
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2. would like to learn captured?
from your peers How often do teams meet?
How did you maximum staff engagement in the process?
How have you operationalized accreditation process?
How have you worked through the domains?
What’s the relationship between local and state
accreditation? What elements rely on the other?
What have been barriers or obstacles? How are you
working to overcome?
Would like to see other community health needs
assessments and how the state links performance measures
to community health needs assessment to be posted on
website as part of the requirement of accreditation.
Better understanding of the specific requirements of
accreditation and better understanding of concerns of
local agencies
What are the timelines on data needs and how can we
provide those
What are the processes needed to meet requirements of
engaging partners/community for the state or community
health needs assessment (SHNA/CHNA) and the state or
community health improvement plan (SHIP/CHIP)
What tools and methods are being utilized for
stakeholder/community input for the CHNAs?
Health assessment requires a lot of input from
stakeholders. How do you manage the # of partners?
What is the overlap between state and locals?
Re: CHNA, how to get more community input and
involvement; how to convene those stakeholders and
sustain the group and understand what is the role of health
dept once the health plans are developed – as leader or
partner?
How to engage stakeholder regarding environmental
indicators? Questions on indicators to identify how
services are linked to certain factors and how we address.
Saw one from Chicago that seemed well done.
Where is the state in the process of their application?
Phone line participants
What do others feel are best practices in documentation of
domains and measures? Wants to understand some of the
difficulties of becoming accredited in order to provide
input to the PHAB board of on what to keep and what to
drop from accreditation standards.
What are best practices, how to cover bases with reduce
staff and resources?
We are struggling with a variety of definitions such as
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3. quality improvement, performance measures and how this
becomes a smooth process and not another program. They
would be interested in seeing other share communication
plans.
What do we already know and how do we best share?
Discussion of Items mentioned included:
experiences The health data profile does not equal a community health
members would needs assessment; we are not getting the environment data
want others we need internally or from the state to meet this
preparing for accreditation requirement. Past community health
accreditation to assessment was done FOR the community and not WITH
know community as required by accreditation. Using MAPP
model to see what community/stakeholder priorities for us
and what they see as gaps, existing resources.
Held meetings with partners and residents in the
community with two meetings a month for a period of five
months; process was funded through MFFH.
Community engagement/planning process is very time
consuming. In Clay County’s strategic plan started in
2008 was included a commitment to reorganize how we
did business as a public health agency. This was traumatic
for organization; created a position of coordinator for
accreditation, did trainings, hosted week long training on
EB decision making for public health. Had Beverly
Tremain work with Board and staff. Utilized an existing
group doing global community assessments every five
years since 2000 and health dept. was able to plug into
this group. This group had over 200 stakeholders from
Clay and Platte Counties and hired an independent person
from National Civic League to lead process. Hospitals,
social services, mayors, etc… and over 200 participated.
This group met over 8 months and developed key
performance areas: community wellness, chronic disease
emerged. Health dept. created a Healthy Policy Planning
Section and realigned staff (epi’s, MSNs) to work on
CHNA. Took 1.5 years. Had to create baseline. We had
not previously done a thorough evaluation so we did this
and posted to our website and are using this Vision North
2010 and plugging this together to create a community
health assessment. Seven mayors, police chiefs, council
members so they made decision to only address those
communities that are active in the Vision North process
because of the large stakeholder group. They will go after
these targets in these communities using EBPH practices
and hopefully that will grow because most of these
communities are competitive and will want to move out to
more communities. This was very time consuming and
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4. long haul but it made the organization stronger and more
vital to the community to have positive impact. The
original commitment has to come from director of public
health and board; management and staff have to get on
board. This has been a challenge. Some of the existing
infrastructure has assisted with this moving forward to
make a stronger PH agency which will create a stronger
PH system which are two different things. Business model
had to change.
Moving away from the “agency” and moving to looking at
the essential public health services delivery both internally
and EXTERNALLY; system wide processes. What do
you collect and how do they overlap and related back to
ten essential services. People complained I don’t have
enough time to do my job now how am I supposed to look
externally?
Clay County incorporated the domains in everyday
business to “connect the dots” which was a challenge but
was able to do so even though it was huge.
KC is scheduling site visits and will be able to share the
practical stuff. As an agency we are responsible for
systems development in public health however, the
accreditation is based on the agency itself because PHAB
recognizes that there are external influences that agencies
have no control over. Expectation is that you must
document your efforts to engage external partners. It is not
expected that you demonstrate EVERY measure fully to
be accreditation. You can be told that you are not
accredited yet but could be given the opportunity to
complete weakness and demonstrate then become
accredited within the year.
Discussion of Items discussed included:
members see as Exciting:
exciting about Benefit of accreditation occur both individually, agency
accreditation as well and state with creditability, accountability, streamlining of
as what is reporting requirements, access to knowledge of peers,
concerning or funding opportunities, etc… MICH accreditation allowed
overwhelming for KC to leverage that with city council to restore 50
them and/or positions and kept budget intact and were the only
organization department to not receive cuts.
This is about quality improvement to better service
constituents.
Employees feel more pride in work; feel better supported
MICH accredited agencies state “It is worth it”.
Remember it is not about obtaining seal but in improving
how we serve
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5. Have used the same team model through MICH
accreditation to address domain measures that continues to
allow us to grow together and changed our culture and
increased our performance through the PHAB
accreditation
Appreciate co-workers support in spite of gaps
Realize they need the data because it will drive the ability
to say whether or not we are raising the bar using outcome
measures
Hospital systems have partnered with LPHA and now they
have a CORE MAP/CHIP team that meets every other week
and each hospital team is involved in strategic plan. Used
regional data to give a better example of need because county
level data didn’t show. Children’s and Cardinal Glennon
Hospitals did focus groups together to address the health
information found through the sub-region study. This had
never happened before. MHA has been excited about
learning where to target their efforts for STDs, obesity, etc.
Concerning/Overwhelming:
Changed since today
Scary to the change thinking but has pushed us to different
level creating a better department in the end.
Still concerned about the length of time to get the data
needed to measure between last year and this year. Scary
what if we don’t get data again – we won’t be able to be
accredited again.
Discussion of It was suggested that we might pull out common or top ten of
prioritization of importance from the meeting notes today. It was also
topics suggested that we know the three prerequisites – community
health needs assessment, community health plan and strategic
plan. There was general consensus that the CHA had been
mentioned several times as well as processes relating to it
around how and who to engage, what is the best process, what
models work, how to provide assistance to each other. One
concern was expressed that if they share and others follow
their example and it is not the correct example they don’t
want to mislead others. Not sure they would be giving good
guidance if they haven’t already had their assessment site visit
yet. It was discussed that until we get concrete feedback from
agencies going through the site visit, it is probably better to
focus on prerequisites and get organized on how to go about
these.
It was pointed out that the PHAB requirements are articulated
for the pre-requisites. The question was asked if since the
state must meet these requirements, if it would be helpful if
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6. the counties utilized a similar template for comparison
purposes if they wished.
Jo – start looking at the standards for the community health
assessment and looking at common elements and then looking
at how they play out with the local agencies.
Next steps Group discussed they were committed to meeting quarterly Jo will send out
and that there would be work between meetings for members meeting roster to
to complete. Members expressed they would like to be able all and convene a
to call and check in with others working on the workgroup. planning subgroup
Jo asked for volunteers to plan agendas to address the first meeting to set date
priority around CHNA. Les, Jamie and Frank volunteered; and agenda for
Marty Galutia was volunteered by Rex and Jodee Frederick next meeting.
by Gary pending their agreement. It was also suggested that Members are to
consideration be given that the agenda may have enough start looking at the
things for four or five hour meeting to justify travel, possibly standards for the
using phone conferencing for specific topics with more community health
frequent meetings. Agendas may evolve to be topic focused assessment for
allowing folks to participate based on interest/need. It was both state and
suggested to look at scheduling with other meetings that are local, identifying
occurring for travel purposes, i.e., piggyback on DAC or the common elements.
5th Tues/Wed/Thurs of the month. It was decided to leave These standards
the decision to the planning subgroup regarding meeting are all those in
structure. It was also discussed that to make this PHAB Domain 1 and can
Accreditation Exchange work, that a shared leadership is be accessed at
needed utilizing the knowledge and skills of the entire group. http://www.phaboa
It was also suggested that we make sure that all have access to rd.org/accreditatio
PHAB standards for any discussion points addressing the n-process/public-
standards. health-department-
The possibility was questioned if we could link by standards-and-
teleconference to the other nineteen sites in the queue for the measures/ .
first wave of PHAB accreditation. Rex indicated Marty will
have this information after her meeting with that group.
Evaluation Jo facilitated an oral evaluation of meeting. The following
items were stated as things that worked well:
liked others don’t know where to start either
easier to communicate face to face
acknowledgement that LPHAs and state must work
together to make this successful for accreditation
getting out of the silo and working with teams
accomplished work here and having ploughed that
ground will make it easier for others
Suggestions for improvement included:
Continue to publicize that the group exist and other may
want to join in the future.
Meeting adjourned at 11:30 a.m.
Next Meeting: To be determined by planning group
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