Publication Title: 
The North Carolina Institute for Public Health
Publication Date: 
Wednesday, June 1, 2011

The accreditation of public health departments is expected to play a significant role in strengthening the performance, effectiveness, and accountability of the nation’s public health system. After extensive study, a national voluntary accreditation program has been endorsed by leading public health organizations, including the American Public Health Association (APHA), Association of State and Territorial Health Officials (ASTHO), National Association of County and City Health Officials (NACCHO), and the National Association of Local Boards of Health (NALBOH). 
The Public Health Accreditation Board (PHAB) was incorporated in 2007. With support from the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention (CDC), PHAB has been working with public health experts to develop a national voluntary accreditation program for state and local public health departments. In 2009-2010, 30 state, local, and tribal health departments (“beta test sites”) piloted the full accreditation process and provided feedback to PHAB. The program is now set to launch in fall 2011. PHAB’s goal is to have 60% of the US population served by an accredited public health department by 2015. 
In 2010-2011, the North Carolina Institute for Public Health conducted a study of state legal frameworks supporting public health department accreditation or related programs (e.g., certification, performance management, quality improvement). First, a mapping study of 23 states was conducted to identify current programs and their legal frameworks (see Table 1). Ten states were then selected for in-depth study. These states are Illinois, Iowa, Kansas, Michigan, Missouri, Montana, New Hampshire, North Carolina, Oklahoma, and Wisconsin. While all ten states are planning to participate in the national program, they approach accreditation from a variety of starting points. Some have mandatory accreditation programs based in statute, while others operate voluntary performance management or quality improvement programs. Still others are experimenting with regional cooperation (through interlocal agreements) as an approach to accreditation and/or quality improvement. 
This report presents the results of the study, with the hope that the research findings and legal lessons learned from these ten diverse states will be of benefit to other states as they prepare 
to participate in the national voluntary accreditation program. 


Matthews, G. & Markiewicz, M. (2011). Legal Frameworks Supporting Public Health Department Accreditation: Key Findings and Lessons Learned from Ten States [Report]. Chapel Hill, NC: The North Carolina Institute for Public Health.