The release of Version 2022 of the Standards & Measures for Initial and Reaccreditation marks the culmination of a multi-year journey to ensure national standards for governmental public health departments are reflective of the changing nature of public health practice.

PHAB embarked on the development of Version 2022 in 2017 by gathering input from multiple sources, including Insights on the Standards & Measures collected through think tanks, expert panels, workgroups, as well as commissioned papers. A summary of recommendations that informed Version 2022 can be found in the Proposed Changes based on Think Tank and Expert Panel Recommendations Report. Development of Version 2022 was also guided by psychometrics, evaluation findings conducted by NORC at the University of Chicago, and approximately 2,000 responses about specific measures and 700 comments collected during the 8-week public vetting period (Report on Vetting Version 2022), as well as feedback collected through presentations during several national conferences.

PHAB’s Accreditation Improvement Committee, which is made up of experts from the field, provided oversight to develop both Initial and Reaccreditation versions of the Standards & Measures. PHAB worked closely with partners throughout the revision process to improve alignment with other reporting requirements and technical assistance provided by others. For example, Version 2022 aligns emergency preparedness requirements with NACCHO’s Project Public Health Ready (PPHR) and CDC’s Operational Readiness Reviews (ORR) for PHEP grantees. PPHR recognized health departments may choose to submit evidence of PPHR recognition in place of documentation for Standard 2.2 in both Initial and Reaccreditation. 

PHAB established four (4) goals to guide the development of Version 2022. Several of the ways in which these goals are reflected in the resulting Standards & Measures include:

Goal #1: Reflect current aspirations of the field, while being mindful not to raise the bar too high.

• Infused health equity concepts within each domain, which is also reflective of the updated Essential Public Health Services.
• Integrated preparedness lessons learned during the COVID-19 pandemic.

Goal #2: Focus on meeting the intent of the measures rather than on documenting it.

• Streamlined and reduced duplication across requirements, resulting in approximately 90 fewer documents required for Initial accreditation (as compared to Version 1.5).
• Increased options for how measure requirements can be demonstrated.

Goal #3: Promote accountability. Stakeholders should feel confident that accredited health departments possess key capacities. For this reason, the Foundational Public Health Capabilities are clearly visible in Version 2022. 

• Designated which measures align with the Foundational Capabilities.
• Developed a Governance overview highlighting the important role of the governing entity and advisory boards which are interwoven across domains.
• Increased alignment between initial and reaccreditation to better assist a health department’s continuous improvement between cycles.

Goal #4: Clarify requirements.

• Restructured the Standards & Measures by shifting all requirements into the “Required Documentation” column and expanded guidance with examples.
• Incorporated intent statements to outline the purpose and importance of requirements.
• For Reaccreditation, brought back Standards from initial and broke up long measures into more, shorter measures to more clearly articulate what is being measured.

Additional information, including a Version 2022 FAQ of commonly asked questions, one-pagers, and series of recorded informational webinars, including information on PHAB’s new Pathways Recognition Program can be found on PHAB’s website: https://phaboard.org/version-2022/.

Marita Chilton, MPH, is the Director of Accreditation at PHAB, where she is responsible for managing the operations of the accreditation program. Prior to joining PHAB in 2011, Marita was a Project Coordinator at the National Association of Local Boards of Health. She holds a Master’s in Public Health from American Public University, a graduate certificate in Leadership and Management from the University of Notre Dame College of Business, and undergraduate degrees in Political Science and Intercultural Studies from Fresno Pacific University.

Emily Frantz, MPH, serves as a member of PHAB’s Evaluation and Quality Improvement (EQI) Committee and PHAB Site Visitor. Her consultancy, ALPHA, LLC has provided accreditation technical assistance and guidance to health departments in multiple states, since 2014. She honored to have contributed towards the development of Version 2022 of PHAB’s Standards & Measures. She holds a Master of Public Health degree with emphasis in Health Policy & Management from Emory University and undergraduate degree in Communication Science from Michigan State University.