In October 2023, the Missouri Department of Health and Senior Services (DHSS) engaged with the Public Health Accreditation Board (PHAB) to launch a first-of-its kind statewide initiative designed to build public health capacity, strengthen infrastructure and support governmental public health system transformation. This partnership invests in public health accreditation for Missouri’s 115 local public health agencies, supporting accreditation-related activities to enhance the readiness and effectiveness of public health services statewide.

The statewide initiative supports transformation by assessing performance across the Foundational Public Health Service (FPHS), which aligns with the state’s #HealthierMO transformation framework. The FPHS framework describes the minimum set of fundamental services and capabilities that must be available to every community in order to ensure Missouri’s public health system delivers equitable opportunities for community members to achieve their optimal health. DHSS is leveraging Public Health Infrastructure Grant (PHIG) funds to bolster statewide transformation efforts, offering multiple support options to agencies pursuing accreditation. Public health accreditation ensures that health agencies meet national standards for delivering essential public health services, enhancing their capacity to respond effectively to public health challenges.

Among the support avenues, access to PHAB’s Readiness Assessment to all 115 Local Public Health Agencies (LPHAs) serves as a stepping-stone towards Pathways Recognition or Initial Accreditation. To date, 63 LPHAs have registered to attend training, 30 have completed training and expressed a commitment towards completion, and 3 LPHAs have already completed and received feedback on the Readiness Assessment. The PHAB Readiness Assessment evaluates the departments’ readiness to pursue accreditation, identifies strengths and areas for improvement, and assesses capacity in key areas of public health. The project offers free-of-charge training and office hours to LPHAs with additional incentive dollars available for engagement. While participation in the statewide initiative is voluntary, the opportunity offers many benefits to LPHAs, including receiving in-depth results to assess performance against two nationally recognized frameworks, the 10 Essential Public Health Service (EPHS) and Foundational Public Health Service (FPHS). The results may be used to highlight each departments strengths and opportunities for improvement, guide quality improvement efforts, and may be used to garner support for the purposes of articulating the needs of the department, including additional investments in public health funding or resource allocations.

As one of multiple tools for transformation, the readiness assessment also provides a snapshot of the state’s collective public health capacity and guides the state’s efforts to build and strengthen public health infrastructure. Missouri also encourages LPHAs to further their accreditation endeavors through leveraging PHIG funds by offering reimbursements for any activities related to accreditation or reaccreditation efforts.

Missouri also uses other PHAB tools to build capacity, strengthen infrastructure, and promote public health system transformation. Missouri is a member of the PHAB 21st Century Learning Community, where MDHSS and other partners collaborate with 17 other states to share leading practices and promote systemwide transformation. Additionally, local public health agencies in Missouri are undertaking the Foundational Public Health Services (FPHS) Capacity & Cost Assessment to understand the resources and expertise needed for delivering foundational services as outlined in the national FPHS framework.

These efforts combined underscore the collective commitment to improving the health and well-being of communities through systematic transformation and alignment with national standards of public health practices.

To learn more about the DHSS, visit https://health.mo.gov/

To learn more about PHAB’s Tools for Public Health Transformation, visit phaboard.org/toolsfortransformation

To learn more about the Public Health Infrastructure Grant (PHIG), visit https://www.cdc.gov/infrastructure/phig/index.html

Brenna Davidson is Operational Excellence Leader and Chief of the Office of Performance Management at the Missouri Department of Health and Senior Services.

Ashlyn Sherman is Health Planning Coordinator at the Missouri Department of Health and Senior Services.

Emily Frantz, MPH, is Senior Specialist at the Public Health Accreditation Board.