Public health accreditation and emergency preparedness leveraging the linkages
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Public health preparedness standards and performance measures

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Public Health Preparedness: Standards and Performance Measures

Resham Patel, MPH

Senior Program Analyst, Preparedness, NACCHO

COPPHI Open Forum

December 6, 2012

Importance of standards and performance measures in preparedness
Importance of Standards and Performance Measures in Preparedness

  • Measures progress on preparedness capabilities and capacities

  • Demonstrates return on investment of federal and state funding

  • Informs state and local public health, policy makers, key preparedness partners and other stakeholders

  • Provides a framework to ensure that public health preparedness is meeting national standards

Pphr phep and phab an overview
PPHR, PHEP, and PHAB: An Overview Preparedness

  • Set a standard of achievement for performance for local health departments

  • NACCHO’s PPHR criteria address preparedness and response, specifically in planning, training, and demonstration of readiness.

  • CDC’s PHEP capabilitiesassist state and local planners in identifying gaps, determining priorities, and developing plans for building and sustaining capabilities.

  • PHAB’s standards address global organizational and system-wide agency capacity and capability.

Pphr phep and phab a shared history
PPHR, PHEP, and PHAB: A Shared History Preparedness

  • Since the early 2000’s, PPHR and PHEP have focused on building public health preparedness capacity and capability at the state and local level.

  • PPHR criteria contributed to the development of the PHEP capabilities, creating strong synergy between the programs.

  • PHAB referenced the PPHR criteria, and the newly released PHEP capabilities, in developing the accreditation standards and measures.

  • The PPHR criteria are updated annually to incorporate local practices and the most recent national preparedness initiatives, including PHEP and PHAB.

Public health accreditation and emergency preparedness leveraging the linkages

Project Public Health Ready Preparedness

  • Project Public Health Ready (PPHR) is a collaborative activity between the National Association of County and City Health Officials (NACCHO) and the Centers for Disease Control and Prevention (CDC).

  • Vision

  • Local health departments (LHDs) will be fully integrated into the response community and prepared to respond to any emergency.

  • Mission

  • To protect the public’s health and increase the public health infrastructure by building local health department preparedness capacity and capability. With assistance from state health departments, LHDs will use sustainable tools to plan, train, and exercise using a continuous improvement model.

Public health accreditation and emergency preparedness leveraging the linkages

About PPHR Preparedness

  • Piloting began in 2003

  • Collaborative activity between NACCHO and CDC

  • PPHR Workgroup

  • Committee developed criteria, led by local public health practitioners

  • 285 LHDs recognized individually or as part of a region

  • Utilizes a continuous quality improvement process

  • Develops Community Partnerships

Public health accreditation and emergency preparedness leveraging the linkages

Project Public Health Ready Preparedness

* New States

Public health accreditation and emergency preparedness leveraging the linkages

PPHR Criteria Preparedness

PPHR Criteria are divided into three goals:

All-Hazards Response Plan

Workforce Development

Demonstration of Readiness: Exercise or Event

Public health accreditation and emergency preparedness leveraging the linkages

PPHR Criteria Preparedness

  • Updated annually and aligned with federal guidelines and national initiatives, including:

  • National Health Security Strategy (NHSS)

  • CDC Public Health Emergency Preparedness (PHEP) Capabilities

  • National Incident Management System (NIMS)

  • Homeland Security Exercise & Evaluation Program (HSEEP)

Public health emergency preparedness phep cooperative agreement
Public Health Emergency Preparedness (PHEP) Cooperative Agreement

  • Public Health Emergency Preparedness (PHEP) Cooperative Agreements are between CDC and the 50 states, 8 territories, and 4 directly funded cities (NY, Chicago, DC, and LA)

  • Appropriated by Congress in 2002

  • In 2011, CDC released 15 Public Health Preparedness Capabilities which were designed to align with the National Health Security Strategy

  • PHEP funding will be used by grantees to work towards these capabilities

Phep 15 capabilities
PHEP: 15 Capabilities Agreement

Community Preparedness

Community Recovery

Emergency Operations Coordination

Emergency Public Information and Warning

Fatality Management

Information Sharing

Mass Care

Medical Countermeasure Dispensing

Medical Materiel Management and Distribution

Medical Surge

Non-Pharmaceutical Interventions

Public Health Laboratory Testing

Public Health Surveillance and Epidemiological Investigation

Responder Safety and Health

Volunteer Management

Preparedness capabilities structure
Preparedness Capabilities Structure Agreement


Capability Definition


3-5 broad “Functions” per Capability


  • Resource Elements include owning or, where applicable, having access to:

  • Plans (includes vulnerable populations, legal authorities)

  • Skills and Training

  • Equipment and Technology

A number of Essential Tasks for completion of each Function

Tasks form the basis for training and exercises



Resource Elements

Application Work Plan Component

Office of Public Health Preparedness and Response

Division of State and Local Readiness

Public health accreditation and emergency preparedness leveraging the linkages

PHAB Framework: Domains, Standards, and Measures Agreement

12 Domains(10 Essential PH services plus

administration & governance)

~ Standards

~ Measures


Public Health Accreditation Board (PHAB)

Naccho s document selection tool pphr and accreditation
NACCHO’s Document Selection Tool: Agreement PPHR and accreditation

  • NACCHO’s PPHR Workgroup members were involved with the PHAB Standards and Measures development.

  • This tool highlights 2012 PPHR Criteria that correlate to current PHAB Standards and Measures.

  • Completed in November 2012, and available online at

Naccho s document selection tool pphr and accreditation1
NACCHO’s Document Selection Tool: Agreement PPHR and accreditation

Naccho s document selection tool pphr and accreditation2
NACCHO’s Document Selection Tool: Agreement PPHR and accreditation

Examples Agreement

Questions? Agreement

  • Resham Patel, MPH

  • Senior Program Analyst, Public Health Preparedness

  • National Association of County and City Health Officials

  • Phone: 202-507-4233

  • E-mail: