207504 Accreditation and Public Health Preparedness in North Carolina

Monday, November 9, 2009: 1:10 PM

John B. Wayne, PhD , College of Public Health, Univ of Arkansas for Medical Sciences, Little Rock, AR
Glen Mays, PhD, MPH , Dept. of Health Policy & Management, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
Mary Davis, Dr PH, MSPH , North Carolina Institute for Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
James H. Bellamy, CNMT, MPH , Division of Nuclear Medicine Imaging Sciences, University of Arkansas for Medical Sciences, Little Rock, AR
Cammie Marti, BSN, MPH, PhD , College of Public Health, Univ of Arkansas for Medical Sciences, Little Rock, AR
Rachel Willard, MPH , Public Health Infrastructure and Systems, National Association of County and City Health Officials (NACCHO), Washington, DC
Edward L. Baker, MD, MPH, MSc , NC Institute for Public Health, UNC School of Public Health, Chapel Hill, NC
Local public health agencies (LPHAs) occupy pivotal positions within the nation's emergency preparedness (EP) and response systems because of their statutory authority to perform public health (PH) functions and their ability to coordinate the public health actions of many other community organizations. Accreditation of PH agencies has received considerable policy attention because of its potential to promote consistency and interoperability in PH practice, and its ability to encourage participation in other beneficial initiatives. This study reports the impact of one of the nation's first state-based public health agency accreditation programs on local emergency preparedness and response capabilities.

The 2005 and 2008 NACCHO National Profiles of Local Health Departments (NPLHD) and LPHA accreditation information are the data sources for this study. The 2005 NPLHD included 82 local county health departments/districts in NC (10 accredited before 2006, 10 in 2006, 10 in 2007, and 52 seeking accreditation in future years). EP activities included: Developing an EP plan; Legal review of the plan; Participating in drills; Assessing competencies; and Providing training.

Accredited LPHAs were more likely to have performed all EP activities and significantly more likely to have had a legal review of the plan (X2 < 0.01). Syndromic surveillance was more likely to be performed in accredited LPHAs (85% to 69%) and a greater percentage was preformed directly by the LPHA. While accredited LPHAs budgets were twice those of the unaccredited, they received almost 5 times the amount of CDC bioterrorism funding. Urban-rural differences were not detected. 2008 results are forthcoming.

The results show: that the preparedness and response capabilities of communities served by accredited LPHAs exceed those of non-accredited LPHAs. The ability of accreditation measures to detect meaningful differences in preparedness will be discussed. Structural and organizational attributes of LPHAs that influence their preparedness capabilities and accreditation outcomes will be presented.

Learning Objectives:
Participants will be able to: 1. Identify the emergency preparedness indicators included in the 2005 and the 2008 NACCHO Local Health Unit Profile survey. 2. Describe characteristics of accredited local public health agencies and those planning to become accredited. 3. List at least two factors that impact local public health preparedness.

Keywords: Accreditation, Bioterrorism

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a full professor in the UAMS Department of Health Policy and Management with extensive knowledge, training, and experience in the subject matter.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.