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J Public Health Manag Pract. 2014 Jan-Feb;20(1):111-8. doi: 10.1097/PHH.0b013e3182a505c9.

An examination of state laws and policies regarding public health agency accreditation prerequisites.

Author information

  • 1Thielen Consulting, Fort Collins, Colorado (Ms Thielen); University of Denver Sturm College of Law, Denver, Colorado (Mr Dauer and Dr Burkhardt); and Colorado Association of Local Public Health Officials, Denver (Mss Lampe and VanRaemdonck).



The Public Health Accreditation Board (PHAB) began accepting applications for national voluntary accreditation in the fall of 2011. There are 3 prerequisites for accreditation: health assessments; health improvement plans; and strategic plans. These prerequisites must be in place for a state or local public health agency to apply for PHAB accreditation. Completion of the prerequisites can become a barrier for agencies that are considering applying for accreditation.


This project looked at all 50 states through a legal lens to identify legal tools in the form of laws, rules, executive orders, contracts, legislative resolutions, and other tools that are used to authorize or require that a state or local health agency complete 1 or more of the prerequisites.


Using legal research platforms and a Boolean search stream, an inquiry of legal tools in all 50 states was completed to determine where legal tools are used to authorize or require the 3 PHAB prerequisites. Once legal tools were found, interviews were conducted with key informants from each state to understand the implementation and use of the legal tools found and collect any additional legal tools that were not found from the legal search.


The results include key findings and, importantly, an inventory of laws and legal tools that are being used around the country to require and support completion of the prerequisites. Within all 50 states, 26 states have some type of a mandate regarding 1 or more of the PHAB prerequisites. This includes 1 state that includes a mandate for PHAB accreditation.


States use a wide variety of legal tools to implement the prerequisites for voluntary accreditation. It is important to understand the interpretation, enforcement, and support of the laws and legal tools to determine whether the tools have impact in individual states.

[PubMed - indexed for MEDLINE]
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