Accreditation and Performance


Accreditation Support Initiative (ASI)

ASTHO, with support from CDC/OSTLTS, offers the Accreditation Support Initiative (ASI) technical assistance opportunity to health departments in the U.S. territories and freely associated states. Through ASI, ASTHO works with the insular areas to build capacity, strengthen public health infrastructure, and advance the readiness and ability of these jurisdictions to apply for and achieve Public Health Accreditation Board (PHAB) accreditation. Health departments initiate and complete self-identified accreditation readiness projects and activities in the areas of:

  • Community health assessments
  • Health improvement planning
  • Strategic planning
  • Workforce development planning
  • Performance management and quality improvement
  • Accreditation road-mapping and organizational self-study

ASTHO guides the work and activities of ASI sites by: facilitating and providing direct one‐on‐one technical assistance; utilizing subject matter experts to train staff and provide capacity building support; offering opportunities to participate in national trainings; disseminating and implementing accreditation readiness resources and tools; leading webinars and conference calls; facilitating peer-to-peer networking and mentoring; and reviewing and providing feedback on documents and deliverables.

2017 – 2018 ASI Sites

ASTHO has selected three territorial and freely associated state health agencies for the 2017 – 2018 ASI technical assistance project:

May 2018 Progress Updates

Guam recently hosted a two-day organizational self-assessment meeting with Division of Public Health and Environmental Health staff. Facilitated by ASTHO staff, they walked through the PHAB Standards and Measures and identified the areas where Guam is excelling and where there are opportunities for improvement. Participation spanned from agency leadership, division heads, and programmatic staff. They Divisions of Public Health and Environmental Health will use the results of the OSA to set priorities and develop a roadmap and timeline to prepare for and apply for PHAB Accreditation.

The Republic of Palau Ministry of Health has made significant progress in workforce development assessment and planning activities. With guidance from ASTHO , the agency identified core and discipline-specific competencies for agency staff. They also designed a workforce and training needs assessment which was disseminate to staff in May. The agency will use the results of the assessment to develop a roadmap for developing a workforce development plan that will meet the requirements in PHAB Domain 8. This technical assistance was provided in collaboration with consultant, Melissa Sever.

Laurie Call, ASTHO consultant from the Illinois Public Health Institute, traveled to CNMI to provide onsite QI/performance management training and technical assistance to the division of public health services. Quality and Performance Manager and ASI project lead, Halina Palacios, and Laurie met with various program areas to provide coaching on how to develop meaningful performance measures using the Results Based Accountability (RBA) model. Participating staff and QI council members also participated in hands-on training on how to select QI projects, use appropriate QI tools, and plan a process to update the agency’s QI Plan. Next steps for CNMI include, taking the various strategies and lessons learned through the TA and training to fully integrate a performance management system and improvement processes into the agency’s programs, policies, and interventions.

ASI will run from November 2017 – June 2018. Check back for updates and progress from this year’s ASI sites.

2016 – 2017 ASI Sites

From November 2016 – July 2017, the Commonwealth of the Northern Mariana Islands, Guam, and the Republic of the Marshall Islands participated in ASI. ASTHO supported each health agency to develop key plans and lead activities that resulted in documentation for the following PHAB domains:

  • PHAB Standard 8.2: Ensure a Competent Workforce Through Assessment of Staff Competencies, the Provision of Individual Training and Professional Development, and the Provision of a Supportive Work Environment
  • PHAB Standards 9.1 and 9.2: Use a Performance Management System to Monitor Achievement or Organizational Objectives and Develop/Implement Quality Improvement Processes Integrated into Organizational Practice, Programs, Processes, and Interventions

Success From The Field

Health Department Members from Commonwealth of the Northern Mariana Islands and GuamBuilding Agency Capacity Through Workforce Development Planning: Creating a workforce development plan was not an easy task for health departments in the Commonwealth of the Northern Mariana Islands and Guam. Both wanted to learn more about their public health workforce and identify opportunities for growth, but had minimal staff and resources to support these efforts. Through ASI, the agencies gained the skills needed to identify and adopt core competencies for their staff, deploy a workforce needs assessment, and develop a training plan to fulfill the needs of their workforce. Collaboration between the two agencies, building on work from established internal workgroups, and utilizing their public health leaders as champions contributed to the success of their ASI work.



Health Department Members at Republic of Marshall IslandsProcess Mapping and Improvement in the Republic of the Marshall Islands: In an effort to increase the efficiency with which federal funds are spent, the Ministry of Health (MOH) identified opportunities to utilize performance management and quality improvement to better manage grants, streamline recruitment and procurement processes, and increase collaboration with external partners. During ASI, ASTHO worked with CDC and the Pacific Island Health Officers’ Association (PIHOA) to facilitate an on-site process mapping workshop. Next steps include developing new standard operating procedures for grants management, recruitment, and procurement processes.

  • Process Maps (coming soon)
  • Revised Standard Operating Procedures (coming soon)

For more information on the Accreditation Support Initiative, please contact Joya Coffman, Director of Accreditation and Performance Management.