North Carolina’s Local Health Department Accreditation Program Evolves for the Future

The North Carolina Local Health Department Accreditation (NCLHDA) program and its partners have accomplished a great deal since the program’s inception. Not content to rest with past success, however, program leaders and public stakeholders are planning for the future.

Established in 2002,  the accreditation program exists to ensure all North Carolinians have access to quality public health services. Through the program, local health departments are certified to perform at a prescribed, basic level of quality the three core functions of assessment, policy development and assurance, and to provide the ten essential services of public health.

As of January 1, 2016, all of North Carolina’s 85 health departments have received accreditation and 63 departments have been reaccredited, some more than once depending on when they started the process. By achieving this legislatively mandated status, health departments in North Carolina are poised to improve the health of the state’s citizens.  

Having achieved accreditation across the state, it is time to think of how we move forward with guaranteeing high quality local public health practice in 2016 and beyond.

On February 4, 2016, Dr. Joy Reed, former Head of the Local Technical Assistance and Training Branch at the NC Division of Public Health, convened a meeting on behalf of NCIPH to explore potential changes in the accreditation process.  A group, which included representation from local health directors, agency accreditation coordinators, NCLHDA board members, NCIPH and DPH staff, brainstormed ideas for “Accreditation 2.0.” 

Discussions included improving alignment with the national accreditation offered through the Public Health Accreditation Board, modifying scoring to a scale model, and developing a human services accreditation process. Communication from this stakeholder group to the North Carolina Local Health Department Accreditation Board, the NC Association of Local Health Directors, NC Division of Public Health, and other key partners will be critical to our future success. Stay tuned for suggestions and future plans.

A Warm Welcome. Our Sincere Gratitude.

Amy Belflower Thomas

On November 16, 2015, we welcomed Amy Belflower Thomas as administrator of the North Carolina Local Health Department Accreditation program. Amy has over twelve years’ experience with state and local public health, and brings a strong working knowledge of the program to this role, including having worked as an accreditation coordinator in a local health department.

“I am excited to step into my new role at the Institute. It is a great and unique opportunity to bridge my academic and applied public health background and contribute to the improvement of public health practice across the state. I hope my work can promote innovative and meaningful projects well-grounded in the realities of local public health.” 

In addition to serving as accreditation administrator, Amy also serves as technical assistance manager at the Institute. Her duties include overseeing development and implementation of projects with our partners to increase local communities’ capacity to meet the public health needs of residents. Feel free to contact Amy at amy.b.thomas@unc.edu or 919.843.3973 with any questions you may have about the accreditation process.

We are sincerely grateful to Dr. Dorothy Cilenti, former accreditation administrator, for her contributions to the accreditation program. Dr. Cilenti is on faculty in the Department of Maternal and Child Health at the Gillings Global School of Public Health. We would also like to thank Dr. Joy Reed for serving as interim accreditation administrator this past summer and fall.

Zika Virus: The Network for Public Health Law Prepares for Global Threat

On February 1, 2016, the World Health Organization (WHO) designated the Zika virus a global Public Health Emergency of International Concern (PHEIC), noting a "strongly suspected but not yet scientifically proven" causal link to congenital brain defects.

The designation, WHO’s highest level of alert and used only in response to the most extraordinary events, should help fast-track international action, funding and research priorities. The Southeastern Region Office of The Network for Public Health Law, based at the Institute, is ready to assist in providing technical assistance and research on topics spanning associated legal issues such as:

• Treatment, screening and research
• Reproductive health
• Mosquito abatement
• Liability
• Privacy
• Scope of practice
• Travel restrictions and closures

According to the Centers for Disease Control and Prevention, Zika is transmitted by an infected mosquito from the Aedes genus, primarily found in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.

Zika symptoms typically include a mild fever, skin rash and conjunctivitis (pink eye). Currently, there is no treatment or vaccine, leaving prevention as the only way to fight Zika. While previous Zika outbreaks have occurred in recent history, this particular outbreak has high level of concern because of reports of associations between microcephaly, a serious birth defect of the brain,  and other negative outcomes in babies of mothers infected with Zika virus during pregnancy. While further research is needed to confirm that Zika virus infection causes microcephaly.

The WHO designation helps to ensure countries are able to respond as needed to prevent infections while further research is carried out. Sanctioned response efforts include:

• Enhancing surveillance of Zika virus and potential complications
• Strengthening capacity in risk communication
• Training on clinical management, diagnosis and vector control
• Strengthening lab capacity
• Supporting health authorities to implement vector control strategies aimed at reducing Aedes mosquito populations, and
• Preparing recommendations for clinical care and follow-up of people with Zika virus

Get more information and updates on legal and policy issues related to Zika virus.

Institute Helps Launch Online Internship Clearinghouse for Students

On January 15, 2016, public health students at East Carolina University (ECU) and the University of North Carolina at Wilmington (UNC-W) students were given access to an online clearinghouse designed to link them with internships at local health departments and with sections within the North Carolina Division of Public Health.

While internships are common, this project is not. It represents years of discussion and building partnerships among public health partners at the state and local levels, professional organizations and the various undergraduate and graduate public health programs at different North Carolina university campuses. The Institute has been a critical partner in bringing the project to fruition.

During 2015, a web-based clearinghouse of internship opportunities was developed as a cooperative project of the North Carolina Institute for Public Health, the North Carolina Public Health Association, the NC Division of Public Health, the NC Association of Local Health Directors, ECU and UNC-W. Partners worked together to develop and build the clearinghouse and pilot it. Students at the two universities can scan internships available to them and organizations can post as new opportunities become available. All internships will be for Summer 2016.

If successful, this sort of web-based clearinghouse could simplify students’ search for practice-based opportunities, reduce unnecessary duplication of effort by organizations that host students, be a valuable asset to students and public health agencies and eventually can be a focal point for all North Carolina students seeking internships/practica. 

A note about internships

North Carolina students pursuing education in public health must complete a practicum or internship experience to receive their degree. The practicum engages students in activities aligned with their career goals, helps them develop their skill sets, adds new tools to their professional toolkits, and provides them with evidence to potential employers of concrete experience in their field of study. Host organizations, while providing these essential educational opportunities to students and participate in the development of the future public health workforce, also benefit from student assistance. View the clearinghouse portal.

Highlight: North Carolina Community Health Improvement Collaborative

Gene Matthews (left) and Jeff Spade (right) presented webinars on requirements and best practices in developing Community Health Needs Assessments and Implementation Strategies.

The North Carolina Institute for Public Health is pleased to participate in a statewide partnership, the North Carolina Community Health Improvement Collaborative. Created in 2007, the effort brings together local and state public health leaders, hospital leaders, and community-based stakeholders to lead joint efforts to measurably improve the health of North Carolinians.

The effort was originally titled the NC Public Health/Hospital Collaborative, and it grew out of a desire by the North Carolina Hospital Association and the North Carolina Division of Public Health to explore areas of overlap and mutual partnership. Over time, the collaboration expanded to include interested leaders from local health departments, academic institutions, community partners and other organizations. (See current membership.)

The Collaborative explores best practices and models for improving the community health needs assessment process between hospitals and public health agencies. This information is then shared with public health stakeholders. For example, the Collaborative has hosted several webinars:

• In-Depth Analysis of NC Hospitals' Community Health Needs Assessments and Implementation Strategies
• Meeting Requirements for Collaborative Community Health Needs Assessments: Summary of IRS and Local Public Health Accreditation Requirements and Recommended Practices

Webinars were presented by Gene Matthews (Senior Investigator, NCIPH) and Jeff Spade (Senior Vice President, NC Hospital Association and Executive Director, NC Center for Rural Health):

The next webinar is March 8 from 2:00–3:00 PM  

The focus of the webinar will be to share examples of successful hospital-health department collaborations in conducting joint implementation strategies for community health needs assessments and also provide updates on the Collaborative’s healthy weight initiative using shared strategies among hospitals, health departments, and community partners.  Register here.

Learn more about the Collaborative.

Institute Annual Report

The 2015 annual report for the North Carolina Institute for Public Health is live.  Last year, we showed you our work “by the numbers.” This year, we incorporated maps to show you our reach across the state and beyond.  For example:

• We trained 31,516 public health and allied professionals including 11,455 NC-based participants
• We worked with 7 of the 9 AHECs across the state to help to improve skills in cultural competency, social marketing, evidence-based strategies, and strategic planning and leadership development
• Our Network for Public Health Law answered 279 requests this year for information and/or technical assistance from the Southeastern Region and beyond, on a wide range of topics including the duties and authority of physician assistants, nurse practitioners and dental hygienists.
• Learn more

Institute Review

As stipulated by the UNC Board of Governors, the Institute is undergoing a periodic formal organizational review as required of all university centers and institutes. The review covers the work of the Institute for the past 5 years and includes assessment of mission and goals, organization structure and leadership, accomplishments, funding model, and vision for the future.

The review process is overseen by a committee appointed by Gillings School Dean Barbara Rimer. The committee is chaired by Dr. Sandra Martin, Associate Dean for Research, and has 10 members including UNC-Chapel Hill faculty and staff, representatives from state and local public agencies, and two Institute staff.

Thus far the committee has reviewed background information assembled by Institute staff, solicited additional input from multiple stakeholders and conducted several meetings. A final report with recommendations will be issued by early March. The report will be shared with the UNC Vice Provost for Academic Initiatives. We look forward to sharing the results of this organizational review in the next issue of Impact.