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How Does Accreditation Work in Indian Country?


Accreditation In Indian Country  

Enhancing public health in Indian Country entails addressing a complex set of services, provided by a diverse group of partners and stakeholders.

Who is eligible?

The governmental entity that has the primary statutory or legal responsibility for public health in a Tribe, state, territory, or at the local level is eligible to apply for accreditation from the Public Health Accreditation Board (PHAB), the accrediting agency. 

To be eligible, such entities must operate in a manner consistent with applicable federal, Tribal, state, territorial, and local statutes. A health department must meet one of the following definitions to apply for PHAB accreditation:

Tribal Health Departments

A Tribal health department is defined, for the purposes of PHAB accreditation, as a federally recognized Tribal government*, Tribal organization, or inter-Tribal consortium, as defined in the Indian Self-Determination and Education Assistance Act, as amended. Such departments have jurisdictional authority to provide public health services, as evidenced by constitution, resolution, ordinance, executive order, or other legal means, intended to promote and protect the Tribe’s overall health, wellness and safety, prevent disease, and respond to issues and events. Federally recognized Tribal governments may carry out the above public health functions in a collaborative manner through formal agreement or partnership. 

*As evidenced by inclusion on the list of recognized Tribes mandated under 25 U.S.C. § 479a-1. Publication of List of Recognized Tribes.


What does it cost? 

After careful planning and vetting, PHAB officially launched its program of public health department accreditation in September 2011. Like other accreditation organizations, PHAB instituted a fee structure to allow it to manage and sustain the national accreditation program.  Public health departments may pay the fee in a lump sum or break the fee into a series of smaller payments.

Please refer to PHAB’s website for the full Fee Overview: PHAB: What Does It Cost?  


How long does the entire accreditation process take? 

The time for the process varies for each applicant.  While there are defined timelines in the process (for example, applicants have 12 months to upload all of their supporting documents into the E-PHAB system, once they have been granted access to the site), much will depend on the readiness of the applicant at the start of the process and the schedule the applicant determines, based on available staffing and financial resources.  Based on experience over the past two years, PHAB has found  applicants, on average, are able to complete the process in 14-18 months, plus whatever time is needed in the pre-application phase.  PHAB reports that some Public Health Department applicants have been working approximately 4 years to be ready to apply (pre-application).

What staffing resources are needed to complete the accreditation process? 


Again, this varies for each applicant and is dependent on how quickly an applicant wishes to move through the process.  However, PHAB requires that all applicants  designate an accreditation coordinator.  PHAB estimates that accreditation coordinators dedicate between 25% to 75%  of their time to accreditation efforts.  In addition to the requirement of a designated accreditation coordinator, PHAB suggests applicants assemble an accreditation team of 6-8 individuals who can meet monthly for 2-4 hours and help with the process and the selection of documentation.  In addition to this core accreditation team, all staff involved in the delivery of public health services  should help evaluate potential documentation as they go through their day-to-day work. 
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How Does Acceditation Work in Indian Country?