The development of a local level instrument began in

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Nature of Mathematics
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Chapter 4 / Exercise G11
Nature of Mathematics
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The development of a local-level instrument began in 1998. Since then, the instrument has been tested in local public health agencies throughout Florida, Hawaii, Minnesota, Mississippi, New York, Ohio, and Texas. This testing en- sures that the instrument is responsive to the needs of communities, accu- rately assesses local performance and capacities, and addresses the broad variation in local public health infrastructures across the nation (NACCHO, 2001f). Recent pilot testing of the NPHPSP instruments indicates that the per- formance standards based on the 10 essential services have validity for mea- suring local public health performance (Beaulieu and Scutchfield, 2002). The local instruments were developed by the same NACCHO CDC partnership that developed the community-wide strategic planning tool for improving com- munity health, Mobilizing for Action through Planning and Partnerships (MAPP), as part of the Assessment Protocol for Excellence in Public Health project. The local instrument will be included in the new MAPP tool as a meth- od for assessing the local public health system and identifying areas of improvement. The Future of the Public's Health in the 21st Century Copyright National Academy of Sciences. All rights reserved.
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Nature of Mathematics
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Chapter 4 / Exercise G11
Nature of Mathematics
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THE GOVERNMENTAL PUBLIC HEALTH INFRASTRUCTURE 157 can be achieved when the resources to provide even the most basic services are often lacking. Linking federal funding to accreditation based on public health performance standards has been proposed, but there may not be adequate incentives for states and localities that do not receive significant portions of their overall funding from federal agencies. The promise of a long-term federal investment at the state and local levels linked to such a system could change the situation considerably. To address these and other concerns, NACCHO has convened the Voluntary Accreditation Committee, which consists of eight local health officers who are charged with maintaining an ongoing discussion of the advantages and disadvantages of voluntary accreditation of local health departments. They are currently researching lessons that might be learned from other voluntary accreditation efforts, such as those for hospitals, managed care organizations, and law enforcement agencies. The Voluntary Accreditation Committee is also taking into account the work of states such as Florida, Illinois, Michigan, Missouri, Ohio, and Washington that are already active in the development of state-specific accreditation or perfor- mance standards for their local public health agencies. Despite the controversies concerning accreditation, the committee be- lieves that greater accountability is needed on the part of state and local public health agencies with regard to the performance of the core public health functions of assessment, assurance, and policy development and the essential public health services. Furthermore, the committee believes that development of a uniform set of national standards leading to public health

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