WARREN — The Trumbull County Combined Health District joined the Mahoning County Combined Health District in achieving an accreditation mandate that has been described as difficult to achieve.

Mahoning County’s district was one of the first in the state to receive accreditation through the Public Health Accreditation Board of Virginia in 2014, two years after the state issued a mandate requiring all boards of health to achieve accreditation, said Mahoning health commissioner Patricia Sweeney.

“We were an early adopter. It improves our ability to be more accountable, because to meet the standards, you need systems in place to monitor performance and outcomes and to continually improve. I think it is a very positive thing and helps us improve our performance. It tells us we are providing the most efficient services possible and meeting national standards,” Sweeney said.

But, it can be a challenge, Sweeney said.

“It is not just the dollars paid, it is the time investment of the staff to make documents available and upload them and making sure it is the best example of what we are doing. But, understanding the requirements builds your strength as a health department,” she said.

The Trumbull County district was accredited in November after working for years to meet standards and document proof with the board, and agreeing to a $24,000 fee to be paid over the five-year life of the accreditation.

The statewide requirement is something unique to Ohio, said Warren’s Deputy Health Commissioner Robert Pinti. Since the mandate was put in place by former Gov. John Kasich’s administration, health departments around the state have dished out millions of local tax dollars to an out-of-state entity, Pinti said.

“Millions in the state have been spent on this. It is a tremendous amount of money, but once mandated, it is something we have to comply with,” Pinti said.

While the accreditations are supposed to be in place by July 2020, Pinti said he doesn’t think many departments will make it by the deadline.

Only 39 of the 113 health department in Ohio have been accredited. And only 300 of nearly 3,000 nationwide have been accredited through PHAB since 2011, when the organization launched.

But, departments that might miss the deadline, like Warren’s, are in the process.

“We would fall in the category of being in the process of being accredited. We have a site visit scheduled for March. Visitors from PHAB will come in and go through a two-day process. And then we will receive a report back from the site visitors and the report will tell us if we are in compliance or not. Then, from that point, we will have a year to respond to an action plan. About a year after the site visit, they will rule on how we carried out the action plan,” Pinti said. “In about 12 months, we should know if we made it or not.”

Peer review is used in the accreditation process, said Kaye Bender, president and CEO of PHAB.

“The peer review process provides valuable feedback to inform health departments of their strengths, and areas for improvement, so that they can better protect and promote the health of the people they serve in their communities. Residents of a community served by a nationally accredited health department can be assured that their health department has demonstrated the capacity to protect and promote the health of that community,” Bender said.

When Trumbull County went through the process, PHAB identified strengths at the department, including a commitment to building a culture of quality in the organization, developing community plans that demonstrate improved collaboration to address key community issues and building relationships to benefit the community, according to information provided by Natalie Markusic, accreditation coordinator for the Trumbull district.

“Now that we have achieved accreditation, our work is really just beginning. We have to continue to make improvements through our (quality improvement) process and implement strategies developed for various plans. We will provide documentation to PHAB annually to report our progress. Through our work and the work of our partners, we hope to have a positive impact on Trumbull County’s health outcomes,” Markusic said.

Improvements the department is working on include rewriting a workforce development plan to include a workforce assessment to “identify the overall workforce competency gaps, strategies to address the gaps, and barriers to achieving those strategies.”

And, Trumbull County has a low ratio of physicians and dentists, so the department will work on strategies to increase access to care for residents.

The office is also striving to improve communication between internal departments document more internal work and working to establish a greater presence in the community.

“Public perception cannot be changed/improved, if the public isn’t aware of the health department’s role in the community or the positive work being done by the department. The health department has always been known as an enforcement agency. And while enforcing environmental laws and rules are a crucial role the health department plays in protecting the health and environment of the Trumbull County residents, this is by far not our only function,” Markusic said.

One of the accreditation themes is improving community relations, she said.

“Accreditation focuses on communicating with the public and establishing a greater presence in the community,” Markusic said.