To advance quality improvement in public health, national associations are supporting the development of accreditation standards for state and local health agencies. In November 2004, the National Association of Local Boards of Health adopted a statement on voluntary accreditation. In July 2005, NACCHO adopted a resolution in support of voluntary national accreditation programs for public health agencies provided that: 

• Local public heath jurisdictions are involved in the development process;
• Community heath status improvement is a focus;
• Financial barriers are minimized; and
• Standards are developed by consensus and updated regularly.[1]

Since then, the Association of State and Territorial Health Officials and the American Public Health Association have affirmed and reaffirmed their support for public health agency performance improvement and are supporting accreditation as a means to this end.

The purpose of voluntary accreditation is to create a tool to improve the quality and performance of public health departments without regard to organizational structure or jurisdiction.[2] The voluntary accreditation tool would be used to advance the pursuit of excellence, continuous quality improvement, and accountability for the public's health.

Recognizing the need for state and local influence on the national agenda, the Robert Wood Johnson Foundation and the Network of National Public Health Institutes (NNPHI) are spearheading an effort called the Multi-State Learning Collaborative or MLC project. The MLC project has created a peer network across ten states to exchange quality improvement ideas and strategies in public health. The MLC project provides a valuable opportunity for public health professionals to learn from and teach each other. MLC-1 contributed to the growing enthusiasm for developing similar programs throughout the country and for developing the national public health accreditation program. Ohio was selected to participate in MLC-2, which is continuing the process. The key elements of the MLC project are to:

• Bolster the public health performance assessment or accreditation programs in the 10 participating states;
• Foster peer exchange and collaboration among the participating states;
• Convene the states to share best practices and lessons learned as well as explore quality improvement efforts;
• Produce resources and tools to be used by others;
• And inform the public health practice community about the findings and products of the project.