Overview

The National Public Health Performance Standards Program (NPHPSP) is a collaborative effort to enhance the Nation’s public health systems. Seven national public health organizations have partnered to develop national performance standards for State and local public health systems.

The stated mission and goals of the NPHPSP are to improve the quality of public health practice and the performance of public health systems by:

1. Providing performance standards for public health systems,
2. Improving quality and accountability of public health practice,
3. Conducting systematic collection and analysis of performance data, and
4. Developing a science-base for public health practice improvement.

The NPHPSP is a collaborative effort of national partners representing the organizations and individuals that will use the performance standards:

• Centers for Disease Control and Prevention, Office of the Chief of Public Health Practice (CDC / OCPHP),
• American Public Health Association (APHA),
• Association of State and Territorial Health Officials (ASTHO),
• National Association of County and City Health Officials (NACCHO),
• National Association of Local Boards of Health (NALBOH),
• National Network of Public Health Institutes (NNPHI), and
• Public Health Foundation (PHF).

The Instruments

The NPHPSP includes three instruments:

• The State Public Health System Assessment Instrument focuses on the “state public health system,” which includes state public health agencies and other partners that contribute to public health services at the state level. This instrument was developed by ASTHO and CDC.
• The Local Public Health System Assessment Instrument focuses on the “local public health system” or all entities that contribute to public health services within a community. The local instrument was developed by NACCHO and CDC.
• The Local Public Health Governance Assessment Instrument focuses on the governing body accountable for public health at the local level. Such governing bodies may include boards of health, councils, or county commissioners. The governance instrument was developed by NALBOH and CDC.

There are four concepts that have helped to frame the NPHPSP:

1. The standards are designed around the ten Essential Public Health Services to assure that the standards fully cover the gamut of public health action needed at state and community levels.
2. The standards focus on the overall public health system (all public, private, and voluntary entities that contribute to public health activities within a given area), rather than a single organization. This assures that the contributions of all entities are recognized in assessing the provision of essential public health services.
3. The standards describe an optimal level of performance rather than provide minimum expectations. This assures that the standards can be used for continuous quality improvement. The standards can stimulate greater accomplishment and provide a level to which all public health systems can aspire to achieve.
4. The standards are intended to support a process of quality improvement. System partners should use the assessment process and the performance standards results as a guide for learning about public health activities throughout the system and determining how to make improvements.

The Benefits of Implementation

The NPHPSP is a valuable tool in identifying areas for system improvement, strengthening state and local partnerships, and assuring that a strong system is in place for effective response to day-to-day public health issues as well as public health emergencies. NPHPSP instrument users at all levels report numerous such benefits, including:

• Improves organizational and community communication and collaboration, by bringing partners to the same table.
• Educates participants about public health and the interconnectedness of activities, which can lead to a higher appreciation and awareness of the many activities related to improving the public’s health.
• Strengthens the diverse network of partners within state and local public health systems, which can lead to more cohesion among partners, better coordination of activities and resources, and less duplication of services.
• Identifies strengths and weaknesses to address in quality improvement efforts. Responses to the assessment can be tracked over time to identify system improvements or changes.
• Provides a benchmark for public health practice improvements, by providing a “gold standard” to which public health systems can aspire.

Resources and Technical Assistance
State and local public health systems are encouraged to conduct the performance assessment through a coordinated statewide approach. The NPHPSP provides a variety of resources, including training and technical assistance, to support states in moving toward statewide performance standards implementation.

Resources
Assessment Instruments (local, state, and governance), Glossary, and User Guide documents may be downloaded at www.cdc.gov/od/ocphp/nphpsp/.  Links to NPHPSP partner organizations and additional resources, such as case studies and quality improvement tools, are also available at this website. Information on MAPP, a community strategic planning process that incorporates the NPHPSP local instrument, is available at www.naccho.org.

Technical Assistance
CDC and NPHPSP partners are available for phone and email consultation to states and localities as they plan for NPHPSP implementation.

Training
CDC and NPHPSP partners can provide training to states planning statewide implementation of the NPHPSP instruments. Different formats such as satellite videoconferencing, regional meetings, or a statewide orientation conference, can be considered, as can a train-the-trainer approach.

NPHPSP Brochure (PDF)

NPHPSP Fact Sheet (PDF)