Small and Mighty Vision – Carter County Health Department

“Congratulations!  The Public Health Accreditation Board (PHAB) is pleased to notify you that the PHAB Accreditation Committee, on August 28, 2025, made its decision to confer accreditation to Carter County Health Department.”

Achieving national public health accreditation is no small task, especially if a health department is small in staff capacity and resources, as is Carter County Health Department (CCHD) in Missouri.  In fact, with a population of 5,359 in 2024, CCHD is the second smallest county health department by county population accredited by PHAB, the nation’s only national public health accrediting entity.

Michelle Walker, Administrator of CCHD, says it was a moment of profound gratitude and joy for she and her staff.  They began their accreditation journey when invited to participate in a pilot with PHAB to develop a Readiness Assessment process. Completion of this pilot resulted in CCHD being gifted by PHAB with use of the finalized Readiness Assessment which they completed over a 9-10 month period.  That process led to a department-wide, joint decision to pursue accreditation, knowing that even with all of the work already completed, pursuing accreditation was a lofty goal for only 6.0 FTE to accomplish in the required timeframes.

Michelle says it was incredibly validating and touching for so many community partners to attend their PHAB accreditation interviews.  Like many public health departments, CCHD was plagued by public and media scrutiny during the COVID response.  CCHD recognized their community partnerships were not as strong as needed and they set out to change that, in part through the vehicle of the accreditation process.  So, when community partners attended the accreditation interviews and praised the work of CCHD and staff, it was a time of great celebration and gratitude.  Michelle says that was an even greater reward than the accreditation itself in many ways.

CCHD and Michelle’s leadership is an excellent example of Inspire a Shared Vision, one of The Five Practices identified by Jim Kouzes and Barry Posner in The Leadership Challenge, 7th edition as practiced by exemplary leaders.  The entire CCHD team chose the path of national accreditation because they wanted to be their best for their county’s citizens and their neighbors, a shared vision of quality improvement.

Michelle completed training sponsored by the Missouri Department of Health and Senior Services on The Leadership Challenge® (TLC) in January 2025. She says she learned to recognize that not everyone identifies leadership as she does and it became important for her to understand how her team members defined leadership. In this pursuit, Michelle says she benefited from the feedback provided by team members on her Leadership Practices Inventory (LPI), a 360º assessment of how frequently the leader being assessed displays the 30 behaviors of exemplary leaders.

Congratulations to Michelle and CCHD, you inspire a vision for all public health departments, particularly those that are small and mighty, to pursue national accreditation!