Becoming Accredited: Myths and Misconceptions

Rochelle Haimes, ACSW
ECSG Consultant

Ask senior leaders why their agency is accredited, and the answer they offer will probably vary greatly from the answer they gave 10-15 years ago. In the past, most agencies that became accredited did so voluntarily to stretch beyond minimal state regulations. Accreditation, in these “early days,” was likened to the Good Housekeeping Seal.

But times have changed. As more public entities have become accredited, their private providers are expected to follow suit. Many states continue to mandate accreditation for those programs that receive Medicaid money for identified mental health services. And, as dollars shrink for nonprofits, accreditation has increasingly become a competitive edge on an agency’s application for corporate and philanthropic dollars.

What hasn’t changed, however, are the myths and misconceptions that keep organizations from pursuing accreditation—misconceptions about how much information to share with the board, how much work is required after the plaque is on the wall, and whether to hire a consultant. This article will identify some common misconceptions about becoming successfully accredited, within the context of this consultant’s experience.

Myth 1: It’s Easier to Get Accredited if You Are a Medium or Large Agency

While most medium or large agencies have more resources—financial and human—this does not assure a successful result. Organizing the work is more complex, involving key staff is more difficult, and demonstrating consistency of practice across similar programs is often a challenge. This is compounded by the number of program sites and/or regions that an agency operates in.

In many cases, smaller agencies are less complex and more transparent. Although many staff have multiple responsibilities, describing how the agency operates is often easier.

Myth 2: Choose the Accreditation that Seems Easiest to Accomplish

Most agencies take accreditation very seriously and understand the ultimate value in enhancing capacity and infrastructure. In addition, agencies have benefited from more consistent service delivery and from more consistent personnel performance and accountability.

If a national accrediting body has been selected for the perceived ease of the outcome, there is a real risk of reduced benefits from the work and to the agency.

Myth 3: Hire a Consultant to Do the Work for You

From the viewpoint of this consultant, who has worked with multiple agencies and serves as a Council on Accreditation (COA) Team Leader, there is little value in having someone else do the actual work.

Consultants may be valuable in developing and facilitating the agency’s work plan, in reviewing critical materials, and in keeping the process on track. But when the agency has an in-person or on-site review, the staff and governing body are the only viable spokespersons for the agency and its work. That is where the investment in accreditation is represented, and if staff has not been involved they are often left with a very weak script.

This caution also applies to agencies that select one person to do the majority of the work for everyone else. There is very important value in having an internal coordinator or point person to manage the process. But, like when using a consultant, similar negative outcomes can result if other staff have been excluded from the process.

Myth 4: Keep the Board/Governing Body in the Dark

The role of the board in most agencies, in relation to accreditation, can be minimal in terms of the actual work plan. However, it is very important that the board is educated about the process of accreditation, the scope and rigor of the standards, the costs and challenge to staff time, and the amount of effort required.

Most accreditations have very clear standards for the responsibilities of the board/governing body. Regular updates to the board about the work and the timeline, as well as serious preparation for on-site interviews are essential. This keeps the board supportive of the effort, prepared to participate, and proud of a successful outcome.

Myth 5: Do as Little as Possible in Performance/Quality Improvement

Central to the accreditation process is a comprehensive, broad-based process of performance and quality improvement. This process encourages agencies to use data to identify outcomes. Organizations must explain how those outcomes are measured and used internally to target areas of needed improvement in service delivery or within other areas of the agency. Avoiding ongoing quality improvement activities is counterproductive.

Most standards of practice have become highly sophisticated and use data to achieve better results; most standards also involve staff in the selection of measures and the review of gains against goals. Although technology has greatly advanced and many software programs are available to agencies, demonstrating a commitment to improvement comes from how information is used and communicated. Staff who have been involved and have an investment are a mark of a high-performing agency where a culture of quality has been established.

Myth 6: Expect Everything to Go Smoothly from Start to Finish

Accreditation, from start to finish, is a process that will have ups and downs, and being prepared for this is helpful. If an agency makes a commitment to a realistic work plan and timeline, it is easier to make adjustments along the way.

Staff working on accreditation—regardless of whether their role is major or minor—will continue to have their full-time jobs. It is to be expected that some meetings will go better than others and that at times the work will flow smoothly while at other times snags will be encountered. Knowing this in advance is often helpful in keeping staff invested for the long haul and ensuring they are not discouraged when mid-course adjustments have to be made.

Myth 7: Forget about Accreditation as Soon as the Shining Plaque is On the Wall

In working with many agencies for many years, one of the more discouraging situations has been to see the pattern of not keeping up with the work of accreditation. All accrediting bodies have regular cycles of reaccreditation, and in that time their standards often change or more are added.

If an agency’s initial accreditation has had value, then the organization will have systems of practice, policy review, and numerous processes already put in place. Keeping up with accreditation standards should be easier and the next accreditation cycle should be more manageable.

Of course, changes in key staff that were involved are always a challenge. But a core of accreditation-committed staff can ensure that new staff are introduced to the value of accreditation at orientation and then as part of ongoing training and work expectations.

Dispelling Myths Alleviates Anxiety

The majority of agencies that have become accredited, or are considering it, know that the process is rigorous, challenging, and costly both in terms of fees as well as staff time and effort. (Note, however, that Alliance for Children and Families members receive a discounted rate through COA.) Few nationally accredited agencies will tell you that the process was easy or that little time and effort was involved. These, unfortunately, aren’t myths.

Most of the national accrediting bodies have a rigorous body of standards that evaluate practice in programs and service delivery, as well as in various support areas of management and administration. All accreditations have increasingly stressed and strengthened the importance of continual self-evaluation, outcome identification and measurement, as well as the use of valid data to plan improvement and to evaluate strategic and short-term benchmarks and goals.

Discerning the myths from the realities will help organizations considering accreditation—and even those that are already accredited—get and stay on track in order to open new opportunities for government programs and new funding streams, or provide a competitive edge with corporations and foundations. Becoming or sustaining national accreditation can also enhance an agency’s status and attractiveness during these times of tightening purse strings.

Ask senior leaders why their agency is accredited, and the answer they offer will probably vary greatly from the answer they gave 10-15 years ago. In the past, most agencies that became accredited did so voluntarily to stretch beyond minimal state regulations. Accreditation, in these “early days,” was likened to the Good Housekeeping Seal.