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Washington began developing standards for public health in the mid-1990s. By 2000, a set of standards and measures based on the Core Functions of Public Health and the Ten Essential Public Health Services had been developed, reviewed, and revised.
The development process relied on the work of an ongoing Standards Committee, as well as multidisciplinary workgroups of state and local health workers. Since 2000, three field test of the assessment tools have taken place.
Washington also participates in the Multi-State Learning Collaborative project, which assesses quality improvement strategies to enhance the work of public health departments.