Austin Public Health in Texas saw renewing its recognition with Project Public Health Ready (PPHR) as a way to demonstrate its alignment with public health preparedness best practices. That’s one of the reasons they completed the application process for recognition in 2025. 

“I’ve seen in six years how much our work has evolved,” said Emergency Management Manager Ana Urueta. “It would be a disservice if we didn’t seek PPHR recognition. It felt like an opportunity to share good plans and helps make sure we have as robust of a program as possible.”

PPHR is a nationally recognized, criteria-based training and recognition program developed by NACCHO in partnership with the Centers for Disease Control and Prevention (CDC). It is designed to help local health departments (LHDs) develop core public health and emergency preparedness competencies. Health departments that successfully complete the program earn PPHR recognition, valid for five years. Re-recognition status, also valid for five years, demonstrates a department’s ongoing commitment to preparedness and highlights improvements made since an agency’s initial recognition.

Austin Public Health’s application to renew PPHR recognition was a full team effort. The emergency preparedness staff of 11 included an emergency plans officer, planner, community health worker, two disaster epidemiologists, three BioWatch staff, and a graphic designer. Staff were assigned to different parts of the application based on their role and familiarity with an area. Urueta helped to coordinate and lead the process.

“This gave me a comprehensive understanding of how everything was coming together and gave me a chance to provide review,” said Urueta.

To manage the process, the team created a live document to collect what was relevant to each section and used color coding to indicate readiness for submission. They also held periodic check-in meetings. 

“We are very collaborative but have a heavy workload,” said Emergency Plans Officer Eleanor Allain. “Everyone could see what we put together in the application and appreciate how much the team has done.”

The PPHR process also helped the team identify opportunities to improve.

“Day-to-day, we do after-action reviews (AARs) and improvement plans,” said Urueta. “This let us see how it was all intertwined and how we could improve. It also provided an opportunity to revisit the plans we have in place.”

For example, the team has strong partnerships in place. The process helped them to become familiar with partner plans and provided an opportunity to see how Austin Public Health is represented in partner plans. 

The agency also has a relatively new Medical Reserve Corps (MRC) unit with a fairly new plan and SOPs. The PPHR process helped to clarify what parts in plans were missing in terms of tracking and deploying volunteers. The team saw its plan in action in response to the July 4 flooding in the Hill Country region.

To assist it throughout the application process, Austin Public Health worked with their State Lead, Tricia Cruz, Public Health Emergency Preparedness Planner with the Texas Department of State Health Services.

State Leads play a critical role as the primary contact between local health departments applying for recognition and NACCHO. State Leads become their state’s subject matter experts on PPHR. They navigate the application process with applicants for the state they represent from start to finish and offer state-level guidance to applicants as they develop their application for submission.

“Tricia provided a lot of opportunities for collaboration,” said Urueta. “She convened the local health departments to create a space to ask questions and was always available by email or phone. She was really helpful during crunch time.”

PPHR State Leads bring health departments within the same state together as cohorts. This allows applicants to share ideas, compare approaches, and support each other along the way. If available, reaching out to past PPHR applicants within the state further strengthens collaboration by bringing first-hand experience, lessons learned, and practical guidance that can make navigating the PPHR process easier.

“It was great to have such an engaged cohort,” said Cruz.

In considering advice to offer other health departments interested in PPHR, Urueta noted that the process does require advanced planning.

Participating health departments must submit several key documents as part of the PPHR application to be successful in the process. These include:

• Risk Assessment completed within the last three years, whether as a standalone document or incorporated into a response plan, JRA/THIRA, or Hazard Mitigation Plan.
• Multi-Year Training and Exercise Plan—such as an MYIPP, MYTEP, or workforce development plan—updated within the past three years.
• All-Hazards Response Plan developed or revised within one year of submission. This may be a standalone plan or part of a broader Emergency Operations Plan.
• Continuity of Operations Plan updated within the last year, demonstrating how essential functions will continue during operational disruptions.
• Current Training and Exercise Schedule, updated within the past year, outlining opportunities that support preparedness and response competencies.
• After-Action Report and Improvement Plan from a real incident or a full-scale exercise conducted within the last two years.

“Before going through the process, review all the different requirements,” advised Urueta. “While it could be a tedious process, it also provided evidence of all that we have gone through.”

Ready to demonstrate excellence in planning for, responding to, and recovering from public health emergencies? Celebrate your commitment to building stronger communities. Click here to learn more about PPHR, including details of the application process and ways to get involved in the program as a reviewer, state lead, or workgroup member. Interested in a one-on-one connection or staying in the loop about program updates? Click here.