The Accreditation of the International Commission on Health Care Certification

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The Accreditation of the International Commission on Health care Certification

Accreditation of a certifying agency is the pinnacle of that agency’s success in its specific area of certification(s). The accredited agency presents a well-structured, reformatted system that has complied with the required standards of the accrediting body for the benefit of the group of certificants who hold the respective certifying agency’s credential. Additionally, the field of certificants is protected in terms of testimony in deposition or in court. For example, the practitioner holding the accredited Certified Life Care Planner^TM (CLCP^®) or Canadian Certified Life Care Planner^TM (CCLCP^TM) credentials will no longer experience the attempt of the opposing counsel in deposition or cross examination projecting pernicious descriptors of the ICHCC^® in an effort to encourage doubt from the jury about the life care planner’s expertise and/or credibility. Rather, the Certified Life Care Planner^TM from the International Commission on Health Care Certification^TM (ICHCC^®) can now respond that the credential’s accreditation agency is the largest and oldest accreditation agency in the United States, with standards applied to the ICHCC^® that require annual reviews of examination, business structure, and validation of the examination. Per the requirements of the accrediting agency, the ICHCC^® has turned its internal focus to monitor any potential biases towards an applicant or applicant groups from its Board of Commissioners, review and maintain ethical business practices, as well as ensure the ICHCC^® continues to follow its stated mission.

ICHCC^® History

The ICHCC^® was established in 1994 as the Commission on Disability Examiner Certification (CDEC) in response to the health care industry’s need for certified clinical examiners in impairment and disability rating practices. The CDEC expanded rapidly over its first 8 years such that its name was updated in the spring of 2002 to that of the Commission on Health Care Certification. By 2005 the ICHCC^® was certifying Canadian health care practitioners, and therefore the name changed again with the addition of “International”, resulting in the full name of the agency as being the International Commission on Health Care Certification^TM (ICHCC^®) (May, 2023).

The ICHCC^® established its mission statement as being the overseeing of the examination of healthcare providers and professionals in the specialty rehabilitation areas of United States life care planning, Canadian life care planning, Medicare Set-aside allocation development, geriatric care management, and medical cost projections (May, 2023). Through the accrediting body that oversees the continued review and acceptance of the accrediting agency’s test and operational standards, the ICHCC^® is required to continue development and updating of various knowledge domains within the 5 credentials to meet its revised post-accreditation stated mission. Knowledge domains usually result from survey research of those practitioners who carry the respective ICHCC^® credential. While knowledge domains are identified through survey research, they are strengthened and monitored through continued research and development of credential standards. For example, the accrediting body requires the ICHCC^® to continue development, reviewing, and researching standards for United States and Canadian life care planning credentials, Medicare Set-aside allocation, geriatric care management service providers, and medical cost projections analysts for postgraduate training in these respective areas. Additionally, the ICHCC^® is required to develop, review, and research standards of practice for United States and Canadian life care planning, Medicare Set-aside allocation, geriatric care management providers, and medical cost projection analysts (International Standard ISO/IEC 17000, 2020).

The accreditation process requires the ICHCC^® to develop and administer examinations that assess the knowledge and skills that comprise the essential functions required of United States and Canadian life care planners, Medicare Set-aside allocations, geriatric care managers service delivery providers, and medical cost projection analysts. The process also requires the ICHCC^® to appoint qualified health care practitioners as Commissioners to sit on the Board of Commissioners specific to each credential offered by the ICHCC^®. The represented specialty areas may include but are not limited to vocational rehabilitation evaluators/counselors, medical physicians, nurses, occupational therapists, physical therapists, attorneys, social work professionals, psychologists, and physician assistants as applied to health care settings (May, 2023).

The accreditation process requires the ICHCC^® to establish Subject Matter Expert committees to review and modify or update test items that are coordinated with the changes in the life care planning methodology over time. Accreditation requires the ICHCC^® to solicit the assistance of Subject Matter Experts in researching the validity and reliability of the examinations, incorporating appropriate research design and statistics. Such a requirement also helps the ICHCC^® to develop national and international tests that measure the health care provider applicant’s working knowledge of disability, medical systems, associated disabilities, and treatment/maintenance protocols required to sustain life within an acceptable comfort level.

The ICHCC^® accrediting agency requires that ICHCC^® to conduct ongoing research in terms of test-item validity and reliability. Such research ensures that tests measure what they purport to measure and that the items are a fair representation of the respective credential’s subject matter and required knowledgebase.

Recertifying one’s credential(s) is an important process for keeping ones credential(s) active. The ICHCC^® accreditation agency requires that ICHCC^® establish and monitor recertification policies to measure continued competence and/or to enhance the continued competence of all certified health care professionals under the ICHCC^® (May, 2023).

The ICHCC^® currently offers 5 credentials for healthcare practitioners. These include the Certified Life Care Planner^TM (CLCP^®), the Canadian Certified Life Care Planner^TM (CCLCP^TM), the Medicare Set-aside Certified Consultant^TM (MSCC^®), the Certified Geriatric Care Manager^TM (CGCM^®), and the Certified Medical Cost Projection Specialist^TM (CMCPS^®) (May, 2023). Each credential has its own Board of Commissioners, and the ICHCC^® has worked diligently with ANAB to ensure that its credentials meet the applicable accreditation standards and have successfully achieved accreditation. The qualification criteria for applicants as well as training program locations for each credential can be found on the ICHCC^® website at ICHCC.org. The reader can find all information about the ICHCC^® in both the ICHCC^® Standards and Guidelines and the CLCP^® /CCLCP^TM Candidate Handbook. These manuals can be found in the horizontal menu bar under the headings of “About Us” and “Resources.”

The American National Standards Institute (ANSI) and the National Accreditation Board

The ICHCC^® achieved its accreditation through the American National Standards Institute National Accreditation Board (ANAB). This agency has a history rooted in standardization and accreditation and was originally referred to as the American National Standards Institute (ANSI) prior to its acquisition of the National Accreditation Board. Initially formed in 1918 by five engineering societies and three government agencies as the American Engineering Standards Committee (AESC), it evolved into the American Standards Association (ASA) in 1928. Shortly after World War II, ASA joined with the national standards bodies of 25 countries to form an international organization devoted to standardization. The objective of this newly formed International Organization for Standardization (ISO) was to promote international standards development and to facilitate the international unification of industrial standards. The America Standards Association (ASA) was reorganized and renamed the United States of America Standards Institute (USASI), and in 1969 the USASI organization officially adopted its current name, The American National Standards Institute (ANSI). It was in 2018 that ANSI acquired all rights to the National Accreditation Board and created a new standards agency under its organization named the American National Standards Institute National Accreditation Board, or ANAB (American National Standards Institute National Accreditation Board, n.d.; Ansi: A historical overview. n.d.; ANSI National Accreditation Board, 2024; Hayes & Clarke, 2022).

The ANAB (ANSI National Accreditation Board) history began in 1989 as the Registrar Accreditation Board (RAB), a program of the American Society for Quality (ASQ). In 1991, RAB and ANSI partnered, leading to the ANSI-RAB National Accreditation Program for quality and environmental management systems. After becoming a legal entity in 2005 under the name ANSI-ASQ National Accreditation Board (ANAB), ANSI acquired full ownership in December 2018 resulting in its current name as the ANSI National Accreditation Board (ANAB). The role of ANAB is that of providing accreditation and training services for a broad range of conformity assessment bodies. The ANSI National Accreditation Board (ANAB) is a key component of ANSI, focusing on accreditation services and training for organizations in the public and private sectors. ANAB is now a wholly owned subsidiary of ANSI and operates as a separate legal entity. Thus, ANSI focuses on the development and oversight of American National Standards (ANS), while ANAB (National Standards Board) provides accreditation services for conformity assessment bodies, such as management systems certification, testing labs, inspection bodies, and personnel certification bodies such as the ICHCC^® (ANSI, 2025; ANSI National Accreditation Board, 2024).

The Importance of Accreditation for Certified Life Care Planners

Before addressing the benefits of accreditation, one must understand the purpose and role of accreditation, its differences among certification and licensure processes, and how it benefits both the credentialing agency and the practitioners who carry certification credentials from certifying agencies. The purpose of accreditation is to serve as independent evaluating bodies to protect the best interests of certification candidates and to ensure that the accreditation agency’s standards remain in place within the accredited credentialling agency (Babcock, 2016). When applied to life care planning, the goal of accreditation is to enhance the quality of care within the life care plan and fairness to the person with the disability who is the subject of the plan (Goldstein, 2007). This tenet applies to both the plaintiff and the defense referral sources that rely on Certified Life Care Planners to determine the need and costs necessary to assist the person with a disability to return to functional levels as close to preinjury function as possible.

Accreditation has been defined by many authors, all of whom offer consistency being that accreditation is a status granted to an institution, specialized training program, or a credentialing agency that has been found by nongovernmental bodies to meet or exceed stated criteria of credentialing quality (Moore & Shook, 2001). This process requires an evaluation team representing the accrediting agency to visit the specific credentialing agency to review all program content and to ensure the certifying agency is maintaining the accreditation agency’s assigned standards (Alhawajreh et al., 2023). The program content may include, but not limited to bank accounts and statements, current application of accreditation, agency standards and guidelines to the credentialing agency’s operations, examination results of candidates, item validation reports, frequency of correctly and incorrectly marked test items, and the assessment of Commissioner Boards regarding possible biases toward certain groups or individuals requesting to test for a specific credential.

The certified agency that is awarded accreditation must undergo cyclical reviews and an evaluation of specified criteria and procedures (Boulet & Zanten, 2014). For example, the ICHCC^® is audited by a specialist in business operation standards from ANAB and visited by an external assessor team annually. The advantage for the Certified Life Care Planner^TM and Canadian Certified Life Care Planner^TM is that a higher authority is managing their credential’s certification agency (ICHCC^®) business operations and testing criteria, rather than leaving such important aspects of credentialing to persons in the certification agency not familiar with such standards for credentialing operations, test constructs, and validation.

There are two types of accreditations awards: 1) institutional and 2) programmatic awards (Babcock, 2016). The ICHCC^® complies with both types in its approval of training programs that are specialized and designed specifically to the ICHCC^®’s research of knowledge domains on which the certification examination is based. The institutional standards are tied to a university that is accredited through its major departments of study. The ICHCC^® has accepted a life care planning training program designed specifically to the CLCP^® /CCLCP^TM credentials at Thomas Jefferson University in Philadelphia, Pennsylvania. The University’s accreditation covers the affiliation of the ICHCC^® with the Thomas Jefferson University Department of Occupational Therapy in the College of Rehabilitation Sciences. Additionally, the ICHCC^® is covered under the accreditation of Virginia Commonwealth University’s College of Health Professions, Department of Gerontology for its Certified Geriatric Care Manager credential.

The programmatic accreditation award applies to independent training programs that are not affiliated with universities (Babcock, 2016). The programmatic training programs benefit from accreditation that ensures that the educational content of the CLCP^® /CCLCP^TM follows the knowledge domains of the job task inventory published in the Journal of Life Care Planning in 2020. Additionally, programmatic accreditation award ensures that the training programs the ICHCC^® has accepted for its credentials maintain the highest standards in training education.

Accreditation Process

The accreditation process engages in steps that are standard in all industries. Zaman and Fatima (2024) list the accreditation process steps as follows:

1. Accreditation agencies formulate a set of quality standards specific to the industry. For example, life care planning qualifies for medical and health care practices, and therefore the standards set upon by ANAB address human resource policies for staff and certificant practitioners, as well as ensuring proper and necessary medical/rehabilitation services, durable medical equipment, environmental adjustments, and barrier-free living space, etc., to name just a few.

2. The accreditation agency enters a preparatory phase after receiving the application from the credentialing agency, which includes a comprehensive and robust assessment of the credentialing agency’s processes, policies, and procedures in accordance with the standards and regulations of the accreditation provider.

3. The accreditation agency identifies gaps in compliance that are mitigated or removed in consultation with accreditation assessors to meet standards and regulations.

4. The accreditation assessors visit the certification agency to perform an onsite survey. The purpose is for the assessors to check and review the compliance of policies and procedures by staff.

5. Once accredited, the awarded certification agency is allowed to use the stamp/logo of the accrediting body on its documents and digital platforms.

6. The accredited credential agency must undergo annual reviews and surveys annually to ensure adherence and compliance with the set of qualitative standards.

Benefits of Accreditation

There are many benefits accreditation offers to the credentialing agency and most importantly, to the health care practitioner who carries any one of the 5 credentials the ICHCC^® offers to health care practitioners. According to the Institute for Credentialing Excellence (2023, 2024), Accreditation provides value to the certification agency and to the health care practitioners who carry the ICHCC^®’s credential(s) by having the credentialing agency adopt and adhere to standards provided by a third-party assessment agency. However, and more importantly, the accrediting agency verifies each credential being held accountable to appropriate rigorous standards set by the credentialing profession through review and suggestions by the accrediting agency (The Association for Behavior Analysis International, 2025). All suggestions, rules, and standards from the accrediting agency are beneficial to the credentialing agency as well as to the credentialed practitioner carrying any one of its 5 credentials. Regarding the ICHCC^®, accreditation creates through its requirement for continuous evaluation and quality improvement of the ICHCC^® test curriculum and creates the impetus for identifying strengths and weaknesses of the agency. Regarding the credentialed practitioner, this person understands that their CLCP^® or CCLCP^TM credential has undergone evaluation and has met standards of a higher authority in test standards and the administration of certification examinations.

Accreditation creates guidelines for Board Commissioners under each credential, which leads to an increased focus for Board-Member development. This includes a focus of impartiality guaranteed by each Commissioner on the Board of Commissioners. Thus, no credentialing candidate can be the subject of an impartial perceptive by any Commissioner, and acceptance will be applied only to their qualifications, training program completion, an approved life care plan constructed during training, and a passing score on the examination.

Accreditation promotes an outcome assessment process linking goals, activities, and outcomes of test scores and decision-making. The candidate through the accreditation process can demonstrate their ability to share their goals in the use of their ICHCC^® credential(s), their behaviors and approach to interacting with people with disabilities, and an exam score that is at the level of the researched passing score or above.

Accreditation creates guidelines when reviewing and advising programs (research, journal publications, test item development and validation, statistical analysis of test outcomes among test groups, etc.). This provides the respective credentialing agency an opportunity to include field practitioners that carry specific ICHCC^® credentials to participate in the ICHCC^® research studies, benefit from being included as a primary or secondary author from participating in subject matter expert committees, participate in the ICHCC^®-ACLCP monthly webinars, submit manuscripts to the ICHCC^® Journal for Health Care Professionals, and to be able to apply to the ICHCC^® for a Commissioner position on the respective credential Board of Commissioners.

Accreditation awards respect the credentialing agency’s mission, objectives, and Commissioner Board members’ expertise by providing flexibility in the agency’s arrangement and areas of training. This flexibility opens up more committees and Boards of Commissioners positions that need to be filled in any of the 5 credentials currently offered by the ICHCC^®.

The accreditation process validates the quality of the ICHCC^® work in the certification processes and communicates achievements at multiple levels of the agency to stakeholders as well as credentialed field practitioners. This validation projects confidence in the health care practitioners who carry one of the ICHCC^®’s 5 credentials knowing that they have a credential that is a valid representation of the knowledge domains of the specific credential, and one that remains consistent to those knowledge domains.

Accreditation is a symbol of excellence that demonstrates a program’s high-quality design and appropriately rigorous processes designed to test candidates seeking certification from the ICHCC^®. Thus, the person carrying any one of the 5 ICHCC^® credentials know that they are protected by having a well-researched, validated examination and by having an Agency to which the ICHCC^® is committed and having to maintain specific standards required of the higher authority of the accreditation agency.

The accreditation process identifies opportunities for program enhancement and increased efficiency and effectiveness. This reflects on the research studies required of the ICHCC^® by its credentialing agency, the American National Standards Institute National Accreditation Board (ANAB). It also provides the credentialed practitioner confidence in the ICHCC^® knowing that the agency subscribes to accreditation standards and that the agency follows the rules and regulations provided by ANAB. In essence, the ICHCC^® maintains accreditation standards developed and required by ANAB that are grounded in validated health care practices, leveraging the expertise of Subject Matter Experts (SMEs), a collaborative methodology, and a well-defined governance structure.

ANAB accreditation standards recognize and define the difference between certifications and certificates, including micro-credentials. It is extremely important that health care practitioners understand the differences among these varying awards so they can choose the award level that best reflects the strength and quality of their health care practices.

Finally, ANAB accreditation standards provide a defensible rationale in response to opposing attorneys questioning the credentialed practitioner regarding the status of their credentialing agency. Often, attorneys do not fully understand credentialing, what accreditation means to the credentialing agency, and the assurance of objective and fair applications of program policies (360 Blog, 2022; Institute for Credentialing Excellence, 2023, 2024). With accreditation of an agency and a credential from that specific accredited credentialing agency, the certificant holder can provide reasonable responses to depositions and witness stand testimony while having the confidence and continued assurance that their credential(s) are properly validated by a credential agency that is well structured and has met all standards of the higher-level agency that provides the certifying agency its accreditation awards.

ICHCC^® Obligations

The ICHCC^® has obligations to the field of certificants holding one or more of its credentials to ensure the ICHCC^® certifying agency follows the continued accreditation protocols assigned to it by ANAB. Additionally, the ICHCC^® is obligated to protect its certificants through its ability to maintain the 130 standards required of ANAB for all of its accredited certifying agencies and prepare well for annual assessors’ reviews.

The ICHCC^® is obligated to ensure all standards from ANAB are maintained. Without the standards, accreditation can be threatened by ANAB’s policies and procedures regarding standards maintenance. The ICHCC^® understands that a loss of its accreditation only affects the practitioners who carry the ICHCC^® credentials, which violates its mission and founding.

The ICHCC^® is obligated to ensure the CLCP^® and CCLCP^TM examinations meet ANAB standards, the examination items are properly validated, and the validity of examination items reflects the role and function knowledge domains and subfactors/essential functions researched by the ICHCC^®. This alone demonstrates to the ICHCC^® certificant that the ICHCC^® is an agency that follows the tenets of certification and the development of its examinations.

The ICHCC^® must ensure that the qualifying standards to sit for the CLCP^® and CCLCP^TM examinations are clear and apply to all applicants equally, regardless of formal training, credentials, and years in their health care practice. Additionally, the ICHCC^® ensures that biases of candidates as individuals or groups are non-existent. Otherwise, bias attitudes result in a detriment and disservice to the candidate as well as to the ICHCC^®.

The ICHCC^® is obligated to present to ANAB, during their annual assessor audit visit, the required and maintained standards. Each year the ICHCC^® must undergo assessor assessments onsite to satisfy the ANAB Agency that the ICHCC^® maintains their standards as applied to testing in all facets of health care practices.

The ICHCC^® must ensure that the CLCP^® and CCLCP^TM remain the gold standard in life care planning certification and continue to be highly respected throughout the health care industry (May, 2025, Slide 17). Without standards from an accreditation agency designed to improve business operations, examination items improvement, and test scores that reflect good life care planning training in 120-hour preapproved training programs, there would not be a gold standard in the ICHCC^®’s 5 credentials and their administration process.

The impact of accreditation on the quality of healthcare services was examined by Alkhenizan and Shawb (2011) in a systematic review of literature. The authors concluded that general accreditation programs improved the process of care provided by healthcare services; improved clinical outcomes of a wide spectrum of clinical conditions within various subspecialties and, as such, accreditation programs should be supported as a tool to improve the quality of healthcare services.

Summary

There are eight credentialing agencies that offer life care planning credentials. There are 7 credentialing agencies in that group that are not accredited, while the ICHCC^® remains the oldest and only accredited agency for life care planners worldwide. The health care practitioner has to make the decision; do they want a credential from an agency with qualifying standards, annual assessments of business operations, assessments of examination item choices and validation of the examination, required research of methodology and job tasks assigned to life care planning methodology, all by an accreditation agency at a higher level of authority than that of the ICHCC^®? The other choice, of course, is to receive a credential from a credentialling agency that is without any authoritative review of credentialing processes, test development and validation protocols, administration of examinations, and decisions made by agency owners or board members who are without any understanding of certification credentialing processes, examinations structures, or test validation protocols. In these agencies biases can exist and there is no consequence or accountability to be answered for the rejected certification candidate. In essence, the credentialed practitioner is not protected.

The accredited credentialing agency offers many safeguards and benefits for the credentialed practitioner as well as for the credentialing agency that were discussed in this article. Accreditation has demonstrated its benefit to many areas of health care that has shown improvement in clinical outcomes and positive rehabilitative outcomes. More importantly, there is considerable evidence that accreditation improves health care practice outcomes and relative changes in health care practice settings (Alkhenizan & Shawb, 2011; Budin, 2022; Davis et al., 2011; Regnier et al., 2022).

Overall, given the stated benefits of accreditation as detailed above and the evidence of the impact and benefits profited through accreditation, the best choice for health care practitioners is to seek credentialing agencies that have been accredited and committed to standards of fairness and accountability through the accreditation process. Regarding ANAB accreditation in health care agencies and hospitals, please review Appendix A.

Author Note

Correspondence concerning this article should be addressed to Virgil May, International Commission on Health Care Certification, 13801 Village Mill Drive, Suite 103, Midlothian, VA 23114. Email: mayrehab3@gmail.com

Conflicts of Interest

I do not have any conflicts of interests to disclose