Strategies for establishing a national voluntary public health agency accreditation program have been gathering momentum. Recent efforts funded by the Robert Wood Johnson Foundation (RWJF) and the Centers for Disease Control and Prevention (CDC) have made a significant impact on the potential for national diffusion of accreditation models. The Exploring Accreditation Project was a collaboration of the American Public Health Association, the Association of State and Territorial Health Officials, the National Association of County and City Health Officials, and the National Association of Local Boards of Health with a national steering committee that studied the feasibility and desirability of a national voluntary accreditation program for state and local public health agencies. Concurrently, the Robert Wood Johnson Foundation funded the "Multi-State Learning Collaborative on Performance and Capacity Assessment or Accreditation of Public Health Departments" (MLC). Among the other purposes of the MLC was the intent for states already engaged in accreditation or assessment activities to inform the national accreditation debate. Five states were selected to be MLC grantees from 18 states completing a formal application process. This article reviews data extracted from the applications of 16 of the 18 applicant states and reviews common themes emerging across programs. Other states contemplating similar programs, as well as those charged with implementing the voluntary model at the national level, may find guidance from these examples.