Accreditation has been identified as a crucial strategy for strengthening the public health infrastructure. As agencies prepare for accreditation, it is important to understand how intentions to seek accreditation are related to the current level of readiness based on the three Public Health Accreditation Board (PHAB) prerequisites. Using the National Association of County and City Health Officials’ (NACCHO) 2010 Profile Study, we examined the relationship between the PHAB accreditation prerequisites and local health department (LHD) intentions to seek PHAB accreditation using multinomial logistic regression. Our results indicate that completion of a community health assessment (CHA) or community health improvement plan (CHIP) within the past five years had negative association with LHDs’ intention to seek accreditation, and recent completion of an agency-wide strategic plan had no association. These findings have important implications for LHDs, PHAB and its partners.