Show-me Public Health Award Nomination Form (Downloadable Word .doc)

PURPOSE OF AWARD: to acknowledge extraordinary performance by a community based Local Public Health System. The Center for Local Public Health Services would like to recognize and showcase best practices where a local public health agency provided leadership, either independently, or as a member of a coalition or other group, to implement successful, innovative, and cost effective methods to carry out an aspect of the core functions or essential services of public health.

SELECTION CRITERIA: (selection criteria will be applied rigorously to retain significance of the award)

The project or activity was:

Ø an innovative solution to a public health issue

Ø related to core functions and essential public health services

Ø a demonstration of a public health system approach within the community

Ø effective and results oriented (Best Practice)

Ø suitable that it may be replicated by another local public health system

Ø implemented within the past one year, or resulted in a positive, quantifiable outcome within 1 year prior to date of nomination

Ø implemented with minimal resources and/or resources were attained from other than routine revenue sources.

WHO CAN SUBMIT A NOMINATION? DHSS staff, community partners of a LPHA, a staff member of LPHA, a governing board member, or another LPHA, can submit nominations.

HOW SHOULD NOMINATIONS BE SUBMITTED? A form to submit a nomination is available on the Internet. Nominations can be submitted at any time. They will be retained by CLPHS and may be considered for an award for up to one year after receipt.

WHAT IS THE AWARD? An agency or community group selected for award will receive a plaque that can be displayed within the community.

HOW WILL RECIPIENT BE RECOGNIZED? Presentation of the award will be done at Local Public Health Agency meetings (district and/or statewide), a detailed item will be included in the Friday Facts, a press release will be drafted and sent to the agency’s home newspaper(s), and DHSS staff will be available to give recognition at local board or commission meetings.

HOW IS RECIPIENT SELECTED FOR AN AWARD? A selection committee, including at least 5 designated staff from CLPHS, will review nominations. The committee will solicit input from other appropriate DHSS staff who may have observed, or who may have familiarity with the activity or action for which the agency was nominated. Staff from whom additional information is likely to be requested are representatives of CLPHS, EHCDP, CDPHP, CHI, NHS, CHIME, MCFH, and DHDs. The administrator of the nominated agency may also be contacted if additional information is needed. The committee members will independently score nominations, then will meet to reach consensus as to whether a nomination has met award selection criteria.

FREQUENCY OF AWARDS: Awards will be given 1 to 3 times per year. CLPHS reserves the right to not present an award if nominations on file do not meet selection criteria.

OTHER INFORMATION: A descriptive narrative of the selected nominations will be collected and shared among Local Public Health Agencies.