2017 Health Equity Awards Nomination Form

health equity

Delaware Healthy Mother and Infant Consortium 2017 Health Equity Awards Nomination Form

CELEBRATE YOUR FAVORITE HEALTH EQUITY CHAMPION! The Delaware Healthy Mother and Infant Consortium Dr. Kitty Esterly Health Equity Award Competition is NOW OPEN!

Do you know an individual or organization that goes the extra mile to put better health in reach of everyone, no matter how much money they have, their race, or the language they speak?

It may be your doctor or nurse, a community health worker, an elected official, clergy or someone else you know who has all the people’s best interest at heart. Or, it might be a local clinic, school health center, wellness program or other place you look to when you are sick, or when you just want to feel better.

We want you to help us say thanks to those individuals and organizations that are making healthy changes in our communities. They stand for diversity, social justice and equality. They help make sure everyone has a fair chance for better health. You know them by their words and actions. Some provide compassionate, culturally competent care. Some fight for better laws and policies. They go where they are needed most, and listen openly to what others have to say.

This Award is sponsored by the Delaware Healthy Mother and Infant Consortium (DHMIC). It is working to save babies lives, and to lift up mothers and families.

Anyone can make a nomination. It’s easy. Just fill out the form, answering all questions. We will contact you if more information is needed.

Please enter the name of your nominee and complete the ranking form, with 1 BEING THE LOWEST AND 5 THE HIGHEST. You may nominate both an organizational and an individual nominee, or just one.

ORGANIZATIONAL CATEGORY

(Please take time to include comments as it could be the deciding factor should there be a tie.)

INDIVIDUAL CATEGORY

(Please take time to include comments as it could be essential should there be a tie in nominations.)


Award recipients will be recognized at the DHMIC Annual Summit in April 2017. A committee of DHMIC members will review and score nominations. Finalists and nominators will be notified weeks prior to the Summit.

DUE NO LATER THAN FEBRUARY 28th, 2017

*The CLAS Standards evaluate the systemic implementation of cultural competence principles within organizational policies and practices. The CLAS Standards are available at the link below.
http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=15


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