Application Form

(Answers must be submitted for consideration)

1. When was the program established? What was the month and year of initiation?  NOTE: Programs must be between nine months and three years old as of May 17, 2020 (i.e., established between May 17, 2017, and November 17, 2019) to qualify. 2020 (i.e., established between May 17, 2017, and November 17, 2019) to qualify. Older programs will be considered if significant updates or expansions with tangible results in the same time period can be demonstrated.
2. Why was the program created? What problems or issues is it designed to address?
3. What are the specific activities and operations of the program? (Please list in chronological order, if applicable.)
4. What equipment, technology and/or software (if any) are used to operate and administer the program?
5. What are the annual operational costs of the program? How is it funded?
6. Has the program been effective at addressing the problem or issue? Please provide tangible results and examples.
7. What measurable impact has the program had? Has it created significant change in your state?
8. Did the program originate in your state? If YES, please indicate the innovator’s name, present address, telephone number and email address.
9. Are you aware of similar programs in other states? If YES, which ones and how does your program differ?
10. Is the program transferable to other policy areas or states? What limitations or obstacles might other states expect to encounter when attempting to adopt this program?