2022 Caliber Awards Nomination Form

Mid Shore Behavioral Health, Inc.

The 24th Annual Caliber Awards
Achieving Excellence in Public Behavioral Health

Question Title

* Your Name, Phone, and Email:

Under the category that fits your nomination, list the name, organization or program nominated, along with an explanation supporting how the nominee exemplifies the criteria in the category nominated. Incomplete nominations will not be considered. Nominations are due by May 13.

Question Title

* ACHIEVING EXCELLENCE THROUGH EFFECTIVE PROGRAMMING:
This award recognizes programs which are effective in improving the provision of behavioral health services for residents in the mid-shore region. Nominees will have demonstrated effective collaboration with consumers, family members, providers, and community leaders, using creative and cost-effective methods.

What is the full name of the person, organization, or program?
Who or what entities were involved with the collaboration?
What were the creative and/or cost-effective methods?
How were behavioral health services improved?

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* ACHIEVING EXCELLENCE THROUGH EMPOWERMENT OF CONSUMERS:
This award recognizes initiatives that have fostered the empowerment of consumers in the public behavioral health system through the promotion of wellness and recovery. Initiatives nominated for this award have helped to form a more resilience-oriented system of care, providing consumers with support to improve their health and wellness, live a self-directed life, and achieve their fullest potential.

Describe how the initiative resulted in an improvement to consumers' health and wellness, ability to live a more self-directed life, and to achieve their fullest potential.

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* ACHIEVING EXCELLENCE THROUGH INTER-AGENCY AND COMMUNITY COLLABORATION:
This award recognizes a provider’s efforts and initiatives successfully collaborate with other agencies to provide easily accessible and needed services, support, and/or opportunities that improve the quality of life for consumers in the public behavioral health system.

Who did the provider collaborate with and what was the outcome? How did the collaboration result in reducing barriers to needed services or improve the quality of life for consumers in the public behavioral health system?

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* LIFETIME ACHIEVEMENT AWARD:
This award recognizes a professional life of hard work, dedication, and contributions by an individual who has shown through their commitment and dedicated focus on improving the public behavioral health system. Please elaborate on specific accomplishments and/or the impact the person made in the behavioral health field.

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* MARY BETH BRENNAMAN AWARD:
This award recognizes an outstanding individual who demonstrates an unconditional commitment to, and passion for, the mission and vision of his or her organization. This individual brings sincere compassion to the population served, and humor, generosity, spirit, and an overall outstanding attitude to the workplace. The individual eligible for the Mary Beth Brennaman Award can be any person in an agency who demonstrates an exceptionally positive attitude and support for their team, and consumers served.

Please provide specific examples of how this nominee embodies the qualities of Mary Beth, and how the nominee impacts others or enhances teamwork and the lives of consumers.

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* ROUND TABLE ON HOMELESSNESS AWARD:
This award is to recognize an individual who has shown exemplary dedication to our group’s mission of ending homelessness in the mid-shore region. This individual is committed to developing relationships, collaborating with community partners, and connecting individuals and families to quality services, to foster resiliency and growth. This individual is a fierce and knowledgeable advocate for those experiencing homelessness in our communities and works diligently to improve service delivery across the continuum.

Please provide examples that support the nomination.

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* AGING WITH BEHAVIORAL HEALTH AWARD:
The ABHD Workgroup award recognizes an advocate for the most vulnerable in our community: those older adults who may be weakened by physical frailty and social isolation, and who struggle to find a place to gather strength and emotional support in their community. This nominee may help create this ‘place’ by devising a virtual cocoon of supportive services, or work with a community program or facility to enhance the opportunity to thrive. Through partnerships that span the aging, health and social services in our mid-shore region, this person recognizes the very real gaps in aging services and finds a way around them for the benefit of us all.

Please provide examples that support the nomination.

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* CHILD & ADOLESCENT ADVOCATE AWARD:
This award is to recognize an individual who has shown exemplary dedication to our group’s mission of all children and families will be safe and healthy in their communities, have access to quality behavioral health services and the opportunity to utilize supportive community resources. This individual is committed to developing relationships, collaborating with community partners, and connecting individuals and families to quality services, to foster resiliency and growth. This individual is a fierce and knowledgeable advocate for children, youth and families and works diligently to improve behavioral health service delivery across the continuum.

Please provide examples that support the nomination.

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* FORENSIC MENTAL HEALTH AWARD:
The Forensic Mental Health Award honors a member of the workforce community or of the Forensic Workgroup. This nominee will be someone who serves tirelessly in the community advocating for clients that currently have judiciary requirements and behavioral health concerns. The recipient must be striving hard to help reduce stigma and trauma to this unique population of people.

Please provide examples that support the nomination.

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* SPECIAL RECOGNITION:
If there is anyone else you feel deserves recognition please list below and provide an explanation that includes specific achievements, outcomes, or results the person, organization or program has accomplished that has made a difference.

Consider the following categories:

- Deaf and Hard of Hearing
- Latino Pop
- Technology
- Volunteer
- Veterans
- Employment
- Consumer Choice
- Behavioral Health Integration
- Peer Support
- Primary Care
- Emergency/Crisis Services
- Education
- Trauma
- Advocacy
- Prevention
- Leadership
- Transitional Age Youth (TAY)
- Defeating Stigma
- Suicide Prevention
- Wellness and Recovery
- Unsung Hero

Question Title

* Contact information for the nominee:

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number