Dear Chronic Disease Director,

Please complete the following application for STAR. Applications are due November 16th. 

Information about the STAR framework and process can be found at: chronic disease.org/STAR

States will be selected to participate in a STAR visit based on the following criteria:
• Georgraphic distribution
• Level of commitment, experience and readiness to participation in the STAR process

Selection notifications will be sent by November 27th. If you have any questions about the application process or about STAR itself, please contact Tamara Engel at tengel@chronicdisease.org

* 1. State

* 2. Agency name

* 3. Contact info for the person completing the application.

* 4. Please indicate your two preferred months for a STAR visit.

* 5. Chronic Disease Director contact information

* 6. Please designate a point of contact other than the Chronic Disease Director to assist with work shop logistics and communications.

* 7. Please indicate the likelihood of your level of participation and the participation of your team in each of the following activities.

  Unknown Likely Very likely Guarranteed
Chronic Disease Director participation in monthly Peer to Peer calls with other STAR states (2nd Thursday of the month at 3:00 pm eastern time beginning January 11th through July 12th, 2018).
Completion of the STAR tool by Chronic Disease Director, management team, and chronic disease unit staff
Chronic Disease Director and management team attendance at the day and a half long workshop.
Chronic Disease Director and management team willingness to mentor future participating states.

* 8. Describe the state chronic disease unit's experience with improving organizational capacity. Focus on the chronic disease unit's readiness to engage successfully in a quality improvement process.

T