Kudos Form

“KUDOS FOR COMMUNITY CAREGIVERS” is the Annual Awards Program of Life Circle Alliances.
On behalf of our community, LCA wishes to recognize FOUR (4) outstanding volunteer caregivers. Nominees may be an individual, faith community, organization, or corporation in the Fairfax County, VA area. Nominees must be actively providing care to older adult(s) OR adult(s) with disabilities.

One award recipient, whose volunteer service reflects the work of the Long Term Care Coordinating Council, will be selected in each of the following categories:
-- Access
-- Senior Services
-- Workforce
-- Young Adults with Disabilities

Check this box to view category descriptions

Access Committee
The Access Committee seeks to increase public awareness and access to services. The committee has overseen the development of the LTC Web site in the Health Department, developed a video describing the LTCCC’s activities, and created a speakers program to provide LTC information to organizations and groups in the community. The committee is currently developing a social marketing campaign to expand awareness of the LTCCC.

Committee Projects and Events
-- Developing a disAbility Navigator Web site which is a web based resource and service locater for individuals with disabilities.
-- Accessible government project- To make all county government buildings optimally accessible.

Services for Seniors Committee
The Services for Seniors Committee seeks to increase and strengthen the viability, accessibility and variety of long term care services for seniors in the community. The committee has most recently conducted a survey of faith-based community service providers to learn of their needs.

Committee Projects and Events
-- Alzheimer’s Disease education and awareness

Workforce Committee
The Workforce Committee seeks to improve and expand the LTC direct care workforce. The committee has worked with the Northern Virginia Workforce Investment Board and with the non-profit Korean Central Senior Center to create training programs for personal care attendants, with a special emphasis on culturally sensitive training for multi-cultural populations. The committee is working with CareFaxLTC to enhance a direct care workers registry to enable consumers to better access workers for care through a web-based database of workers.

Committee Projects and Events
-- Advocating for affordable housing units and better benefits for direct care workers.

Young Adults with Disabilities Committee
The Services for Young Adults with Disabilities Committee seeks to increase and strengthen the viability, accessibility and variety of long term care services for young adults with disabilities in the community. The committee has identified day supports and programs for adults with physical disabilities and/or autism as major service needs. The committee has worked with community members to help establish the non-profit SPARC (SPecially Adapted Resource Clubs) that is now serving 14 young adults with physical disabilities in a day program that allows them to be independent and fully functioning individuals. The committee hopes to replicate the program for young adults with autism.

Committee Projects and Events
-- Young Adults with Autism Focus Groups- Conducting needs assessments via focus groups for young adults with autism and their parents.
-- Researching best practice programs for young adults with autism.

Please click "NEXT" to proceed to the nomination form.

2010 KUDOS FOR COMMUNITY CAREGIVERS
AWARD NOMINATION FORM

NOMINATION PROCESS:
Any person or organization in the greater Fairfax County area may nominate.
Only one nomination per person or organization, per year.
All nominations must be submitted by 5PM on June 30, 2010.
Nominees must provide care giving within Fairfax County

1.	Date:

2.	Nominee:
	Name:
	Address:
	Contract:
	Phone:
	Cell Phone:
	Email address:

3.	Please tell us HOW this individual/organization provides care in our community. WHY is this person/organization worthy of community recognition? (500 words or less)

4.	Nominated by
	Name:
	Organization:
	Address:
	Contact:
	Title:
	Phone:
	Cell phone:
	Email address:

Our winners will be announced on August 15, 2010 and will be honored at the LCA “Kudos for Community Caregivers” Awards Breakfast on September 20, 2010 at the new Mason Inn on the Campus of George Mason University, Fairfax, VA.

Please submit this form by 5:00 PM, June 30, 2010. Thank you!

Please click "NEXT" to proceed to the nomination form.

2010 KUDOS FOR COMMUNITY CAREGIVERS AWARD NOMINATION FORM

NOMINATION PROCESS: Any person or organization in the greater Fairfax County area may nominate. Only one nomination per person or organization, per year. All nominations must be submitted by 5PM on June 30, 2010. Nominees must provide care giving within Fairfax County

2010 KUDOS FOR COMMUNITY CAREGIVERS
AWARD NOMINATION FORM

NOMINATION PROCESS:
Any person or organization in the greater Fairfax County area may nominate.
Only one nomination per person or organization, per year.
All nominations must be submitted by 5PM on June 30, 2010.
Nominees must provide care giving within Fairfax County