State Activity Submission Review Rubric Criteria Excellent Satisfactory Unsatisfactory 2-3 points 0-1 point 4-5 points Points Description of Dental Public Detailed with clear, vivid Provides limited description of Lacks clear description of description of activity activity activity Health Activity Provides clarity on who is Limited description on who is Lacks information on who is involved with the activity involved with the activity doing the activity Provides information on why Limited description on why Lacks information on why those persons/entities are those persons/entities are those persons/entities are involved involved involved Objectives / Rationale The submission addresses the Provides limited information on Does not discuss how the following: how the practice addresses at practice addresses any of the HP 2020 objectives , one of the following: following: responds to the Surgeon HP 2020 objectives, HP2020 objectives, General’s Report on Oral Surgeon General’s Report on Surgeon General’s Report on Health, Oral Health, Oral Health, and/or builds basic Builds basic infrastructure and Builds basic infrastructure and infrastructure and capacity for capacity for capacity for state/territorial/community state/territorial/community state/territorial/community oral health programs oral health programs oral health programs Clear rationale is provided, Rationale for activity described Rationale for activity Provides measurable Measurable objectives Measurable objectives objectives Impact/Effectiveness/Efficiency Describes benefit to the oral Limited description of benefit Benefits poorly identified health and well-being of to the oral health and Activity achievements not populations or communities of populations or identified Describes activity communities cost information achievements by including Limited description of activity Lacks information on staffing number served or impacted achievements such as number and time requirements Describes costs associated served or impacted with activity, including Limited description of cost resource efficiency associated with activity Expenses are appropriate to Limited description of staffing benefits and time requirements Discusses staffing and time requirements that are realistic and reasonable Collaboration/Integration Describes how the practice Limited description of how Lacks information on how the builds, or involves, effective practice builds, or involves, practice builds, or involves, partnerships among various effective partnerships effective partnerships organizations Limited description of how the Lacks description of how the Describes how the practice practice integrates oral health practice integrates oral health integrates oral health with with other health projects and with other health projects and issues issues
State Activity Submission Review Rubric Criteria Excellent 4-5 points Satisfactory 2-3 points Unsatisfactory 0-1 point Points Description of Dental Public Health Activity Detailed with clear, vivid description of activity Provides clarity on who is involved with the activity Provides information on why those persons/entities are involved Provides limited description of activity Limited description on who is involved with the activity Limited description on why those persons/entities are involved Lacks clear description of activity Lacks information on who is doing the activity Lacks information on why those persons/entities are involved Objectives / Rationale The submission addresses the following: HP 2020 objectives , responds to the Surgeon General’s Report on Oral Health, and/or builds basic infrastructure and capacity for state/territorial/community oral health programs Clear rationale is provided, Provides measurable objectives Provides limited information on how the practice addresses at one of the following: HP 2020 objectives, Surgeon General’s Report on Oral Health, Builds basic infrastructure and capacity for state/territorial/community oral health programs Rationale for activity described Measurable objectives Does not discuss how the practice addresses any of the following: HP2020 objectives, Surgeon General’s Report on Oral Health, Builds basic infrastructure and capacity for state/territorial/community oral health programs Rationale for activity Measurable objectives Impact/Effectiveness/Efficiency Describes benefit to the oral health and well-being of populations or communities Describes activity achievements by including number served or impacted Describes costs associated with activity, including resource efficiency Expenses are appropriate to benefits Discusses staffing and time requirements that are realistic and reasonable Limited description of benefit to the oral health and of populations or communities Limited description of activity achievements such as number served or impacted Limited description of cost associated with activity Limited description of staffing and time requirements Benefits poorly identified Activity achievements not identified cost information Lacks information on staffing and time requirements Collaboration/Integration Describes how the practice builds, or involves, effective partnerships among various organizations Describes how the practice integrates oral health with Limited description of how practice builds, or involves, effective partnerships Limited description of how the practice integrates oral health with other health projects and issues Lacks information on how the practice builds, or involves, effective partnerships Lacks description of how the practice integrates oral health with other health projects and issues
state-activity-submission-form-final-2013-09-01.docx