How to Apply for a 2017 STAT Visit
About the STAT Program | Become a STAT Team Member
States wishing to receive a STAT visit should submit a formal request by Friday, February 10, 2017 COB.
The request should be from the state Secretary/Commissioner
of Health or designee, and indicate that the Secretary or a senior
Department official will attend the summary session of the visit (an
official who is organizationally above the most senior person in the
Injury and Violence Prevention Program). The required content of the
visit request is described below.
Submit the completed STAT visit request to Safe States Alliance by email (email@example.com).
STAT Visit Request: Content & Format
Please limit your request to 3-5 pages in length and include the following information:
- Injury Program Description:
In two pages or less, provide a brief overview of your injury
prevention program, including your location organizationally within your
department of health, the number of staff, total annual budget, and a
description of your program’s major activities.
- SWOT Analysis:
Please provide a brief SWOT analysis (Strengths, Weaknesses,
Opportunities, and Threats) of your program. Bulleted text is
- Plans for Using the STAT Report: Please
briefly describe what you want out of the visit and how your program
plans to use the information resulting from the STAT visit.
- Timing of STAT Visit: Describe
why this is a particularly good time for your program to receive a STAT
visit. Is your program at a pivotal point? Is your program in a
position to use information from a STAT visit?
- Cost Sharing: Please describe your program's ability to cost share.
- Potential STAT Visit Dates: Please
provide three potential dates (week in length) for the requested STAT
visit. Please limit the dates for a period between June - August.
- Safe States Alliance Representative Contact Information:
Please provide current contact information for your state’s Safe States
Alliance Designated Representative, including complete address,
telephone/fax numbers, and email address.
- Ability to Participate on a STAT Team:
As part of the preparation for your visit, should you be selected, Safe
States Alliance would like you to be a member of a team on a STAT visit
prior to yours, if possible. Please indicate your past or
future availability to participate on a STAT visit.
States selected to receive a STAT visit will be notified by February 24, 2017.
If you have any
questions about requesting a STAT visit or about STAT in general, please
contact the Safe States Alliance at (770) 690-9000 or firstname.lastname@example.org