Application for Appointment to Boone County Childrens Services Board

The Boone County Children's Services Board was established in 2013 as a result of the passage of a special sales tax levy in November, 2012. It is the responsibility and goal of the Boone County Commission to appoint members to the Board that are representative of our community, with diversity in age, race, gender, and experience. Individuals with experience in one of the following six areas are especially encouraged to apply; however, the County Commission recognizes that these areas are not exclusive:

The Boone County Children's Services Board consists of nine members, each serving a three-year term. Initial board terms were staggered such that three positions will be open to applicants each year. Any Board member desiring reappointment at the conclusion of their term will be required to submit a new application.

The Board, in partnership with the Boone County Commission, is charged with making Boone County a better and healthier community through the provision of services to protect the well-being and safety of children under the age of nineteen (19) and their families. The Board's goal is to maximize positive outcomes in a transparent, accountable fashion in recognition of the fact that the taxpayers of Boone County are an important stakeholder and beneficiary of this program. The Board's partnership with the Boone County Commission allows it to benefit from the ability to hire dedicated, professional staff with competitive salary and benefits packages into a professional environment with supports that include facilities maintenance, purchasing, human resources, legal, auditing, and other organizational supports and synergies that stem from being integrated into Boone County government as a County department. This partnership also allows the Boone County taxpayers to benefit from a coordination of social service spending at the County level in order to avoid duplication of effort, ensure efficient spending of public resources, and increase transparency. Finally, being part of County government allows the Children's Services sales tax proceeds to retain its character as "local tax dollars," allowing for the pursuit of matching federal dollars through various federal programs administered through the State Department of Mental Health, State Department of Social Services, and other federal matching programs.

Composition of the board of directors must meet the statutory requirements of the enabling legislation. Additionally, persons appointed to the board must comply with the provisions of the bylaws of the board and the conflict of interest policies promulgated by the County Commission and the Board. As appointees of a statutorily created Board with powers to direct the expenditure of public funds, board members have certain fiduciary duties, which require that they conduct themselves without conflict to the interest of the Children's Services Board or the Boone County taxpayer. Certain types of conflicts of interest are not prohibited, but disclosure is critical. Disclosure should not be construed as creating a presumption of impropriety or as automatically precluding someone from participation. Rather, it reflects the recognition of the many factors that can influence one's judgement and a desire to make as much information as possible available to other participants. Potentially conflicting interests may relate to programs and services or operations, such as contracts with third parties.

To apply for the Boone County Children's Services Board, please complete the following form or complete and print the PDF form available below. Be sure to sign and date the printed copy before submitting. Applicants should also submit their resume or curriculum vitae. Applications and resumes/C.V.s may be delivered to the Boone County Commission Office in person; sent by mail to 801 E. Walnut Street, Room 333; or emailed as an attachment to .

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Home Address:
City: Zip:
Employment Address:
City: Zip:
At which address would you prefer to be contacted:

Email Address (where you wish to be contacted):
Home Phone: Business Phone:
Cell Phone:
Section 205.970 RSMo requires that at least 7 of the board members be residents of the county where the facility is located.
Are you a Boone County resident?

How long have you lived in Boone County? Years:
Are you a registered voter?

Have you previously served as a member of a board? If yes, identify the board and the dates of service.
What other professional, civic or community endeavours are you currently involved in?
Are you or have you previously held any local, state or federal government positions, appointments or elected office(s)? If so, please list dates and positions held.
Have you ever volunteered with or been employed by an agency that may provide services to eligible service recipients of the Children's Services Fund (examples include the following services provided to one under the age of 19 or their families: outpatient chemical dependency or psychiatry treatment services, counselling services, or other services as a result of being abused, neglected, runaway, homeless, or emotional disturbance, or services to an unwed mother)?

If yes, please list the Agency, a description of the services provided by the Agency, the time frames of your involvement, and contact person and contact information for said Agency.
Section 210.861, Revised Statutes of Missouri, prohibits membership on the board by certain persons, including current County Commissioners, those having any financial interest in any agency receiving funds from the Children’s Services Fund, and those employed by any agency receiving funds. In addition, the Boone County Commission, based on its experience with other board appointments and the experiences of other counties in the administration of other Children's Services funds, prohibits membership on the board by those who are board members or volunteers with agencies that receive funds, or are employed by, have a financial interest in, serve on the board of, or otherwise volunteer with affiliated organizations of those agencies receiving funds. For purposes of this policy, "affiliated organizations" are those organizations which are controlled by or have systemic legal relationships with an agency who receive funds from the Children's Services Fund. [For example, two entities controlled by the same Board of Directors or the same administration team or an entity that relies on another almost exclusively for its financial support. Many other examples of such affiliated organizations exist, and the intent of this policy is to examine the substance of the relationships between entities and not the strict legal organization they have chosen to employ.] The questions below are designed to determine if a prohibited conflict of interest exists and to allow for the disclosure of any conflicts that do not amount to a prohibition but, absent disclosure, would tend to indicate that a board member may have an appearance of a conflict of interest.
For purposes of the following questions, “related family member” is defined to include relationships within the third degree by blood or marriage. [Relationships in the third degree include mother, father, child, brother, sister, (including half, step and in-law relationships in these same categories), and grandparent, grandchild, aunt, uncle, niece, nephew, great grandparent, great grandchild.]
Do you or any related family member have any financial interest, directly or indirectly in any agency or entity, or are employed by any agency or entity, or volunteer or serve as a Board member of any agency or entity or any "affiliated organization" of any such agency or entity, that has applied for or receives funds from, or plans to apply for funds, or otherwise contracts, or subcontracts with the Boone County Children's Services Board?

If yes, please explain.
Have you or a related family member applied for eligibility and been determined eligible or ineligible for funding from the Boone County Children's Services Fund at any time?

If yes, identify the individual who applied, their relationship to you and the date of application.
Explain briefly why you are seeking this position and identify any special qualifications you have for this position.
Are you or any related family member now or have you or a related family member ever been employed by Boone County?

If yes, please give dates of employment, the position held, and describe if the position had any responsibilities or duties regarding the Boone County Children's Services Fund.
Do you or does any related family member have any other interest which might conflict or be perceived to conflict with your duty of loyalty to the interests of Boone County Children's Services Fund?

If yes, identify the interest and the relationship.
Have you ever been arrested, charged, or convicted of any felony?

If yes, please explain.
Have you ever been disciplined, cited, or sanctioned for a breach of ethics or unprofessional conduct by, or been the subject of a complaint to any court, administrative agency, professional association, disciplinary committee, or other professional group?

If yes, please explain.
Have you ever been the subject of a substantiated allegation of abuse, neglect, or misconduct by any agency that involves care to others or abuse of others?

If yes, please explain.
Are your Boone County taxes paid in full to date?

If no, please explain.
(Include name, nature of relationship, contact information, and number of years known)
Please submit your resume or curriculum vitae:
*File name length limited to 30 characters including the extension
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