Exhibit B - Health Care Authority：附录B保健局

Exhibit B Page 1 of 3 GOA #14-028

EXHIBIT B: Application Narrative
Scored: Pilot and Design Applicants (Max 80 Points)
These questions are designed to allow for an honest assessment of your organization and the
level of development within the community partnership.
1. Population Served: the Counties/population represented by the community partnership.

a. Please describe the RSA represented by the partnership. If the partnership is proposing
any sub-award to facilitate RSA adjustments that impact the ACH design, please
describe.

b. Please describe any unique challenges or opportunities within the population.

2. Governance Structure: the structure and process for decision making, leveraging
community and multi-sector stakeholder input.

a. Please describe your partnership’s recent efforts to develop or consider the development
of a governance structure to leverage broad multi-sector community and stakeholder
input toward a common agenda of achievement of better health, better care at a lower
cost.

b. Please describe how you have built upon existing community based health improvement
coalitions, leveraged and enhanced the existing relationships, commitments and
initiatives already in place to ensure a diverse, multi-sector approach to health and
health care.

c. Please describe the existing or planned decision-making process for the partnership.
Include a description of any existing or planned policies or strategies to address conflicts
of interest.

d. Please describe the existing or planned committees/sub-committees and the scope of
each.

e. Please describe the existing or planned mediation and conflict resolution strategy that
supports the decision making strategy and the ACH’s voluntary compact.

f. Please describe additional strengths and/or challenges regarding your existing and/or
proposed governance model.

g. Describe what mechanisms are in place or planned for keeping committees, sub-
committees and other involved entities, including the ACH, accountable.