DETAILED GUIDELINES: SUBMITTING A PLAN
The Plan should include the following sections:
1. TARGET COMMUNITY
- Description of the target community – the health plan community must be located within the USA but there are no restrictions in community size or location within the USA
- Description of already existing ongoing assets or population based health initiatives already existing within the community
2. COMMUNITY TEAM COMPOSITION
- Identify the role of the following Team members (can list up to 10 members)
- Team Leader (A single Team member that is a company, institution or other entity (but not an individual) must serve as an official representative for each Team (“Team Leader”). The Team Leader must be a Team member with authority to make high-level decisions. Identification of a Team Leader is required.)
- Program Manager (Required)
- Other team members such as: Experts, NGO, Not for profit, Government, Business, Other
b. Details regarding at least one of the corporate members of the Team (Required) Note that the type and size of the corporate member is not restricted and may range from a large global corporation to a local business in industries such as manufacturing, retail, services and/or medical technologies, including hospitals.
- Describe the role the corporate Team member will play (e.g. why is the corporate member essential to the success of the Plan);
- Identify any resources of any kind that the corporate Team has committed. (If monetary contributions are committed for Round One activities they should be included in the budget for Round One); and.
- If part of the Plan will include a corporate employee health and wellness program, health benefits program, or health promotional activities, describe how these programs and activities will contribute to the Plan
c. Demonstration of likelihood of success/cooperation.
- Provide examples of past successes (e.g. involving any subset of the Team working together) and include the strategies that helped build the collaborations and partnerships. Explain how such strategies will be utilized in your Plan; and
- Provide a description of how the Team will build effective collaborations and partnerships, particularly if the Team is newly forming.
3. OUTLINE OF PLAN FOR ROUND ONE (October 2016 - November 2017)
a. State the Plan goal – The goal should be outcomes based and align with a model, such as the Population Health Model – and should focus specifically one of the 5 key social determinants described [health behaviors, clinical care, social and economic factors, physical environment and other]. This Population Health Model is nationally and internationally recognized as one way to weigh the impact of all the many factors that, if improved, can help make communities healthier places to live, learn, work and play.
b. Provide a clear explanation for the rationale for each Plan component, including
c. An explanation for how the project Plan will impact the specific community and will complement already existing community efforts
d. Anticipated accomplishments and potential pitfalls of the proposed Plan
4. OUTLINE BUDGET FOR ROUND ONE
a. Outline budget for Round One including any contributions or other funding sources to the Plan (the purpose of which is to enhance the level of success of and significant ownership, commitment, and sustainability of the Plan through investment of resources). State major anticipated funding sources and for Round One of the Plan. Include an explanation of how GE funds will be used and why such funds are essential and would not otherwise supplant already existing funds for the proposed program
5. LETTERS OF SUPPORT
a. Provide letters of support (1-3) from community based organizations, businesses, local governments, academic institutions, or other stakeholders in the community who are familiar with the efforts and the Team, and share the values and mission of the Plan and are interested and could benefit from its success (example letter).