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2. When does the State agency accept applications from potential local agencies? ☐ Annually

☐ Biennially

☐ On an on-going basis ☐ Other (specify) Click or tap here to enter text.

3. Does the State agency require existing local agencies to reapply and compete with new applicant agencies for authorization? ☐ Yes ☐ No If yes, what is the frequency? ☐ Annually

☐ Biennially

☐Not applicable ☐Other (specify) Click or tap here to enter text.

4. Selection Criteria a. The State agency uses the following criteria in selecting local agencies in new service areas and/or in reviewing applications from existing service areas: (Check all that apply) New Service Areas Existing Service Areas

☐ ☐ Coordination with other health care providers ☐ ☐ Projected cost of operations/ability to operate with available funds ☐ ☐ Location/participant accessibility ☐ ☐ Financial integrity/solvency ☐ ☐ Relative need in the area ☐ ☐ Range and quality of services ☐ ☐ History of performance in other programs ☐ ☐ Ability to serve projected caseload ☐ ☐ Non-smoking facility ☐ ☐ Americans with Disabilities Act (ADA) compliance

Other (specify by typing into the cells below): ☐ ☐

☐ ☐

b. The State agency conducts studies (provide a link to or copy of the most recent study: Click or tap here to enter text. of the cost-effectiveness of local agency operations that examine:

☐ Location and distribution of local agencies in proportion to new applicants/participants ☐ Clinic procedures to optimize participant access/service (Patient Flow Analysis, etc.) ☐ Staff-to-participant ratios and related staffing analyses