Georgia ACE
For your Health Center to qualify as a Georgia Advocacy Center of Excellence, you must meet the requirements and submit the completed form to GPCA for review. There are three ACE status levels: Bronze, Silver, and Gold. The achieved level will be valid for two calendar years, with the qualifying activities beginning January 1, 2025, and renewal is biennial. If you feel before the renewal date, you have completed activities for a higher level; you can resubmit. If you meet the new level's requirements, you will be awarded the monetary difference between the first level achieved and the new level. After you have submitted your application and it has been reviewed, you will receive an email with your ACE Status level achieved. Don't hesitate to contact Debbie L. Channell at dchannell@gaphc.org with any questions.
Community Health Center Name
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Name of Person Submitting the Application
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First Name
Last Name
Email of Person Submitting the Application
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example@example.com
Phone number of the Person Submitting the Application
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Please enter a valid phone number.
Format: (000) 000-0000.
What Georgia ACE level are you applying for?
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Please Select
Bronze
Silver
Gold
Designated a staff and/or board Advocacy Coordinator – 10 Pts
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Yes
No
Name of the Advocacy Coordinator
Create and submit Advocacy Plan – 20 Pts
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Yes
No
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Include advocacy/policy report on board & staff meeting agenda – 5 Pts
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Yes
No
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Pass Board resolution endorsing advocacy – 10 Pts
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Yes
No
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of
Host elected officials at your center
Federal (each visit) – 15 Pts
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1
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State (each visit) – 10 Pts
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Local (each visit) – 5 Pts
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Host at least one National Health Center Week event - 15 pts
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Yes
No
Date(s) and brief description of event
Submit Letter to the Editor or Op-Ed (x2 if published) – 10 pts
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No
Submitted
Submitted & Published
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Attend GPCA legislative reception/day at the Capitol - 10 pts
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Yes
No
List those who attended
Hold staff and/or board advocacy training - 10 pts
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Yes
No
List training and date held
Involve community partners e.g. letters of support, attending events (each Partner) – 10 Pts
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Participate in ongoing VOTE-ER or other voter engagement activity - 10 pts
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Yes
No
Describe your organization’s activities
TOTAL NUMBER OF POINTS
Submit
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