RURAL HEALTH TRANSFORMATION COMPETITION
GOOGLE FORMS BUILD PROMPT

Create a Google Form titled:
Rural Health Transformation Competition Submission

Form description:
Submit your team's solution for the fictional Challis, Idaho rural primary-care case study. The case includes a modeled $1.5 million launch grant. Your goal is to propose a financially sustainable operating model that improves access after grant funding ends.

Every team must submit one primary narrative document of at least three full pages, excluding a cover page, references, and appendices. The document must include thorough research with citations; graphs, tables, maps, or other relevant visuals; a proposed solution; an Idaho implementation plan; and estimated startup plus recurring implementation costs. Supplemental files are preferred whenever they strengthen your solution, such as a spreadsheet model, slide deck, map, workflow, appendix, or prototype.

AI research and tools are allowed and encouraged. However, entries that appear to be direct, substantially unedited output from ChatGPT, Gemini, Claude, or other generative tools may be rejected. Your team is responsible for original analysis, accurate sources, calculations, and a solution tailored to the Challis case. Disclose material AI tool use in an appendix or methods note.

Use these sections and questions:

SECTION 1  Team information
1. Team name  Short answer  Required
2. Primary contact name  Short answer  Required
3. Primary contact email  Short answer  Required
4. School or organization  Multiple choice  Required
   - North Idaho College
   - University of Idaho
   - Other
5. Team member names and roles  Paragraph  Required

SECTION 2  Solution summary
6. Solution title  Short answer  Required
7. Executive summary  Paragraph  Required
   Prompt: In 250 words or fewer, state the rural-health problem, your proposal, who it serves, why it can be sustainable, and its expected impact.
8. Primary solution type  Checkboxes  Required
   - Service-line or care-model redesign
   - Mobile clinic or rotating care model
   - Real estate or facility strategy
   - Staffing, workflow, or workforce model
   - Technology, EHR, data, or risk-identification model
   - Payer, contracting, affordability, or revenue model
   - Other
9. What makes this specifically appropriate for Challis or rural Idaho?  Paragraph  Required

SECTION 3  Required deliverables
10. Upload primary narrative document  File upload  Required
    Accept: PDF or DOCX
    Help text: Minimum three full pages excluding cover page, references, and appendices. Include research, citations, visuals, a solution, Idaho implementation plan, and estimated costs.
11. Upload supplemental files  File upload  Optional
    Accept: XLSX, PDF, DOCX, PPTX, CSV, ZIP, PNG, JPG
    Help text: Strongly encouraged. Examples include spreadsheet models, slides, maps, data analysis, workflows, cost detail, prototypes, or appendices.
12. Link to any supplemental material that cannot be uploaded  Short answer  Optional

SECTION 4  Implementation and economics
13. Estimated startup implementation cost  Short answer  Required
    Help text: Enter a dollar estimate and identify major assumptions.
14. Estimated annual recurring cost  Short answer  Required
15. Explain the revenue, savings, cost avoidance, partnership, or funding logic that sustains the model after the $1.5 million grant  Paragraph  Required
16. Describe the first 90 days and first 12 months of implementation  Paragraph  Required
17. Describe key staffing, provider education, clinical specialties, licensure, equipment, technology, partners, and referral needs  Paragraph  Required
18. List the three largest risks and how you would reduce them  Paragraph  Required

SECTION 5  Research and AI disclosure
19. List your five most important sources  Paragraph  Required
20. Did you use AI tools?  Multiple choice  Required
   - Yes
   - No
21. If yes, identify the tools and describe their material use  Paragraph  Show only if Yes
22. Certification checkbox  Required
    Checkbox text: I certify that this submission represents our team's own analysis and work; our sources and material AI use are disclosed; our calculations and claims are our responsibility; and we accept the Competition Terms and Conditions.

Confirmation message:
Thank you for submitting to the Rural Health Transformation Competition. Keep a copy of your files. Idaho Advanced Consulting and Cornerstone Whole Healthcare may contact the team’s primary contact with questions, judging information, or potential future opportunities.
