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(Incoming) Sponsorship Authorisation Form

This form sets out the relevant information which should be considered in evaluating and approving an incoming sponsorship, and provides a record of approvals required to proceed with the establishment of a sponsorship arrangement. This form may also be used to evaluate and approve in-kind sponsorships.

The Sponsorship Overview section of this form identifies who will be responsible for the ongoing management of the sponsorship.

Part A of this form documents the opportunity for an incoming sponsorship within the Department of Health or a Health Service Provider (collectively, the WA health system), and considers the suitability of a sponsorship in the context of that opportunity. It identifies the proposed Sponsor(s) and what will be sought from the Sponsor(s) and the reciprocal benefit to be provided in exchange as part of the sponsorship. It also includes a separate section for corresponding sign off (Sponsorship Initiation Approval), which records the decision to further consider a proposed sponsorship. Where external parties approach the WA health system with an offer of sponsorship, Part A of this form does not need to be completed, and may be deleted from the template.

Part B of this form evaluates the suitability of the proposed sponsorship. Part B approval provides authorisation to establish a sponsorship arrangement. Note that as part of the process of obtaining Part B sign-off, approval from the Minister for Health, and/or the relevant highest authority within the organisation (the Board of Management or Chief Executive Officer) may be required in some instances.

Within the forms below:
Guidance Notes have been provided in red text, and provide relevant information in completing the forms. They should be deleted once the form is completed.

Response descriptions have been provided in blue text to assist in preparing appropriate responses. This text describes the response required, and should be replaced with the actual information described.

Sponsorship Overview

This Sponsorship Overview section identifies who will be responsible for managing a proposed sponsorship on an ongoing basis.

Sponsorship Details

Sponsorship Manager / Name
Title / Position
Division / Branch / Section
Contact Details / Phone Number:
Email:
Sponsorship Recipient / Specify the legal entity (within the WA health system), along with the Event / Project / Activity which will the subject of the sponsorship

Incoming Sponsorship Overview 1 | Page

Part A – Sponsorship Initiation

[For Internally Initiated Sponsorships Only]

This Part A – Sponsorship Initiation considers the merits and feasibility of a sponsorship opportunity, and whether it should be further considered, and is used to provide approval to undertake more detailed work developing a sponsorship arrangement.

It records the details of a potential sponsorship opportunity which is initiated by an entity within the WA health system, and must be completed and approved (in the Sponsorship Initiation Approval sign-off section below) prior to approaching a potential Sponsor(s)).

This Part A – Sponsorship Initiation, and corresponding Sponsorship Initiation Approval does not need to be completed (and may be deleted) where the Sponsorship is initiated by an external party seeking to provide sponsorship to an entity within the WA health system.

Proposed Sponsor(s) / Identify the proposed Sponsor(s) from which sponsorship will be sought.
If the Sponsorship opportunity will be provided to the market generally to respond to, specify the mechanism for engaging with the market (E.g. unrestricted advertisement)
Sponsorship Value / Specify what will be provided by/sought from the Sponsor
For non-monetary contributions, estimate the market value of the contribution.
Where the benefit to be provided relates to sponsored travel, note that the Air Travel Policy applies, and approval should be sought under the Air Travel Policy instead of the Sponsorship Policy.
Proposed Benefit / Describe how the Sponsorship Recipient will benefit from receiving the sponsorship.
Describe how this sponsorship aligns with the mission, vision or objectives of the WA health system or the Recipient.
Note that the Recipient means the Sponsorship Recipient as identified above.
Proposed Term / Single Event (Specify this if the sponsorship is for a discrete event or activity, and the sponsorship will be provided in a lump sum or at a single point in time.
Or
[Specify Term] (If the sponsorship will be provided or applies over a period of time, specify the period of time for which the sponsorship will need to be managed)
Proposed Benefit to be Offered / Specify what will be offered to the Sponsor in exchange for the sponsorship.
E.g.: Recognition of sponsor through placement of Sponsor logo or other permission to advertise at the sponsored event.
Other Notes / Considerations / Risks / Specify any other matters which should be considered or taken into account in relation to the sponsorship opportunity; for example, potential respondents to the request for sponsorship.

Sponsorship Initiation Approval

[For Internally Initiated Sponsorships Only]

This approval is required to proceed with sponsorship opportunities initiated within the WA health system as identified in the Sponsorship Initiation section above. It does not need to be completed (and may be deleted) for Sponsorships initiated by external parties seeking to provide sponsorship to an entity within the WA health system.

Approved: / Not Approved:
Comments:
Sign Off: / Name
TITLE

Refer to the applicable Authorisations Schedule to identify the authorised officer able to provide sign-off where approval is required.

Part A | Incoming Sponsorship Initiation 3 | Page

Part B – Sponsorship Evaluation

This Part B – Sponsorship Evaluation considers the merits a sponsorship with a specific Sponsor, and whether authorisation to establish a formal sponsorship arrangement should be provided.

Sponsor Details

Sponsor Name / Legal Identity / Identify the Sponsor(s) which will be providing sponsorship to the Recipient.
Sponsor Description / Provide details of key information about the Sponsor(s) which would be relevant for considering appropriateness of association with the Sponsor.
E.g.: Who they are, what they do, their goals, mission, and objectives.
It may also be relevant to consider the Sponsor’s reputation, associations, and any activities it may be undertaking or affiliated with.
Other Notes / Considerations / Risks / Note any other information or factor relating to the Sponsor which is relevant in planning for or evaluating the suitability of the sponsorship.
E.g.: Any notable activities the Sponsor is involved in, or general reputation

Sponsorship Details & Suitability Assessment

If multiple potential Sponsors were evaluated as part of this sponsorship evaluation process, prepare and attach a separate document which addresses the below headings for each potential Sponsor. The document should clearly identify which potential Sponsor(s) are recommended for the purposes of establishing a sponsorship agreement. Where a separate document is prepared and attached to this form, the below table may be deleted, and replaced with a reference to the attached document.

Benefit Details / Benefit/Value: Specify what the Sponsor will provide as part of the sponsorship. If it includes something non-monetary in nature, include an estimated value of what is provided.
Term: Specify the Term as addressed above in Sponsorship Opportunity – Proposed Term
Sponsorship Benefits: Identify the benefits that will flow from what is provided.
Specify any other benefits which will be achieved.
Benefit to be provided in exchange / Confirm the details of what will provided to the sponsor in exchange for the Sponsorship.
E.g.: Recognition of sponsor through placement of Sponsor logo or other permission to advertise at the sponsored event.
Sponsor Evaluation / Identify whether any issues could arise from accepting a sponsorship from the Sponsor. Consider if any issues arise from the Sponsor’s identity, business, activities, goals/objectives, and other relevant factors as identified under Sponsor Details.
For any issues identified:
a)  discuss the severity of the issue;
b)  compare it against the expected benefits of the sponsorship;
c)  identify any steps which could be taken to mitigate the risk/issue; and
d)  recommend whether the sponsorship should proceed in light of the above.
In evaluating the Sponsor and any issues identified, consider the impact on the WA health system of entering into a sponsorships arrangement with the Sponsor, and the potential for negative repercussions.
No issues were identified in establishing a sponsorship arrangement with the Sponsor.
Or
The following issues were identified and considered:
[Discuss each issue identified as per the guidance text above]
Conflicts of Interest / No conflicts of interest were identified in entering into the proposed sponsorship arrangement.
Or
The following conflict(s) of interest were identified:
[Identify the conflict(s) and how they will be managed]
Contentious Activities / Sponsorships should not relate to or result in contentious activities or outcomes.
A Sponsorship may be considered contentious if it will relate to or otherwise result in, be perceived to result in, or may at a future point result in any of the following:
a)  a negative impact or outcomes for the WA health system, the WA Government or the broader community;
b)  tobacco related sponsorships;
c)  alcohol related sponsorships;
d)  where a potential sponsor could seek to use the sponsorship arrangement to influence legislation, public policy or the legislated role of the WA health system;
e)  events which duplicate or would compete with existing Government sponsorship projects;
f)  constraints on the ability of the WA health system to undertake its activities efficiently and effectively, or otherwise impede the performance of its functions;
g)  the politicisation of the WA health system, or other effect which undermines the political neutrality of the WA health system (this includes sponsorship of a political party);
h)  service organisations which may use the funds to sponsor or make a grant to a third party; and
i)  areas which have the potential to cause widespread public controversy.
In addition, a Sponsorship should not involve the endorsement of a Sponsor’s product.
The Sponsorship does not involve, and will not relate to or result in any contentious activities or outcomes.
Or
The Sponsorship involves, or may relate to or result in the following:
[Identify all applicable contentious outcomes/activities]
Other Notes / Considerations / Risks / Note any other information or factor relating to the Sponsor which relevant in planning for or evaluating the suitability of the sponsorship.
Other relevant factors to consider may include:
a)  other Sponsors for the Beneficiary;
b)  the nature of the Recipient and its business (e.g. a Respondent that is associated with unhealthy food and/or beverages may not align with the WA health system’s goals).
If the Sponsorship:
a)  exceeds $50,000 in value and has a term in excess of 3 months; or
b)  has a term in excess of 6 months regardless of value;
a Sponsorship Management Plan should be prepared, which documents how the Sponsorship will be managed over its Term to ensure the achievement of expected outcomes.
If an contentious issues or conflicts of interest (as identified above) are present, a Risk Management Plan should be prepared, identifying how risks will be managed.
A Sponsorship Management Plan or Risk Management Plan may be appropriate even if the above criteria do not apply, if other risks are present, or if the Sponsorship involves a substantial degree of complexity in its execution, activity or other aspects.
Where both a Sponsorship Management Plan and Risk Management Plan are required, the Risk Management Plan may be addressed and included as part of the Sponsorship Management Plan.
A Sponsorship Management Plan has been prepared and is attached.
And / Or
A Risk Management Plan has been prepared and is attached.
Recommendation / The Department may approve sponsorship arrangements which will not involve contentious issues, and which do not involve any product endorsement.
Sponsorships which involve contentious issues or product endorsement will require Ministerial approval, and must instead be endorsed by a Tier 1 prior to seeking approval.
That you approve the establishment of this Sponsorship Arrangement with the Sponsor.
Or
That you endorse the establishment of this Sponsorship Arrangement with the Sponsor, and request ministerial approval to proceed with this sponsorship.

Department Sponsorship Approval / Endorsement

Approved: / Endorsed: / Not Approved:
Comments:
Sign Off: / Name
TITLE

Refer to the applicable Authorisations Schedule to identify the authorised officer able to provide sign-off where approval is required.

For sponsorships which need ministerial approval, endorsement from a Tier 1 is required prior to seeking approval.

Ministerial Approval

Approval from the Minister for Health is required if the Sponsorship:

a)  involves contentious issues; or

b)  moves beyond acknowledgement of a Sponsor’s product, and instead provides endorsement of the product.

Where approval is required, the Chief Executive Officer of the public authority, or in the case of a statutory authority the Board of Management, must refer the proposed sponsorship to the Minister for approval.

Within the WA health system, the following Health Service Providers are board governed statutory authorities (with a Board of Management):

a)  North Metropolitan Health Service;

b)  South Metropolitan Health Service;

c)  East Metropolitan Health Service;

d)  Child and Adolescent Health Service; and

e)  WA Country Health Service;

while Health Support Services is a chief executive governed Health Service Provider.

Ministerial approval should be sought through the standard correspondence process with the Minister’s Office, and recorded in the table below.

Approved: / Not Approved:
Reference Number
Date

Part B | Incoming Sponsorship Evaluation 9 | Page