Which RHIO function involves creating governance agreements among stakeholders?

• A. Initiating collaboration of stakeholders
• B. Matching the national model for RHIOs
• C. Formulating associational agreements
• D. Constructing security and access procedures

Answer: (C)

Formulating associational agreements is the function that formalizes how the RHIO will be governed. It involves drafting and agreeing on governance documents—charters, bylaws, MoUs—that define who has decision-making authority, how decisions are made, accountability mechanisms, dispute resolution, and policy oversight. These agreements bind participating organizations (hospitals, clinics, payers, public health, and others) to a common governance structure and data-sharing framework. Other functions focus on starting collaboration, aligning with a national blueprint, or implementing security and access controls, but they do not establish the overarching governance relationships and commitments that associational agreements capture.