CHOICES Florida\u27s version of ObamaCare was a unique case voted in by the public in Alachua County Florida. A mixed methods research design was utilized and provided context in which policy entrepreneurs operated, as well as an explanatory model of internal determinants. Social, economic and political factors were examined to determine the predictor variable in the adoption of the CHOICES health services program. The results revealed that voters 51 years of age and older had a greater probability of voting for the Alachua Referendum. CHOICES legality has not been under contention but its effectiveness has. This study found that CHOICES has been effective at providing comprehensive primary preventative care in a disjointed incremental system of healthcare by purposefully collaborating with all stakeholders involved. A model for purposeful collaboration is presented and is titled the policy adoption wheel of collaboration
