; (C) that have prior experience working on projects with the goal of reducing health disparities; (D) that demonstrate long-term commitment to providing health services to the target population or populations; and (E) with a demonstrated need for additional financial resources in order to strengthen and advance existing efforts of the health system to reduce health disparities. (3) Duration of action plan (A) In general The State may not approve an action plan submitted under paragraph (1) for a period exceeding 5 years. (B) Report At the end of any such period, the State shall require each participating qualified community health system to submit a report to the State describing the effectiveness of its initiative using the measures described in paragraph (1)(D). (C) Extension A State may extend the initiative of such health system upon approval of a new action plan to extend, improve, or expand the initiative, if the State determines that the initiative has proved effective, taking into account the report submitted under subparagraph (B). (d) State report and evaluation (1) In general A State with a State plan amendment approved under this section shall submit to the Secretary, in a time and manner to be specified by the Secretary— (A) an annual report on the progress of the Health Disparities Elimination Program of the State towards meeting the goals of the State described under subsection (b)(1); and (B) not less than once every 5 years, an evaluation of the effectiveness of the Health Disparities Elimination Program of the State. (2) Contents The evaluation described in paragraph (1)(B) shall include— (A) an assessment of the effectiveness of initiatives receiving incentive payments pursuant to this section during the period covered by the report in meeting the goals of the State described under subsection (b)(1)