Common use of RESPONSIBILITIES OF SUBRECIPIENT Clause in Contracts

RESPONSIBILITIES OF SUBRECIPIENT. 4.1 For a Strategic Approach to Advancing Health Equity for Priority Populations with or at risk for diabetes the Subrecipient shall: (1) Strengthen self-care practices by improving access, appropriateness, and feasibility of DSMES services for priority populations. (A) identify one new organization, assess interest and evaluate capacity to provide DSMES; (B) engage referring providers, community and clinical partners in streamlined referral processes to DSMES or other diabetes support programs; and (C) distribute DSMES marketing materials to increase awareness of DSMES programs in priority populations and among referring providers. (2) Improve acceptability and quality of care for priority populations with diabetes. (A) support two existing or new clinic partnes to implement diabetes care practices through QI projects, improving interpretation services offered, clinic workflow and follow up procedures, implementing team-based care, etc. (3) Increase enrollment and retention of priority populations in the National DPP lifestyle intervention and the MDPP by improving access, appropriateness, and feasibility of the programs. (A) support existing MDPP sites to increase referrals and participation and improve reimbursement processes. (4) Expand availability of the National DPP lifestyle intervention as a covered health benefit for Medicaid Beneficiaries, employees and covered dependents at high risk for type 2 diabetes. (A) explore becoming trained and recognized as a Healm guide to promote National DPP to worksites. 4.2 For the National Cardiovascular Health Program the Subrecipient shall: (1) Implement team-based care to prevent and reduce cardiovascular disease risk with a focus on hypertension and high cholesterol prevention, detection, control and management through the mitigation of social support barriers to improve outcomes. (A) work with two local clinics to implement or improve team based care; and (B) work with two clinics to assist clinical teams with providing and connecting patients with social services to help with reducing hypertension and high cholesterol. (2) Link community resources and clinical services that support bidirectional referrals, self- management, and lifestyle change to address social determinants that put the priority populations at increased risk of cardiovascular disease with a focus on hypertension and high cholesterol. (A) refer people in the community and in clinical settings with hypertension to social service programs, including the National DPP as well as traditional social service programs, including 211; (B) conduct an inventory of CHWs in their areas to identify where they are working and the populations they serve; and (C) work with two clinics in local areas to implement and improve SMBP programs. 4.3 For reporting the Subrecipient shall: (1) Submit detailed reports on progress, results and performance measure data by the following dates: (A) October 15, 2023; (B) January 15, 2024; (C) April 15, 2024; and (D) July 15, 2024. (2) Comply with the reporting format in Catalyst to document the progress made on the activities. The Subrecipient shall ensure that necessary information is entered into all required reporting fields. 4.4 For contract responsibilities the Subrecipient shall: (1) attend the annual Department Forum; (2) attend the Chronic Conditions Disease Management group; and (3) Jointly review expenditures with the Department to determine if at least 35% of funds have been expended on activities as allocated: (A) if Subrecipient is below 35% expenditures a written plan of action will be provided by Department to ensure utilization of remaining funds for contract and funding purposes; and (B) over a three-year time period if the Subrecipient consistently underspends funds, the Department will work with the Health Promotion and Prevention Executive group and Governance to determine appropriate reallocation of funds.

RESPONSIBILITIES OF SUBRECIPIENT. 4.1 3.1 For a Strategic Approach to Advancing Health Equity for Priority Populations with or at risk for diabetes the Subrecipient shall: (1) Strengthen strengthen self-care practices by improving access, appropriateness, and feasibility of DSMES services for priority populations. (A) identify one new organization, assess interest and evaluate capacity to provide DSMES; (B) engage referring providers, community providers and community/clinical partners (i.e. DSMES providers) in streamlined referral processes to DSMES or DSMES/other diabetes support programs; and (CB) distribute work with DSMES providers to identify needs related to increasing referrals (i.e. marketing materials to increase awareness of DSMES programs in priority populations and among referring providersmaterials, communication efforts, etc.). (2) Improve improve acceptability and quality of care for priority populations with diabetes. (A) support two existing or new clinic partnes partners to implement diabetes care practices through QI projects, improving interpretation services offered, clinic workflow and follow up procedures, implementing team-based care, etc. (3) Increase increase enrollment and retention of priority populations in the National DPP lifestyle intervention and the MDPP by improving access, appropriateness, and feasibility of the programs. (A) support existing MDPP sites partner with new organizations (i.e. senior centers) to increase referrals and participation and improve reimbursement processes. (4) Expand availability of offer the National DPP lifestyle intervention as a covered LCP and assist organizations in registering to become CDC-recognized National DPPs through the Diabetes Prevention Recognition Program; and (B) identify geographic areas that have gaps in access to culturally appropriate services, by using the information gleaned in 2.1. Additionally, find opportunities to use the Utah Healthy Places Index to expand health benefit for Medicaid Beneficiaries, employees and covered dependents at high risk for type 2 diabetesequity efforts in diabetes prevention. (A) explore becoming trained and recognized as a Healm guide to promote National DPP to worksites. 4.2 3.2 For the National Cardiovascular Health Program the Subrecipient shall: (1) Implement track and monitor clinical and social services and support needs measures shown to improve health and wellness, health care quality, and identify patients at the highest risk of cardiovascular disease with a focus on hypertension and high cholesterol. (A) work with local primary care clinic to implement or improve their SDOH screenings. (2) implement team-based care to prevent and reduce cardiovascular disease risk with a focus on hypertension and high cholesterol prevention, detection, control and management through the mitigation of social support barriers to improve outcomes. (A) work with two local clinics to implement or improve team based care; and (B) work with two clinics to assist build the capacity of clinical teams with providing to provide and connecting connect patients with social services to help with reducing hypertension and high cholesterol.. This shall include conducting formal and informal assessments of the current multidisciplinary team employed by the clinic, and planning how to improve the team based on the assessment results; (23) Link link community resources and clinical services that support bidirectional referrals, self- management, and lifestyle change to address social determinants that put the priority populations at increased risk of cardiovascular disease with a focus on hypertension and high cholesterol. (A) refer people in the community and in clinical settings with hypertension to social service lifestyle change programs, including the National DPP as well as traditional social service programshealthy heart ambassador program, including 211SNAP-ED and EFNEP; (B) conduct an inventory of CHWs in their areas to identify where they are working and the populations they serve; and; (C) work with two clinics one clinic and one community partners in local areas to implement and improve SMBP programs. 4.3 3.3 For the State Physical Activity and Nutrition Program the Subrecipient shall: (1) implement state level policies and activities that promote food service and nutrition guidelines and associated healthy food procurement in facilities, programs, or organizations where food is sold, served, and distributed. (A) identify food venues that have a mission that would support FSG guidelines; and (B) partner with local government entities to adopt Eat Well Utah in their cafeterias. (2) implement state level policies and activities that coordinate uptake and expansion of existing fruit and vegetable voucher incentives and produce prescription programs. (A) promote and educate community and clinical partners on the health benefits of SNAP and WIC and provide them with the tools and training required to offer help with SNAP and WIC enrollment to their patients and clients. (3) implement state-level policies and activities to connect pedestrian, bicycle, or transit transportation networks to everyday destinations. (A) provide technical assistance to government agencies & communities working to improve PA safety and access on everyday routes to destinations; and (B) engage with community organizations to identify & implement policy or environmental changes that support PA in local areas (e.g., walk audits, citizen science assessments). (4) implement state level policies and activities that achieve continuity of care for breastfeeding families. (A) finalize a breastfeeding campaign with unified messages for hospitals, worksites, and ECEs based on existing platforms for partners and public; and (B) utilize assessments conducted from previous years to make improvements to lactation accommodations. 3.4 For reporting the Subrecipient shall: (1) Submit submit detailed reports on progress, results and performance measure data by the following dates: (A) October 15, 20232024; (B) January 15, 20242025; (C) April 15, 20242025; and (D) July 15, 20242025. (2) Comply comply with the reporting format in Catalyst Qualtrics to document the progress made on the activities. The Subrecipient shall ensure that necessary information is entered into all required reporting fields. 4.4 3.5 For contract responsibilities the Subrecipient shall: (1) attend the annual Department Forum; (2) attend the Chronic Conditions Disease Management group; and (3) Jointly jointly review expenditures with the Department to determine if at least 35% of funds have been expended on activities as allocated: (A) if Subrecipient is below 35% expenditures a written plan of action will be provided by Department to ensure utilization of remaining funds for contract and funding purposes; and (B) over a three-year time period if the Subrecipient consistently underspends funds, the Department will work with the Health Promotion and Prevention Executive group and Governance to determine appropriate reallocation of funds.

RESPONSIBILITIES OF SUBRECIPIENT. 4.1 3.1 For a Strategic Approach to Advancing Health Equity for Priority Populations with or at risk for diabetes the Subrecipient shall: (1) Strengthen strengthen self-care practices by improving access, appropriateness, and feasibility of DSMES services for priority populations. (A) identify one new organization, assess interest and evaluate capacity to provide DSMES; (B) engage referring providers, community providers and community/clinical partners (i.e. DSMES providers) in streamlined referral processes to DSMES or DSMES/other diabetes support programs; and (CB) distribute work with DSMES providers to identify needs related to increasing referrals (i.e. marketing materials to increase awareness of DSMES programs in priority populations and among referring providersmaterials, communication efforts, etc.). (2) Improve improve acceptability and quality of care for priority populations with diabetes. (A) support two existing or new clinic partnes partners to implement diabetes care practices through QI projects, improving interpretation services offered, clinic workflow and follow up procedures, implementing team-based care, etc. (3) Increase increase enrollment and retention of priority populations in the National DPP lifestyle intervention and the MDPP by improving access, appropriateness, and feasibility of the programs. (A) support existing MDPP sites partner with new organizations (i.e. senior centers) to increase referrals and participation and improve reimbursement processes. (4) Expand availability of offer the National DPP lifestyle intervention as a covered LCP and assist organizations in registering to become CDC-recognized National DPPs through the Diabetes Prevention Recognition Program; and (B) identify geographic areas that have gaps in access to culturally appropriate services, by using the information gleaned in 2.1. Additionally, find opportunities to use the Utah Healthy Places Index to expand health benefit for Medicaid Beneficiaries, employees and covered dependents at high risk for type 2 diabetesequity efforts in diabetes prevention. (A) explore becoming trained and recognized as a Healm guide to promote National DPP to worksites. 4.2 3.2 For the National Cardiovascular Health Program the Subrecipient shall: (1) Implement track and monitor clinical and social services and support needs measures shown to improve health and wellness, health care quality, and identify patients at the highest risk of cardiovascular disease with a focus on hypertension and high cholesterol. (A) work with local primary care clinic to implement or improve their SDOH screenings. (2) implement team-based care to prevent and reduce cardiovascular disease risk with a focus on hypertension and high cholesterol prevention, detection, control and management through the mitigation of social support barriers to improve outcomes. (A) work with two local clinics to implement or improve team based care; and (B) work with two clinics to assist build the capacity of clinical teams with providing to provide and connecting connect patients with social services to help with reducing hypertension and high cholesterol.. This shall include conducting formal and informal assessments of the current multidisciplinary team employed by the clinic, and planning how to improve the team based on the assessment results; (23) Link link community resources and clinical services that support bidirectional referrals, self- management, and lifestyle change to address social determinants that put the priority populations at increased risk of cardiovascular disease with a focus on hypertension and high cholesterol. (A) refer people in the community and in clinical settings with hypertension to social service lifestyle change programs, including the National DPP as well as traditional social service programshealthy heart ambassador program, including 211SNAP-ED and EFNEP; (B) conduct an inventory of CHWs in their areas to identify where they are working and the populations they serve; and; (C) work with two clinics one clinic and one community partners in local areas to implement and improve SMBP programs. 4.3 3.3 For reporting the Subrecipient shall: (1) Submit submit detailed reports on progress, results and performance measure data by the following dates: (A) October 15, 20232024; (B) January 15, 20242025; (C) April 15, 20242025; and (D) July 15, 20242025. (2) Comply comply with the reporting format in Catalyst Qualtrics to document the progress made on the activities. The Subrecipient shall ensure that necessary information is entered into all required reporting fields. 4.4 3.4 For contract responsibilities the Subrecipient shall: (1) attend the annual Department Forum; (2) attend the Chronic Conditions Disease Management group; and (3) Jointly jointly review expenditures with the Department to determine if at least 35% of funds have been expended on activities as allocated: (A) if Subrecipient is below 35% expenditures a written plan of action will be provided by Department to ensure utilization of remaining funds for contract and funding purposes; and (B) over a three-year time period if the Subrecipient consistently underspends funds, the Department will work with the Health Promotion and Prevention Executive group and Governance to determine appropriate reallocation of funds.

RESPONSIBILITIES OF SUBRECIPIENT. 4.1 For a Strategic Approach to Advancing Health Equity for Priority Populations with or at risk for diabetes the Subrecipient shall: (1) Strengthen strengthen self-care practices by improving access, appropriateness, and feasibility of DSMES services for priority populations. (A) identify one new organization, assess interest and evaluate capacity to provide DSMES; (B) engage referring providers, community and clinical partners in streamlined referral processes to DSMES or other diabetes support programs; and (C) distribute DSMES marketing materials to increase awareness of DSMES programs in priority populations and among referring providers. (2) Improve improve acceptability and quality of care for priority populations with diabetes. (A) support two existing or new clinic partnes to implement diabetes care practices through QI projects, improving interpretation services offered, clinic workflow and follow up procedures, implementing team-based care, etc. (3) Increase increase enrollment and retention of priority populations in the National DPP lifestyle intervention and the MDPP by improving access, appropriateness, and feasibility of the programs. (A) support existing MDPP sites to increase referrals and participation and improve reimbursement processes. (4) Expand expand availability of the National DPP lifestyle intervention as a covered health benefit for Medicaid Beneficiaries, employees and covered dependents at high risk for type 2 diabetes. (A) explore becoming trained and recognized as a Healm guide to promote National DPP to worksites. 4.2 For the National Cardiovascular Health Program the Subrecipient shall: (1) Implement implement team-based care to prevent and reduce cardiovascular disease risk with a focus on hypertension and high cholesterol prevention, detection, control and management through the mitigation of social support barriers to improve outcomes. (A) work with two local clinics to implement or improve team based care; and (B) work with two clinics to assist clinical teams with providing and connecting patients with social services to help with reducing hypertension and high cholesterol. (2) Link link community resources and clinical services that support bidirectional referrals, self- management, and lifestyle change to address social determinants that put the priority populations at increased risk of cardiovascular disease with a focus on hypertension and high cholesterol. (A) refer people in the community and in clinical settings with hypertension to social service programs, including the National DPP as well as traditional social service programs, including 211; (B) conduct an inventory of CHWs in their areas to identify where they are working and the populations they serve; and (C) work with two clinics in local areas to implement and improve SMBP programs. 4.3 For the State Physical Activity and Nutrition program the Subrecipient shall: (1) implement state level policies and activities that promote food service and nutrition guidelines and associated healthy food procurement in facilities, programs, or organizations where food is sold, served, and distributed. (A) explore ways to engage existing partners in Eat Well Utah in innovative ways; and (B) identify food venues in high need areas and implement Food Service Guidelines (FSG) culturally competent FSG by conducting a needs assessment. (2) implement state-level policies and activities to connect pedestrian, bicycle, or transit transportation networks (e.g., activity-friendly routes) to everyday destinations. (A) promote safe places to recreate to communities & agencies (including Parks and Rec. agencies); and (B) provide technical assistance to government agencies & communities working to improve PA safety and access on everyday routes to destinations. (3) implement state level policies and activities that integrate national standards related to nutrition, physical activity, and breastfeeding and advance Farm to ECE. (A) promote Farm to ECE educational program through outdoor learning environment, and experiential gardening trainers, curricula, and resources. (4) implement state level policies and activities that achieve continuity of care for breastfeeding families. (A) work with the State to finalize a breastfeeding campaign with unified messages for hospitals, worksites, and ECEs based on existing platforms for partners and public. 4.4 For reporting the Subrecipient shall: (1) Submit submit detailed reports on progress, results and performance measure data by the following dates: (A) October 15, 2023; (B) January 15, 2024; (C) April 15, 2024; and (D) July 15, 2024. (2) Comply comply with the reporting format in Catalyst to document the progress made on the activities. The Subrecipient shall ensure that necessary information is entered into all required reporting fields. 4.4 4.5 For contract responsibilities the Subrecipient shall: (1) attend the annual Department Forum; (2) attend the Chronic Conditions Disease Management group; and (3) Jointly jointly review expenditures with the Department to determine if at least 35% of funds have been expended on activities as allocated: (A) if Subrecipient is below 35% expenditures a written plan of action will be provided by Department to ensure utilization of remaining funds for contract and funding purposes; and (B) over a three-year time period if the Subrecipient consistently underspends funds, the Department will work with the Health Promotion and Prevention Executive group and Governance to determine appropriate reallocation of funds.