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EXIIIBIT "A" <br />SCOPE OF WORK <br />In addition to providing all material and labor, the Contractor shall perform the following: <br />1) Employ a registered nurse, fully licensed within the State of Washington to perform the work <br />described below within the Children with Special Health Care Needs Program, hereinafter <br />"CYSHCN". <br />This work shall include mei4hly quarterly reporting (Exhibit E) and the following: <br />Task/Activity/Description \ <br />Deliverables/Outcomes <br />Due Date/Time Frame <br />Complete Child Health Intake Form (CHIF) using <br />Submit CHIF data into <br />1/15/19 <br />the CHIF Automated System on all infants and <br />Secure File Transport <br />4/15/19 <br />children served by the CYSHCN Program as <br />(SFT)website: <br />7/15/19 <br />referenced in CYSHCN Program Manual. Ensure <br />https:/Isft.wa.eov <br />10/15/19 <br />client data is collected on all children served by <br />CYSHCN contractors, including <br />neurodevelopmental centers, regional maxillofacial <br />coordinators, and the DOH Newborn Screening <br />Program. <br />Administer requested DOH Diagnostic and <br />Submit completed <br />30 days after forms are <br />Treatment funds for infants and children per <br />Health Services <br />completed. <br />CYSHCN Program Manual when funds are used. <br />Authorization forms <br />and Central <br />Treatment Fund <br />requests directly to <br />the CYSHCN <br />Program as needed. <br />Professional Services Agreement <br />Page 12 <br />