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Exhibit A -ABCD Quarterly Outreach & Case Management Report <br />Year One 2018 -2019 • 2nd Quarter Report <br />Please complete and submit report electronically to: <br />Janice Tadeo, Dental Program Administrator <br />Division of Health Care Services, Washington State Health Care Authority <br />PO Box 45506, Olympia, WA 98504-5506 <br />Phone: (360) 725-1583 Email: Janice.Tad eo @HCA.W A.GOV <br />Organization : Kittitas County Public Health Network <br />ABCD Contact Person : Kasey Knutson kasey .knutson@co.kittitas.wa.us <br />Phone : 509/962-7029 <br />2nd <br />Quarter <br />Report Due: 10/1/18- <br />01/31/2019 12/31/18 <br />Maximum$$ Brief description (for events, provide date held/attended/ for <br />Performance Category <br />Contact at least 10% <br />of client list <br />Attend and participate <br />in ABCD <br />Coordinator /Program <br />Meeting <br />Community and <br />Provider Outreach <br />Coordinate Care <br />HCA Contract No. K2747 <br />Amendment #01 <br />available for staff assignments, provide name and title) -no more than 100 <br />this words (complete Exhibit A and attach supporting document if <br />Yes/No deliverable providing additional detail) <br />$450 Complete Exhibit B <br />$500 <br />$960 Complete Exhibit B <br />$465 Complete Exhibit B <br />Page 2 of 2 <br />1 1