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DocuSign Envelope ID:FF14B287-E90C-42B9-8A0F-A14FA00E82AF <br />Exhibit A-3 ABCD Quarterly Communityand Provider Outreach and Case ManagementReport <br />Year One July 1,2022 -June 30,2023•2nd ÛUarter ÑOpOft <br />Please complete and submit report electronically to: <br />Janice Tadeo,ABCD Program Manager at lanice.tadeo hca.wa.gov <br />Cc:Pixie Needham,Dental Program Administrator at pixie.needham@hca.wa.gov and <br />Heather Gallagher,ABCD State Managing Director,hqallaqher@arcorafoundation.orq <br />Organization: <br />ABCD Contact Person: <br />Phone and Email: <br />2nd Quarter <br />10/1/2022 - <br />Report Due:01/31/2023 12/31/2022 <br />Maximum Brief description (for events,provide date heldlattendedl for <br />$$available staff assignments,provide name and title)-no more than 100forthiswords(complete Exhibit A-3 and attach supporting document ifPerformanceCategoryYes/No ,deliverable providing additional detail) <br />Community and Provider Outreach _ <br />I <br />_ <br />$1,298.00 Complete Exhibit B-3 <br />Coordinate Care $324.00 Complete Exhibit B-3 <br />Update DentistLink roster $100.00 Complete Exhibit B-3 <br />Submit invoice showing expenses for dental champion to attendAttendandparticipateindevelopmentday$2,000.00 developmentday. <br />Page 9 of 20 <br />HCA Contract No.:K2747-04