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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•3rd Quarter Report <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.qov and <br />Heather Gallagher,ABCD State Managing Director,hqallaqher@arcorafoundation.org <br />Organization: <br />ABCD Contact Person: <br />Phone and Email: <br />3rd Quarter <br />1/1/2023 - <br />Report Due:04/30/2023 3/31/2023 <br />Maximum Brief description (for events,provide date heldlattendedl for <br />$$available staff assignments,provide name and title)-no more than <br />for this 100 words (complete Exhibit A-3 and attach supporting <br />Performance Category Yes/No deliverable document if providing additional detail) <br />Attend and participate in ABCD <br />Coordinator/Program Meeting $1,000.00 <br />Community and Provider Outreach $1,298.00 Complete Exhibit B-3 <br />Coordinate Care __$324.00 Complete Exhibit B-3 <br />Provide outcome information such as minutes,copies of <br />Convene Health Coalition/ABCD Steering information provided or list of items provided,examples of type <br />committee or participate in a Coalition or Steering of Organizations attended,what were outcomes or next steps <br />Committee Focused on Health Care,Access or for ABCD. <br />Early Learning with ABCD as a Quarterly Agenda <br />Item.Send invitation and report back any concernslissues to HCA <br />$500.00 Dental Program Administrator &AB_CD Administrator <br />Page 10 of 20 <br />HCA Contract No.:K2747-04