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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 Two July 1,2023 -June 30,2024•2nd Quarter Report <br />Please complete and submit report electronically to: <br />Janice Tadeo,ABCD Program Manager at |anice.tadeo@hca.wa.qov <br />Cc:Pixie Needham,Dental Program Administrator at pixie.needham@hca.wa.gov and <br />Heather Gallagher,ABCD State Managing Director,hqallaqher@arcorafoundation.org <br />Organization: <br />ABCD Contact Person: <br />Phone and Email: <br />2nd Quarter <br />10/1/2023 - <br />Report Due:01/31/2024 12/31/2023 <br />Maximum Brief description (for events,provide date heldlattended/for <br />$$available staff assignments,provide name and title)-no more than 100 <br />for this words (complete Exhibit A-3 and attach supporting document if <br />Performance Category Yes/No deliverable providing additional detail <br />Community and Provider Outreach $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 attend <br />Attend and participate in developmentday $2,000.00 |developmentday. <br />Page 13 of 20 <br />HCA Contract No.:K2747-04