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DocuSign Envelope lD: F F 1 48.287 -E90C-4289-840F-A1 4FA00E82AFExhibit A-3Please complete and submit report electronically to:Janice Tadeo, ABCD Program Manager at ianice.tadeo@hca.wa.govCc: Pixie Needham, Dental Program Administrator at pixie.needham@hca.wa.gov andHeath er Gallagher, ABCD State Managi n g Director, hgallao her@arcorafoundation.orqABCD Quarterly Gommunity and Provider Outreach and Case Management ReportYear One July 1 ,2022 - June 30,2O2S o 2nd Ouarter ReportBrief description (for events, provide date held/attended/ forstaff assignments, provide name and title) - no more than 100words (complete Exhibit A-3 and attach supporting document ifdiadditionaldetaComExhibit B-3ComExhibit B-3Exhibit B-3Submit invoice showing expenses for dental champion to attenddevelopment day.Maximum$$ availablefor thisdeliverable$1,298.00$324.00$100.00$2,000.002nd Quarter10t1t2022 -12t31t2022Yes/NoOrqanizationABCD Contact PersonPhone and EmailReport Due:0113112023Performance CateqorvCommunity and Provider OutreachCoordinate CareUpdate Dentistlink rosterAttend and participate in development dayHCA Contract No.: K2747-04Page 9 of 20