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DocuSign Envelope lD: F F 1 48287 -E90C-42B9-8A0F-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.qov andHeath er Gallagher, ABCD State Managi n g Di rector, hgallaq her@arcorafo undation. orqABCD Quarterly Community and Provider Outreach and Case Management ReportYear Two July 1, 2023 - June 30,2024.3rd Quarter ReportBrief description (for events, provide date held/attended/ forstaff assignments, provide name and title) - no more than100 words (complete Exhibit A-3 and attach supportingdocument if providing additional detail)Complete Exhibit B-3Complete Exhibit B-3Provide outcome information such as minutes, copies ofinformation provided or list of items provided, examples of typeof Organizations attended, what were outcomes or next stepsfor ABCD.Send invitation and report back any concerns/issues to HCADental Program Administrator & ABCD AdministratorMaximum$$ availablefor thisdeliverable$1,000.00$1.298.00$324.00$500.003rd Quarter1t1t2024 -3t31t2024Yes/NoOrqanizationABCD Contact Person:Phone and Email:Report Due:.0413012024Performance GategoryAttend and participate in ABCDCoordinator/Proqram MeetinqCommunity and Provider OutreachCoordinate CareConvene Health Coalition/ABCD Steeringcommittee or participate in a Coalition or SteeringCommittee Focused on Health Care, Access orEarly Learning with ABCD as a Quarterly AgendaItem.HCA Contract No.: K2747-04Page 14 of 20