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DocuSign Envelope lD: FF 1 48287 -E90C-4289-840F-A1 4FAO0E824F Washington State 1 -f,1 Health Care fiilthority DATA SHARE AGREEMENT AMENDMENT HCA Contract No.: K4677 Amendment No.: 01 THIS A M E N DM E NT TO T H E DA T A SHA RE A G REE M E NT IS between the Washi ngto n State Hea Ith Care Autho rity and t he pa rty wh ose name a ppears below an d is effective AS of t he date S et fo rth below RECEIVING PARTY NAME Kittitas County Public Health Network RECEIVING PARTY doing business as (DBA) RECEIVING PARTY ADDRESS 507 North Nanum St., Suite 201 Ellensburg, WA 98926 ASSIGNED SERVICE REGION/COUNTY Kittitas County AMENDMENT START DATE July 1, 2022 AMENDMENT END DATE June 30,2024 GONTRACT END DATE June 30,2024 WHEREAS, HCA and Receiving Party previously entered into a Data Share Agreement (DSA) to provide Access to Baby and Child Dentistry (ABCD) services to detect and prevent early childhood dental decay for engaging dentists in seeing birth to six year old and disabled six to twelve year old Medicaid eligible childien anOlngaging local public health departments in outreach and case management, and; WHEREAS, HCA and Receiving Party wish to amend the DSA pursuant to Section 14 to extend term, revise eligible children population, add definition; NOW THEREFORE, the parties agree the DSA is amended as follows: 1. The Data Share Agreement term is extended from June 30,2022 to June 30,2024. 2. Section 1, Background is amended to read as follows: 1. Background The Receiving Party has previously entered into a Contract with HCA, K2747, in 2018. The purpose of the Contract is to provide Access to Baby and Child Dentistry (ABCD) services to detect and prevent early childhood dental decay for engaging dentists in seeing birth to six (6) year old and disabled six (6) to twelve (12) year old Medicaid eligible children and engaging locai public health departments in outreach and case management. 3. Section 2, Purpose of the DSA is amended to read as follows: 2. Purpose of the DSA The purpose of this Data Share Agreement (DSA) is to identify, describe and protect the Medicaid data being provided by HCA from ProviderOne to the Receiving Party. The purpose for sharing the Data is for the Receiving Party to identify eligible ABCD clients in order to match them to a dentist, then provide client outreach to families with children under the age of six (6) and disabled children under the age of thirteen (13). Outreach will be done by making phone calls to families to assist with connecting the child to an ABCD certified dentist, and information regarding the ABCD program will be sent via mail. The Data will help identify and address family barriers to accessing oral health care. 4. Section 3, Justification and Authority for Data Sharing is amended to read as follows: HCA Contract No. K4677-0'1 Page 1 of 3