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HCA Amendment Signed
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2022
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07. July
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2022-07-19 10:00 AM - Commissioners' Agenda
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HCA Amendment Signed
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Last modified
7/25/2022 8:11:19 AM
Creation date
7/25/2022 8:10:52 AM
Metadata
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Template:
Meeting
Date
7/19/2022
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Alpha Order
d
Item
Request to Approve an Amendment to the Health Care Authority Access to Baby Dentistry
Order
4
Placement
Consent Agenda
Row ID
91496
Type
Agreement
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DocuSign Envelope lD: FF148287-E90C-4289-8AOF-A14FAO0EB2AF <br />Schedule 1: Description of Shared Data <br />Per K2747 Contract with HCA, the Contractor is to identify eligible ABCD clients and match them to a dental home <br />provide family orientation, assist with scheduling dental appointments, identify and address family barriers to <br />accessing oral health care. The Data will be provided semiannually for the timeframe of July 2020 through June <br />2022, in an excel format transferred via Secure File Transfer (SFT). HCA will provide access to the Receiving party. <br />The HCA Dental Program Manager will upload the excel containing the specified Data to their region/county to the <br />ABCD Coordinator's assigned folder in SFT. The Data will only include eligible ABCD clients that have not had a <br />dental claim in the past 12 months. <br />1,. Data Elements: <br />a. Client lD; <br />b. Full name; <br />c. Age; <br />d. DOB; <br />e. Mailing address; <br />f. Phone number; <br />g. Head of household name; and <br />h. Preferred language. <br />HCA Contract No. K4677-01 Page 3 of 3
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