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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: FF 1 4F.287 -E90C-42B9-8A0F-A1 4FAo0EB2AF <br />j) lf the Contractor determines that it can no longer serve as the ABCD Contractor, reasonable <br />notice 90 days must be given to HCA in order to assure uninterrupted service to clients and work <br />with providers and: <br />i. Work with HCA and other state partners to identifu potential new ABCD-lead agencies. <br />2. Each quarter, the contractor must complete and submit the following via email: <br />a) Community and Provider Outreach and Coordination Care summary which shall <br />include; <br />i. Exhibit A-3, ABCD Quarterly Community and provider Outreach and Case Management <br />Report forthe specific quarter; and <br />ii. Exhibit B-3, ABCD Quarterly Outreach and Coordination of Care Report. <br />3. Each year, the contractor must complete and submit via email the Exhibit C-2, ABCD Yearly <br />Budget Tool, as applicable to the requirements, contained in Exhibit A-3. <br />4. The contractor must meet with the State Managing Partner, Arcora Foundation, on a yearly basis <br />to review local needs, utilization, and review the desk manual that outlines the ABCD contractual <br />deliverables and how the contractor has met or plans to meet those deliverables. <br />5. Each quarter the contractor must submit a fully completed invoice that conelates with dollar <br />values for completed deliverables outlined in Exhibit A-3: <br />a) Exhibit templates are available on the ABCD website http://abcd-dental.orq/for-coordinators/: <br />and <br />b) Reports and billing must be submitted no later than one month after each quarter end date, <br />unless othenrvise mutually agreed by both parties. <br />HCA Contract No.: K2747-O4 <br />PageT of20
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