2004 S Health - Renewal Chapel Hill Training & Outreach, Inc & Health Dept for Dental -Head Start

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3. OCHD will provide treatment services to each group as follows: A) Examination B) Needed extractions C) Needed restoration including pulp therapy and stainless steel crowns, if needed D) Prophylaxis and topical fluoride application where indicated 4. OCHD will provide educational services which may include but not be limited to the following: A) Dental health education for children B) Dental health education for parents C) Dental health education for staff D) Suggestions for classroom activities E) Hand-outs to be taken home by the children 5. OCHD will complete the CAP-H.S.S.-30 forms pertaining to dental health and return the forms to OCHS/EHS to be made a part of the child's permanent Head Start record. 6. OCHD will file for M edicaid/other t hird p arty i nsurance p tans f or r eimbursement w hen n ecessary (OCHS/EHS is not a health provider, therefore cannot file). 7. OCHD will submit a bill to Angela Wilcox, Director, OCHS/EHS, in the amount of $10,000 on an annual basis. OCHS/EHS agrees to pay the OCHD in two installments, $5,000 by December 31, 2004 and the remaining $5,000 by June 30, 2005, upon receipt of OCHD original invoice. The check should be made payable to Orange County Health Department and mailed to Letitia Burns, Central Administrative Services Director, PO Box 8181, Hillsborough, NC. 8. OCHS/EHS agrees as follows: a. To transport no more than 5-10 children to be scheduled at least every other week on a block basis and to provide adequate supervision in the waiting room. OCHS/EHS shall be responsible for obtaining and maintaining adequate automobile liability insurance as required by law and if requested will furnish to the County certificates of such insurance. b. To arrive for the scheduled appointments on-time with all children scheduled for that day. OCHS/EHS shall be responsible for re-scheduling any appointments unable to be met at least 24 hours in advance.