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3 <br />3. OCHD will provide treatment services to each group as follows: <br />A) Examination <br />B) Needed extractions <br />C) Needed restoration including pulp therapy and stainless steel crowns, if needed <br />D) Prophylaxis and topical fluoride application where indicated <br />E) Provide follow-up documentation of dental exams and treatment on each child <br />F) Referral of children with severe need to UNC School of Dentistry for evaluation and <br />possible acceptance for treatment <br />4. OCHD will provide educational services which may include but not be limited to the following: <br />A) Dental health education for children <br />B) Dental health education for parents, including meeting with a dental staff member and <br />individual parents of children requiring follow-up treatment <br />C) Dental health education for staff <br />D) Suggestions for classroom activities <br />E) Hand-outs to be taken home by the children <br />5. OCHD will complete the CAP-H.S.S.-30 forms pertaining to dental health and return the forms to <br />OCHS/EHS to be made a part of the child's permanent Head Start record. <br />6. OCHD will fi-e for Medicaid/other third party insurance plans for reimbursement when necessary <br />(OCRs/EHS is not a health provider, therefore cannot file). <br />7. OCHD will submit a bill to Angela Wilcox, Director, OCHS/EHS, in the amount of $10,000 on an <br />annual basis. OCHS/EHS agrees to pay the OCHD in two installments, $5,000 by December 31, <br />2007 and the remaining $5,000 by June 30, 2008, upon receipt of OCHD original invoice. The <br />check should be made payable to Orange County Health Department and mailed to Letitia Burns, <br />Central Administrative Services Director, PO Box 8181, Hillsborough, NC. <br />8. OCHS/EHS agrees as follows: <br />a. To transport no more than 5-10 children to be scheduled at least every other week on a <br />block basis and to provide adequate supervision in the waiting room. OCHS/EHS shall be <br />