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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 />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 <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 file for Medicaid/other third party insurance plans for reimbursement when necessary <br />(OCHS/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 />2004 and the remaining $5,000 by June 30, 2005, upon receipt of OCHD original invoice. The check <br />should be made payable to Orange County Health Department and mailed to Letitia Burns, Central <br />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 />responsible for obtaining and maintaining adequate automobile liability insurance as <br />required bylaw and if requested will furnish to the County certificates of such insurance. <br />b. To arrive for the scheduled appointments on-time with all children scheduled for that day. <br />OCHS/EHS shall be responsible for re-scheduling any appointments unable to be met at <br />least 24 hours in advance. <br />