Community Health Center 11/20/2018

D. Levels of Accomplishment - Goals and Performance Measures In addition to the normal administrative services required as part of this Agreement, the Subrecipient agrees to provide the following levels of program services: Activity Units of Service* per Month Total Units/Year Dental Visits 5 (Jan - June 2019) 30 Total People or Households to be served Total unduplicated Everett Residents or Households to be served Approximately 15 individuals Approximately 15 individuals *Note: Provide definition of Units of Service, which may include such measures as units rehabbed, persons or households assisted, or meals served, here. If this is a construction project, please explain here how the improvements will be used and how they benefit the community, what the target population is for the project, etc. The Subrecipient agrees to track outcome performance measures as required by the U.S. Department of Housing and Urban Development (HUD) and the City. The Subrecipient will report the outcomes to the City on the following schedule: Performance Period Report Due July 1, 2018 — September 30, 2018 October 31, 2018 October 1, 2018 — December 31, 2018 January 31, 2019 January 1, 2019 — March 1, 2019 April 30, 2019 April 1, 2019 — May 30, 2019 June 30, 2019 Information and forms will be provided to the Subrecipient by the City for reporting this information. E. Staffing [List of staff and time commitments to be allocated to the activity specified in I.A. above] Services are delivered by licensed Dentists, Dental Hygienists and a support staff consisting of Dental Assistants and Receptionists and Care Coordinators. There are not specific CHC dentists providing these services, patients can see any dental provider at either clinic site in Everett. Appointments are normally 45-60 minutes, depending upon the procedures that are being done. A-4