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Docusign Envelope ID: 05005881-3C14-83E7-8045-2D61DE4FEE73 _ %NDMENT 4 <br />AMENDED AND RESTATED <br />FY2026 AND FV2027 COMMUNITY SERVICES PERFORMANCE CONTRACT <br />MASTER AGREEMENT AND SUPPLEMENTAL DOCUMENTS <br />Portsmouth Department of Behavioral Healthcare Services <br />Contract No. P1636.778.4 <br />Other Performance Contract Document Attachments <br />❑Exhibit A: Resources and Services (Only available through the electronic reporting application provided by <br />the Department) <br />®Exhibit B: Continuous Quality Improvement (CQI) Process and CSB Performance Measures <br />DExhibit C: PHI Data Sharing and Use Agreement (Repurposed effective July 1, 2025) <br />DExhibit D: Individual CSB Performance Measures (Provided separately as needed by the Department) <br />®Exhibit E: Performance Contract Schedule and Process <br />®Exhibit F: Federal Grant Requirements <br />DExhibit F(B): Single Audit Exemption Form (Template Document provided by Department) <br />©Exhibit F(C): Assurance of Compliance - Title VI of the Civil Rights Act of 1964 <br />®Exhibit G: Community Services Boards Master Programs Services Requirements <br />DExhibit H: Regional Local Inpatient Purchase of Services (LIPOS) Requirements <br />®Exhibit l: IT Security and Compliance <br />❑Exhibit J: Certified Preadmission Screening Clinicians Requirements <br />DExhibit K. State Hospital Census Management Admission and Discharge Requirements <br />px Exhibit L: List of Acronyms (See Table of Contents) <br />®Exhibit M: Department of Justice Settlement Agreement <br />®Addendum is Administrative Requirements and Processes and Procedures <br />[]Addendum II: Partnership Agreement <br />❑Addendum III: RESERVED FOR FUTURE USE <br />Page 3 of 27 <br />