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Exhibit E <br />a <br />Page 1 Of 3 <br />11 <br />OC HMIS Participating Agency Agreement <br />Purpose <br />The HMIS (Homeless Management Information System) Is a HUD -mandated Information technology system <br />that is designed to capture client -level information over time, on the characteristics and service needs of <br />homeless persons. Client data is maintained on a central server, which will contain all client Information in an <br />encrypted state, HMIS Integrates data from all homeless service providers and organizations In the community <br />and captures basic descriptive information on every person served. Participation in the OC HMIS allows <br />organizations to share information with other participating organizations to create a more coordinated and <br />effective service delivery system. The OC HMIS is the secured electronic database for Orange County and Is a <br />valuable resource for local communities. <br />Agreement and Understanding <br />This Agreement authorizes this Participating Agency (Agency) to designate HMIS Users (User). A User Is a staff <br />person entrusted to enter Protected Personal Information (PPI) into the OC HMIS, on behalf of this Agency. In <br />order to allow a User to access the OC HMIS, a User Agreement must be signed by the User and stored <br />electronically in the HMIS. <br />Confidentiality and Informed Consent <br />Confidentiality. This Agency must require all Users to abide by its organization's policies and procedures; <br />uphold all privacy protection standards established by the OC HMIS Policies and Procedures; and comply with <br />all relevant federal and State of California confidentiality laws and regulations that protect client records. <br />Except where otherwise provided for by law, this Agency shall ensure that confidential client records are <br />released with the client's written consent. <br />Written Consent: To obtain written consent, prior to each client's assessment, each client must be informed <br />that the client's information will be entered into an electronic database called HMIS. The terms of the Consent <br />to Share Protected Personal Information form must also be explained to each client. Clients who agree to have <br />their PPI entered Into the OC HMIS must sign the Consent to Share Protected Personal Information form. <br />Verbal Consent: Verbal consent to enter PPI into the OC HMIS may be obtained during circumstances such as <br />phone screenings, street outreach, or community access center sign -ins. Each client must be informed that <br />their information will be entered into the HMIS database. The terms of the Consent to Share Protected <br />Personal Information form must also be explained to each client. The client's written consent must be <br />obtained once the client appears for their Initial assessment. <br />Updated 8/24/1e <br />