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<br />Los Angeles/Orange County <br />Homeless Management Information System (HMIS) Collaborative <br />HMIS Agency Agreement <br />1. Purpose <br />The Los Angeles/Orange County (LA/OC) Homeless Management Information System (HMIS) is a web- <br />enabled database used by homeless service providers within the Los Angeles and Orange County region, to <br />capture information about the persons they serve. The LA/OC HMIS Collaborative consist of four separate <br />Continuum of Cares. The continuums are: Los Angeles Homeless Service Authority (LAHSA), Orange <br />County Continuum of Care, the City of Glendale and the City of Pasadena. <br />The LA/OC HMIS Collaborative's goal is to go beyond the HUD mandate of producing unduplicated <br />counts of homeless persons. Our mission is to provide a comprehensive case management system to <br />advance the provision of quality services for homeless persons, improve data collection, and promote more <br />responsive policies to end homelessness in Los Angeles and Orange Counties. <br />H. Audience and Agreement <br />This Participating Agency Agreement permits The Agency and its participants to use the LA/OC HMIS and <br />security services on their computers systems through an Internet connection. The LA/OC HMIS <br />Collaborative and their assigned HMIS System Administrators are the primary coordinating Continuum of <br />Cares (CoC) for the LA/OC HMIS. The Participating Agency is the "Agency" named in this agreement as <br />participants of the LA/OC HMIS. The HMIS "User" are the guardians entrusted with personal data to be <br />entered and used in the LA/OC HMIS and the "Client" is the consumer of services. <br />All agencies which have been granted access to the LA/OC HMIS have agreed to abide by all laws, and the <br />LA/OC HMIS Collaborative Policies and Procedures pertaining to client confidentiality, user conduct, <br />security, and the ongoing functionality and stability of services and equipment used to support the LA/OC <br />HMIS. <br />The signature of the Executive Director of the Participating Agency indicates agreement with the terms <br />set forth for an LA/0C HMIS account for the Agency. <br />III. Confidentiality and Informed Consent <br />The Agency agrees to abide by and uphold all privacy protection standards established by the LA/OC <br />HMIS Collaborative as well as their respective agency's privacy procedures. The Agency will also uphold <br />relevant Federal and California State confidentiality regulations and laws that protect client records, and the <br />Agency will only release confidential client records with written consent by the client, or the client's <br />guardian, unless otherwise provided for in the regulations or laws. Access to the LA/OC HMIS is granted <br />to AGENCY NAME IF-' based on the follow?n premises: <br />r7i <br />Oral Explanation: All clieqA nts willl be proOvidedGC/lGd1; an oral 0 <br />expl nation stating their information will be <br />entered into a computerized record keeping system. The Agency will provide an oral explanation of the <br />LA/OC HMIS and the terms of consent. The agency is responsible for ensuring that this procedure <br />takes place prior to every client interview. <br />Written Explanation: Each client whose information is being shared with another participating <br />agency must agree via the written Client consent/Information Release form. A client must be informed <br />as to what information is being shared and with whom it is being shared. <br />Information Release: The Agency agrees not to release client identifiable information to any other <br />organization pursuant to federal and California State law without proper client consent. See attached <br />Client Consent/Information Release Form and Regulations below. <br />HMIS Agency Agreement Page 1 of 5 Revised 02/01/08