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Los Angeles /Orange County Homeless Management Information System (HMIS) Collaborative HMIS Agency Agreement I. Purpose The Los Angeles /Orange County (LA /OC) Homeless Management Information System (HMIS) is a web - enabled database used by homeless service providers within the Los Angeles and Orange County region, to capture information about the persons they serve. The LA/OC HMIS Collaborative consist of four separate Continuum of Cares. The continuums are: Los Angeles Homeless Service Authority (LAHSA), Orange County Continuum of Care, the City of Glendale and the City of Pasadena.. The LA/OC HMIS Collaborative's goal is to go beyond the HUD mandate of producing unduplicated counts of homeless persons. Our mission is to provide a comprehensive case management system to advance the provision of quality services for homeless persons, improve data collection, and promote more responsive policies to end homelessness in Los Angeles and Orange Counties. H. Audience and Agreement This Participating Agency Agreement permits The Agency and its participants to use the LA/OC HMIS and security services on their computers systems through an Internet connection. The LA/OC HMIS Collaborative and their assigned HMIS System Administrators are the primary coordinating Continuum of Cares (CoC) for the LA/OC HMIS. The Participating Agency is the "Agency" named in this agreement as participants of the LA/OC HMIS. The HMIS "User" are the guardians entrusted with personal data to be entered and used in the LA/OC HMIS and the "Client" is the consumer of services. All agencies which have been granted access to the LA/OC HMIS have agreed to abide by all laws, and the LA/OC HMIS Collaborative Policies and Procedures pertaining to client confidentiality, user conduct, security, and the ongoing functionality and stability of services and equipment used to support the LA/OC HMIS. The signature of the Executive Director of the Participating Agency indicates agreement with the terms set forth for an I.AIOC HMIS aeeountfor the Agency. III. Confidentiality and Informed Consent The Agency agrees to abide by and uphold all privacy protection standards established by the LA/OC HMIS Collaborative as well as their respective agency's privacy procedures. The Agency will also uphold relevant Federal and California State confidentiality regulations and laws that protect client records, and the Agency will only release confidential client records with written consent by the client, or the client's guardian, unless otherwise provided for in the regulations or laws. Access to the LA/OC HMIS is granted to AGENCY NAME based on the following premises: RAN Oral Explanation: All clients will be provided an oral explanation stating their information will be entered into a computerized record keeping system. The Agency will provide an oral explanation of the LA /OC HMIS and the terms of consent. The agency is responsible for ensuring that this procedure takes place prior to every client interview. Written Explanation: Each client whose information is being shared with another participating agency must agree via the written Client consent/Information Release form. A client must be informed as to what information is being shared and with whom it is being shared. Information Release: The Agency agrees not to release client identifiable information to any other organization pursuant to federal and California State law without proper client consent. See attached Client Consem/Information Release Form and Regulations below. HMIS Agency Agreement Page 1 of Revised 02 101108