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GREATER LOS ANGELES & ORANGE COUNTY <br />HOMELESS MANAGEMENT INFORMATION SYSTEM (LA/OC HMIS) <br />PARTICIPATING ORGANIZATION AGREEMENT <br />I. Purpose <br />The HMIS is a HUD -mandated information technology system that is designed to capture client -level information <br />overtime, on the characteristics and service needs of homeless persons. Client data is maintained on a central <br />server, which will contain all client information in an encrypted state. HMIS integrates data from all homeless <br />service providers andorganizations in the community and captures basic descriptive information on every person <br />served. Participation inLA/OC HMIS allows organizations to share information with other participating <br />organizations to create a morecoordinated and effective delivery system. <br />The LA/OC HMIS is the secured electronic database for the Greater Los Angeles and Orange Counties and is a <br />valuable resource for local communities. The LA/OC HMIS Collaborative consists of four separate Continuums of <br />Care (CoC). The continuums are: Los Angeles City and County; Santa Ana/Anaheim/Orange County; Glendale; and <br />Pasadena. <br />The LA/OC HMIS Collaborative's goal is to provide a comprehensive case management system to advance the <br />provision of quality services for homeless persons, improve data collection, and promote more responsive policies <br />to end homelessness in the Greater Los Angeles and Orange Counties. <br />If. Agreement and Understanding <br />This Agreement authorizes this Participating Organization (Organization) to designate HMIS Users (User). A User is <br />a staff person entrusted to enter Protected Personal Information (PPI) into the LA/OC HMIS, on behalf of this <br />Organization. In order to allow a User to access the LA/OC HMIS, a User Agreement must be signed by the User, <br />the HMIS Administrator, and this Organization's Authorized Representative. <br />III. Confidentiality and Informed Consent <br />Confidentiality: This Organization must require all Users to abide by its organization's policies and procedures; <br />uphold all privacy protection standards established by the LA/OC HMIS Collaborative Policies and Procedures; and <br />comply with all relevant federal and State of California confidentiality laws and regulations that protect client <br />records. Except where otherwise provided for by law, this Organization shall ensure that confidential client records <br />are 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 to <br />Share Protected Personal Information form must also be explained to each client. Clients who agree to have <br />their PPI entered into the LA/OC HMIS must sign the Consent to Share Protected Personal Information form. <br />Verbal Consent: Verbal consent to enter PPI into the LA/OC HMIS may be obtained during circumstances such <br />as phone screenings, street outreach, or community access center sign -ins. Each client must be informed that his <br />or her 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 obtained <br />once the client appears for his or her initial assessment. <br />Version 1.5 Page 1 of 3 Modified 10/21/2015 <br />