Common use of Statement of Confidentiality Clause in Contracts

Statement of Confidentiality. Staff, volunteers, and any other persons with access to the Homeless Management Information System (HMIS) are subject to certain guidelines regarding its use. HMIS contains a wide range of personal and private information on individuals and all such information must be treated carefully and professionally by all who access it. Guidelines for use of HMIS include: • Personal User Identification and Passwords must be kept secure and are not to be shared. • Informed client or guardian consent, as documented by a current Authorization to Release form, is required before entering, updating, editing, printing, or disclosing basic identifying information via the HMIS. • Informed client or guardian consent, as documented by a current Authorization for Release of Information with a HMIS clause, is required before entering, updating, editing, printing, or disclosing information beyond basic identifying non-confidential information. • Confidential information obtained from the HMIS is to remain confidential, even if my relationship with my employer changes or concludes for any reason. • Only individuals that exist as clients under the Agency jurisdiction may be entered into the HMIS. • Misrepresentation of the client base by entering known, inaccurate information is prohibited. • Discriminatory comments based on race, color, religion, national origin, ancestry, handicap, age, sex, and sexual orientation are not permitted in the HMIS. Profanity and offensive language are not permitted in the HMIS. • The HMIS is to be used for business purposes only. Transmission of material in violation of any United States Federal or State of Hawaii regulations or laws is prohibited and includes material that is copyrighted, legally judged to be threatening or obscene, and considered protected by trade secret. The HMIS will not be used to defraud the Federal, State, or local government or any individual entity or to conduct any illegal activity. • Any unauthorized access or modification to computer system information or interference with normal system operations will result in immediate suspension of your access to the HMIS. Your signature below indicates your agreement to comply with this statement of confidentiality. Submit a completed agreement to the Department of Human Services (DHS), Benefit, Employment, and Support Services Division (BESSD) in order to receive a new employee user code. Employee: Executive Director: Signature Date Signature Date Printed Name Date Printed Name Date HMIS User Agreement Forms for current employees and those no longer employed by the Agency should be kept on file for seven years at the agency and with the HMIS Administration Team.

Statement of Confidentiality. Staff, volunteers, and any other persons with access to the Homeless Management Information System (HMIS) are subject to certain guidelines regarding its use. HMIS contains a wide range of personal and private information on individuals and all such information must be treated carefully and professionally by all who access it. Guidelines for use of HMIS include: • Personal User Identification and Passwords must be kept secure and are not to be shared. • Informed client or guardian consent, as documented by a current Authorization to Release form, is required before entering, updating, editing, printing, or disclosing basic identifying information via the HMIS. • Informed client or guardian consent, as documented by a current Authorization for Release of Information with a HMIS clause, is required before entering, updating, editing, printing, or disclosing information beyond basic identifying non-confidential information. • Confidential information obtained from the HMIS is to remain confidential, even if my relationship with my employer changes or concludes for any reason. • Only individuals that exist as clients under the Agency jurisdiction may be entered into the HMIS. • Misrepresentation of the client base by entering known, inaccurate information is prohibited. • Discriminatory comments based on race, color, religion, national origin, ancestry, handicap, age, sex, and sexual orientation are not permitted in the HMIS. Profanity and offensive language are not permitted in the HMIS. • The HMIS is to be used for business purposes only. Transmission of material in violation of any United States Federal or State of Hawaii regulations or laws is prohibited and includes material that is copyrighted, legally judged to be threatening or obscene, and considered protected by trade secret. The HMIS will not be used to defraud the Federal, State, or local government or any individual entity or to conduct any illegal activity. • Any unauthorized access or modification to computer system information or interference with normal system operations will result in immediate suspension of your access to the HMIS. Your signature below indicates your agreement to comply with this statement of confidentiality. Submit a completed agreement to the Department of Human Services (DHS), Benefit, Employment, and Support Services Division (BESSD) in order to receive a new employee user code. Employee: Executive Director: Signature Date Signature Date Printed Name Date Printed Name Date HMIS User Agreement Forms for current employees and those no longer employed by the Agency should be kept on file for seven years at the agency and with the HMIS Administration Team.. Bridging the Gap Training Request Form (Please type or clearly print all information) Today’s Date: New User’s Full Name: New User’s Company Email Address: Supervisor’s Name: Supervisor’s Email Address: Agency Name: HMIS Program Name: Island: Hawaii Kauai Maui Training Day Preference (please select your 1st and 2nd choice): Monday Tuesday Wednesday Thursday Friday Training Time Preference: 9am-12pm or 1:30pm-4:30pm * We will do our best to accommodate your preferences. **To be completed by supervisor (please respond either “Yes” or “No”): New HMIS user will enter program enrollments New HMIS user will enter VI-SPDAT assessments New HMIS user will need access to Coordinated Entry (pulling and/or updating client referrals) New HMIS user will not enter program enrollment or VI SPDAT assessments

Statement of Confidentiality. Staff, volunteers, and any other persons with access to the Homeless Management Information System (HMIS) are subject to certain guidelines regarding its use. HMIS contains a wide range of personal and private information on individuals and all such information must be treated carefully and professionally by all who access it. Guidelines for use of HMIS include: • Personal User Identification and Passwords must be kept secure and are not to be shared. • Informed client or guardian consent, as documented by a current Authorization to Release form, is required before entering, updating, editing, printing, or disclosing basic identifying information via the HMIS. • Informed client or guardian consent, as documented by a current Authorization for Release of Information with a HMIS clause, is required before entering, updating, editing, printing, or disclosing information beyond basic identifying non-confidential information. • Confidential information obtained from the HMIS is to remain confidential, even if my relationship with my employer changes or concludes for any reason. • Only individuals that exist as clients under the Agency jurisdiction may be entered into the HMIS. • Misrepresentation of the client base by entering known, inaccurate information is prohibited. • Discriminatory comments based on race, color, religion, national origin, ancestry, handicap, age, sex, and sexual orientation are not permitted in the HMIS. Profanity and offensive language are not permitted in the HMIS. • The HMIS is to be used for business purposes only. Transmission of material in violation of any United States Federal or State of Hawaii regulations or laws is prohibited and includes material that is copyrighted, legally judged to be threatening or obscene, and considered protected by trade secret. The HMIS will not be used to defraud the Federal, State, or local government or any individual entity or to conduct any illegal activity. • Any unauthorized access or modification to computer system information or interference with normal system operations will result in immediate suspension of your access to the HMIS. Your signature below indicates your agreement to comply with this statement of confidentiality. Submit a completed agreement to the Department of Human Services Partners In Care (DHSPIC), Benefit, Employment, and Support Services Division (BESSD) Data Manager in order to receive a new employee user code. Employee: Executive Director: Signature Date Signature Date Printed Name Date Printed Name Date HMIS User Agreement Forms for current employees and those no longer employed by the Agency should be kept on file for seven years at the agency and with the HMIS Administration Team.