Homeless Management Information System (HMIS) Notice of Privacy Practices
Effective 10/2022
Version 4.0
The purpose of this notice is to explain to you why we collect personal information from you and refer you to the HMIS Statement of Privacy Practices for additional information regarding how this information may be used or disclosed.
When you request services from this agency, we enter information about you, and members of your family, into a computer system, called the Homeless Management Information System (HMIS). We collect personal information directly from you for reasons that are discussed in our HMIS Statement of Privacy Practices. We may be required to collect some personal information as required by the United States Dept of Housing and Urban Development (HUD), by law, or by organizations that this agency funds to operate this program. The personal information we collect is important to run our programs, to improve services for homeless, or those at risk of homelessness, individuals and families.
We may use or disclose your information to provide you with services. We may also use or disclose your information to comply with legal and other obligations. We assume that you agree to allow us to collect information, and to use or disclose it, as described in the HMIS Statement of Privacy Practices.
You can inspect personal information about you that we maintain, as provided in the HMIS Statement of Privacy Practices. You can also ask us to correct inaccurate or incomplete information. Please contact the Case Manager, agency Site Administrator, or Executive Director of the agency who entered the data to make this request.
Please read the HMIS Statement of Privacy Practices for additional information. You will be provided with a copy of the HMIS Statement of Privacy Practices upon request.
HMIS STATEMENT OF PRIVACY PRACTICES Effective: 10/2022
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
IHCDA’s Homeless Management Information System (HMIS)
When you request services from this agency, we will enter information about you and your family into the Homeless Management Information System, a computer database commonly referred to as “HMIS”. This HMIS is administered by the Indiana Housing and Community Development Authority (“IHCDA”). The HMIS is used by many agencies throughout the state of Indiana that provide services to persons and families in need. The information collected in the HMIS will help us reduce duplicate intakes, document the need for services, provide historical information, and generate reports in order to comply with federal requirements and expectations.
How your information in the HMIS may be used or disclosed
Unless restricted by other laws, your information will be used as follows:
Exercising your rights regarding your information in the HMIS
You can exercise these rights by making a written request to this agency, or by making a written request to IHCDA. The addresses are listed at the end of this notice.
Enforcement of your privacy rights:
If you believe your privacy rights have been violated, you may send a written complaint to this agency. If your complaint is not resolved to your satisfaction, you may send your written complaint to IHCDA. Addresses are listed at the end of this notice. You will not be retaliated against for filing a complaint. This agency is required by law to maintain the privacy of your Protected Personal Information (PPI), and to display a copy of the most recent HMIS Notice of Privacy Practice (“Notice”). This Agency reserves the right to change this Notice from time to time, and if it does, the change will affect all the information in the HMIS, not just the information entered after the change. The revised Notice will be posted by this Agency. You may request a copy of it from this Agency or IHCDA.
[INSERT AGENCY NAME AND ADDRESS HERE]
Agency Name: Telephone: Facsimile: Email:
INDIANA HOUSING AND COMMUNITY DEVELOPMENT AUTHORITY
30 S. Meridian St., Suite 900 Indianapolis, IN 46204
Attn: Grant O. Peters, HMIS Manager
Re: HMIS Protected Personal Information (PPI)
Agency Name: InnerMission Inc
Telephone: 219-933-7013
Facsimile: 219-933-7013
Email: IM@thegateonline.net
INDIANA HOUSING AND COMMUNITY DEVELOPMENT AUTHORITY 30 S. Meridian St., Suite 900 Indianapolis, IN 46204 Attn: Grant O. Petes, HMIS Manager Re: HMIS Protected Personal Information (PPI)
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