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Miami-Dade County Homeless Trust Homeless
Management Information System
THIS NOTICE DESCRIBES
HOW MEDICAL
AND OTHER INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN
GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We will enter information you provide our agency into a computerized
record-keeping system called HMIS. Local social service agencies use
this system in order to better organize and deliver helpful services to
individuals and families in Miami-Dade County that are homeless. Our
goal is to improve efforts to work together to end homelessness.
Information you provide can play an important role, including:
Help us prioritize, plan, and provide meaningful services for you and
your family;
Allow local agencies to work better together to fight homelessness;
Provide statistics for local, state, and national policy makers to set
effective goals.
IMPORTANT POINTS ABOUT HOW YOUR INFORMATION WILL BE
USED
We will use HMIS to keep an electronic record of your involvement with
our Homeless Continuum of Care, All the rest of your information will be
kept confidential unless you give us specific permission to share it.
With your consent, a portion of the information you provide is shared
between all of the agencies that use this system. The information the
agency will share consists of basic demographic data (e.g., name, last
address, birth date, phone number) and a list of the services and
referrals you receive.
For your protection, protected health information, such as medical,
substance abuse, mental health, HIV, and certain domestic violence
records, and any other records required to be kept confidential by State
or Federal law, will not be shared without a specific release of
information, as required by law, or
court
order.
HOW WILL MY INFORMATION BE KEPT SECURE?
As required by law, we are required to maintain the privacy of your
protected health information and to provide you with notice of our legal
duties and privacy practices, to abide by these practices, and to change
our privacy notice and practices. We may change future versions of this
privacy notice, and if we do change this document within 1 year of your
signing it, you have a right to request a copy of the new notice.
All employees receive training in privacy protection and agree to follow
rules before using the system; any information that could identify you,
like your name or birth-date, will be viewed only by people working to
provide services to you;
KNOW YOUR INFORMATION RIGHTS
As a client receiving services from a Miami-Dade County Homeless Trust
funded agency, you have the following rights:
A. You have the right to place certain restrictions on your records, to
the extent permitted by the Florida Public Records Act.
B. You have the right to receive certain confidential communications
of protected health information.
C. You have the right to view, inspect, and copy your HMIS record.
U. You have the right to change protected health information.
B. You have the right to know which other agencies are receiving your
protected health information.
F. You have the right to request a paper copy of this notice.
Complaints: If you believe your privacy rights have been violated, you
have a right to file a complaint with contact person listed below, or
with The Secretary of the Centers for Medicare and Medicaid, via their
website www.cms.hhs.gov
The contact person to request additional information about your privacy
rights is:
Name: Dr. Sandra Bauman
Title: Director of Programs
Phone: (305) 235-2616
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