Fillable NW Social Service Connections (City of Portland)

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NW Social Service Connections (City of Portland)

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NW Social Service Connections
User Agreement
NWSSC CMIS/HMIS Page 1 of 2 Legal Review 12/28/2010
Released 01/12/2011
User name: ____________________________ Organization:_____________________________
Email: ___________________________________________________________________________
Statement of Confidentiality
Employees, volunteers, and any other persons with access to NW Social Service Connections CMIS/HMIS
are subject to certain guidelines regarding use of ServicePoint
TM
. ServicePoint
TM
contains 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 ServicePoint include:
• The User shall comply with all data standards and policies and procedures.
• ServicePoint
TM
User Identification and Passwords must be kept secure and are not to be shared.
• Information obtained from ServicePoint
TM
is to remain confidential, even if my relationship with
______________ changes or concludes for any reason.
• The CHO must post a privacy notice describing its policies and practices for the processing of PPI.
The User must offer to explain any information that the individual does not understand, and must
provide a copy of its privacy notice to any individual upon request.
• Informed client or guardian consent, as documented by a Release of Information form, is required
for any data sharing, or disclosure of identifying information and service transactions via
ServicePoint
TM
.
• If a client or guardian chooses not to sign Release of Information form, all client information must be
closed with no exceptions
• Only general, non-confidential information is to be entered in the “other notes/comments” section
of the Client Profile on ServicePoint
TM
. Confidential information, including TB diagnosis, HIV
diagnosis or treatment information, domestic violence and mental and/or physical health
information, is not permitted to be entered in this section.
• Client records only pertaining to user’s assigned work duties will be accessed.
• Only individuals that exist as clients under the Organization’s jurisdiction may be entered into
ServicePoint
TM
.
• Misrepresentation of the client base by entering known, inaccurate information is prohibited.
• Client records are not to be deleted from ServicePoint
TM
, contact NWSSC CMIS/HMIS System
Administrators for appropriate action.
• Discriminatory comments based on race, color, religion, national origin, ancestry, handicap, age,
sex, and sexual orientation are not permitted in ServicePoint
TM
. Profanity and offensive language are
not permitted in ServicePoint
TM
.
• ServicePoint
TM
is to be used for business purposes only.
• Transmission of material in violation of any United States Federal or State of Oregon regulations or
laws is prohibited and includes material that is copyrighted, legally judged to be threatening or
obscene, and considered protected by trade secret. ServicePoint
TM
will not be used to defraud the
Federal, State, or local government or an individual entity or to conduct any illegal activity.
• Any unauthorized use, access or unauthorized modification to ServicePoint
TM
computer system
information or interference with normal system operations will result in immediate suspension of
your access to ServicePoint
TM
and may jeopardize your ServicePoint access and/or your employment
status.
NW Social Service Connections
User Agreement
NWSSC CMIS/HMIS Page 2 of 2 Legal Review 12/28/2010
Released 01/12/2011
• ServicePoint
TM
shall only be accessed from the Organization’s network, desktops, laptops, mini-
computers and any other electronic devices that are web capable. In special circumstances access
from remote locations may be permitted after application and approval by both the Agency and
System Administrators.
• The User is expected to physically enter the password each time he or she logs on to the system. DO
NOT Save passwords in auto-complete settings.
• Should the User download client identifiable information in any format, he or she will securely store
and/or dispose of all electronic and hardcopy in a manner to protect the client’s personal
information. At a minimum
this will require the use of strong password protection, preferably
including encryption.
• This agreement will be superceded by any additional or alternative agreements presented by
NWSSC CMIS/ HMIS System Administrators.
Failure to comply with the provisions of this Statement of Confidentiality may result in the termination
of the User License or Agency Participation. Your signature below indicates your agreement to comply
with this statement of confidentiality. There is no expiration date of this agreement, and may be
renewed when System Administrators see the need.
______________________________ ______________________________ ______
Signature Witness Signature Date
______________________________ ______________________________ ______
Printed Name and Title Witness Printed Name and Title Date
The User Agreement/Statement of Confidentiality should be kept on file at the Organization or returned
to the appropriate lead organization when requested. Forms for individuals no longer employed by the
Participant should be kept on file for seven years following date of termination. System Administrators
may, at any time, monitor compliance.
NWSSC CMIS/HMIS System Administrator
Wendy Smith
Portland Housing Bureau
421 SW 6th Ave, Suite 500
Portland, OR 97204
503-823-2386
wendy.smith@portlandoregon.gov
Internal Use Only:
Login _______________________________ Login Provider ____________________________
Access Level _________________________ ART License _______________________________
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NW Social Service Connections (City of Portland)

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Completed 25 January 2022

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