Update HMIS Participating Agency Contacts
A few staff members at your agency play key roles in managing your organization's use of the HMIS and serve as main points-of-contact for RTFH on various HMIS issues. New agencies have to identify which staff members will play each of these roles and all agencies are asked to update the list of HMIS contacts on a regular basis.

Please review the HMIS-related roles described below, confer with your team and - once you have designated the most appropriate choice of staff member for each role - provide the name and contact information for the staff member at your agency who will serve in that role by filling out the form below.

If you have questions or would like guidance from RTFH on the best individual for each role, please email Support at support@rthfsd.org.

Thank you!
HMIS Tech Team
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Agency Name *
Agency Administrator
The Participating Agency Administrator shall be responsible for:

Reviewing the Participating Agency’s Privacy and Security Policies to ensure consistency with the HMIS Privacy and Security Policies and Procedures;

Providing oversight of all personnel who generate or have access to client data in the HMIS for HMIS Policy & Procedure compliance;

Serving as the primary contact between end-users and the HMIS System Administrator;

Providing Participating Agency technical support by troubleshooting data and escalating unresolved issues to the HMIS System Administrator;

Notifying members of their Participating Agency of any system-wide changes and other relevant information;

Offering training support to Participating Agency end-users when approved by the HMIS Lead Agency (ex. “Train-the-Trainer”);

Notifying the HMIS Lead Agency of Participating Agency personnel changes

Monitoring compliance with standards of confidentiality and data collection, entry, and retrieval related to the HMIS;

Ensuring all authorized end-users are trained before being granted access to the system and are adhering to the HMIS User Agreement (Appendix B);

Ensuring Participating Agency adherence to internal Privacy and Security Policies and Procedures and contractual privacy and security procedures;

Making continuous efforts to detect violations of privacy and security of the HMIS and respond to any indication or report of violations; and

Providing the name and contact information of the Participating Agency’s Security Officer.
Name *
Job Title *
Email address *
Backup Agency Administrator
A backup point-of-contact in case the primary administrator cannot be reached/is out of-the-office. Responsible for fulfilling the same responsibilities as the agency administrator when he/she is not available and has designated the backup agency administrator to fulfill one or more duties.

The backup agency administrator should be a staff member at your agency who is familiar or can become familiar with using the HMIS and advising staff member on its use.
Name *
Job Title *
Email address *
Security Officer
The Participating Agency Security Officer is responsible for ensuring compliance with the security standards outlined in the HMIS Policies and Procedures.

Responsibilities include but are not limited to:
• Review and testing the Participating Agency’s security practices for compliance;
• Certify the Participating Agency’s adherence to the HMIS Security Policy and Procedures;
• Develop mitigation plans for identified security shortfalls including milestones;
• Demonstrate reduction in risk over time;
• Complete HMIS Security Certification Checklist and submit it within thirty (30) days of its due
  date to the HMIS Security Officer;
• Communicate any security questions, requests, or security breaches to the Participating Agency Administrator;
• Communicate security-related HMIS information relayed from the HMIS Security Officer to the Participating Agency end-users;
• Manage the security of hardware and software used to access HMIS data
Name *
Job Title *
Email address *
Billing Contact
Agency staff person who RTFH should direct billing inquiries to for HMIS user license fees.
Name *
Job Title *
Email address *
Are there any additional staff members you would like us to copy to email communications regarding HMIS? *
Name *
Job Title *
Email Address *
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