Attached is the form used by STEP program for collecting data for entry into HMIS and for Application to the STEP program. This includes applicant certification and information release.
This sample form includes the March 2010 HUD Universal Data Elements (To be used effective June 1 2010) plus the current Maine extended UDE / Point-in-Time questions.
Who needs this?
A one page form to collect all of the basic information required to be collected by Maine Homeless Shelters. Shelters and others who are required to collect the HUD Universal Data Elements should use this or a similar form to assure that all the required data is collected.
Click here to download: hmis_me_ude_2010_intake_form_sample
The new HUD HMIS “rule book” is out.
Final Revised HMIS Data Standards March 2010 - 03/29/2010
We will be doing training to cover the changes (once we have digested them and understand what it all means).
( http://www.hmis.info/Resources/7523/Resource-Final-Revised-HMIS-Data-Standards-March-2010.aspx )
The HPRP eligibility field now has a new pick list choice, “Meets FED HPRP guidelines but NOT sustainability”. This should be used to identify clients who meet general guidelines but who are unlikely to meet state sustainability guidelines.
Note: this field is not used to filter the QPR. The QPR is based on entry/ exit dates for an HPRP program, the Homeless Status field, and the presence of one or more HPRP services during the quarter.
This form is official form for the Maine HPRP intake screening process. It includes the HUD universal data elements with pick-list values plus the HPRP specific intake screening questions and fininancial intake information. It is Designed for use by grantee programs processing HPRP intakes.
Download: HPRP_ME_Eligibility_Screening_form_v1.0
Agency Paticipation Agreement
If your agency would like to participate in the Maine HMIS, the Agency Participation Agreement is the first form you will need to complete. The agreement covers the areas of: terms of use, training and technical assistance, confidentiality, security, and access to data. This agreement should be signed by an official who is authorized to enter into contractual agreements on your agency’s behalf.
Click here to download: HMIS Agency Participation Agreement
Agency Information Form
After your agency has agreed to participate in Maine HMIS, please take some time to tell us about the types of housing and services that your agency provides. This will assist the Maine HMIS administrators when configuring your agency in HMIS.
Click here to download: Agency Information Form
User Policy and Agreement
Once your agency is set up in HMIS, it would be helpful if users could login to enter data and run reports on behalf of the agency. All users must read, acknowledge and sign the HMIS/ServicePoint User Policy, Responsibilities Statement, and Code of Ethics before they are allowed access to the HMIS system.
Click here to download: Addendum_E_HMIS User Policy July2010rev
Virtual Office Acceptable Use Policy
Maine HMIS provides automated agency reports that demonstrate HMIS participation, monitor data completeness and data quality, and document shelter funding via a secure portal called the Virtual Office. Authorized agency users may have access to the reporting portal after they have completed and agreed to the Acceptable Use Policy for the secure reporting site.
Click here to download: Virtual Office Acceptable Use Policy Agreement
HUD standards require that each participating program must make information regarding the organization’s privacy and confidentiality practices available to clients. This sample privacy brochure covers privacy and confidentiality in much the way similar brochures cover medical confidentiality in a doctor’s office.
Download from here: HMIS Privacy Brochure DRAFT SAMPLE
