Capital Area Alliance for the Homeless

The mission of the Capital Area Alliance for the Homeless is to provide a continuum of care network for the homeless in the Capital Area (comprised of the civil parishes of Ascension, East Baton Rouge, East Feliciana, Iberville, Pointe Coupee, West Baton Rouge, and West Feliciana) through a coordinated body of diverse organizations and individuals.

HMIS Common Documents


LSNDC HMIS User Agreement - v.(2/2012)

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What is the Document Used For?

This document provides the terms and conditions under which the User shall utilize the LSNDC system. This agreement includes policies, code of ethics, and responsibility statements. Any User proven to be in non-compliance of these terms will be immediately terminated from entry processing by the Regional LSNDC System Administrator.

Who Uses the Document?

Every User is required to execute this document in order to gain access to the LSNDC system. A signed copy must be on file with the Agency as well as being forwarded to the Regional LSNDC System Administrator prior to activation of the User ID.

Submit Completed User Agreements Through the Link Below

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LSNDC General Release of Information

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What is the Document Used For?

Provides written documentation identifying the release of information agreements between the Agency and the Client specifically as it relates to LSNDC system entry. Once executed, the Agency maintains the signed document in the Client case file.

Who Uses the Document?

Every Agency utilizing the LSNDC system is required to have a current ROI for every client receiving services.


LSNDC Public Notice of Privacy Policy - v.(2/2010)

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What is the Document Used For?

Provides written posting of the Privacy Policy of LSNDC and the Agency. This document is to be posted near every Client intake location and lobby.

Who Uses the Document?

Every Agency is required to post this document in all lobby and intake locations in plain view of all Clients accessing services.


LSNDC Privacy Notice - v.(12/2012)

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What is the Document Used For?

Provides written documentation to the Client identifying why and how their information is shared within the LSNDC system and also provides instructions on action steps should they feel their data is being misused by an Agency or their agent. Document is not signed by either the Agency or the Client. Agency maintains information in the Client case file that the Privacy Notice was provided to the Client.

Who Uses the Document?

Agencies are required to provide a copy of the Privacy Notice to any Client entering their program, whenever the document is requested. It is the responsibility of the Agency to ensure that the Client understands his/her rights and privileges as it relates to the protection requirements of the data he/she shares through the LSNDC system.


LSNDC Client Grievance Form - v. (2/2010)

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What is the Document Used For?

This document provides a method for a Client to file a grievance in the event they believe their privacy rights have been violated through the use of the LSNDC system.

Who Uses the Document?

Every Agency is required to have this document available in the event that a client wishes to file a grievance against any agency regarding the privacy of their information within the LSNDC system.


LSNDC Release for Confidential Information

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What is the Document Used For?

Provides written documentation identifying the agreement between the Agency and the Client concerning the release to provide or obtain confidential and privileged information for a specified purpose and time frame. If executed, the Agency maintains the signed document in the Client case file.

Who Uses the Document?

Agencies utilizing the LSNDC system are required to execute this document for every client as it relates to physical, mental, substance abuse, HIV, psychotherapy, foster care, and sexually transmitted diseases. This document is supplemental to the General ROI and should only be used when information relating to any of these conditions is to be shared through the LSNDC system.


LSNDC Agency Partner Agreement - v.(12/2017)

Download - Balance of State

Download - Monroe

Download - Northlake

What is the Document Used For?

This document provides the terms of the agreement between the LSNDC, the Regional LSNDC Lead Agency and the Participating Agency regarding the use and management of the LSNDC system. This agreement includes data sharing and confidentiality guidelines.

Who Uses the Document?

Every Agency is required to execute this document in order to gain access to the LSNDC system. A signed copy must be on file with the Agency as well as being forwarded to the Regional LSNDC System Administrator prior to activation of the Agency. A renewal agreement must be signed annually.


Background and Photographs by Weston Schild