Conflict of Interest and Confidentiality Agreement

This document applies to any stakeholder engaged with NCOPE in the capacity of: employee, consultant/independent contractor, director/member of the "Board", volunteer, committee member, self-study reviewer, or site visitor. In instances where a statement only applies to a specific role or roles, it will be explicitly stated.

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Select all that apply

Conflict of Interest Policy

In their capacity, all stakeholders engaged with NCOPE defined above must act at all times in the best interests of NCOPE. The purpose of this policy is to help inform those stakeholders about what constitutes a conflict of interest, assist those stakeholders in identifying and disclosing actual and potential conflicts, and help ensure the avoidance of conflicts of interest where necessary. This policy may be enforced against an individual stakeholder as described below.

1. NCOPE stakeholders have a fiduciary duty to conduct themselves without conflict to the interests of NCOPE. In their capacity, they must subordinate personal, individual business, third-party, and other interests to the welfare and best interests of NCOPE.

2. A conflict of interest is a transaction or relationship, which presents or may present a conflict between a Stakeholder's obligations to NCOPE and the Stakeholder's personal, business or other interests.

3. All conflicts of interest are not necessarily prohibited or harmful to NCOPE. However, full disclosure of all actual and perceived conflicts of interest, and a determination by the disinterested members of the Board (or NCOPE Executive Committee) members - with the interested stakeholders recused from participating in debates and voting on the matter - are required.

4. All actual and potential conflicts of interests shall be disclosed to the NCOPE Executive Committee through the annual disclosure form and/or whenever a new potential conflict of interest arises. The disinterested members of the NCOPE Executive Committee shall make a determination as to whether a conflict exists and what if a subsequent action to address it is appropriate. The NCOPE Executive Committee shall inform the Board of such determination and action. The Board shall retain the right to modify or reverse such determination and shall retain the ultimate enforcement authority with respect to the interpretation and application of this policy.

5. On an annual basis, all stakeholders shall be provided with a copy of this policy and required to complete and sign the acknowledgment and disclosure form. All completed forms shall be provided to and reviewed by the NCOPE staff / NCOPE Executive Committee, as well as all other conflict information provided.

In making this decision, an NCOPE stakeholder must consider the possibility of perceived conflict of interest as well as actual conflicts as defined by these
conditions:

1. A close personal, professional or financial interest, or other special relationship, in any institution/program in question.

2. A former candidate for a paid position within the past five years with the entity in question.

3. A position, whether paid or voluntary, current or within the past five years, as a consultant, advisor, or clinical mentor or adjunct faculty, to or for the institution/program in question.

4. A position, whether paid or voluntary, current or within the past five years, as a consultant, advisor or clinical mentor or adjunct faculty, in an institution or residency that is generally viewed by peers and O&P students/residents as a major competitor to the institution/program in question.

If you are employed by an organization that has a developing / accredited orthotic, prosthetic, or pedorthic education program OR a developing / accredited NCOPE residency program, select "Yes" for the following question.

Based upon the definitions and policies defined above, do you have a perceived or actual conflict of interest? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Please select "Yes" if you feel that a COI may be present but you are unsure how if it specifically applies to the policy above

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How many potential conflicts of interest may exist based upon the COI policy? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Conflict of interest 1

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Conflict of interest 2

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Conflict of interest 3

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Conflict of interest 4

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5 or More Potential Conflicts - File Upload {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Provide a separate document that clearly identifies the organization name, city and state in addition to details about the potential conflict in MS Word or PDF format. This form can accept files up to 10MB in size.

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Confidentiality Policy

The following policies apply to all NCOPE Stakeholders defined on the previous page. Topic specific confidentiality statements may be required for certain activities, such as NCOPE site visits for educational and residency programs, standard development meetings, and other committee meetings.

1. Board and Committee Meetings: On any vote of the board, both the numbers of affirmative and negative votes and the individual votes of board members shall be confidential.

2. Board, committee, and staff members shall not disclose to anyone outside of NCOPE the statements, positions, or votes by any board or committee member on actions taken by the board or its committees. The general “sense of the board” on a particular matter may be conveyed to a third party when the sharing of such information is helpful in
conveying the board’s concerns or actions.

3. Executive Sessions: The minutes of the board meeting shall indicate when the board goes into executive session but shall not normally reflect any of the topics or discussion that occurs in executive session. However, when the board takes an action in executive session that needs to be recorded, the board chair will provide any such text that is to be included in the official minutes of the meeting.

4. Board Agendas and Materials: The agendas and all documentation prepared for the board are confidential and should be treated as an internal document restricted to NCOPE use. No portion of the agenda may be shared, in written or oral form, with any individual or with any organization outside of NCOPE. Exceptions may be made only with the consent of the chief executive or Chairman.

5. Personal Information on Staff, Board Members or Residents: The home addresses, telephone numbers, fax numbers and email addresses of board, committee, staff and residents are not to be given out to any individual or organization without the express permission of the person to be disclosed.

6. Program Documentation and Student Files: These documents are considered confidential and are not to be copied or provided to anyone that may verbally request them. Only upon written consent of programs/institutions or residency sites/residents may the entire or portions of the self-study or file be copied and provided to non-board or committee members. Upon the completion of an accreditation decision by CAAHEP/NCOPE, any documents in the possession of a self-study reviewer or site visitor in paper or electronic format must be destroyed. Definitive copies will only be kept on file by the NCOPE Staff using a secure electronic platform.

7. Data Records/Information: Data that is generated through the variety of NCOPE systems is considered confidential. Sharing of data may be appropriate, but the staff member will need to receive permission from the executive director prior to sharing any data reports produced from Accreditation Management Portal, Canvas LMS, Accredible, Netforum, NCOPE Tracker, Typhon, WebAdmit, OPCAS and OPRESCAS.

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Conflict of Interest and Confidentiality Agreement

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Conflict of Interest Policy

1. A close personal, professional or financial interest, or other special relationship, in any institution/program in question.

2. A former candidate for a paid position within the past five years with the entity in question.

3. A position, whether paid or voluntary, current or within the past five years, as a consultant, advisor, or clinical mentor or adjunct faculty, to or for the institution/program in question.

Based upon the definitions and policies defined above, do you have a perceived or actual conflict of interest? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Conflict of interest 1

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Conflict of interest 2

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Conflict of interest 3

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Conflict of interest 4

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Confidentiality Policy

1. Board and Committee Meetings: On any vote of the board, both the numbers of affirmative and negative votes and the individual votes of board members shall be confidential.

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Attestation and Agreement

I have read the NCOPE Conflict of Interest and Confidentiality Policy set forth above and agree to comply fully with its terms and conditions at all times during my service with NCOPE.

If at any time following the submission of this form I become aware of any actual or perceived conflicts of interest, or if the information provided becomes is no longer accurate, I will promptly notify the NCOPE Executive Director in writing and re-submit this form with the correct information.

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Conflict of Interest and Confidentiality Agreement

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NCOPE Stakeholder Rolls/Responsibilities {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Conflict of Interest Policy

1. A close personal, professional or financial interest, or other special relationship, in any institution/program in question.

2. A former candidate for a paid position within the past five years with the entity in question.

3. A position, whether paid or voluntary, current or within the past five years, as a consultant, advisor, or clinical mentor or adjunct faculty, to or for the institution/program in question.

Based upon the definitions and policies defined above, do you have a perceived or actual conflict of interest? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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How many potential conflicts of interest may exist based upon the COI policy? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Conflict of interest 1

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Conflict of interest 2

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Conflict of interest 3

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Conflict of interest 4

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5 or More Potential Conflicts - File Upload {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Confidentiality Policy

1. Board and Committee Meetings: On any vote of the board, both the numbers of affirmative and negative votes and the individual votes of board members shall be confidential.

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Attestation and Agreement

I have read the NCOPE Conflict of Interest and Confidentiality Policy set forth above and agree to comply fully with its terms and conditions at all times during my service with NCOPE.

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