CONFLICT OF
INTEREST OR COMMITMENT POLICY
INTRODUCTION
Employees of
POLICY STATEMENT
University employees shall not realize personal gain in any form which would influence improperly the conduct of their University duties. Employees shall not knowingly use University property, funds, position or power for personal or political gain. Employees must notify their supervisor(s) in writing of reasonably foreseen potential conflicts. Conduct by an employee that violates the University policies may lead to disciplinary action.
Definitions:
Conflict of interest exists when an employee is in a position to influence any University business transaction, research activity or other decisions in ways that could lead to any manner or form of personal gain for the employee, or for his/her family members, other than salary from Northeastern State University, regardless of source.
Conflict of Commitment is an activity that interferes with an employee’s ability to carry out his/her duties effectively. External employment, or self-employment in an employee’s profession or specialty, is permitted where there is not a conflict of interest or commitment. Employees on a full-time appointment are compensated for full-time employment and outside or dual employment or other activity, whether compensated or not, that substantially interferes with the performance of an employee’s University duties and responsibilities is a conflict of commitment and as such is not permitted.
Employees include all paid members of the University community including faculty, administrators, appointed personnel, classified staff and student employees, whether full-time, part-time or contract employees.
Immediate family, whether by blood or marriage, includes (1) spouse (2) parents, (3) children, (4) siblings, (5) in-laws, (6) any other individuals residing in the same household, or having a relationship with, the person covered by this policy.
Personal gain is defined as an increase in monetary or other tangible resources, promotion or achievement awards or job placement, preferential treatment in the work environment or other advantages to an employee or immediate family member due to a conflict in interest or commitment.
EXAMPLES of CONFLICT of INTEREST REQUIRING DISCLOSUREPROHIBITED ACTIVITIES:
The following activities are prohibited :PERMISSIBLE ACTIVITIES:
REPORTING OF
POTENTIAL CONFLICTS
Self-Disclosure
Reporting of
Potential Conflict by Others
Review of
Potential Conflicts of Interest and Commitment
CONFLICTS OF INTEREST LAW:
FREEDOM OF EXPRESSION AND ACADEMIC FREEDOM:
This policy does not purport to
prohibit expressive conduct protected from severe sanctions, punishment, or
other undue burdens by the Constitutions of the
11/2008
Northeastern State University
Potential Conflict of Interest Self Disclosure
Statement
NSU faculty
and staff are to fully disclose potential conflicts of interest resulting from
direct or indirect outside business, financial, employment, or consulting
interests which are related to their University employment. It is each person’s responsibility to provide
this information to the appropriate University official for review. This form
may also be used by students and vendors to disclose potential conflicts of
interest.
Please complete the following information
and submit it to the Director of Human Resources , 116
Name:
____________________________________ Department:
_________________________
Campus
Address: __________________________________ Campus
phone: ___________________
University
title:_______________________________________________________________________________
Do you have Research involved with any of
the following:
Human Subjects: yes / no
Animals: yes /
no
Please
briefly describe the business, financial interest, outside employment, or
consulting activities that
are raising a
potential conflict of interest. Include names, addresses, nature of interest,
your role at the
University
and how it relates to the outside interest, and any other relevant information.
Feel free to use
additional
sheets if necessary or attach additional documentation.
Nature of
your Interest (check all
that apply)
_______Consulting/Employment
_______Director/Officer/Partner/Agent/Manager/Advisor/Board
Member position
_______Receipt
of Loan/Gift
_______Receipt
of Honoraria
_______Receipt
of Royalty Revenue/Patent Holder
_______Research
Support
_______Other
(describe)
I attest to the accuracy of these answers
and, should circumstances change in the future, I will contact the Director of
Human Resources to appropriately update
this disclosure statement.
Signature: _________________________________________Date:_____________________
Print
Name_________________________________________
I approve this disclosure filing.
Supervisor /
Department Chair
Signature: _________________________________________Date:_____________________
Print
Name_________________________________________
Divisional Dean / Director
Signature: _________________________________________Date:_____________________
Print
Name_________________________________________
POTENTIAL REVIEW QUESTIONS
for COMMITTEE USE
·
Are
financial interests in the outside entity/activity disclosed that support any
of the research or training activities?
_____YES
_____NO
·
Are
outside activities (employment, consulting, management and other contractual
activities) with the outside entity/activity disclosed that support any of the
research or training activities?
_____YES
_____NO
Please
briefly describe the outside activity, estimate the hours per week spent and
total number of weeks.
·
Is
compensation for teaching/speaking at
educational programs sponsored by the outside entity/activity disclosed?
_____YES
_____NO
·
Is
travel and personal expense support for
teaching/speaking at educational programs sponsored by the outside
entity/activity disclosed?
_____YES
_____NO
·
Is
compensation for consultation services
from the outside entity/activity disclosed?
_____YES
_____NO
·
Does
the outside entity/activity disclosed hold a license agreement(s) with the
University relating to an invention or software.
_____YES
_____NO
·
If
this disclosure is related to a new research project, will the outside
entity/activity disclosed hold any rights to research and/or inventions for
discoveries associated with this project?
_____YES
_____NO
·
Is
the outside entity/activity disclosed imposing restrictions on the
disseminations of research results?
_____YES
_____NO
If
yes, please describe the restrictions.
·
Are
commercial activities with the outside entity/activity disclosed that are
related to University responsibilities (i.e. vendor selection, purchasing,
sponsored projects, teaching, etc)?
_____YES
_____NO
·
Does
the activity require or involve the use
of a sole-source vendor agreement for the outside entity/activity disclosed?
_____YES
_____NO
·
Does
the reporting entity supervise, select
or evaluate services provided to the University by the outside entity/activity
disclosed?
____YES
_____NO
·
Is
University business referred to the
outside entity/activity disclosed?
_____YES
_____NO
·
Do
any University activities sponsored by the outside entity/activity disclosed
involve technology developed at the University and which is now owned by or
contractually obligated to the outside entity/activity disclosed?
_____YES
_____NO
·
Is
interest in the outside entity/activity disclosed in any publications,
presentations and papers submitted regarding the research
_____YES
_____NO
·
Are/will
any University employees and/or students directly or indirectly supervised be
involved in any activity sponsored by the outside entity/activity disclosed?
_____YES
_____NO
Please
explain the use of University employees/students in activity.
·
When
acting on behalf of the outside entity/activity disclosed, are any students or
University personnel employed or supervised?
_____YES
_____NO
·
Is
the relationship with the outside entity/activity disclosed the type of
activity that could cause an independent observer to be concerned and/or call
into question the integrity of the reporting person and/or the University?
_____YES
_____NO