Conflict of Interest Disclosure Form

Mines Conflict of Interest Policy (COI) is applicable to employees in the performance of their Institutional Responsibilities and the use of Mines facilities and equipment.  Read the Mines Conflict of Interest Policy.

Conflict of Interest Disclosure Form

There are two types of disclosures that employees generally will make to Mines:  (1)  disclosure of actual or potential conflict of interest and (2) disclosure of conflict of interest regarding commitment to Mines. Disclosures of actual or potential conflicts of interest/commitment are required within 30 days of hire and at least annually. The disclosure form is available here: Conflict of Interest FormPDF version.

Where to submit forms?

  • All completed disclosure forms should be emailed to compliance@mines.edu or mailed to the Office of Compliance at 1600 Jackson Street, Suite 240.
Please download the form and use the “save as” feature. Save with a file name in the following format:  firstname.lastname. When the form is complete email it to: compliance@mines.edu

Tip for Mac users: There is an issue with saving the Form with Preview, so please use Adobe Pro/Reader to open and complete the form.
Options to get around the issue:

  1. Send screen shots of the completed pages
  2. Use Adobe Acrobat/Reader to complete the form, or
  3. If using Preview, after filling in the form:
                       Choose File Menu, Select Print, and then use the Dialog Box’s PDF Option—Save to PDF.

Training

Mines faculty and staff responsible for research may obtain the required COI training through the CITI Program. This training must be completed every four (4) years by each principal investigator (PI) and the faculty and staff that are responsible for the design, conduct, and/or reporting of research.

  • To take the training, go to the website (CITI Program) and sign in via SSO.
  • First time completing the training? Expand the section below for easy step-by-step directions to complete the training.
  • The CITI training allows you to start and stop the modules as needed, and it will retain your progress.  There are two (2) required modules included in the BASIC course, including:
    • Financial Conflicts of Interest: Overview, Investigator Responsibilities, and COI Rules (ID: 15070)
    • Institutional Responsibilities as They Affect Investigators (ID: 15072)
  • When you have completed the required modules, please print a copy of your certification for your files and email a copy to compliance@mines.edu.  This training must be updated at least every four (4) years or if there is a change to our policy.

Directions for CITI Program COI training

There are three easy steps to completion:

  1. Training: Follow the step-by-step directions to use the CITI training system found below.
  2. Disclosure Form: Fill out the Disclosure Form and sign.
  3. Submit Disclosure Form: Send the completed Disclosure Form to Compliance & Policy Office (compliance@mines.edu).

  • NEW USER: A new CITI user should go to the “SSO Login” box and click. Then they are redirected to university selection, pick Colorado School of Mines from the list and click. Last, enter your normal Mines user name and password. This will create their account and affiliation automatically.
  • EXISTING USER: If the user already has a CITI account, then they perform the steps above (using SSO Login) along with selecting the one time only “self-match” and log-in again one time with their CITI credentials. The system should automatically affiliate their existing account with Mines if they self-match.

  1. Go to the CITI Program homepage and click “Register” in the top right-hand corner.
  2. In “Select Your Organization Affiliation” type in Colorado School of Mines (SSO).
    1. Select the “Colorado School of Mines (SSO)” option in the drop down menu.
    2. Check the I AGREE & I AFFIRM boxes that appear.
    3. Click “Continue to SSO login/Instructions”.
  3. It will then automatically bring you to the Single Sign On page for Mines – enter your Mines Credentials (username & password).
  4. The next screen will ask you if you already have a CITI Program account, choose the correct option for you (If you’ve never used this training program before, please select the option to create “A New CITI Program Account”).
  5. Once the next screen loads (where it says “Welcome, (your name)” in the left hand corner), click the blue “View Courses” button.
  6. On the next page, click “Add a Course”.
  7. Answer Question 1-4 based on your needs (you MUST answer “Yes” to Question 4 to gain access to the required COI courses).
  8. Your profile page will load again and you’ll see that the “Conflicts of Interest” course is now available for you to start.
  9. Click “Start Now”.
  10. You will then see the two required modules.
  11. Click “Start” next to begin the first available Required Course.
  12. You’ll start the Financial Conflicts course first, then begin on the Institutional Responsibilities course afterward.

Conflict of Interest Definitions

  • Conflict of Commitment means when an employee’s external commitments or activities (such as professional consulting, other business interests, or personal pursuits) substantially interfere with, or impede, the employee’s ability to satisfy Institutional Responsibilities and commitments to Mines.
  • Equity means an interest or stake in an entity including, but not limited to: stock, stock options, warrants, or any security representing ownership/stake in an entity.
  • External Employment and Services means employment or services undertaken by an employee for compensation from an individual or entity outside Mines including but not limited to arrangements whereby the employee provides goods or services to external businesses or individuals, paid board appointments, paid speaking engagements, etc.
  • Foreign Entity includes country, regional, or local level foreign governments, foreign corporations (private, public and non-profit), foreign universities and foreign research institutes/centers.
  • Immediate Family means any family member with whom you have a close relationship that could influence your judgment.  Immediate Family includes, but is not limited to, spouse, domestic or civil union partner, parents, siblings, and children.
  • Institutional Responsibilities means professional responsibilities performed on behalf of Mines (e.g., research, scholarship, education, and service). Examples include, but are not limited to, activities such as research, research collaborations, other sponsored programs such as continuing education training, program development, etc., teaching, work on scholarly publications, responsibilities for financial and transactional activities, and service on institutional committees.
  • Non-Remunerative External Commitment means continual volunteer service, and external professional service or development activities such as participation in professional societies or organizations, participation in review boards or accreditation efforts for other institutions, etc. The term “continual” means more than sporadically.
  • Professional Consulting means the provision of professional advice or services to external constituents with or without remuneration.

Additional Resources

For any questions, please email compliance@mines.edu.  

Contact us

Compliance and Policy Office

compliance@mines.edu

1600 Jackson Street
Suite 240
Golden, CO 80401

FAQs

Policy

When were COI policies updated?
In December 2014, new federal regulations regarding the governance of federally-funded research became effective (Uniform Guidance). This guidance mandates stricter requirements for award recipients to monitor sub-recipient compliance with federal regulations, including Conflict of Interest (COI). In response to requests by prime award recipients to verify our compliance with federal regulations, we have updated our COI policies and practices to ensure federal requirements are met.

What is the difference between an Actual COI and a Potential COI?
A Conflict of Interest is a situation in which financial or other personal considerations have the potential to compromise or bias professional judgment and objectivity. A Potential Conflict of Interest is a situation in which a reasonable person would think that the professional’s judgment is likely to be compromised. A Potential COI may develop into an Actual COI when a faculty member has a significant financial interest that competes with or is adverse to the individual’s Institutional Responsibilities.

Does the Faculty Handbook address Conflict of Interest?
Yes. Section 6PDF version of the Faculty Handbook describes Actual and Apparent or Potential Conflict of Interests. The Handbook also addresses what is not a Conflict of Interest.

What are Institutional Responsibilities?
Institutional Responsibilities refer to the faculty member’s professional responsibilities on behalf of Mines. Typically, these include the performance of duties related to research, scholarship, education, and service.

What is the purpose of the COI Policy and Disclosure at Mines?
Mines adopted a policy that follows the requirements of federal regulations and ties into the receipt of federal dollars by Mines. The COI requirements promote objectivity in research by establishing standards that provide a reasonable expectation that the design, conduct, and reporting of research at Mines under grants or cooperative agreements will be free from bias resulting from Investigator financial conflicts of interest.

Who has to comply with the COI Policy at Mines?
All faculty must submit a Disclosure to comply with Mines policy. Additionally, any faculty, staff, student-employee or student, volunteer, or collaborator (as well as sub-recipients) must comply with Mines’ policy if they are involved in designing, reporting, and/or conducting of the research in any fashion.

Disclosure

When do I submit the Disclosure?
The Disclosure must be submitted within 30 days of hire and at least annually thereafter by the faculty member.

Who will see my Disclosure?
The Disclosure will be submitted to the Institutional Official designated for review and compliance with the Policy, the Director of the Office of Compliance and Policy. Additionally, there is the possibility that the appointed members of the Mines’ Conflict of Interest Committee will see the Disclosure if necessary for oversight of the process or management of a conflict. This document is considered part of the personnel file and not open to the public.

What is in the Disclosure Form?
The annual Conflict of Interest Disclosure statement contains information regarding the faculty member name, department, contact, and status of employment. The form requires basic information regarding faculty involvement in the following categories: compensation/remuneration for external work, equity interests in external organizations, intellectual property disclosure external to Mines, travel reimbursement by external organizations and service on boards or in external organizations. The Form also provides space for additional information where the disclosure impacts the faculty member’s Institutional Responsibilities. The form is available herePDF version.

Do I have to submit/supply my Social Security Number or Account Numbers on the Disclosure Form?
No. The form does not require that specific information and may not be necessary to this process.

How do I submit the Disclosure form?
The original form should be completed, printed and delivered to the Office of Compliance and Policy at 1600 Jackson Street, Suite 240. We recommend that you retain a copy of the Disclosure form for your records.

Will I be required to disclose everything I own or invest in outside of Mines?
No. The Disclosure of assets excludes pooled or managed in Mutual Funds that the faculty.

What happens if I do not file my annual or updated Disclosure?
The Disclosure is required as part of the annual Faculty Data Reporting (FDR) process and the Department Head/Deans of each college are required by policy to confirm that the Disclosure was filed. Failure to file the Disclosure will be brought to the DH/Dean’s attention by the Institutional Official. Additionally, receipt of federal dollars may be stopped during any period where the faculty member fails to have current filings with the Compliance and Policy office.

Who do I contact with questions?
Please contact the Compliance System & Policy Manager to discuss questions or procedures regarding the process.

Does the Disclosure Form just cover me or does the Disclosure cover others in my family/home?
The faculty member or Mines’ person participating in the design, report, or conduct of research must disclose for themselves and their spouse and dependent children when completing the Disclosure Form.

Am I required to disclose interests in mutual funds or retirement accounts? (Institution and Investigator)
Maybe. The 2011 revised regulation does not require the disclosure of income from investment vehicles, such as mutual funds and retirement accounts, as long as the Investigator does not directly control the investment decisions made in these vehicles.

Do I have to disclose foreign investments (shares in foreign corporations/organizations)?
Maybe. Foreign investments, just like domestic investments, must be considered when filling in the Disclosure Form. Financial interests are defined as “anything of monetary value, whether or not the value is readily ascertainable.” Any financial interest that meets the definition of “Significant Financial Interest” must be disclosed.

What kind of documentation is required with the Disclosure Form I submit?
The Disclosure Form requires responses and listing of interests that meet the policy. Additionally, documentation may be requested on a case-by-case basis by the Institutional Official or the COI Committee, if necessary.

Does this Disclosure form work for Conflict of Commitment?
No. The form is meant to address Actual or Potential Conflict of Interests regarding remuneration, asset or value. Time out of office for activities such as Consulting are addressed through your Department Head or Supervisor. Please see Academic Affairs’ additional professional work forms.

Conflict & Management

If I disclose an Actual or Potential COI on the form, does that prevent me from performing research or other work at Mines?
Not necessarily. Any disclosure will be reviewed for conflicts with the Institutional Responsibility of the faculty or employee. Most Actual or Potential COIs will be submitted for a Management Plan.

What is a “Management Plan”?
A Management Plan is a written plan between the faculty/disclosing party and the Institutional Official to describe the issues and how those problems will be managed. Some key elements of the Management Plan include the following:
(A) The role and principal duties of the conflicted Investigator in the research project;
(B) Conditions of the Management Plan;
(C) How the Management Plan is designed to safeguard objectivity in the research project;
(D) Confirmation of the Investigator’s agreement to the Management Plan;
(E) How the Management Plan will be monitored to ensure compliance; and
(F) Other information as needed.

What might a Management Plan include or require?
How an Institution manages COI policies and procedures. Some possible examples of conditions or restrictions that might be imposed to manage a Conflict of Interest include, but are not limited to: Public disclosure of financial conflicts of interests (e.g., when presenting or publishing the research; to staff members working on the project; to the Institution’s committee or relevant oversight board(s), etc;) For research projects involving human subjects research, disclosure of financial conflicts of interest directly to participants; Appointment of an independent monitor capable of taking measures to protect the design, conduct, and reporting of the research against bias resulting from the Financial Conflict of Interest; Modification of the research plan or project; Change of personnel or personnel responsibilities, or disqualifications of personnel from participation in all or a portion of the research; Reduction or elimination of the financial interest (e.g., sale of an equity interest); or Severance of relationships that create financial conflicts.

When does a Conflict of Interest arise?
A Conflict of Interest arises when a faculty member has or represents a Significant Financial Interest that competes with, or is adverse to, the individual’s Institutional Responsibilities. Where a personal bias or consideration does or has the potential to compromise the faculty member’s professional judgment, the conflict that arises may adversely impact the institution’s research, instructional or administrative programs or operations. See Faculty Handbook Section 6 for further explanation.

Training

What kind of training is required by the policy?
Each person must complete the required training through the CITI Program website at least every 4 years, or with a change in the COI policy. You may go to the Training Website and log in to the “Log in through my institution” via SSO (Single Sign-On) block. This log-in will allow you to use your Mines username and Mines password without remembering another password. Additionally, you can stop and re-start the training as needed and your completion should be saved in the system.

Is the COI training the same at other colleges and universities?
Yes. At least 80 universities use the CITI Program training for required modules. Mines also uses the Human Subjects Research catalog to meet the training requirements for ethics and understanding in research. (CITI stands for the Collaborative Institutional Training Initiative at the University of Miami.)

Do sub-recipients or collaborators on a project have to submit a Disclosure to Mines?
Maybe. If the project is federally-funded to Mines, then Mines as the awardee institution must ensure that sub-recipients comply with all regulations and required reporting of Conflict of Interest. The home institution may require compliance with a specific program or the sub-recipient may comply with the Mines program. For more information, please contact your grant administrator in the Office of Research Administration or the Compliance & Policy Office.

Other

How long are the records retained by Mines?
The Institutional Official must retain the records at least during the period of the funding plus three (3) years following the final reporting.

Do Administrative Faculty need to fill out the Conflict of Interest forms?
Yes, the policy applies to all faculty. Administrative faculty involved in the design, reporting, or conducting of research or any of the support processes, such as research administration, purchasing, etc., should provide a Disclosure within 30 days of hire and annually thereafter.

Should teaching faculty take the training and complete the Disclosure?
Yes. All Academic Faculty should complete the training and disclosure. The training is from a research perspective, but it still has excellent information and resources for everyone.

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