ENA Volunteer Group Agreements
Conflict of Interest Policy
Conflict of Interest Disclosure Statement Instructions
- Please read the following Emergency Nurses Association Conflict of Interest Policy Statement before completing the disclosure statement.
- The terms "family relationship" and "immediate family" as used herein, refer to any parent, spouse, domestic partner or child.
- The term "affiliate" means any organization that directly or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with the Association.
- If any item is inapplicable, answer "none" or "n/a" as appropriate.
- After completing the disclosure statement, you will be directed to the application
Conflict of Interest Policy Statement
- In general, any outside activity or direct or indirect financial interest which might, in any way, adversely influence or appear to influence an individual's judgment in the performance of his duties to ENA or any of its subsidiaries or affiliates,
involves a possible conflict of interest.
- ENA recognizes that there are many situations, which give rise to a conflict of interest. It intends to approach each case objectively, giving full recognition to all attendant circumstances.
- Situations in which a conflict of interest would or might arise (and should be reported immediately to ENA) include, but are not limited to, the following:
- Involvement with the ENA's members, sponsors, donors, providers, vendors, consultants or insurers.
- Ownership of a material interest in any member, sponsor, donor, provider, vendor, consultant, insurer or other entity with which ENA, or one of its affiliates or subsidiaries, does business.
- Acting in any capacity, including as a director, officer, partner, consultant, employee, distributor, agent or the like, for any entity which does business with ENA, its affiliates or subsidiaries.
- The acceptance, directly or indirectly, of payments, services or loans from an entity with which ENA or one of its affiliates or subsidiaries does business. This includes gifts, trips, entertainment or other favors, of more than nominal
value, but excludes loans for publicly-held insurance companies and commercial or savings banks at normal rates of interest.
- Misuse of information to which an officer or director has access by reason of his or her position.
- Use of such information in a manner, which is or can be detrimental to ENA's interest.
- The disclosure of or other misuse of confidential information of any kind obtained through the individual's connection with ENA.
- Interest in or position with a competitor or potential competitor.
- The ownership, directly or indirectly, by a Covered Person of a material interest in any entity which competes or might compete with ENA, or one of its affiliates or subsidiaries.
- Acting as a director, officer, partner, consultant, employee or agent of any enterprise which is in actual or potential competition with ENA, or one of its affiliates or subsidiaries.
- The Executive Director will review each completed Disclosure Statement and determine which actual, potential or perceived conflicts of interest involving a Covered Person or the editor of the Journal of Emergency Nursing must be disclosed to the board
(or other committee) and which, if any, require further management. Any possible further management will be address by the board.
- The board of directors, exclusive of interested members, shall review each conflict in consultation when necessary with ENA's legal counsel, and determine whether any action, other than mere disclosure, is required. The discussion and resolution of
each conflict will be recorded in accord with standard procedures for board meeting minutes.
- In some circumstances, full disclosure of the facts by the Covered Person or editor is all that is necessary to enable ENA to protect its interests, and those of its members. Should the board find, however, that proper management of a conflict of
interest requires more than disclosure, additional action may be taken, including, when appropriate, recusal or even removal from a position.
- In all instances in which a Covered Person has reported that a potential conflict of interest exists with respect to a proposed transaction under board or committee consideration, that Covered Person will not be entitled to participate in discussions
regarding the transaction, except to the extent specifically requested by the board or committee, or to vote. Furthermore, such transaction shall not be approved unless and until (1) the material facts of the transaction the Covered Person's interest
or relationship are disclosed or known to the board or committee and (2) the board or committee authorized, approves or ratifies the transaction by the affirmative vote of a majority of disinterested board members (or committee members, as applicable),
even though the disinterested board members (or committee members, as applicable) are less than a quorum.
- The presence of the board member, who is directly or indirectly a party to the transaction being considered by the board, or a board member who is otherwise not disinterested, may be counted in determining whether a quorum is present but such person's
vote may not be counted when the board of directors or a committee of the board takes actions on the transaction. A board member is "indirectly" a party to a transaction if the other party to the transaction is an entity in which the board member
has a material financial interest or of which the board member or a member of the board member's family (parent, spouse, domestic partner or child) is an officer, director, employee or general partner.
- Disclosure Statements are generally confidential but may be disclosed as necessary to protect the interests of ENA, and may not be used by any ENA member for his or her benefit.
I hereby state that I or members of my immediate family have the following affiliations or interests and have taken part in the following transactions that, when considered in conjunction with my position with or relation to the Emergency Nurses Association
("ENA") or any of its affiliates or subsidiaries, might possibly constitute a conflict of interest. (Indicate "none" where applicable.)
Outside Interests
Identify any position held by yourself or a member of your immediate family in any outside concern from which ENA or any of its subsidiaries or affiliates secures goods or services or that provides services
competitive with ENA or any of its subsidiaries or affiliates.
Investments
List and describe, with respect to yourself or a member of your immediate family, all investments that might be considered a "material financial interest", as described below:
- Capital stock, obligations, or a combination of both, of any concern the capital stock or obligation of which are listed on any nationally recognized securities exchange, having an aggregate value in excess of $500,000; or
- Any interest in any other outside concern, with the exception of the holding of indebtedness; or
- Holding of indebtedness of any outside concern, other than those mentioned in subparagraph A above, in any amount in excess of $100,000.
Outside Activities
List any other activities in which you or your immediate family are engaged that might be regarded as constituting a conflict of interest, giving particular attention to activities rendered as a director, manager, consultant or employee of any outside
concern that does business with or competes with ENA or any of its subsidiaries or affiliates, and to activities in which it would be possible to disclose or use information relating to ENA or any of its subsidiaries or affiliates for your advantage
or of that of a member of your immediate family.
Gifts, Gratuities and Entertainment
List and describe any gifts, gratuities or entertainment that you or members of your immediate family have received from any person or outside concern that does business, hopes to do business, or competes with ENA or any of its subsidiaries or affiliates.
(If you have received such benefits, please approximate their value. Do not list gifts or entertainment of nominal value.)
Acknowledgement
I hereby agree to report to the ENA Executive Director any changes in the response to each of the foregoing questions which may result from changes in circumstances before completion of my next Conflict of Interest
Disclosure Statement.
I have read, understand and agree to the terms of ENA's Conflict of Interest Policy. To the best of my knowledge and belief, the information reported is complete and accurate, and I am not aware of
any other personal or professional position(s) or interest(s) or activities in which I am, or am about to be, engaged that reasonably may be anticipated to conflict with the interests of ENA.