An electronic version of this declaration must be completed prior to the review of materials for a site visit by all members of the site team.
Definitions:
“You or Your” refers to the Site Team Member or prospective Site Team Member signing this form.
“Program” refers to an approved Clinical Pastoral Educational program or institution, including staff, accredited by ACPE and under review by the Accreditation Commission;
“Bias” refers to a pre-existing impression or opinion, either positive or negative, that you have about a program, the institution in which it is located, or its staff, which might affect your ability to objectively serve as a Site Team Member.
“Conflict of interest” refers to any circumstance in which:
- You could be adversely affected by or benefit from a proposed accreditation decision or action that you are or may be involved with as part of your role as a Site Team Member ;
- There is a significant risk that your ability to carry out your responsibilities as a Site Team Member will be materially limited as a result of any bias towards the program; or,
- There is a significant risk that your ability to carry out your responsibilities as a Site Team Member will be materially limited as a result of your other personal or professional responsibilities or interests.
In addition to any circumstances constituting a conflict of interest as defined above, the following specific circumstances shall be considered a “conflict of interest” requiring your withdrawal as a Site Team Member for the review of any program in which:
- You have graduated from, worked for or associated with;
- You have served as a consultant or as a Site Team member during its last accreditation review;
- You have served on the board or in any advisory capacity;
- You have in the past demonstrated any bias or lack of objectivity;
- You have received gifts from (Token gifts (coffee mugs, pens) are acceptable);
- You work at a different or competing center in close geographic proximity (less than 100 miles) to the program;
- You have been employed at a program that had an accreditation review within the past six years on which a faculty member of the program being reviewed served as a Site Team member; or
- You have a pecuniary or financial interest.
If you have a conflict of interest or if there is a reasonable likelihood that your involvement as a Site Team Member will give the appearance that you have a conflict of interest, you will be required to identify this conflict of interest to the National Site Team Chair and/or the Chair of the Accreditation Commission and will need to step down from the site team.
The responsibility for disclosing conflicts of interest is the mutual responsibility of the program being reviewed, the National Site Team Chair, and invited participants. All persons involved in a site visit must make objective observations, reports, and recommendations. When persons are unable to do this, they must recuse themselves from participation in the review of that program.
Additional Requirements
Site Team Members or prospective Site Team Members:
- May not accept gifts from a program (Token gifts (coffee mugs, pens etc.) are acceptable);
- May not use a visit for purposes of gathering confidential or proprietary information for their own program’s benefit; and
- May not seek to recruit for own program during visits;