Procedure for Institutional Policy GA-35: Procedure For the Adoption, Amendment, Or Repeal of Institutional Operating Procedures

1. Purpose

The purpose of this procedure for the adoption, amendment, or repeal of institutional operating procedures ("IOP Procedure") is to establish a uniform system for the preparation, submission, review, approval, distribution, and notice of institutional operating procedures for the West Virginia School of Osteopathic Medicine ("WVSOM").

2. Applicability

2.1

The IOP Procedure applies to all Institutional Operating Procedures, as that term is defined in Section 3.3 below.

2.2

Internal office procedures are exempt from the requirements of this IOP Procedure.

2.3

WVSOM reserves the right to amend this IOP Procedure from time to time as deemed necessary by the appropriate WVSOM administrator.

2.4

Any procedure subject to this IOP Procedure that is being utilized as of the date this IOP Procedure is approved shall continue in effect until superseded by an approved procedure pursuant to the terms of this IOP Procedure.

3. Definitions

3.1 

"Approving Administrator" means the Vice President for Academic Affairs and Dean for academic IOPs and the Vice President for Administration and External Relations for institutional IOPs, respectively.

3.2

"Institutional Policy" or "IP" means any rule as defined in Institutional Policy GA-35: Adoption, Amendment, or Repeal of Rules and Posting of Administrative Procedures.

3.3

"Institutional Operating Procedure" or "IOP" means a procedure that meets one or more of the following criteria: (a) the procedure is related to a specific Institutional Policy, (b) the procedure is related to institution-wide operating functions, (c) the procedure is related to institutional committee functioning, and (d) the procedure is implementing aspects of the academic program, such as teaching procedures, examination procedures, and library procedures.

4. General Document Format

4.1 New IOPS. 

All new IOPs must comply with the following format:

4.1.1 Title.

The title of the IOP must be brief and concise. If an IOP is associated with a specific Institutional Policy, the title must include the policy number and full name (i.e., "Procedure for Institutional Policy GA-33: Travel"). The title of an IOP for an institutional committee must include the name of the institutional committee (i.e., "Procedure for WVSOM Institutional Review Board").

4.1.2  Purpose.

A specific statement as to the purpose of the IOP must be provided at the beginning of the IOP.

4.1.3  Applicability.

The titles of individuals, groups, or entities to which the IOP applies should be included after the purpose if the IOP's applicability is unclear.

4.1.4  Scope.

The extent and the limitations of the IOP, if any, should be included after applicability.

4.1.5  Body.

The body of the IOP should be modeled after the body of this IOP Procedure. The IOP body may utilize as many sections and subsections as necessary for clarity. However, the sections and subsections should be kept simple, understandable, and pertinent to the given topic.

4.1.6  References.

Any applicable references within the IOP must include sufficient citations, including dates of publication. Such references may include, but not be limited to, Institutional Policies, WVSOM Handbooks, and state and federal laws and regulations.

4.1.7  Key Words.

To allow website users to locate the IOP during a search of WVSOM's website, a separate list of appropriate key words should be included with the IOP submission to tag IOP when it is placed online (i.e., an IOP related to the WVSOM Institutional Review Board might include such key words as research, review, human, subject, ethical, and investigation).

4.2 Amended IOPs.

All amendments to an existing IOP must be made in redline using the Track Changes feature of Microsoft Word. A copy of a specific IOP in Word format using Track Changes is available in the Office of the General Counsel.

4.3  Repealed IOPs

4.3.1

Any existing IOP to be repealed must have the entire text of the IOP marked through in redline using the Track Changes feature of Microsoft Word.

4.3.2

The words "TO BE REPEALED" must be inserted in bold using red front at the top of the first page of any IOP to be repealed.

4.4

Final formatting of IOPs will be controlled by the Office of the General Counsel.

4.5

Numbering of IOPs will be consistent and will correspond with any applicable IP numbers.

5. Review and Approval Process

5.1  General Provisions

5.1.1  

All proposals for adoption, amendment, or repeal of an IOP must be approved by the appropriate policy and procedure committee, the appropriate Approving Administrator, and the General Counsel before the IOP will take effect.

5.1.2

Exceptions to this review and approval process may be made by the Approving Administrator and the General Counsel for special, limited circumstances (i.e., emergency procedures).

5.2  Pre-Submission

5.2.1 

An administrator, staff or faculty member proposing the adoption, amendment, or repeal of an IOP shall draft or have drafted the proposed IOP for adoption, amendment, or repeal, and shall submit the proposed draft to the applicable policy and procedure committee set forth in Section 5.3 below.

5.2.2

Faculty committees that propose an IOP may be required to consult with the Faculty Council  and secure approval by the Faculty Assembly prior to submitting the draft IOP to the applicable policy and procedure committee.

5.2.3

All proposed IOPs shall be drafted in the correct format set forth in this IOP Procedure prior to submission to the applicable policy and procedure committee.

5.3 Submission to the Applicable Policy and Procedure Committee

5.3.1

Academic Policy and Procedure Committee. IOPs related to aspects of the academic program shall be submitted to the Academic Policy and Procedure Committee. The committee chair is the Associate Dean for Preclinical Education. The Approving Administrator is the Vice President for Academic Affairs and Dean.

5.3.2

Institutional Policy and Procedure Committee. IOPs related to general administration, finance, personnel, physical plant, research, or other non-academic areas shall be submitted to the Institutional Policy Committee. The committee chair and the Approving Administrator is the Vice President for Administration and External Relations.

5.4 Review

5.4.1 

Upon receipt of a proposed IOP, the applicable committee chair will conduct an initial review of the proposed IOP for proper format and subject matter. Any IOP not in compliance with the formatting or subject matter standards set forth in this IOP Procedure will be returned to the originator with guidance on how to correct shortcomings. Acceptable IOPs will be added to the committee review schedule.

5.4.2

The applicable policy and procedure committee will review proposed IOPs and involve appropriate stakeholders in the discussion and revision of proposed IOP. When the policy and procedure committee has a recommendation to adopt, amend, or repeal the proposed IOP, that recommendation will be submitted to the Office of the General Counsel. 

5.4.3

The office of the General Counsel will review all proposed draft IOPs.

a.

If the Office of the General Counsel determines that a proposed draft IOP requires significant changes (more than editorial corrections), the draft shall be returned to the applicable policy and procedure committee for further revision.

b.

If the Office of the General Counsel determines that a proposed draft IOP does not require significant changes, the Office of the General Counsel will make or recommend revisions to the IOP, in consultation with the applicable policy and procedure committee or other stakeholders as necessary, and shall return the proposed draft IOP to the applicable policy and procedure committee for further discussion, if any, and approval.

5.4.4

After the review process in Section 5.4.3 above has been completed, the applicable policy and procedure committee will then forward the proposed draft IOP to the Approving Administrator for review.

5.5 Review of Proposed Draft IOPs by Approving Administrator and General Counsel

5.5.1

Upon receipt of a proposed draft of an IOP, the applicable Approving Administrator will review the proposed draft IOP.

5.5.2

Upon review, if the applicable Approving Administrator does not approve the proposed draft IOP, the applicable Approving Administrator will return the propsed draft IOP to the applicable policy and procedure committee for further review and revision.

5.5.3

If the applicable Approving Administrator approves the proposed draft IOP, the applicable Approving Administrator will acknowledge his or her approval of the proposed draft IOP by signing and dating the approval box located at the end of the proposed draft IOP and will forward the proposed draft IOP to the Office of the General Counsel for final review and approval.

5.5.4

Upon receipt of the proposed draft IOP from the Approving Administrator, the Office of the General Counsel will review the proposed draft IOP.

5.5.5

Upon final review, if the Office of the General Counsel does not approve the proposed draft IOP, the Office of the General Counsel will return the proposed draft IOP to the Approving Administrator and the applicable policy and procedure committee for further review and revision.

5.5.6

If the Office of the General Counsel approves the proposed draft IOP, the General Counsel will complete the remaining portions of the approval box located at the end of the proposed draft IOP, including acknowledging his or her approval of the IOP by signing and dating the approval box. The Office of the General Counsel will complete the final formatting of the IOP to conform to the WVSOM document style.

5.6  Posting and Notice of Approved IOPs

5.6.1

Pursuant to Institutional Policy GA-35: Adoption, Amendment, or Repeal of Rules and Posting of Administrative Procedures, the Office of the General Counsel will post each approved IOP on the WVSOM "Institutional Policies and Procedures" webpage, located at http://www.wvsom.edu/AboutWVSOM/admin-policies.

5.6.2

Each approved IOP shall also be available at the main WVSOM administrative office of the unit, division, or department for which each IOP is applicable.

5.6.3

The Office of the General Counsel shall provide notice to the appropriate stakeholders via email regarding the approval, posting, and availability of any adopted, amedned or repealed IOPs.

5.7  Effective Date and Time of Approved IOPS.

Any adopted, amended, or repealed IOP shall become effective on the date and time on which the Office of the General Counsel provides the notice required in Section 5.6.3 above.

6.  Archives

6.1

The Office of the General Counsel will maintain an electronic file of the Word version of all IOPs, for use when revisions are necessary.

6.2

Archiving of IOPs will be performed by the Office of the General Counsel.