Membership Application

Conflict of Interest Disclosure Form

The purpose of the conflict of interest policy is to protect the Kentuckiana Health Collaborative's interest when contemplating entering into a transaction or arrangement that might benefit the interest of a Director, Officer, or Member of the Collaborative. This policy is intended to supplement but not replace applicable state and federal laws governing conflict of interest applicable to nonprofit and charitable organizations.

Terms and Definitions. The term "interest" shall include personal interest, interest as Director, Officer, Member, stockholder, shareholder, partner, manager, trustee, or beneficiary of any concern and having an immediate family member who holds such an interest in any concern. The term "concern" shall mean any corporation, association, trust, partnership, limited liability entity, firm, person, or other entity other than the Collaborative.

Disclosure, abstention, and rationale. No Director, Officer, or Member of the Collaborative shall be disqualified from holding any office in the Collaborative by reason of any interest in any concern; nor shall any Director, Officer, or Member be disqualified from dealing, either as vendor, purchaser or otherwise, or contracting or entering into any other transaction with the Collaborative or with any entity of which the Collaborative is an affiliate; nor shall any transaction of the Collaborative be voidable by reason of the fact that any Director, Officer, or Member of the Collaborative has an interest in the concern with which such transaction is entered into, provided that:

• The interest of such Officer, Director, or Member is fully disclosed to the Board
• Such transaction is duly approved by the Board not so interested or connected as being in the best interests of the Collaborative
• Payments to the interested Officer, Director, or Member are reasonable and do not exceed fair market value
• No interested Officer, Director, or Member may vote or lobby on the matter or be present when the matter is debated when the matter concerns only the particular entity or individual in which they have an interest or concerns a small group of entities or individuals that includes such a particular entity or individual.

Unless noted above, nothing prevents any Officer, Director, or Member of the Collaborative from full participation in discussion and debate about community needs, priorities, projects, and funds. After disclosing of an interest, the KHC Board will determine if a conflict of interest exists.