Compliance Roles and Responsibilities

Questions? Contact Office of Ethics and Compliance

Compliance Roles

Locally Designated Official (LDO) 

  • Brian Smith
  • Receives reports of allegations of suspected improper governmental activities under the University’s Whistleblower Policy
  •  Receives retaliation complaints and implements procedures under the University’s Whistleblower Protection Policy

Retaliation Complaint Officer (RCO)

  • Eric Press
  • Oversees investigations of complaints under the University’s Whistleblower Protection Policy

Research Integrity Officer (RIO)

  • Brian Smith 
  • Receives and assesses allegations of research misconduct
  • Determines when an allegation of research misconduct warrants an inquiry &/or investigation
  • Oversees research misconduct inquiries & investigations
  • Reports on research misconduct proceedings to appropriate funding agencies & others as required

Title IX Officer

  • Tracey Tsugawa
  • Receives reports of prohibited conduct under the University’s Sexual Violence and Sexual Harassment Policy
  • Oversees resolution process under the University’s Sexual Violence and Sexual Harassment Policy

Compliance Offices and Units

(additional compliance functions may be carried out at the Schools)

Human Resources (HR) 

  • Owns and implements University’s HR policies
  • UCSF representative in labor/management interactions
  • Assists with resolution of workplace problems
  • Ensures compliance with University’s collective bargaining agreement

Information Technology (IT) Security

  • IT Security risk management and compliance 
  • Security incident response and investigation

Innovation Ventures

  • Owns the process for disclosures, reviews and management of conflicts of interest related to licensing technology
  • Establishes and maintains licensing and strategic partnerships 
  • Ensures compliance related to UCSF patents

Investigations Unit (IU)
within Office of Ethics & Compliance

  • Independent (neutral) body to investigate complaints of alleged violations of University policies

Medical Center Risk Management

  • Address and/or triage patient rights concerns
  • Authority on clinical care consent requirements
  • Authority on minors’ rights to consent for sensitive services and third-party consent for minors 
  • Responsible for law enforcement interactions involving patient privacy

Office of Diversity and Outreach (ODO)

  • Owns and implements University policy prohibiting discrimination & harassment
  • Receives and processes complaints of alleged discrimination, harassment &/or related retaliation 
  • Prepares annual Affirmative Action Plan and program

Office of Ethics & Compliance (OEC)

  • Provides overall compliance oversight
  • Owns following compliance functions and operations:  Investigations Unit; Conflicts of Interest in Research; FDA Regulatory Support; Export Control; Research Misconduct
  • Central point of coordination of all investigations
  • Responsible for coordination of policies and procedures for prevention of foreign influence 
  • Coordinates investigations involving foreign influence

Office of Faculty and Academic Affairs (OFAA)

  • Responsible for case administration of faculty misconduct investigations 
  • Ensures compliance with Academic Personnel Manual

Office of Healthcare Compliance & Privacy (OHCP)

  • Provides overall compliance oversight for UCSF Health 
  • Owns following compliance functions and operations:  Revenue Cycle Compliance; Privacy

Office of Legal Affairs (OLA)

  • Provides legal advice on applicable laws, regulations, University policies 
  • Partners with compliance leaders, committees and managers in decision making & problem solving

Office of Research

  • Compliance functions and operations for: protection of human and animal research subjects; compliance with sponsored projects requirements; environment, health and safety

Risk Management and Insurance Services (RMIS)

  • Owns and implements insurance and self-insurance policies
  • Performs risk assessment related to insurance and contractual indemnification
  • Responsible for insurance allocation, insurance premiums and settlement of claims 
  • Manages clinical trials insurance and compensation for subject injury

Supply Chain Management (SCM)

  • Responsible for identification and management of conflicts of interest involving employee-supplier relationships

UCSF Health Office of Regulatory Affairs 

  • Responsible for Joint Commission Accreditation, California Department of Public Health licenses, West Bay laboratory accreditation and CLIA certifications

University of California Office of the President (UCOP) Ethics, Compliance and Audit Services (ECAS)

  • Provides direction, education & oversight of UCOP policies & processes
  • Provides investigatory services, auditing & monitoring 
  • Provides ethics & compliance related guidance and resources