1000 PR.01 Creating and Revising University Policies, Procedures, and Forms

Revision Date: 
January 12, 2018

Contents

This procedure describes the steps involved in creating or revising University policies, procedures, and forms, as outlined in Policy 1000 Development, Revision, and Posting of University Policies, Procedures, and Forms

Any individual or unit who identifies the need for a new policy, procedure, form, or a revision to an existing policy, procedure, or form, should contact Policy and Compliance Services (PCS).  PCS coordinates the process of developing, reviewing, approving, and posting University policies, procedures, and forms.

PCS can, if needed, help to identify the appropriate Policy Sponsor.

PCS provides the Policy Sponsor, or their designee, with the following information:

  • An overview of the policy, procedure, and form development and approval process and the Policy Sponsor’s role in the process, as outlined in Policy 1000 Development, Revision, and Posting of University Policies, Procedures, and Forms;
  • For a new policy, procedure, or form, a link to the appropriate template to be used;
  • For a revision to an existing policy, procedure, or form, an editable format of the existing version;
  • The number of the policy, procedure, or form (all policies, procedures, and forms must follow the standard University numbering system); and
  • The identities of other known policies, procedures, forms, or stakeholders that the Policy Sponsor should be aware of because they may affect or be affected by the new or revised policy, procedure, or form. 

Every new University policy, or major revision to an existing University policy, begins with a policy proposal.  Policy proposals are not required for minor revisions to existing University policies.  Minor revisions include clarifications, non-substantive changes, and updates to reflect, for example, new position titles, new contact information, or new website addresses.  The Policy Sponsor, or their designee, should work with PCS to develop a policy proposal that contains, at a minimum, the following information:

  • The background, justification, and likely impact of the new or revised policy;
  • The stakeholders (those who will be affected by the policy, as well as subject matter experts) to be consulted when drafting the policy; and
  • The Responsible Official(s) and the Responsible Office(s), as defined in Policy 1000 Development, Revision, and Posting of University Policies, Procedures, and Forms.

The Policy Sponsor, or their designee, presents the policy proposal to the Policy Review Committee (PRC).  The PRC reviews all aspects of the proposal from an institutional perspective.   The Policy Sponsor, or their designee, considers all comments and incorporates revisions, as appropriate, prior to proceeding to the next step.  Only once the PRC approves the policy proposal may the Policy Sponsor proceed to drafting phase.

For a new policy, after the policy proposal is finalized and approved by the PRC, the Policy Sponsor, or their designee, is responsible for:

  • Drafting the new policy and setting a schedule for completion;
  • Obtaining input from stakeholders during the drafting phase;
  • Seeking assistance from PCS with any of the tasks involved in developing the draft policy (e.g. writing, reviewing, arranging meetings with stakeholders);
  • Apprising the Responsible Official, or their designee, of progress and issues, as appropriate; and
  • Indicating when the draft is ready for presentation to the PRC. 

The draft of a new policy should be prepared using the template on the Policy website.  This template includes full instructions on the type of information that may be needed for each University policy and the appropriate layout to ensure consistency among University policies.  Only include the sections of the template that are relevant for the specific policy.

For a policy with major revisions, after the policy proposal is finalized and approved by the PRC, the Policy Sponsor, or their designee, is responsible for:

  • Drafting the revised policy and setting a schedule for completion;
  • Obtaining input from stakeholders during the drafting phase;
  • Seeking assistance from PCS with any of the tasks involved in developing the revised policy (e.g. writing, reviewing, arranging meetings with stakeholders);
  • Apprising the Responsible Official, or their designee, of progress and issues, as appropriate; and
  • Indicating when the draft is ready for presentation to the PRC. 

Revisions to an existing policy are only permitted after obtaining a current, authorized, editable document from PCS.  Revisions to any other documents will not be accepted.

Once the Policy Sponsor, or their designee, indicates that a new or revised draft policy is ready for review, the draft policy undergoes the following review process:

  • The Policy Sponsor, or their designee, submits the draft to PCS;
  • PCS reviews it for editorial content and ensures that it is properly formatted;
  • PCS submits the draft to the Business Operations Operating Group (Operating Group) for review and comment;
  • The Operating Group returns feedback, which PCS relays to and discusses with the Policy Sponsor, or their designee;
  • The Policy Sponsor, or their designee, incorporates any desired revisions based on the Operating Group’s feedback;
  • If appropriate, PCS re-submits the draft to the Operating Group for review and comment, and this process is repeated until the Policy Sponsor is satisfied with the draft;
  • PCS schedules a meeting with the PRC and sends the draft to the PRC members for review no later than one week before the meeting;
  • At the PRC meeting, the Policy Sponsor, or their designee, presents the policy to the PRC and discusses the members’ comments with them.  The Policy Sponsor, or their designee, and the PRC discuss revisions, if any, that should be made;
  • The Policy Sponsor, or their designee, incorporates any desired revisions based on the PRC’s feedback;
  • If appropriate, PCS re-submits the draft to the PRC for review and comment, and this process is repeated until the Policy Sponsor is satisfied with the draft.  This process may be done via email;
  • When the Policy Sponsor, or their designee, has incorporated any additional comments and believes that the draft is ready for approval, the Policy Sponsor, or their designee, obtains the Responsible Official’s approval;
  • If the policy has a major, campus-wide impact, or if it directly affects faculty, the Responsible Official may choose, at his/her discretion, to discuss it with relevant University Officers or a high-level committee (or assign this task to a designee) before approving the draft;
  • The Policy Sponsor, or their designee, submits the approved draft to PCS, along with a draft communication to the Yale community explaining the new or revised policy, pointing out major changes, and inviting comments;
  • PCS posts the draft policy to the Policy Drafts section of the Policy website for a 30-day review period by the Yale community and issues a communication inviting comments;  
  • The Policy Sponsor, or their designee, and PCS review the comments from the Yale community and revise the draft policy, as appropriate; 
  • If the Policy Sponsor, or their designee, and PCS determine that the revisions are significant, PCS will ask the PRC to review the document again to determine whether it should be re-posted to the Policy Drafts section for review.  If there are no comments, or if the Policy Sponsor, or their designee, and PCS determine that the revisions are minor, then no further review and approval is necessary; and
  • The Policy Sponsor indicates to PCS that the draft policy is finalized and approved.

Once the draft policy is finalized and approved, PCS does the following:

  • Posts the policy and its related procedures and forms on the Policy website; and
  • With input from the Policy Sponsor, or their designee, issues the appropriate form of communication informing the community of the new or revised policy.  The type of communication may vary based on the impact of the new or revised policy.

Minor revisions to an existing policy include, but are not limited to, clarifications, non-substantive changes, and updates to reflect, for example, new position titles, new contact information, or new website addresses.  Minor revisions are not required to go through the formal review and approval process detailed in Section 5.  Rather, minor revisions to existing policies should be coordinated with PCS.

Revisions to existing policies are only permitted after obtaining a current, authorized, editable document from PCS.  Revisions to any other documents will not be accepted.  PCS is responsible for editorial content and proper formatting.

Once the Policy Sponsor, or their designee, and PCS approve the minor revisions, PCS posts the revised policy on the Policy website.

Policies typically have associated procedures to facilitate compliance with, and accomplishment of the goals of, the policy.

The Policy Sponsor, or their designee, creates and revises the procedure.  Newly created procedures should use the template available on the Policy website to ensure consistency.  Revisions to existing procedures are only permitted after obtaining a current, authorized, editable document from PCS.  Revisions to any other documents will not be accepted.  PCS is responsible for editorial content and proper formatting.

If a procedure has a major, campus-wide impact, or if it directly affects faculty, PCS, in collaboration with the Policy Sponsor, will submit the procedure to the appropriate group (e.g. General Counsel, Provost, University Officers) for review and comment.  Such procedures also adhere to the approval process detailed in Section 5.

Once the Policy Sponsor, or their designee, and PCS approve the new or revised procedure, PCS posts it on the Policy website.  The Policy Sponsor, or their designee, drafts an appropriate communication to the University community about the procedure, determines whether any training is required, and coordinates the provision of any required training.  PCS ensures that the communication is distributed to affected parties. 

All procedures will follow the same numbering scheme as the related policies.  For example, a procedure associated with Policy 1000 is Procedure 1000 PR.01.

Policies may have associated forms to facilitate compliance with, and accomplishment of the goals of, the policy.

The Policy Sponsor, or their designee, creates and revises the form.  Newly created forms should use the template available on the Policy website to ensure consistency.  Revisions to existing forms are only permitted after obtaining a current, authorized, editable document from PCS.  Revisions to any other documents will not be accepted.  PCS is responsible for editorial content and proper formatting.

Once the Policy Sponsor, or their designee, and PCS approve the new or revised form, PCS posts it on the Policy website.  The Policy Sponsor, or their designee, drafts an appropriate communication to the University community about the form, determines whether any training is required, and coordinates the provision of any required training.  PCS ensures that the communication is distributed to affected parties. 

All forms will follow the same numbering scheme as the related policies.  For example, a form associated with Policy 1000 is Form 1000 FR.01.

Process Map